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Adolescent offspring of substance abuse parents (SA+) were compared on the scales of the Drug Use Screening Inventory to offspring of control parents (SA-). Neither clinical nor community samples of SA+ subjects were different from controls. These findings indicate that parental substance abuse does not necessarily impart maladjustment to their offspring.
Personality, as measured by subscales of the Sensation Seeking Scale (Zuckerman, 1979), social environmental exposure to alcohol use measured by parental and peer alcohol use, and past alcohol use were examined as predictors of late adolescent alcohol use in a sample of 575 1st-year college students. Efficacious predictors, in order of importance, include peer alcohol use, disinhibition, and age of first intoxication. The results support the relative importance of peer networks over parental models in determining late adolescent alcohol use. Our combinatorial model of personality, social environment, and past behavior is one such model in a growing trend toward the use of interactional models for predicting behavior.
A population sample comprised of 765 subjects (367 males and 398 females), in the age range of 15-81 years, completed the EMBU, a reliable questionnaire aimed at assessing experiences of parental rearing, and the TCI, a self-report questionnaire aimed at assessing dimensions of temperament and character. The study had three main aims: 1) to verify, on a larger scale, previous findings suggesting the occurrence of significant associations between experiences of parental rearing and aspects of temperament and character, 2) to assess possible variations in temperament and character in cohorts of subjects who have grown up in different historical epochs, and 3) to investigate to what extent transgenerational differences in parental rearing are detectable in different associations with various dimensions of personality. Several, albeit small, significant and meaningful associations between experiences of parental rearing and both temperament and character dimensions have been found, adding support to the robustness of previously reported results obtained in an independent smaller series. Also, several significant differences among subjects in different age groups have been found, both concerning temperament variables and character dimensions. Finally, the results show that associations between experiences of parental rearing and dimensions of temperament and character are most pronounced in subjects belonging to the youngest cohort and almost nil in the cohort comprising the oldest subjects.
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common human enzymopathy. Because its gene locus is on the X-chromosome it is more common in males than females in all populations. Prevalence rates vary from 62% among Kurdish Jews to the very low rates (0.1% or less in Japan, for example), which are compatible with sporadic cases arising from spontaneous mutations. However, there is at least one population in which G6PD deficiency has not been found, namely the indigenous (Amerindian) population of America. Approximately 400 variants have been described. Despite the clinical burden imposed by this enzymopathy, polymorphic frequencies have been reached in many populations. There is abundant epidemiological evidence that this has happened because of a biological advantage conferred on heterozygotes in falciparum malaria endemic areas. This advantage may apply to quartan malaria as well. Clinical severity varies, from the rare chronic nonspherocytic haemolytic anaemia to progressively milder forms like the Mediterranean and A- types. The other clinical syndromes, i.e. neonatal jaundice and haemolysis caused by infections, foods, drugs and chemicals, are not always predictable. This is because only a fraction of such enzymopathic persons develop these syndromes after exposure to the relevant stimulus. Modern techniques of molecular biology may elucidate why this is so. There is some emerging evidence that the genetic burden or survival value associated with G6PD deficiency may be relevant not only in tropical and infectious diseases, but also in their chemotherapy (e.g. malaria) as well as in the control of a long-recognized environmental pollutant such as lead.
The Young Men's Project has been working with young men and young fathers as part of Great Yarmouth Primary Care Trust in the UK since June 2001. The Project works in schools and other educational environments to promote positive personal development, particularly around sex and relationships, and to increase accessibility of sexual health and contraceptive services, and support for young fathers. Young men generally want to look after themselves and to act responsibly in sexual relationships. Knowledge through education and appreciation of how to understand and express themselves as men are crucial. If they are likely to engage in penetrative sex, then being able to access condoms and use them correctly for every sexual encounter is next. Culturally, we set low expectations of young men when it comes to sexual health and taking responsibility. The same is true of our expectations of young fathers. This is not due to their lack of desire to be involved. Our work challenges the much repeated notion that young men are a hard-to-reach group, which throws the responsibility onto them. I believe we should recognise that we, and the services we provide, have been failing to meet their needs.
