Medical Specialties Commons^™

Understanding Maternity Care Coordination For Women Veterans Using An Integrated Care Model Approach, Kristin M. Mattocks, Aimee Kroll-Desrosiers, Rebecca L. Kinney, Sara Singer

Kristin M. Mattocks

BACKGROUND: An increasing number of women veterans are using VA maternity benefits for their pregnancies. However, because the VA does not offer obstetrical care, women must seek maternity care from non-VA providers. The growing number of women using non-VA care has increased the importance of understanding how this care is integrated with ongoing VA medical and mental health services and how perceptions of care integration impact healthcare utilization. Therefore, we sought to understand these relationships among a sample of postpartum veterans utilizing VA maternity benefits.

METHODS: We fielded a modified version of the Patient Perceptions of Integrated Care survey among …

A Coordinated School Health Approach To Obesity Prevention Among Appalachian Youth: Middle School Student Outcomes From The Winning With Wellness Project, William T. Dalton Iii, Karen Schetzina, Elizabeth Conway-Williams

Karen E. Schetzina

The Winning With Wellness (WWW) project was a school-based obesity prevention program that was developed to promote healthy eating and physical activity in youth residing in rural Appalachia. The project was based on the Coordinated School Health model (Centers for Disease Control and Prevention (CDC), 2013a) and used a community-based participatory research approach with an emphasis on feasibility and sustainability. The purpose of this study was to examine self-reported health outcomes for middle school students across the course of the intervention. Sixth grade middle school students (N = 149; 52% girls) from four schools in Northeast Tennessee completed a …

Uncertainty And Competing Priorities In Shared Clinical Decision-Making, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

In this issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews observes that a connecting thread among the articles published therein is an element of uncertainty among patients and clinicians. Competing priorities for the patient also may be present. Several approaches to overcoming these prevalent conflicts to delivery of better health care have been proposed, the most important of which may be clinicians embracing a will to practice shared decision-making.

Prevalence And Correlates Of Indoor Tanning And Sunless Tanning Product Use Among Female Teens In The United States, Megan Quinn, Arsham Alamian, Joel J. Hillhouse, Colleen Scott, Rob Turrisi, Katie Baker

Arsham Alamian

Background

Indoor tanning (IT) before the age of 35 increases melanoma risk by 75%. Nevertheless, IT and sunless tanning product (STP) use have gained popularity among youth. However, there are limited data on the prevalence and sociodemographic correlates of both IT and STP use in a representative sample of American teens.

Methods

Teenage females (N = 778) aged 12–18 years were recruited as part of an on-going longitudinal study conducted between May 2011 and May 2013. Descriptive statistics explored IT and STP usage in teen females at baseline. Logistic regression was used to determine sociodemographic correlates of IT and STP …

Prevalence And Correlates Of Indoor Tanning And Sunless Tanning Product Use Among Female Teens In The United States, Megan Quinn, Arsham Alamian, Joel J. Hillhouse, Colleen Scott, Rob Turrisi, Katie Baker

Joel Hillhouse

Background

Indoor tanning (IT) before the age of 35 increases melanoma risk by 75%. Nevertheless, IT and sunless tanning product (STP) use have gained popularity among youth. However, there are limited data on the prevalence and sociodemographic correlates of both IT and STP use in a representative sample of American teens.

Methods

Teenage females (N = 778) aged 12–18 years were recruited as part of an on-going longitudinal study conducted between May 2011 and May 2013. Descriptive statistics explored IT and STP usage in teen females at baseline. Logistic regression was used to determine sociodemographic correlates of IT and STP …

New Approaches To Melanoma Prevention, June K. Robinson, Katie Baker, Joel J. Hillhouse

Joel Hillhouse

Skin cancer is a major public health concern, and tanning remains a modifiable risk factor. Multidimensional influences, including psychosocial, individual, environmental, and policy-related factors, create the milieu for individuals to engage in tanning. Parents and physicians can modify the behavior of teens and young adults using strategies based on harm reduction. Environmental and policy-related factors similar to those used to limit smoking by restricting access of minors to cigarettes in the United States in the 20th century need to be created. Federal regulations can restrict direct advertising and the excise tax can be increased to a prohibitive amount. Social networking …

The Behavioral Addiction Indoor Tanning Screener (Baits): An Evaluation Of A Brief Measure Of Behavioral Addictive Symptoms, Jerod L. Stapleton, Joel J. Hillhouse, Rob Turrisi, Katie Baker, Sharon L. Manne, Elliot J. Coups

Joel Hillhouse

No abstract provided.

