Medicine and Health Sciences Commons^™

The Difficulty In The Diagnosis And Management Of Antidepressant Discontinuation Syndrome, Sidney Charm D. Reyes

School of Medicine Publications and Presentations

Background: Antidepressant discontinuation syndrome (ADS) is a condition that occurs in about 20% of patients following the abrupt reduction/stoppage of any antidepressant medication that has been taken continuously for at least one month.

Case Presentation: We present a 36-year-old Hispanic woman who initially presented for evaluation of flu-like symptoms (subjective fever, rhinorrhea) and worsening body aches, trouble sleeping, and headaches for the past three days. She also reported recent exposure to a sick co-worker. Rapid flu, strep, and COVID tests came back negative. Pt was diagnosed with a viral URI and was discharged with counseling on supportive treatment. The patient …

Regaining Effort-Based Food Motivation: The Drug Methylphenidate Reverses The Depressive Effects Of Tetrabenazine In Female Rats, Deanna Pietrorazio

Honors Scholar Theses

Tetrabenazine (TBZ), a vesicular monoamine transporter type 2 (VMAT-2) inhibitor, depletes dopamine and induces motivational deficits and other depressive symptoms in humans. Methylphenidate (MPH) is a dopamine transport blocker that is used to enhance motivational function. Previous studies have shown that in male rats, TBZ induces a shift in effort-related choice such that a low-effort bias is induced. In male rats this occurs at a dose range of 0.75-1.0 mg/kg TBZ, and this effect is reversible with co-administration of MPH. Recent studies have shown that females need a higher dose of TBZ (2.0 mg/kg) to show the low-effort bias. The …

Using A Psychopharmacology Education Program To Increase Primary Care Provider Comfort With Treating Basic Psychiatric Disorders, Latesha Reed

DNP Scholarly Projects

BACKGROUND: Almost 1 in 5 people have been diagnosed with a mental health illness but the supply of psychiatric providers does not meet patient’s needs. Multiple reasons contribute to this shortage and nurse practitioners are part of the solution. Even with nurse practitioners specializing in psychiatric mental health there is still a shortage. Primary care is where most patients first present their mental health issues.

METHODS: Literature review informed the development of the educational intervention presented to the primary care providers using a digital, asynchronous learning format. A gap analysis of organizational needs and weaknesses was used to determine the …

Analytic Hierarchy Process: An Innovative Technique For Culturally Tailoring Evidence-Based Interventions To Reduce Health Disparities, Jaime A. Corvin, Isabella Chan, Claudia X. Aguado, Ian Dollman, Junius Gonzales

Publications from Provost Junius J. Gonzales

Latinos in the United States represent a disproportionate burden of illness and disease and face barriers to accessing health care and related resources. Culturally tailored, evidence-based interventions hold promise in addressing many of these challenges. Yet, ensuring patient voice is vital in the successful development and implementation of such interventions. Thus, this paper examines the application of analytic hierarchy process (AHP) to inform the augmentation and implementation of an evidence-based chronic disease self-management programme for underserved Latinos living with both minor depression and chronic illness. The process of AHP allows for direct input from the individuals that would utilize such …

Relation Of Depression Symptoms To Sustained Reward And Loss Sensitivity, Michael P. Berry, Ema Tanovic, Jutta Joormann, Charles A. Sanislow

Charles A. Sanislow, Ph.D.

Prevention Of Post Intensive Care Syndrome-Family With Sensation Awareness Focused Training Intervention: A Randomized Controlled Trial Pilot Study, Paula L. Cairns

USF Tampa Graduate Theses and Dissertations

Post Intensive Care Syndrome-Family (PICS-F) refers to acute and chronic psychological effects of critical illness on family members of patients in intensive care units (ICU). Evidence about the increase and persistence of PICS-F warrants the need for prevention interventions. This study evaluated the feasibility of providing Sensation Awareness Focused Training (SĀF-T) during the ICU stay for spouses of mechanically ventilated patients. Methods: A randomized controlled trial of SĀF-T versus a control group was conducted (n=10) to assess safety, acceptability, feasibility, and effect size of the intervention on PICS-F symptoms. Symptoms assessed as outcome measures included stress, anxiety, depression, posttraumatic stress …

Physical Activity Helping To Reduce Depression, Ellen Margaret Bier

Chancellor’s Honors Program Projects

No abstract provided.

