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Author (up) Alapin, I.; Fichten, C.S.; Libman, E.; Creti, L.; Bailes, S.; Wright, J. file  url
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  Title How is good and poor sleep in older adults and college students related to daytime sleepiness, fatigue, and ability to concentrate? Type Journal Article
  Year 2000 Publication Journal of Psychosomatic Research Abbreviated Journal J Psychosom Res  
  Volume 49 Issue 5 Pages 381-390  
  Keywords Adaptation, Psychological; Adult; Aged; Attention; Circadian Rhythm--physiology; Cognition Disorders--diagnosis, etiology; Disorders of Excessive Somnolence--diagnosis, etiology; Fatigue--diagnosis, etiology; Female; Humans; Male; Middle Aged; Severity of Illness Index; Sleep--physiology; Sleep Initiation and Maintenance Disorders--complications, diagnosis; Students; Universities; Wakefulness--physiology  
  Abstract We compared good sleepers with minimally and highly distressed poor sleepers on three measures of daytime functioning: self-reported fatigue, sleepiness, and cognitive inefficiency. In two samples (194 older adults, 136 college students), we tested the hypotheses that (1) poor sleepers experience more problems with daytime functioning than good sleepers, (2) highly distressed poor sleepers report greater impairment in functioning during the day than either good sleepers or minimally distressed poor sleepers, (3) daytime symptoms are more closely related to psychological adjustment and to psychologically laden sleep variables than to quantitative sleep parameters, and (4) daytime symptoms are more closely related to longer nocturnal wake times than to shorter sleep times. Results in both samples indicated that poor sleepers reported more daytime difficulties than good sleepers. While low- and high-distress poor sleepers did not differ on sleep parameters, highly distressed poor sleepers reported consistently more difficulty in functioning during the day and experienced greater tension and depression than minimally distressed poor sleepers. Severity of all three daytime problems was generally significantly and positively related to poor psychological adjustment, psychologically laden sleep variables, and, with the exception of sleepiness, to quantitative sleep parameters. Results are used to discuss discrepancies between experiential and quantitative measures of daytime functioning.  
  Call Number Serial 216  
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Author (up) Bryant, R.A.; O'Donnell, M.L.; Creamer, M.; McFarlane, A.C.; Silove, D. file  url
openurl 
  Title A multisite analysis of the fluctuating course of posttraumatic stress disorder Type Journal Article
  Year 2013 Publication JAMA Psychiatry Abbreviated Journal JAMA Psychiatry  
  Volume 70 Issue 8 Pages 839-846  
  Keywords Adolescent; Adult; Aged; Australia/epidemiology; Brain Injuries/diagnosis/epidemiology/*psychology; *Disease Progression; Female; Humans; Injury Severity Score; Male; Middle Aged; Prospective Studies; Severity of Illness Index; Stress Disorders, Post-Traumatic/diagnosis/epidemiology/*psychology; Stress, Psychological/complications/diagnosis/epidemiology; Time Factors; Young Adult  
  Abstract IMPORTANCE: Delayed-onset posttraumatic stress disorder (PTSD) accounts for approximately 25% of PTSD cases. Current models do not adequately explain the delayed increases in PTSD symptoms after trauma exposure. OBJECTIVE: To test the roles of initial psychiatric reactions, mild traumatic brain injury (MTBI), and ongoing stressors on delayed-onset PTSD. DESIGN, SETTING, AND PARTICIPANTS: In this prospective cohort study, patients were selected from recent admissions to 4 major trauma hospitals across Australia. A total of 1084 traumatically injured patients were assessed during hospital admission from April 1, 2004, through February 28, 2006, and 785 (72.4%) were followed up at 3, 12, and 24 months after injury. MAIN OUTCOME AND MEASURE: Severity of PTSD was determined at each assessment with the Clinician-Administered PTSD Scale. RESULTS: Of those who met PTSD criteria at 24 months, 44.1% reported no PTSD at 3 months and 55.9% had subsyndromal or full PTSD. In those who displayed subsyndromal or full PTSD at 3 months, PTSD severity at 24 months was predicted by prior psychiatric disorder, initial PTSD symptom severity, and type of injury. In those who displayed no PTSD at 3 months, PTSD severity at 24 months was predicted by initial PTSD symptom severity, MTBI, length of hospitalization, and the number of stressful events experienced between 3 and 24 months. CONCLUSIONS AND RELEVANCE: These data highlight the complex trajectories of PTSD symptoms over time. This study also points to the roles of ongoing stress and MTBI in delayed cases of PTSD and suggests the potential of ongoing stress to compound initial stress reactions and lead to a delayed increase in PTSD symptom severity. This study also provides initial evidence that MTBI increases the risk of delayed PTSD symptoms, particularly in those with no acute symptoms.  
