Medicine and Health Sciences Commons^™

Differential Impairment As An Indicator Of Sex Bias In Dsm-Iv Criteria For Four Personality Disorders, Christina D. Boggs, Leslie C. Morey, Andrew E. Skodol, M. Tracie Shea, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan, Mary C. Zanarini, John G. Gunderson

Charles A. Sanislow, Ph.D.

The aim of the present study was to investigate the possibility of sex bias in the diagnostic criteria for borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders. A clinical sample of 668 individuals was evaluated for personality disorder criteria using a semistructured interview, and areas of functional impairment were assessed with both self-report and semistructured interview. The authors used a regression model of bias to identify bias as differences in slopes or intercepts between men and women in the relationship between each diagnostic criterion and level of impairment. The results suggest that most of the diagnostic criteria examined do not seem …

Preliminary Evidence For Medication Effects On Functional Abnormalities In The Amygdala And Anterior Cingulate In Bipolar Disorder, Hilary P. Blumberg, Nelson H. Donegan, Charles A. Sanislow, Susan Collins, Cheryl Lacadie, Pawel Skudlarski, Ralitza Gueorguieva, Robert K. Fulbright, Thomas H. Mcglashan, John C. Gore, John H. Krystal

Charles A. Sanislow, Ph.D.

RATIONALE: Abnormal amygdala and frontocortical responses to emotional stimuli are implicated in bipolar disorder (BD) and have been proposed as potential treatment targets.

OBJECTIVES: The aim of this study was to investigate amygdala and frontocortical responses to emotional face stimuli in BD and the influences of mood-stabilizing medications on these responses.

METHODS: Functional magnetic resonance imaging was performed while 17 BD participants (5 unmedicated) and 17 healthy comparison (HC) participants viewed faces with happy, sad, fearful, or neutral expressions.

RESULTS: The group by stimulus-condition interaction was significant (p<0.01) for amygdala activation, with the greatest effects in the happy face condition. Relative to HC, amygdala increases were greater in unmedicated BD, but lower in medicated BD. Rostral anterior cingulate (rAC) activation was decreased in unmedicated BD compared to HC; however, BD participants taking medication demonstrated rAC activation similar to HC participants.

CONCLUSIONS: Although the sample sizes were small, these preliminary results suggest that …

Short- And Long-Term Cause-Specific Survival Of Patients With Inflammatory Breast Cancer, Patricia Tai, Edward Yu, Ross Shiels, Juan Pacella, Kurian Jones, Evgeny Sadikov, Shazia Mahmood

Edward Yu

Background: Inflammatory breast cancer (IBC) had been perceived to have a poor prognosis. Oncologists were not enthusiastic in the past to give aggressive treatment. Single institution studies tend to have small patient numbers and limited years of follow-up. Most studies do not report 10-, 15- or 20-year results. Methods: Data was obtained from the population-based database of the Surveillance, Epidemiology, and End Results program of the National Cancer Institute from 1975-1995 using SEER*Stat5.0 software. This period of 21 years was divided into 7 periods of 3 years each. The years were chosen so that there was adequate follow-up information to …

Evaluating Clinical Rating Scales For Evidence-Based Dermatology: Some Basic Concepts, Madhulika Gupta, Andrew Johnson, Mary-Margaret Chren

Andrew M. Johnson

Evidence-based dermatology has necessitated the development of rating scales that measure multidimensional and abstract constructs, such as quality of life. This article discusses some basic psychometric concepts, such as reliability, validity, standardization, and measurement precision, which need to be considered when choosing a clinical rating instrument. Also discussed is the impact of these parameters on increasing the statistical power of a clinical trial.

The Collaborative Longitudinal Personality Disorders Study (Clps): Overview And Implications, Andrew E. Skodol, John G. Gunderson, M. Tracie Shea, Thomas H. Mcglashan, Leslie C. Morey, Charles A. Sanislow, Donna S. Bender, Carlos M. Grilo, Mary C. Zanarini, Shirley Yen, Maria E. Pagano, Robert L. Stout

Charles A. Sanislow, Ph.D.