Personality Disorders Predict Relapse After Remission From An Episode Of Major Depressive Disorder: A 6-Year Prospective Study, Carlos M. Grilo, Robert L. Stout, John C. Markowitz, Charles A. Sanislow, Emily B. Ansell, Andrew E. Skodol, Donna S. Bender, Anthony Pinto, M. Tracie Shea, Shirley Yen, John G. Gunderson, Leslie C. Morey, Christropher J. Hopwood, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Objective: To examine prospectively the course of major depressive disorder (MDD) and to test for the moderating effects of personality disorder (PD) comorbidity on relapse after remission from an episode of MDD.

Method: Participants were 303 patients (196 women and 107 men) with current DSM-IV diagnosed MDD at baseline enrollment in the Col­laborative Longitudinal Personality Disorders Study. Major depressive disorder and Axis I psychiatric disorders were assessed with the Structured Clinical Interview for DSM-IV, and Axis II PDs were assessed with the Diagnostic Interview for DSM-IV Personality Disorders. The course of MDD was assessed with the Longitudinal Interval Follow­up Evaluation …

State Effects Of Major Depression On The Assessment Of Personality And Personality Disorder, Leslie C. Morey, M. Tracie Shea, John C. Markowitz, Robert L. Stout, Christopher J. Hopwood, John G. Gunderson, Carlos M. Grilo, Thomas H. Mcglashan, Shirley Yen, Charles A. Sanislow, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

OBJECTIVE: The authors sought to determine whether personality disorders diagnosed during a depressive episode have long-term outcomes more typical of those of other patients with personality disorders or those of patients with noncomorbid major depression.

METHOD: The authors used 6-year outcome data collected from the multisite Collaborative Longitudinal Personality Disorders Study (CLPS). Diagnoses and personality measures gathered from the study cohort at the index assessment using interview and self-report methods were associated with symptomatic, functional, and personality measures at 6-year follow-up. Of 668 patients initially recruited to the CLPS, 522 were followed for 6 years. All participants had either a …

Help-Negation And Suicidal Ideation: The Role Of Depression, Anxiety And Hopelessness., Coralie J. Wilson

Frank Deane

Help-negation is expressed behaviorally by the refusal or avoidance of available help and cognitively by the inverse relationship between self-reported symptoms of psychological distress and help-seeking intentions. The current study is part of a larger multi-cite research program developed and led by the first author. It examines the association between suicidal ideation and intentions to seek help from friends, family and professional mental health sources in a sample of 302 Australian university students. Participants were 77.5% female and aged from 18-25 years old, with 85.4% aged 21 years or younger. Higher levels of suicidal ideation were related to lower help-seeking …

Help-Negation And Suicidal Ideation: The Role Of Depression, Anxiety And Hopelessness., Coralie J. Wilson

Coralie J Wilson

Help-negation is expressed behaviorally by the refusal or avoidance of available help and cognitively by the inverse relationship between self-reported symptoms of psychological distress and help-seeking intentions. The current study is part of a larger multi-cite research program developed and led by the first author. It examines the association between suicidal ideation and intentions to seek help from friends, family and professional mental health sources in a sample of 302 Australian university students. Participants were 77.5% female and aged from 18-25 years old, with 85.4% aged 21 years or younger. Higher levels of suicidal ideation were related to lower help-seeking …

Self-Criticism Versus Neuroticism In Predicting Depression And Psychosocial Impairment For 4 Years In A Clinical Sample, David M. Dunkley, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