  Call Number Serial 1306  
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Author (up) Cavedini, P.; Bassi, T.; Ubbiali, A.; Casolari, A.; Giordani, S.; Zorzi, C.; Bellodi, L. file  url
doi  openurl
  Title Neuropsychological investigation of decision-making in anorexia nervosa Type Journal Article
  Year 2004 Publication Psychiatry Research Abbreviated Journal Psychiatry Res  
  Volume 127 Issue 3 Pages 259-266  
  Keywords Adult; Analysis of Variance; Anorexia Nervosa/diagnosis/*psychology; Body Mass Index; Bulimia/epidemiology/psychology; Cognition Disorders/*diagnosis/*etiology; *Decision Making; Diagnostic and Statistical Manual of Mental Disorders; Female; Gambling/psychology; Humans; Male; Neuropsychological Tests; Severity of Illness Index  
  Abstract Anorexia nervosa (AN) could be considered a form of obsessive-compulsive disorder in which an impairment of the cognitive domain related to decision-making was found. We explored this function in AN patients, as well as possible differences between restricting type and binge/purge type, with the aim of examining the hypothesis that AN is part of the obsessive-compulsive spectrum. Decision-making was assessed in 59 inpatients with AN and 82 control subjects using the Gambling task, which simulates real-life decision-making by assessing the ability to balance immediate rewards against long-term negative consequences. We confirmed the supposed deficit of decision-making in AN. However, restricting and binge eating/purge subtypes showed different patterns of decision-making impairment. Poor performance on the Gambling task is not a mere consequence of starvation and does not appear to be related to illness severity. The decision-making deficiency that some AN patients show is linked to those individual features that contribute to the phenomenological expression of the disorder.  
  Call Number Serial 91  
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Author (up) Mehta, M.; Marras, T.K. file  url
doi  openurl
  Title Impaired health-related quality of life in pulmonary nontuberculous mycobacterial disease Type Journal Article
  Year 2011 Publication Respiratory Medicine Abbreviated Journal Respir Med  
  Volume 105 Issue 11 Pages 1718-1725  
  Keywords Aged; Cross-Sectional Studies; Female; *Forced Expiratory Volume; Health Status; Humans; Lung Diseases/*microbiology/*physiopathology; Male; Mycobacterium Infections/microbiology/*physiopathology; Prospective Studies; *Quality of Life; Questionnaires; Severity of Illness Index; Sickness Impact Profile  
  Abstract INTRODUCTION: The impact of pulmonary nontuberculous mycobacterial (pNTM) disease on health-related quality of life (HRQL) has not been quantified. METHODS: We performed a prospective observational study of HRQL in 51 patients with pNTM disease. One generic (Short-form 36, version 2 -SF-36), and one pulmonary disease-specific instrument (St. George's Respiratory Questionnaire--SGRQ) were administered to each subject. RESULTS: Fifty-one patients with pNTM disease from one ambulatory clinic were enrolled. The mean (sd) age was 67 (10) years and 80% (41/51) were female. The most common causative NTM was MAC in 84% (43/51) followed by Mycobacterium abscessus in 8% (4/51). Radiographic disease type was nodular bronchiectasis in 71% (36/51) and fibrocavitary in 22% (11/51). For SF-36, most raw scores were at least 10 points below Canadian population-based normals, and all normbased scores were below the expected normal value of 50. For SGRQ, all scores were worse by >/= 25 points compared with published normals. In multivariable analyses, only FVC and DLCO were significantly associated with SF-36, and only FVC and emphysema were significantly associated with SGRQ. CONCLUSION: Patients with pNTM disease have significantly impaired HRQL that is most closely associated with lung function and not readily explained by age, sex or extra-pulmonary comorbidity.  