The Collaborative Longitudinal Personality Disorders Study (CLPS; Gunderson et al., 2000) was developed to fill gaps in our understanding of the nature, course, and impact of personality disorders (PDs). Here, we review published findings to date, discuss their implications for current conceptualizations of PDs, and raise questions that warrant future consideration. We have found that PDs are more stable than major depressive disorder, but that meaningful improvements are possible and not uncommon. We have confirmed also that PDs constitute a significant public health problem, with respect to associated functional impairment, extensive treatment utilization, negative prognostic impact on major depressive disorder, …

Dimensional Representations Of Dsm-Iv Personality Disorders: Relationships To Functional Impairment, Andrew E. Skodol, John M. Oldham, Donna S. Bender, Ingrid R. Dyck, Robert L. Stout, Leslie C. Morey, M. Tracie Shea, Mary C. Zanarini, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan, John G. Gunderson

Charles A. Sanislow, Ph.D.

OBJECTIVE: This study compared three-dimensional representations of DSM-IV personality disorders and standard categories with respect to their associations with psychosocial functioning.

METHOD: Six hundred sixty-eight patients with semistructured interview diagnoses of schizotypal, borderline, avoidant, or obsessive-compulsive personality disorders or with major depressive disorder and no personality disorder completed questionnaires assessing three-factor and five-factor dimensional models of personality. Personality disorder categories, dimensional representations of the categories based on criteria counts, and three- and five-factor personality dimensions were compared on their relationships to impairment in seven domains of functioning, as measured by the Longitudinal Interval Follow-up Evaluation-Baseline Version.

RESULTS: Both the categorical …

Avoidant Personality Disorder And Social Phobia: Distinct Enough To Be Separate Disorders?, Elizabeth Ralevski, Charles A. Sanislow, Carlos M. Grilo, Andrew E. Skodol, John G. Gunderson, M. Tracie Shea, Shirley Yen, Donna S. Bender, Mary C. Zanarini, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Objective: Existing evidence from anxiety disorder research indicates that social phobics (SP) with avoidant personality disorder (AVPD) experience more anxiety and show more impairment than patients with SP alone. The purpose of this study was to examine whether in patients diagnosed with AVPD, the co-occurrence of SP adds to its severity. We hypothesized that the addition of SP will not add to the severity of AVPD alone.

Method: Two groups of patients (AVPD = 224; AVPD/SP = 101) were compared at baseline and 2 years later on multiple demographic and clinical variables.

Results: Patients with AVPD and an additional diagnosis …

Self-Collection Of Stool: An Alternative To Digital Rectal Examination For Fecal Occult Blood Testing In The Emergency Department, Paris B. Lovett

Paris B Lovett, MD, MBA, FACEP, FACHE

Study Objectives: Our objective was to evaluate a new technique for collection of stool for fecal occult blood testing (FOBT) in the emergency department (ED). We sought to compare the new approach, Self-Collection of Stool (SCS), against the traditional Digital Rectal Examination (DRE).

Methods: Patients were eligible for enrollment if they required stool sampling for FOBT, as judged by their physician. We excluded patients who required DRE for reasons other than stool collection: those requiring assessment of prostatic or rectal anatomy, rectal tone or sensation. Subjects were enrolled on a convenience basis and randomized to SCS or DRE. Blinded data …

Does Sex Influence The Impact That Smoking, Treatment Interruption And Impaired Pulmonary Function Have On Outcomes In Limited Stage Small Cell Lung Cancer Treatment?, Gregory Videtic, Pauline Truong, Robert Ash, Edward Yu, Walter Kocha, Mark Vincent, Anna Tomiak, A Dar, Frances Whiston, Larry Stitt

Edward Yu

PURPOSE: To look for survival differences between men and women with limited stage small cell lung cancer (LS-SCLC) by examining stratified variables that impair treatment efficacy. METHODS: A retrospective review of 215 LS-SCLC patients treated from 1989 to 1999 with concurrent chemotherapy-radiotherapy modelled on the 'early-start' thoracic radiotherapy arm of a National Cancer Institute of Canada randomized trial. RESULTS: Of 215 LS-SCLC patients, 126 (58.6%) were men and 89 (41.4%) were women. Smoking status during treatment for 186 patients (86.5%) was: 107 (58%) nonsmoking (NS) (76 [71%] male [M]; 31 [29%] female [F]) and 79 (42%) smoking (S) (36 M …