The present study extended previous findings demonstrating self-criticism, assessed by the Dysfunctional Attitude Scale (DAS) (Weissman AN, Beck AT. Development and validation of the Dysfunctional Attitude Scale: a preliminary investigation. Paper presented at the 86th Annual Convention of the American Psychological Association, Toronto, Ontario, Canada, 1978), as a potentially important prospective predictor of depressive symptoms and psychosocial functional impairment over time. Using data from a prospective, 4-year study of a clinical sample, DAS self-criticism and neuroticism were associated with self-report depressive symptoms, interviewer-rated major depression, and global domains of psychosocial functional impairment 4 years later. Hierarchical multiple regression results indicated …

Ethnicity And Mental Health Treatment Utilization By Patients With Personality Disorders, Donna S. Bender, Andrew E. Skodol, Ingrid R. Dyck, John C. Markowitz, M. Tracie Shea, Shirley Yen, Charles A. Sanislow, Anthony Pinto, Mary C. Zanarini, Thomas H. Mcglashan, John G. Gunderson, Maria T. Daversa, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

The authors examined the relationship between ethnicity and treatment utilization by individuals with personality disorders (PDs). Lifetime and prospectively determined rates and amounts of mental health treatments received were compared in over 500 White, African American, and Hispanic participants with PDs in a naturalistic longitudinal study. Minority, especially Hispanic, participants were significantly less likely than White participants to receive a range of outpatient and inpatient psychosocial treatments and psychotropic medications. This pattern was especially pronounced for minority participants with more severe PDs. A positive support alliance factor significantly predicted the amount of individual psychotherapy used by African American and Hispanic …

Positive Childhood Experiences: Resilience And Recovery From Personality Disorder In Early Adulthood, Andrew E. Skodol, Donna S. Bender, Maria E. Pagano, M. Tracie Shea, Shirley Yen, Charles A. Sanislow, Carlos M. Grilo, Maria T. Daversa, Robert L. Stout, Mary C. Zanarini, Thomas H. Mcglashan, John G. Gunderson

Charles A. Sanislow, Ph.D.

OBJECTIVE: Recent follow-along studies of personality disorders have shown significant improvement in psychopathology over time. The purpose of this study was to prospectively investigate the association between positive childhood experiences related to resiliency and remission from personality disorder.

METHOD: Five hundred twenty patients with DSM-IV-based semistructured interview diagnoses of schizotypal, borderline, avoidant, or obsessive-compulsive personality disorders were evaluated 6 times over 4 years between September 1996 and June 2002. Positive childhood experiences, including achievements, positive interpersonal relationships with others, and caretaker competencies, were measured using the Childhood Experiences Questionnaire-Revised. The effects of positive childhood experiences on clinically significant remission from …

Depressive Symptoms And Help-Seeking Intentions In Young People., Coralie J. Wilson

Coralie J Wilson

Whether the help-negation effect as demonstrated for suicidal thoughts was also evident for depressive symptoms was investigated in three studies of young people from diverse urban areas. The studies comprised a large sample of younger high school students (years 7-10), a sample of older high school students (years 8-12), and first year university students. A self-report questionnaire that measured help-seeking intentions, prior help-seeking experiences, and depression was administered. Results revealed the strongest inverse association between level of depressive symptoms was with intentions to seek help from parents across all three samples. There was a consistent trend for students to report …

Perfectionism And Depressive Symptoms 3 Years Later: Negative Social Interactions, Avoidant Coping, And Perceived Social Support As Mediators., David M. Dunkley, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Although research has demonstrated perfectionism to have a negative impact on the treatment of depression, little research has examined the mechanisms or processes through which perfectionism predicts subsequent depressive symptoms in clinical populations over time. Using data from a prospective, 3-year study of a clinical sample (N = 96), hierarchical regression analyses indicated that perfectionism, assessed by the Dysfunctional Attitude Scale (Weissman AN, Beck AT. Development and validation of the Dysfunctional Attitude Scale: a preliminary investigation. Paper presented at the 86th annual convention of the American Psychological Association, Toronto, Ontario, Canada; 1978), is distinguished from major depression and neuroticism for …