Theory-Driven Longitudinal Study Exploring Indoor Tanning Initiation In Teens Using A Person-Centered Approach, Joel J. Hillhouse, Rob Turrisi, Michael J. Cleveland, Nichole M. Scaglione, Katie Baker, L. Carter Florence

Joel Hillhouse

Background Younger indoor tanning initiation leads to greater melanoma risk due to more frequent and persistent behavior. Despite this, there are no published studies exploring the predictors of indoor tanning initiation in teen populations. Purpose This longitudinal study uses latent profile analysis to examine indoor tanning initiation in indoor tanning risk subgroups from a national sample of female adolescents. Methods Latent profile analysis used indoor tanning beliefs and perceptions to identify indoor tanning initiation risk subgroups. The teens in each subgroup were reassessed on indoor tanning initiation after a year. Results Three subgroups were identified: a low risk, anti-tanning subgroup …

Engaging Moms On Teen Indoor Tanning Through Social Media: Protocol Of A Randomized Controlled Trial, Sherry L. Pagoto, Katie Baker, Julia Griffith, Jessica L. Oleski, Ashley Palumbo, Barbara Walkosz, Joel J. Hillhouse, Kimberly L. Henry, David Buller

Joel Hillhouse

Background: Indoor tanning elevates the risk for melanoma, which is now the most common cancer in US women aged 25-29. Public policies restricting access to indoor tanning by minors to reduce melanoma morbidity and mortality in teens are emerging. In the United States, the most common policy restricting indoor tanning in minors involves parents providing either written or in person consent for the minor to purchase a tanning visit. The effectiveness of this policy relies on parents being properly educated about the harms of indoor tanning to their children. Objective: This randomized controlled trial will test the efficacy of a …

Accuracy Of Self-Reported Sun Exposure And Sun Protection Behavior, Joel J. Hillhouse, Robert Turrisi, James Jaccard, June K. Robinson

Joel Hillhouse

The objective of this study was to compare the accuracy of self-reported skin cancer risk outcome measures proposed as standards by prevention experts to aggregated estimates of behavior from weekly diaries. Weekly electronic diaries of ultraviolet radiation (UVR) behaviors, initially validated by comparison with daily electronic diaries, were used to assess the accuracy of commonly used end-of-summer self-reported measures among 250 adults. Results revealed low biases, and good correspondence between simple open-ended self-reported estimates of days outside, hours outside, sunbathing days and hours, and days outside when not protected by either sunscreen, long-sleeved shirts, hats, or shade. Rating scale measures …

Evening Snacking In Relation To Self-Reported Declines In Sleep Quality During Pregnancy: Preliminary Results From The Decision-Making, Eating, And Weight Gain During Pregnancy (Dew) Study, Wendy Mccallum, Bradley M. Appelhans, Tiffany A. Moore Simas, Rui Sherry Xiao, Shums Alikhan, Isabelle C. Pierre-Louis, Barbara C. Olendzki, Sherry L. Pagoto, Molly E. Waring

Tiffany A. Moore Simas

Background: Poor sleep in non-pregnant adults has been associated with increased evening snacking, which may contribute to weight gain. Sleep disturbances are common during pregnancy.

Objective: To examine the association between changes in sleep quality from pre-pregnancy and evening snacking.