Longitudinal Comparison Of Depressive Personality Disorder And Dysthymic Disorder, John C. Markowitz, Andrew E. Skodol, Eva Petkova, Hui Xie, Jianfeng Cheng, David J. Hellerstein, John G. Gunderson, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

BACKGROUND: Few studies have compared the related diagnostic constructs of depressive personality disorder (DPD) and dysthymic disorder (DD). The authors attempted to replicate findings of Klein and Shih in longitudinally followed patients with personality disorder or major depressive disorder (MDD) in the Collaborative Longitudinal Personality Disorders Study.

METHODS: Subjects (N = 665) were evaluated at baseline and over 2 years (n = 546) by reliably trained clinical interviewers using semistructured interviews and self-report personality questionnaires.

RESULTS: Only 44 subjects (24.6% of 179 DPD and 49.4% of 89 early-onset dysthymic subjects) met criteria for both disorders at baseline. Depressive personality disorder …

Sacred Disease Of Our Times: Failure Of The Infectious Disease Model Of Spongiform Encephalopathy, Vivian Mcalister

Vivian C. McAlister

BACKGROUND: Public health and agricultural policy attempts to keep bovine spongiform encephalopathy out of North America using infectious disease containment policies. Inconsistencies of the infectious disease model as it applies to the spongiform encephalopathies may result in failure of these policies.

METHODS: Review of historical, political and scientific literature to determine the appropriate disease model of spongiform encephalopathy.

PRINCIPAL FINDINGS: Spongiform encephalopathy has always occurred sporadically in man and other animals. Hippocrates may have described it in goats and cattle. Transmission of spongiform encephalopathy between individuals is too uncommon for it to be usefully considered an infection. Spongiform encephalopathy is …

Minimum Follow-Up Time Required For The Estimation Of Statistical Cure Of Cancer Patients: Verification Using Data From 42 Cancer Sites In The Seer Database, Patricia Tai, Edward Yu, Gábor Cserni, Georges Vlastos, Melanie Royce, Ian Kunkler, Vincent Vinh-Hung

Edward Yu

Background: The present commonly used five-year survival rates are not adequate to represent the statistical cure. In the present study, we established the minimum number of years required for follow-up to estimate statistical cure rate, by using a lognormal distribution of the survival time of those who died of their cancer. We introduced the term, threshold year, the follow-up time for patients dying from the specific cancer covers most of the survival data, leaving less than 2.25% uncovered. This is close enough to cure from that specific cancer. Methods: Data from the Surveillance, Epidemiology and End Results (SEER) database were …

Two-Year Prevalence And Stability Of Individual Dsm-Iv Criteria For Schizotypal, Borderline, Avoidant, And Obsessive-Compulsive Personality Disorders: Toward A Hybrid Model Of Axis Ii Disorders, Thomas H. Mcglashan, Carlos M. Grilo, Charles A. Sanislow, Elizabeth Ralevski, Leslie C. Morey, John G. Gunderson, Andrew E. Skodol, M. Tracie Shea, Mary C. Zanarini, Donna S. Bender, Robert L. Stout, Shirley Yen, Maria E. Pagano

Charles A. Sanislow, Ph.D.

OBJECTIVE: This study tracked the individual criteria of four DSM-IV personality disorders-borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders-and how they change over 2 years.

METHOD: This clinical sample of patients with personality disorders was derived from the Collaborative Longitudinal Personality Disorders Study and included all participants with borderline, schizotypal, avoidant, or obsessive-compulsive personality disorder for whom complete 24-month blind follow-up assessments were obtained (N=474). The authors identified and rank-ordered criteria for each of the four personality disorders by their variation in prevalence and changeability (remission) over time.