PURPOSE: Recent findings on medical care utilization among people with Alzheimer's disease (AD) or other dementia (OD) are conflicting. A population-based case-control study was designed to determine if patients with clinically diagnosed AD or OD have different medical care utilization patterns before and after diagnosis compared to age-matched controls. METHODS: All community dwelling incident cases of AD (n = 240) or OD (n = 208) diagnosed between July 1, 1992 and June 30, 1997, and age-matched controls (n = 363) living in an enumerated population, were included. Medical care services, defined by Physicians' Current Procedural Terminology Codes, were assessed the year prior to diagnosis and up to five years after diagnosis of AD/OD. RESULTS: Prior to diagnosis, AD/OD cases had a significantly greater age-adjusted average number of medical services per year, 33 and 29, respectively, compared to 20 for controls (p = 0.0001 and p = 0.0002, respectively). These differences were significant after adjusting for age, gender, follow-back time, comorbidities, and insurance status. After diagnosis, AD/OD cases still had significantly greater age-adjusted average number of medical services per year (34 services and 37 services, respectively) compared to controls with 27 services (p = 0.0064 and p = 0.0006, respectively). After adjusting for confounding variables (particularly comorbid conditions), these differences were no longer significant. CONCLUSIONS: This research demonstrates that higher medical care utilization by patients with AD/OD after diagnosis is not due to dementia per se, but explained by their poorer physical health compared to controls. Greater utilization prior to diagnosis of AD/OD is most likely due to the search for a diagnosis for the person developing dementia.
PURPOSE: To study the relationship between exercise and human immunodeficiency virus (HIV) disease progression. METHODS: 415 individuals (156 HIV positive, 259 HIV negative), from a cohort study of 851 homosexual men from New York City, 1985-1991. By 1991, 68 of the 156 persons developed Acquired Immune Deficiency Syndrome (AIDS) and 49 died with AIDS. Exercise was defined as self-report of exercising 3-4 times/week or daily at entry; less was considered nonexercise. CD4 lymphocyte decline was constructed for each subject by modeling log CD4 count against time in days. The association between exercise and progression to AIDS and death with AIDS, adjusting for baseline CD4 count, was determined using Cox model. Linear regression was used to model CD4 decline with exercise for HIV positive and HIV negative groups separately, adjusting for initial CD4 count. RESULTS: Having exercised was associated with slower progression to AIDS at 1 year (HR = 0.68, 90% confidence interval (CI): 0.4-1.17); hazard ratios (HR) at 2, 3, and 4 years were 0.96, 1.18, and 1.36, respectively. Having exercised was also associated with slower progression to death with AIDS at 1 year (HR = 0.37, 90% CI: 0.14-0.94) with hazard ratios at 2, 3, and 4 years of 0.68, 0.98, and 1.27, respectively, suggesting a protective effect close to the time exercise was assessed, but an increased risk after 2 years. Exercising 3-4 times/week had a more protective effect than daily exercise. Exercisers in the HIV positive group showed an increase in CD4 count during a year by a factor of 1.07. CONCLUSION: Moderate physical activity may slow HIV disease progression.
In the Louisville Twin Study, pairs of 3- and 4-year-old twins were provided with standardized competitive or cooperative tasks in a laboratory setting. Some tasks required a pair of twins to share toys; other fostered a more competitive engagement between the twins. Behavioral ratings identified temperament and social components at both ages, and between the two ages, there were transformations in the links between the components. Parental ratings of the twins' temperament at the same ages were moderately correlated with the laboratory observations, but the pattern of the relations changed from one age to the next. The combined sets of measures were subjected to twin analyses for 43 pairs of twins. The results are discussed in terms of the similarity of MZ and DZ pairs for the dimensions of temperament and the transformations of temperament.