  Call Number Serial 177  
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Author (up) Newcorn, J.H.; Stein, M.A.; Cooper, K.M. file  url
doi  openurl
  Title Dose-response characteristics in adolescents with attention-deficit/hyperactivity disorder treated with OROS methylphenidate in a 4-week, open-label, dose-titration study Type Journal Article
  Year 2010 Publication Journal of Child and Adolescent Psychopharmacology Abbreviated Journal J Child Adolesc Psychopharmacol  
  Volume 20 Issue 3 Pages 187-196  
  Keywords Adolescent; Analysis of Variance; Attention Deficit Disorder with Hyperactivity/*drug therapy; Body Weight; Central Nervous System Stimulants/administration & dosage/*therapeutic use; Dose-Response Relationship, Drug; Female; Humans; Male; Methylphenidate/administration & dosage/*therapeutic use; Regression Analysis; Severity of Illness Index; Treatment Outcome  
  Abstract OBJECTIVE: The aim of this study was to evaluate dose-response characteristics in adolescents with attention-deficit/hyperactivity disorder (ADHD) treated with once-daily OROS methylphenidate (OROS MPH) during the 4-week, open-label, escalating dose-titration phase of a larger multisite, placebo-controlled trial. Patient factors such as age, height, weight, and baseline symptom severity were evaluated as predictors of selected dose, as was the degree of incremental response with each successive dose escalation. METHODS: Adolescents 13-18 years of age with ADHD underwent a 4-week, open-label, escalating dose-titration trial to determine the minimal effective dose (18, 36, 54, or 72 mg once daily) of OROS to be used in a multiphase, placebo-controlled study (NCT00249353). Both final absolute dose and mean weight-adjusted dose were used to assess predictors of response, using a one-way analysis of variance and regression analyses. RESULTS: The majority of subjects who did not respond at lower doses achieved response at each escalating dose level. Approximately two-thirds of subjects required a dose of 54 mg or greater to achieve improvement criteria. Minimal effective dose correlated modestly with baseline symptom severity. Age, height, and weight did not correlate with absolute dose and accounted for only a small percentage of variance in weight-based dose. Weight was not a major factor in predicting effective dose; however, using weight-adjusted rather than absolute dose proved slightly superior for modeling of adverse effects. CONCLUSIONS: Adolescents required, on average, a higher absolute dose but a lower weight-adjusted dose (mg/kg) of OROS) than was previously reported in children. There were few predictors of optimal dose of OROS other than baseline symptom severity. The increased percentage of adolescent responders at each dose level using this clinically driven approach to titration differs from recent findings from randomized forced dose titration studies in adults with ADHD.  
  Call Number Serial 545  
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Author (up) Oyelese, Y.; Smulian, J.C. file  url
openurl 
  Title Placenta previa, placenta accreta, and vasa previa Type Journal Article
  Year 2006 Publication Obstetrics and Gynecology Abbreviated Journal Obstet Gynecol  
  Volume 107 Issue 4 Pages 927-941  
  Keywords Balloon Occlusion/methods; Cesarean Section; Female; Follow-Up Studies; Humans; Hysterectomy/*methods; Magnetic Resonance Imaging; Methotrexate/therapeutic use; Physical Examination/methods; Placenta Accreta/diagnosis/*therapy; Placenta Diseases/diagnostic imaging/surgery; Placenta Previa/diagnosis/*therapy; Postpartum Hemorrhage/diagnosis/*therapy; Pregnancy; Risk Assessment; Severity of Illness Index; Treatment Outcome; Ultrasonography, Doppler, Color; Ultrasonography, Prenatal  
  Abstract Placenta previa, placenta accreta, and vasa previa are important causes of bleeding in the second half of pregnancy and in labor. Risk factors for placenta previa include prior cesarean delivery, pregnancy termination, intrauterine surgery, smoking, multifetal gestation, increasing parity, and maternal age. The diagnostic modality of choice for placenta previa is transvaginal ultrasonography, and women with a complete placenta previa should be delivered by cesarean. Small studies suggest that, when the placenta to cervical os distance is greater than 2 cm, women may safely have a vaginal delivery. Regional anesthesia for cesarean delivery in women with placenta previa is safe. Delivery should take place at an institution with adequate blood banking facilities. The incidence of placenta accreta is rising, primarily because of the rise in cesarean delivery rates. This condition can be associated with massive blood loss at delivery. Prenatal diagnosis by imaging, followed by planning of peripartum management by a multidisciplinary team, may help reduce morbidity and mortality. Women known to have placenta accreta should be delivered by cesarean, and no attempt should be made to separate the placenta at the time of delivery. The majority of women with significant degrees of placenta accreta will require a hysterectomy. Although successful conservative management has been described, there are currently insufficient data to recommend this approach to management routinely. Vasa previa carries a risk of fetal exsanguination and death when the membranes rupture. The condition can be diagnosed prenatally by ultrasound examination. Good outcomes depend on prenatal diagnosis and cesarean delivery before the membranes rupture.  