Methods: In an ongoing prospective cohort study, pregnant women were recruited from UMMHC obstetric practices and the community. Participants are 18+ years, with singleton gestation <36 >weeks, pre-pregnancy BMI 18.5-40 kg/m2, English-speaking, and with plans to deliver at UMMHC. Participants were asked “compared to the three months before you became pregnant, how is your sleep quality now?”; we combined responses of …

Proyecto Mama: A Lifestyle Intervention In Overweight And Obese Hispanic Women: A Randomised Controlled Trial--Study Protocol, Lisa Chasan-Taber, Bess H. Marcus, Milagros C. Rosal, Katherine L. Tucker, Sheri J. Hartman, Penelope S. Pekow, Edward J. Stanek Iii, Barry Braun, Caren G. Solomon, Joanne Manson, Sarah L. Goff, Glenn Markenson

Sarah L. Goff MD

BACKGROUND: The proportion of women entering pregnancy overweight or obese has been rising and, in turn, is associated with adverse maternal and fetal outcomes. Gestational weight gain (GWG) exceeding Institute of Medicine (IOM) guidelines further increases health risks and has been independently associated with postpartum weight retention. Hispanic women are disproportionately affected by overweight and obesity, but have had limited access to interventions that promote healthy lifestyles due to cultural, socioeconomic, and language barriers. Therefore, the overall goal of this randomized controlled trial is to test the efficacy of a culturally and linguistically modified, individually-tailored lifestyle intervention to reduce excess …

Assessment Of Competence Restoration: Determining The Threshold, Andrea L. Dinsmore

Andrea L. Dinsmore

Discusses the legal precedent and research basis of evaluating a defendant's mental competency to stand trial, the variables that contribute to non-restorable incompetence to stand trial, and the differences between patients who are restorable to competency versus those who are not restorable to competency.

Prediction Of Dengue Disease Severity Among Pediatric Thai Patients Using Early Clinical Laboratory Indicators, James A. Potts, Robert V. Gibbons, Alan L. Rothman, Anon Srikiatkhachorn, Stephen J. Thomas, Pra-On Supradish, Stephenie C. Lemon, Daniel H. Libraty, Sharone Green, Siripen Kalayanarooj

Alan Rothman

BACKGROUND: Dengue virus is endemic in tropical and sub-tropical resource-poor countries. Dengue illness can range from a nonspecific febrile illness to a severe disease, Dengue Shock Syndrome (DSS), in which patients develop circulatory failure. Earlier diagnosis of severe dengue illnesses would have a substantial impact on the allocation of health resources in endemic countries. METHODS AND FINDINGS: We compared clinical laboratory findings collected within 72 hours of fever onset from a prospective cohort children presenting to one of two hospitals (one urban and one rural) in Thailand. Classification and regression tree analysis was used to develop diagnostic algorithms using different …

Effect Of The Planet Health Intervention On Eating Disorder Symptoms In Massachusetts Middle Schools, 2005-2008, S. Bryn Austin, Jennifer L. Spadano-Gasbarro, Mary L. Greaney, Emily A. Blood, Anne T. Hunt, Tracy K. Richmond, Monica L. Wang, Solomon Mezgebu, Stavroula K. Osganian, Karen E. Peterson

Monica L. Wang

INTRODUCTION: The Planet Health obesity prevention curriculum has prevented purging and abuse of diet pills (disordered weight control behavior [DWCB]) in middle-school girls in randomized trials, but the effects of Planet Health on DWCB when implemented by schools under dissemination conditions are not known. METHODS: Massachusetts Department of Public Health and Blue Cross Blue Shield of Massachusetts disseminated Planet Health as part of the 3-year, Healthy Choices obesity prevention program in middle schools. We conducted an evaluation in 45 schools from fall 2005 to spring 2008. We gathered data from school staff to quantify intervention activities, and we gathered anonymous …

Prediction Of Dengue Disease Severity Among Pediatric Thai Patients Using Early Clinical Laboratory Indicators, James A. Potts, Robert V. Gibbons, Alan L. Rothman, Anon Srikiatkhachorn, Stephen J. Thomas, Pra-On Supradish, Stephenie C. Lemon, Daniel H. Libraty, Sharone Green, Siripen Kalayanarooj