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 …

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 …

Validity Of Das Perfectionism And Need For Approval In Relation To The Five-Factor Model Of Personality, David M. Dunkley, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

This study examined the validity of the perfectionism and need for approval scales of the Dysfunctional Attitude Scale (DAS; Weissman & Beck, 1978) by locating these measures within a comprehensive framework of personality, provided by the revised NEO Personality Inventory (NEO-PI-R; Costa & McCrae, 1992), in a clinical sample (N ¼ 132). The results indicated that: (1) DAS perfectionism reflects the self-critical aspects of the broader perfectionism construct rather than the active achievement striving aspects; (2) DAS need for approval generally lacks an association with positive interpersonal traits and shares much in common with DAS perfectionism; and (3) with shared …

Correlates Of Suicide Risk In Juvenile Detainees And Adolescent Inpatients, Charles A. Sanislow, Carlos M. Grilo, Dwain C. Fehon, Seth R. Axelrod, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

OBJECTIVE: To compare correlates of risk for suicidal behavior in juvenile detainees with those in another high-risk group, adolescent psychiatric inpatients.

METHOD: Eighty-one adolescents in a short-term juvenile detention center were contrasted with a matched group of 81 adolescent psychiatric inpatients on a clinical assessment battery of established instruments including a measure for risk of suicidal behavior.

RESULTS: Juvenile detainees and adolescent psychiatric inpatients reported similar levels of distress on measures of suicide risk, depression, impulsivity, and drug abuse. After controlling for depression, impulsivity and drug abuse remained significantly associated with suicide risk scores in the juvenile detention group, but …

Relation Of Therapeutic Alliance And Perfectionism To Outcome In Brief Outpatient Treatment Of Depression, David C. Zuroff, Sidney J. Blatt, Stuart M. Sotsky, Janice L. Krupnick, Daniel J. Martin, Charles A. Sanislow, Sam Simmens

Charles A. Sanislow, Ph.D.

Prior analyses of the National Institute of Mental Health Treatment of Depression Collaborative Research Program demonstrated that perfectionism was negatively related to outcome, whereas both the patient's perception of the quality of the therapeutic relationship and the patient contribution to the therapeutic alliance were positively related to outcome across treatment conditions (S. J. Blatt, D. C. Zuroff, D. M. Quinlan, & P. A. Pilkonis, 1996; J. L. Krupnick et al., 1996). New analyses examining the relations among perfectionism, perceived relationship quality, and the therapeutic alliance demonstrated that (a) the patient contribution to the alliance and the perceived quality of the …

Short And Long-Term Effects Of Medication And Psychotherapy In The Brief Treatment Of Depression: Further Analyses Of Data From The Nimh Tdcrp, Sidney J. Blatt, David C. Zuroff, Colin M. Bondi, Charles A. Sanislow

Charles A. Sanislow, Ph.D.

Prior analyses of data from the NIMH sponsored Treatment for Depression Collaborative Research Program (TDCRP; e.g., I. Elkin, 1994) indicated greater reduction of symptoms at midtreatment (8th wk) with Imipramine (IMI-CM) than with Cognitive-behavioral therapy (CBT) and Interpersonal therapy (IPT), but no significant differences in symptom reduction among these 3 active treatments at termination. Current analyses of previously unanalyzed data from ratings by therapists, clinical evaluators, and 162 patients (mean age 35 yrs) at termination and at 18-mo follow-up also indicated no significant differences among these treatments in symptom reduction or ratings of current clinical condition. But significant treatment differences …

Vulnerability To Depression: Reexamining State Dependence And Relative Stability, David C. Zuroff, Sidney J. Blatt, Charles A. Sanislow, Colin M. Bondi, Paul A. Pilkonis

Charles A. Sanislow, Ph.D.