  Call Number Serial 2166  
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Author (up) Reinecke, A.; Rinck, M.; Becker, E.S.; Hoyer, J. file  url
openurl 
  Title Cognitive-behavior therapy resolves implicit fear associations in generalized anxiety disorder Type Journal Article
  Year 2013 Publication Behaviour Research and Therapy Abbreviated Journal Behav Res Ther  
  Volume 51 Issue 1 Pages 15-23  
  Keywords Adult; Analysis of Variance; Anxiety Disorders/diagnosis/psychology/*therapy; *Association; Attention; Case-Control Studies; *Cognitive Therapy; Depression/diagnosis; Fear/*psychology; Female; Follow-Up Studies; Generalization (Psychology); Humans; Male; Psychiatric Status Rating Scales; Regression Analysis; Severity of Illness Index; Treatment Outcome; Word Association Tests  
  Abstract BACKGROUND: Cognitive schema theories postulate that anxiety disorders are associated with excessive fear associations in memory. For generalized anxiety disorder (GAD), it has been shown that patients not only exhibit negative implicit evaluations of clearly negative worry words (e.g., cancer), but also a generalization of this effect to neutral words (e.g., diagnosis). This study assessed the sensitivity of this bias, which has been interpreted as an indicator of a pathologically broadened fear structure, to cognitive-behavioral therapy (CBT). METHODS: An Extrinsic Affective Simon task was used to measure implicit associations with idiosyncratic neutral and negative worry words in 23 GAD patients and 25 healthy controls (HC). Patients were tested before and after CBT, and half of them were additionally tested while waiting for treatment. Clinical symptoms were measured before and after treatment, and at 6-months follow-up. RESULTS: CBT normalized bias for neutral words, and the extent of bias reduction during treatment predicted the extent of additional symptom improvement during the 6 months following intervention. Furthermore, the amplitude of pre-treatment bias predicted the onset of CBT response, with lower bias predicting immediate symptom improvement at the end of treatment, and higher bias predicting delayed treatment effects during the 6 months follow-up. CONCLUSIONS: Biased implicit evaluation of neutral worry targets does not represent an enduring vulnerability factor for the development of GAD but is related to heightened levels of state worry. Furthermore, the normalization of this bias might be a crucial factor in the therapeutic action of CBT.  
  Call Number Serial 1773  
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Author (up) Seedat, S.; Videen, J.S.; Kennedy, C.M.; Stein, M.B. file  url
doi  openurl
  Title Single voxel proton magnetic resonance spectroscopy in women with and without intimate partner violence-related posttraumatic stress disorder Type Journal Article
  Year 2005 Publication Psychiatry Research Abbreviated Journal Psychiatry Res  
  Volume 139 Issue 3 Pages 249-258  
  Keywords Adult; Aspartic Acid/analogs & derivatives/metabolism; Brain/metabolism; Choline/metabolism; Conflict (Psychology); Creatine/metabolism; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; *Magnetic Resonance Spectroscopy; Severity of Illness Index; *Sexual Partners; Spouse Abuse/*psychology; Stress Disorders, Post-Traumatic/diagnosis/*etiology/metabolism  
  Abstract Preliminary in vivo proton magnetic spectroscopic ((1)H-MRS) studies of N-acetylaspartate (a putative marker of neuronal viability and function) in combat veterans and maltreated children with posttraumatic stress disorder (PTSD) suggest altered neuronal integrity in anterior cingulate and medial temporal lobe structures. In this study, (1)H-MRS was used to measure N-acetylaspartate (NAA), choline (Cho) and myo-inositol (mI) relative to creatine (Cr) in the anterior cingulate of 16 women with histories of intimate partner violence (7 with a DSM-IV diagnosis of PTSD, 9 without PTSD) and 11 healthy, non-abused comparison subjects. The relationship between anterior cingulate chemistry and performance on the Stroop Color-Word task and Part B of the Trail Making Test was also examined. There were no significant differences in anterior cingulate or occipital gray matter metabolite ratios of NAA/Cr and Cho/Cr between intimate partner violence and healthy comparison subjects. Intimate partner violence subjects with PTSD had significantly higher anterior cingulate Cho/Cr than intimate partner violence subjects without PTSD. There was evidence that the subjects with PTSD suffered more severe intimate partner violence as measured by the Conflict Tactics Scale-Revised. Metabolite ratios were not significantly correlated with performance on the Stroop or Trails B. Our findings, in agreement with earlier studies, showed significant alterations in anterior cingulate chemistry in women with PTSD. In contrast to other studies, we found an increase in Cho/Cr rather than a decrease in NAA/Cr, indicating alterations in glia, instead of neuronal dropout.  
  Call Number Serial 83  
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