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Biomedical subjects

A B Rowan

Publications and source records attributed to A B Rowan.

7 recordsLinked to original sources
PubMed1998

Aggression classification and treatment response.

This preliminary study investigated whether the aggression subtypes derived from the Aggression Questionnaire (AQ) are related to treatment response. The subjects were 28 aggressive conduct-disordered children (25 males, 3 females), ranging in age from 9.8 to 17.0 years (mean age = 12.69 years), who participated in a double-blind, placebo-controlled study of lithium as a treatment for reducing aggression. We used the Predatory-Affective Index of the AQ to classify subjects into "predatory" (planned) or "affective" (explosive) subtypes of aggression and then related this classification to treatment response. This index did not differentiate placebo baseline responders from nonresponders. However, the Index did significantly differentiate responders and nonresponders during the experimental treatment period, regardless of whether they received lithium or placebo. Treatment response was associated with a more affective and less predatory subtype of aggression. To the best of our knowledge, this is the first study in children to show an association between the aggression subtype and treatment response.

Adolescent↗
PubMed1997

Home-based behavioral treatments for chronic benign headache: a meta-analysis of controlled trials.

Controlled clinical trials have consistently demonstrated that behavioral treatments for chronic benign headache produce clinically beneficial outcomes both post-treatment and at follow-up. Given these results there is interest in cost-reduction and redesign of these treatments to improve their accessibility. One promising approach in this regard is home-based headache treatment. These treatments seek to provide the same amount of treatment as clinic-based treatments; however, some of the material typically presented to the patient by a clinician is presented through home-study materials (e.g., manuals, audiotapes). To date, the published literature contains 20 controlled clinical trials which have examined the outcomes produced by home-based treatments. This article presents the first comprehensive meta-analysis of these clinical outcome studies. Results of the quantitative analyses suggest that home-based treatments produce comparable, or with certain outcome measures, superior results to clinic-based treatments. Moreover, costeffectiveness scores of home-based treatments were found to be more than five times larger than those of clinic-based therapies. Methodological analyses are also presented along with suggestions for future research.

Adolescent↗
PubMed1997

Nonpharmacological response in hospitalized children with conduct disorder.

OBJECTIVE: There is a paucity of research regarding the effects of hospitalization and/or the response to placebo in children with conduct disorder who are hospitalized for chronic and severe aggression. However, many children with this problem are hospitalized and immediately begin pharmacotherapy. In this report, the effects of hospitalization and placebo administration were examined. METHOD: Subjects were forty-four children (37 males, 7 females) with conduct disorder, aged 9.83 to 17.14 years, who were hospitalized for chronic and severe aggression. This was a 4-week double-blind and placebo-controlled study with a 2-week single-blind placebo lead-in period. During the 2-week placebo baseline period, aggression was measured on a 24-hour basis, using the Overt Aggression Scale. Only subjects meeting a specific aggression criterion were randomized to the treatment period of the trial. RESULTS: Of the 44 subjects enrolled, 23 (52.3%) met the aggression criteria for entering the treatment period (baseline nonresponders), while 21 (47.7%) did not (baseline responders). Thus, almost half of the subjects, while taking no active medication, benefited from the inpatient milieu/structure and/or placebo. CONCLUSION: This finding has important treatment and research implications. Medication to treat aggression should not be initiated immediately upon hospitalization because improvements associated with hospitalization may be attributed inaccurately to pharmacotherapy, resulting in unnecessarily medicating children. A placebo baseline period is essential to decrease the risk of a type II error in pharmacological research concerning aggression.

Adolescent↗
PubMed1996

Posttraumatic stress disorder in a clinical sample of adult survivors of childhood sexual abuse.

One hundred seventeen help-seeking adult survivors of childhood sexual abuse (CSA) were assessed to investigate the relationship between the level of self-reported CSA and posttraumatic stress disorder (PTSD). CSA was measured utilizing the Sexual Abuse Exposure Questionnaire, a new research instrument. Further preliminary psychometric properties of the instrument were reported. CSA was operationalized to include severity, duration, age of onset, number of perpetrators, and use of force. PTSD diagnostic status was assessed utilizing a standardized instrument, the Structured Clinical Interview for DSM-II-R. Eighty-six percent of survivors met full DSM-III-R criteria for a PTSD diagnosis at some point during their lives. Multivariate analysis indicated that CSA severity and duration accounted for significant portions of the variance in PTSD symptoms, providing support for their role as traumagenic variables.

Adult↗
PubMed1996

Demographic, clinical, and military factors related to military mental health referral patterns.

This study examined 693 cases of active duty members from all service branches seen in an Air Force outpatient mental health clinic over a 3-year period. Age, gender, rank, marital status, duty status, presence of special duty status, diagnostic category, and recommendations to the member's unit were examined across referral sources (i.e., self-referred, referred by others in authority, and command-ordered). Results showed significant differences across all variables, with self-referred members being more likely to be older, higher ranking, and married. Permanently assigned members were more likely than students to self-refer. Members with special duty status were less likely to self-refer. Self-referred members were less likely to have recommendations made with negative career impacts. The implications of these findings in terms of targeting interventions to increase self-initiated help-seeking behavior as well as recommendations for future research are discussed.

Adult↗
PubMed1994

Posttraumatic stress disorder in a clinical sample of adults sexually abused as children.

Forty-seven help-seeking, adult survivors of childhood sexual abuse (CSA) were assessed to examine the relationship between the level of CSA exposure and the subsequent development of posttraumatic stress disorder. CSA exposure was operationalized to include the overall level of exposure, frequency and duration of the abuse, age of onset, use of force, perceived life threat, and the occurrence of penetration. Participants were administered standardized measures of PTSD, including the Structured Clinical Interview of DSM-III-R (SCID). On the SCID, 69% of the survivors met full DSM-III-R criteria for PTSD. Significant correlations were found between several overall exposure measures and PTSD diagnostic status and the intensity of PTSD symptomatology. Similar relationships were identified with the duration and frequency of the abuse, the age of onset, and the use of force. This study is important in that it utilized standardized measures of PTSD and found a significant incidence of PTSD among adult CSA survivors.

Adolescent↗