The present paper presents the approach, results and outcome of an innovative piece of action research amongst professionals (health and non-health) and the public (women and young people from low-income families in one of the deprived areas of Birmingham, UK). A cooperative inquiry approach was used and data were collected on concerns about health of professionals (n 15) and the public (n 19), as well as dietary practices, smoking pattern and access to healthy foods amongst the public (n 49). The methods of data collection were: desk research; observation; semi-structured individual and focus-group interviews; structured individual interviews. The findings highlight diverse views and expectations about health amongst the public and the professionals, and suggest the existence of tensions between the partnership and the ownership of inter-agency collaboration. It argues the importance of having a shared vision amongst health and non-health professionals regarding health strategy and the way forward for working together to promote the public's health. It recommends that by using the tenet of action research, and adapting a cooperative inquiry approach, members of a partnership project could learn through reflection on action and achieve personal development and social action.
A genetic analysis was conducted on trait neuroticism and symptoms of anxiety and depression in a five-wave study of 462 twin pairs. Models that assessed the relative importance of genetic and environmental factors to the lability (within-individual variability over time) of these measures were fitted to the data. Previous results concerning the substantial genetic involvement in the level of neuroticism and symptoms were confirmed. However, it was found that neither genes nor the shared environment of the twins was a significant cause of lability of these measures. An attempt was therefore made to identify aspects of individuals' environments that might be responsible for lability of neuroticism and symptoms. Adverse life events were found to predict variability of symptoms, but not of neuroticism. The availability of close social ties or having affectionless control in childhood did not contribute to lability.
The parental representations of male-to-female and female-to-male transsexuals were rated using the EMBU inventory. Scores on the measure were compared against ratings returned by controls of similar biological sex, matched on age, educational level and number of female siblings in an ANCOVA design. In line with previous findings by Parker & Barr (1982), who studied male-to-female transsexuals only, these patients were found not to differ from the male controls in their scoring of their mothers, but did score their fathers as less emotionally warm, more rejecting and more protective. Extending the findings by Parker & Barr (1982), female-to-male transsexuals rated both parents as more rejecting and less emotionally warm, but only their mothers as more protective than their female control equivalents rated theirs. Parental divorce distinguished both patient groups from controls, although further analyses revealed this not to imply more parental absence in patients than in controls. Male and female transsexuals differed from each other in some respects (e.g. lower scores on parental emotional warmth and higher scores on maternal rejection for the female patients), while being comparable in other respects (e.g. parental divorce).
This study aimed to investigate the psychological characteristics of chronic fatigue syndrome (CFS: Holmes et al. 1988). A battery of psychometric instruments comprising the General Health Questionnaire (GHQ), the Beck Depression Inventory (BDI), the Minnesota Multiphasic Personality Inventory (MMPI) and the Lazarus Ways of Coping (WoC) inventory, was administered to a sample of clinically-defined CFS sufferers (N = 58), to a comparison group of chronic pain (CP) patients (N = 81) and to a group of healthy controls matched for sex and age with the CFS sample (N = 104). Considerable overlap was found between CFS and CP patients at the level of both physical and psychological symptoms. This raises the possibility that CFS sufferers are a sub-population of CP patients. However, while there was some commonality between CFS and CP patients in terms of personality traits, particularly the MMPI 'neurotic triad' (hypochondriasis, depression and hysteria), CFS patients showed more deviant personality traits reflecting raised levels on the first MMPI factor, emotionality. Moreover, results were not consistent with the raised emotionality being a reaction to the illness, but rather were consistent with the hypothesis that emotionality is a predisposing factor for CFS. The majority of CFS patients fell within four personality types, each characterized by the two highest MMPI scale scores. One type (N = 20) reported a lack of psychological symptoms or emotional disturbance contrary to the overall trend for the CFS sample. This group conformed to the ICD-10 classification of neurasthenia.