RESULTS: The most prevalent and least changeable criteria over 2 years were paranoid …

Implementing Infant Hearing Screening At Maternal And Child Health Clinics: Context And Interactional Processes, De Wet Swanepoel, René Hugo, Brenda Louw

Brenda Louw

Stability Of Functional Impairment In Patients With Schizotypal, Borderline, Avoidant, Or Obsessive Compulsive Personality Disorder Over Two Years, Andrew E. Skodol, Maria E. Pagano, Donna S. Bender, M. Tracie Shea, John G. Gunderson, Shirley Yen, Robert L. Stout, Leslie C. Morey, Charles A. Sanislow, Carlos M. Grilo, Mary C. Zanarini, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

BACKGROUND: A defining feature of personality disorder (PD) is an enduring pattern of inner experience and behavior that is stable over time. Follow-up and follow-along studies have shown considerable diagnostic instability of PDs, however, even over short intervals. What, then, about personality disorder is stable? The purpose of this study was to determine the stability of impairment in psychosocial functioning in patients with four different PDs, in contrast to patients with major depressive disorder (MDD) and no PD, prospectively over a 2-year period.

METHOD: Six hundred treatment-seeking or treated patients were recruited primarily from clinical services in four metropolitan areas …

Demarcated Truncal Jaundice: A Sign Of Retroperitoneal Bile Leakage, Vivian C. Mcalister, Alp Sener

Vivian C. McAlister

The characteristic feature of the clinical sign described here is the demarcation between jaundiced and unaffected areas of the body. The flanks and the genitalia are stained more than would be expected by examination of the sclera or estimation of bilirubin level. Superiorly, a horizontal line about 3 cm below the clavicles, corresponding to the insertion of the fascia of Scarpa into the clavipectoral fascia, allows an easy comparison between the jaundiced trunk and unaffected adjacent areas, such as the neck, shoulder, and arm. Similarly, a line 3 cm below the groin skin crease corresponds to the insertion of the …

Two-Year Prospective Naturalistic Study Of Remission From Major Depressive Disorder As A Function Of Personality Disorder Comorbidity, Carlos M. Grilo, Charles A. Sanislow, M. Tracie Shea, Andrew E. Skodol, Robert L. Stout, John G. Gunderson, Shirley Yen, Donna S. Bender, Maria E. Pagano, Mary C. Zanarini, Leslie C. Morey, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

In this study, the authors examined prospectively the 24-month natural course of remission from major depressive disorder (MDD) as a function of personality disorder (PD) comorbidity. In 302 participants (196 women, 106 men), psychiatric and PDs were assessed at baseline with diagnostic interviews, and the course of MDD was assessed with the Longitudinal Interval Follow-Up Evaluation at 6-, 12-, and 24-month follow-ups. Survival analyses revealed an overall 24-month remission rate of 73.5% for MDD that differed little by gender. Participants with MDD who had certain forms of coexisting PD psychopathology (schizotypal, borderline, or avoidant) as their primary PD diagnoses had …

Recent Life Events Preceding Suicide Attempts In A Personality Disorder Sample: Findings From The Collaborative Longitudinal Personality Disorders Study, Shirley Yen, Maria E. Pagano, M. Tracie Shea, Carlos M. Grilo, John G. Gunderson, Andrew E. Skodol, Thomas H. Mcglashan, Charles A. Sanislow, Donna S. Bender, Mary C. Zanarini

Charles A. Sanislow, Ph.D.

Few studies have examined the relationship between life events, suicide attempts, and personality disorders (PDs), in spite of the strong associations between PDs and suicidal behavior, and the poor coping strategies often exhibited by these individuals. The authors examined whether participants with PDs who attempted suicide during the first 3 years of a prospective, longitudinal study were more likely to experience specific life events in the month during and preceding the suicide attempt. Of 489 participants with PDs, 61 attempted suicide during the 3-year, follow-up interval. Results indicated that negative life events, particularly those pertaining to love-marriage or crime-legal matters, …

Long-Term Survival Rates Of Laryngeal Cancer Patients Treated By Radiation And Surgery, Radiation Alone, And Surgery Alone: Studied By Lognormal And Kaplan-Meier Survival Methods, Patricia Tai, Edward Yu, Ross Shiels, Jon Tonita