Treatment-related decreases in Dysfunctional Attitudes Scale (DAS; Weissman & Beck, 1978) scores have been interpreted as evidence that dysfunctional attitudes are state-dependent concomitants of depression. Data from the National Institute of Mental Health Treatment of Depression Collaborative Research Program were used to reexamine the stability of dysfunctional attitudes. Mean scores for Perfectionism, Need for Approval, and total DAS decreased after 16 weeks of treatment. However, test-retest correlations showed that the DAS variables displayed considerable relative stability. Structural equation models demonstrated that dysfunctional attitudes after treatment were significantly predicted by initial level of dysfunctional attitudes as well as by posttreatment depression. …

When And How Perfectionism Impedes The Brief Treatment Of Depression: Further Analyses Of The Nimh Tdcrp, Sidney J. Blatt, David C. Zuroff, Colin M. Bondi, Charles A. Sanislow, Paul A. Pilkonis

Charles A. Sanislow, Ph.D.

Perfectionism has previously been identified as having a significant negative impact on therapeutic outcome at termination in the brief (16-week) treatment of depression (S. J. Blatt, D. M. Quinlan, P. A. Pilkonis, & T. Shea, 1995) as measured by the 5 primary outcome measures used in the National Institute of Mental Health Treatment of Depression Collaborative Research Program (TDCRP). The present analyses of other data from the TDCRP indicated that this impact of perfectionism on therapeutic outcome was also found in ratings by therapists, independent clinical evaluators, and the patients and that this effect persisted 18 months after termination. In …

Characteristics Of The Effective Therapist: Further Analyses Of The Nimh Tdcrp, Sidney J. Blatt, Charles A. Sanislow, David C. Zuroff, Paul A. Pilkonis

Charles A. Sanislow, Ph.D.

Analyses of the data of the National Institute of Mental Health-sponsored Treatment of Depression Collaborative Research Program have primarily examined the effects of types of treatment and patient characteristics on outcome, but scant attention has been directed toward evaluating the contributions of the therapist. With an aggregate of residualized therapeutic change scores of the 5 primary outcome measures for each patient at termination as an overall measure of improvement, an average therapeutic effectiveness measure was derived for each of the 28 therapists based on the outcome of the patients they saw in active treatment. The distribution of the therapists was …

Mental Disorders In Primary Care Services: An Update, Junius Gonzales, Kathryn M. Magruder, Samuel J. Keith

Publications from Provost Junius J. Gonzales

Frank mental disorders, such as depression and panic disorder, are prevalent in primary care; they cause people substantial suffering and interfere with daily functioning. Even subthreshold or "subsyndromal" conditions, with fewer symptoms than necessary for making a diagnosis, cause substantial morbidity. Recent literature on mental disorders in primary care, where many, if not most, people with mental health problems are seen, is reviewed with focus on recognition and diagnosis issues, management of these problems in primary care, obstacles to accurate diagnosis and appropriate treatment, and prevention issues. In addition to a review of recent research, there is an effort to …

Mood Induction, Interpersonal Perceptions, And Behavioral Rejection In Students With Depressed, Non-Depressed Disturbed, And Normal Roommates, Charles A. Sanislow, David V. Perkins, Deborah Ware Balogh

Charles A. Sanislow, Ph.D.

The present study used the Minnesota Multiphasic Personality Inventory (MMPI) to select, based on multidimensional criteria, 51 college students who displayed depression alone, depression in conjunction with other psychological disturbance (PD), nondepressive PD, or no PD. All students had been living with randomly assigned roommates (RMs) for at least 10 wks. RMs of these students completed the Multiple Affect Adjective Check List, the Profile of Mood States, MMPI-168 Depression scale items, and items concerning roommate behavior. RMs of students depressed in conjunction with other PD were significantly more depressed themselves on 2 measures than were RMs of students in the …