Sharone Green

BACKGROUND: Dengue virus is endemic in tropical and sub-tropical resource-poor countries. Dengue illness can range from a nonspecific febrile illness to a severe disease, Dengue Shock Syndrome (DSS), in which patients develop circulatory failure. Earlier diagnosis of severe dengue illnesses would have a substantial impact on the allocation of health resources in endemic countries. METHODS AND FINDINGS: We compared clinical laboratory findings collected within 72 hours of fever onset from a prospective cohort children presenting to one of two hospitals (one urban and one rural) in Thailand. Classification and regression tree analysis was used to develop diagnostic algorithms using different …

Socioeconomic-Status And Mental Health In A Personality Disorder Sample: The Importance Of Neighborhood Factors, Zach Walsh, M. Tracie Shea, Shirley Yen, Emily B. Ansell, Carlos M. Grilo, Thomas H. Mcglashan, Robert L. Stout, Donna S. Bender, Andrew E. Skodol, Charles A. Sanislow, Leslie C. Morey, John G. Gunderson

Charles A. Sanislow, Ph.D.

This cross-sectional study examined the associations between neighborhood-level socioeconomic-status (NSES), and psychosocial functioning and personality pathology among 335 adults drawn from the Collaborative Longitudinal Personality Disorders Study. Participants belonged to four personality disorder (PD) diagnostic groups: Avoidant, Borderline, Schizotypal, and Obsessive Compulsive. Global functioning, social adjustment, and PD symptoms were assessed following a minimum two-year period of residential stability. Residence in higher-risk neighborhoods was associated with more PD symptoms and lower levels of functioning and social adjustment. These relationships were consistent after controlling for individual-level socioeconomic-status and ethnicity; however, the positive association between neighborhood-level socio-economic risk and PD symptoms was …

The Impact Of Worksite Weight-Related Social Norms On Associated Behaviors, Stephenie C. Lemon, Qin Liu, Robert P. Magner, Kristin L. Schneider, Lori Pbert

Qin Liu

Objective: To assess the association between descriptive social norms for weight and weight-related behaviors and associated behaviors at the worksite. Design and Sample: Baseline data from site-randomized trial of a worksite ecological intervention for weight control; 12 public high schools in central Massachusetts; Sample of 844 employees enrolled (~ 2/3 of all employees). Conclusions: Associations of weight loss and eating social norms with behavior; Unique from social support; No association of physical activity social norms with physical activity; May be little opportunity for and therefore little exposure to physical activity during the workday; Results support the development of weight loss …

Individuals With Single Versus Multiple Suicide Attempts Over 10 Years Of Prospective Follow-Up, Christina L. Boisseaua, Shirley Yen, John C. Markowitz, Carlos M. Grilo, Charles A. Sanislow, M. Tracie Shea, Mary C. Zanarini, Andrew E. Skodol, John G. Gunderson, Leslie C. Morey, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Background: The study attempted to identify characteristics that differentiate multiple suicide attempters from single attempters in individuals with personality disorders (PDs) and/or major depression.

Method: Participants were 431 participants enrolled in the Collaborative Longitudinal Study of Personality Disorders from July 1996 to June 2008. Suicide attempts were assessed with the Longitudinal Interval Follow-up Evaluation at 6 and 12months, then yearly through 10years. Logistic regression was used to compare single attempters to multiple attempters on Axis I and II psychiatric disorders and personality trait variables.

Results: Twenty-one percent of participants attempted suicide during the 10years of observation, with 39 (9.0%) reporting …

Frequency Of Private Spiritual Activity And Cardiovascular Risk In Post-Menopausal Women: The Women's Health Initiative, Elena Salmoirago Blotcher, George Fitchett, Kathleen M. Hovey, Eliezer Schnall, Cynthia Thomson, Christopher A. Andrews, Sybil Crawford, Mary Jo O'Sullivan, Stephen Post, Rowan T. Chlebowski, Judith K. Ockene