Edward Yu

Background: Validation of the use of the lognormal model for predicting long-term survival rates using short-term follow-up data. Methods: 907 cases of laryngeal cancer were treated from 1973-1977 by radiation and surgery (248), radiation alone (345), and surgery alone (314), in registries of Connecticut and Metropolitan Detroit of the SEER database, with known survival status up to 1999. Phase 1 of this study used the minimum chi-square test to assess the goodness of fit of the survival times of those who died with disease to a lognormal distribution. Phase 2 used the maximum likelihood method to estimate long-term survival rates …

A Case For A Blood Substitute, Christopher Michetti

Christopher P. Michetti, M.D., F.A.C.S.

No abstract provided.

Brain Nerve Conduction Velocity Is A Valid And Useful Construct For Studying Human Cognitive Abilities: A Reply To Saint-Amour Et Al, Andrew Johnson, T. Reed, Philip Vernon

Andrew M. Johnson

No abstract provided.

Estimated Height, Weight, And Body Mass Index: Implications For Research And Patient Safety, Christopher Michetti, K Hendershot, L Robinson, S Fakhry, J Roland, K Vaziri, K Dwyer, H Seoudi, A Rizzo, E Russo, H Reines

Christopher P. Michetti, M.D., F.A.C.S.

No abstract provided.

Conservation And Development Interventions At The Wildlife-Livestock Interface, Steven A. Osofsky, Sarah Cleaveland, William B. Karesh, Michael D. Kock, Philip J. Nyhus, Lisa Starr, Angela Yang

Philip J. Nyhus

No abstract provided.

One In Three, David J. Malebranche

David J Malebranche

No abstract provided.

Community-Acquired Methicillin-Resistant Staphylococcus Aureus: Time To Address The Problem, David J. Malebranche

David J Malebranche

No abstract provided.

Adverse Health Outcomes Among Black Americans: Living With Hiv - Nature Or Nurture?, David J. Malebranche

David J Malebranche

No abstract provided.

Focusing "Down Low": Bisexual Black Men, Hiv Risk And Heterosexual Transmission, Gregorio Millett, David Malebranche, Byron Mason, Pilgrim Spikes

David J Malebranche

Introduction: Black men who have sex with men (MSM) and women but who do not identify as gay or disclose their bisexual activities to main female partners, also known as men “on the down-low,” have been cited as the main reason for the increase in HIV infections in black women. Methods: Three online databases (PsychInfo, MEDLINE and AIDSLINE) were searched for scientific articles related to men on the down-low. A total of 24 articles and two conference abstracts were selected for review. Results: Data from existing studies of MSM reveal low agreement between professed sexual identity and corresponding sexual behavior …

A Wintertime Study Of Pahs In Fine And Coarse Aerosols In Sa˜O Paulo City, Brazil, Paulo A. Lotufo

Paulo A Lotufo

The Polycyclic aromatic hydrocarbons PAHs (naphthalene, acenaphthylene, acenaphthene, phenanthrene, fluoranthene, pyrene, benzo(a)anthracene, chrysene, benzo(b)fluoranthene, benzo(k)fluoranthene, benzo(a)pyrene, indeno(1,2,3-cd)pyrene and benzo(ghi)perylene) concentrations in fine (PM2.5) and coarse (PM2.5–10) atmospheric particulate matter were measured at Sa˜o Paulo city, Brazil. The dominant PAHcompounds were indeno(1,2,3-cd)pyrene, benzo(ghi)perylene and benzo(b)fluoranthene for both the fractions. The calculated ratios of some specific PAHs were in close agreement with those attributed to direct emissions of car exhaust. The factor analysis for PM2.5 produced four factors: Factor 1 was attributed to diesel emissions, Factor 2 was attributed to stationary combustion source, Factor 3 was attributed to vehicular emissions and Factor …

Clinical And Radiographic Correlates Clinical And Radiographic Correlates: A Molecular Epidemiology Study, Elvin H. Geng

Elvin H Geng

No abstract provided.

Lung Cancer Trends. Part 2: Beyond North America, P. Tai, E. Yu

Edward Yu

No abstract provided.