In a case-control study, two potential interpersonal risk factors of non-endogenous depression, namely a patient's perception of their current intimate partner as dysfunctional and a patient's recall of exposure to previous deprivational parenting, were quantified. The interpersonal characteristics of the partner were assessed principally by a brief self-report questionnaire, the Intimate Bond Measure (IBM). By cross-sectional and longitudinal comparison of this instrument with other interview-derived and self-report measures, the convergent, discriminant and predictive validity of the IBM in depressed patients was established. Further, little evidence of any distorting effect of depressed mood or neuroticism was detected. The perception of the current intimate partner as dysfunctional imparted a risk to non-endogenous depression of at least five times, while reported exposure to parental 'affectionless control' was quantified as a four times' risk. Importantly, IBM care scores predicted the course of the depressive disorder over a six-month period.
This study explores possible determinants of somatization in primary care. Hypotheses were tested on samples of 'somatizers', 'psychologizers' and controls recruited by epidemiological procedures. Although 'somatizers' were found to be similar to 'psychologizers' in many respects, they were (i) less depressed; (ii) reported lower levels of social dissatisfaction, social stress and less dependence on their relatives; (iii) more likely to have an unsympathetic attitude towards mental illness and less likely to consult a doctor about psychological symptoms, and (iv) more likely to have received medical in-patient care as an adult before they had consulted their doctor with their current illness. These findings are discussed in the context of previous research.
The hypothesis that recurrent or chronic depressive illness produces a long-term change in neuroticism was examined in a sample (N = 34) from a consecutive series of 89 depressed patients admitted to the Maudsley Hospital in 1965/6. The Eysenck Personality Inventory (EPI) was administered at the time of the index illness both when the patients were depressed and on recovery, and then again at follow-up 18 years later. The change in the neuroticism (N) score over the 18-year-period was compared in good and poor outcome groups defined variously by a global rating of outcome, frequency of episodes, extent of subsequent hospitalization and the presence or absence of subsequent chronicity. The mean N score for the sample as a whole did not change significantly over the 18 years, and no differential change in the N score was observed between any of the good and poor outcome groups. Thus, the hypothesis was not supported.
Three studies explored the causal attributions of common somatic symptoms. The first two studies established the reliability and validity of a measure of attributional style, the Symptom Interpretation Questionnaire (SIQ). Three dimensions of causal attribution were confirmed: psychological, somatic and normalizing. The third study examined the antecedents and consequences of attributional style in a sample of family medicine patients. Medical and psychiatric history differentially influenced attributional style. Past history and attributional style independently influenced clinical presentations over the subsequent 6 months. Symptom attributional style may contribute to the somatization and psychologization of distress in primary care.
Associations between retrospective ratings of parental behaviour and adult affective symptoms were investigated in a British national sample. Symptom scores at ages 36 and 43 years showed low but significant correlations with care (negative) and control (positive), as measured by the Parental Bonding Instrument. Prevalence of high symptom scores was much greater in respondents with low care-high control (affectionless control) parents than in those with high care-low control parents, but there was no synergistic effect of combined care and control. Degree of affectionless control was progressively related to risk of depression. No significant gender differences were found in these associations. Findings could not be explained as spurious relationships resulting from association with other features of childhood adversity, and there was evidence that distorted recall arising from contemporaneous depressed mood was not responsible. Work is needed to establish the causal mechanisms underlying observed associations, including inter-relationships between parental style and other early adversity, and factors mediating or moderating the long-term of parental behaviour.
Potential mediators of the modest association between retrospectively rated parental behaviour and adult affective symptoms in offspring were investigated in a national longitudinal study of a cohort followed to the age of 43. Personality measures from adolescence could account for a small part of this association. Personal relationships in adulthood were more strongly associated with both parental behaviour and symptoms: marital history, emotional support, social network and availability of help in a crisis. Poor parenting did not lead to a general vulnerability to later life events, and socio-economic status and financial hardship were not implicated in the link between parental behaviour and adult symptoms. However, parental affectionless control was associated with certain types of life stressors in adulthood, i.e. interpersonal as opposed to non-interpersonal life events. Collectively, aspects of personal relationships accounted for much of the elevated symptom levels in those rating parents as low on care or high on control. Findings were consistent with the notion that interpersonal competence is important in the continuity between childhood experience and adult mental health, but other possible interpretations are discussed.