Sybil L. Crawford

Purpose: Spirituality has been associated with better cardiac autonomic balance, but its association with cardiovascular risk is not well studied. We examined whether more frequent private spiritual activity was associated with reduced cardiovascular risk in postmenopausal women enrolled in the Women’s Health Initiative Observational Study. Methods: Frequency of private spiritual activity (prayer, Bible reading, and meditation) was selfreported at year 5 of follow-up. Cardiovascular outcomes were centrally adjudicated, and cardiovascular risk was estimated from proportional hazards models. Results: Final models included 43,708 women (mean age: 68.9±7.3; median follow-up: 7.0 years) free of cardiac disease through year 5 of follow-up. In …

Prospective Investigation Of A Ptsd Personality Typology Among Individuals With Personality Disorders, Meghan E. Mcdevitt-Murphy, M. Tracie Shea, Shirley Yen, Carlos M. Grilo, Charles A. Sanislow, John C. Markowitz, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

This study investigated the replicability of a previously proposed personality typology of posttraumatic stress disorder (PTSD, and explored stability of cluster membership over a 6-month period. Participants with current PTSD (n = 156) were drawn from the Collaborative Longitudinal Personality Disorders Study (CLPS). The CLPS project tracked a large sample of individuals who met criteria for 1 of 4 target diagnoses (borderline, schizotypal, avoidant, and obsessive-compulsive) and a contrast group of individuals who met criteria for depression but no personality disorder. A cluster analysis using scales from the Schedule of Nonadaptive and Adaptive Personality yielded 3 clusters: “internalizing,” “externalizing,” and …

Medical Oxymoron Or Necessary Prevention Of Repeat Sex Offenses: An Examination Of The Appropriateness Of Existing Chemical Castration Statutes, Robert Watters

Robert Watters

The current chemical castration statutes in six states are full of logical constitutional, medical and ethical questions and concerns. The basis for the criticism can be traced to how the schemes were developed compared to the those used in Europe. The castration statutes enacted after long trial and error periods are, therefore, easily discernible from those signed into law quickly as a reaction to some outside event.

Avoidant Personality Disorder, Traits, And Type, Charles A. Sanislow, Katelin Da Cruz, May O. Gianoli, Elizabeth M. Reagan

Charles A. Sanislow, Ph.D.

In this chapter, the evolution of the avoidant personality disorder (AVPD) diagnosis, its current status, and future possibilities are reviewed. AVPD is a chronic and enduring condition involving a poor sense of self and anxiety in social situations, and it is marked by fears of rejection and a distant interpersonal stance. AVPD may be conceptualized at the severe end of a continuum of social anxiety. In the extreme, traits, mechanisms, and symptoms become integral to chronic dysfunction in personality and interpersonal style. While AVPD is a valid diagnostic construct, the optimal organization of AVPD criteria for the diagnosis, and the …

Avoidant Personality Disorder, Charles A. Sanislow, Ellen E. Bartolini, Emma C. Zoloth

Charles A. Sanislow, Ph.D.

No abstract provided.

A Shot In Arm: Can Chemical Castration Statutes Cure Sex Offenders Legally And Ethically?, Robert Watters

Robert Watters

At least seven states have chemical castration statutes to combat recidivist sex offenders. This article is an examination of the appropriateness and effectiveness of those statutes as against the successful European models.

Pathological Personality Traits Among Patients With Absent, Current, And Remitted Substance Use Disorders, Christopher J. Hopwood, Leslie C. Morey, Andrew E. Skodol, Charles A. Sanislow, Carlos M. Grilo, Emily B. Ansell, Thomas H. Mcglashan, John C. Markowitz, Anthony Pinto, Shirley Yen, M. Tracie Shea, John G. Gunderson, Mary C. Zanarini, Robert L. Stout

Charles A. Sanislow, Ph.D.

Personality traits may provide underlying risk factors for and/or sequelae to substance use disorders (SUDs). In this study Schedule for Nonadaptive and Adaptive Personality (SNAP) traits were compared in a clinical sample (N=704, age 18–45) with current, past, or no historical alcohol or non-alcohol substance use disorders (AUD and NASUD) as assessed by DSM-IV semi-structured interview. Results corroborated previous research in showing associations of negative temperament and disinhibition to SUD, highlighting the importance of these traits for indicating substance use proclivity or the chronic effects of substance use. Certain traits (manipulativeness, self-harm, disinhibition, and impulsivity for AUD, and disinhibition and …

Self-Harm Subscale Of The Schedule Of Nonadaptive And Adaptive Personality (Snap): Predicting Suicide Attempts Over 8 Years Of Follow-Up, Shirley Yen, M. Tracie Shea, Zach Walsh, Maria O. Edelen, Christopher J. Hopwood, John C. Markowitz, Emily B. Ansell, Leslie C. Morey, Carlos M. Grilo, Charles A. Sanislow, Andrew E. Skodol, John G. Gunderson, Mary C. Zanarini, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Objective: We examined the predictive power of the self-harm subscale of the Schedule for Nonadaptive and Adaptive Personality (SNAP) to identify suicide attempters in the Collaborative Longitudinal Study of Personality Disorders (CLPS).

Method: The SNAP, a self-report personality inventory, was administered to 733 CLPS participants at baseline, of whom 701 (96%) had at least 6 months of follow-up data. Cox proportional hazards regression analyses were performed to examine the SNAP–self-harm subscale (SNAP- SH) in predicting the 129 suicide attempters over 8 years of follow-up. Possible moderators of prediction were examined, including borderline personality disorder, major depressive disorder (MDD), and substance …

Ten-Year Course Of Borderline Personality Disorder: Psychopathology And Function From The Collaborative Longitudinal Personality Study, John G. Gunderson, Robert L. Stout, Thomas H. Mcglashan, M. Tracie Shea, Leslie C. Morey, Carlos M. Grilo, Mary C. Zanarini, Shirley Yen, John C. Markowitz, Charles A. Sanislow, Emily B. Ansell, Anthony Pinto, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

Context: Borderline personality disorder (BPD) is traditionally considered chronic and intractable.

Objective: To compare the course of BPD’s psychopathology and social function with that of other personality disorders and with major depressive disorder (MDD) over 10 years. Design: A collaborative study of treatment-seeking, 18- to 45-year-old patients followed up with standardized, reliable, and repeated measures of diagnostic remission and relapse and of both global social functioning and subtypes of social functioning.

Setting: Nineteen clinical settings (hospital and outpatient) in 4 northeastern US cities.

Participants: Three study groups, including 175 patients with BPD, 312 with cluster C personality disorders, and 95 …

Can Personality Disorder Experts Recognize Dsm-Iv Personality Disorders From Five-Factor Model Descriptions Of Patient Cases?, Benjamin M. Rottman, Nancy S. Kim, Woo-Kyoung Ahn, Charles A. Sanislow

Charles A. Sanislow, Ph.D.

Background: Dimensional models of personality are under consideration for integration into the next Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but the clinical utility of such models is unclear.

Objective: To test the ability of clinical researchers who specialize in personality disorders to diagnose personality disorders using dimensional assessments and to compare those researchers’ ratings of clinical utility for a dimensional system versus for the DSM-IV.

Method: A sample of 73 researchers who had each published at least 3 (median = 15) articles on personal- ity disorders participated between December 2008 and January 2009. The Five-Factor Model (FFM), one …

The Association Of Personality Disorders With The Prospective 7-Year Course Of Anxiety Disorders, Emily B. Ansell, Anthony Pinto, Maria O. Edelen, John C. Markowitz, Charles A. Sanislow, Shirley Yen, Mary C. Zanarini, Andrew E. Skodol, M. Tracie Shea, Leslie C. Morey, John G. Gunderson, Thomas H. Mcglashan, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

Background. This study prospectively examined the natural clinical course of six anxiety disorders over 7 years of follow-up in individuals with personality disorders (PDs) and/or major depressive disorder. Rates of remission, relapse, new episode onset and chronicity of anxiety disorders were examined for specific associations with PDs.

Method. Participants were 499 patients with anxiety disorders in the Collaborative Longitudinal Personality Disorders Study, who were assessed with structured interviews for psychiatric disorders at yearly intervals throughout 7 years of follow-up. These data were used to determine probabilities of changes in disorder status for social phobia (SP), generalized anxiety disorder (GAD), obsessive-compulsive …