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Biomedical subjects

A C Heath

Publications and source records attributed to A C Heath.

At least 91 records · Page 5Linked to original sources

Long-term reliability and validity of alcoholism diagnoses and symptoms in a large national telephone interview survey.

The long-term reliability and validity of telephone lay interview assessments of alcoholism were examined in the context of a large national community-based survey of over 8,000 male Vietnam era veterans. A subsample of 146 men was interviewed twice by telephone using the same structured interview an average of 15 months apart to evaluate the long-term reliability of alcoholism symptoms and diagnoses. In addition, a search of Department of Veterans Affairs patient treatment files of inpatient hospitalizations between 1970 and 1993 yielded a subsample of 89 interviewed men with a past discharge diagnosis of alcohol dependence. The test-retest reliability of alcohol abuse and alcohol dependence diagnoses was good, with kappa coefficients of 0.74 and 0.61, respectively. The reliability of individual alcoholism symptoms was fair to good, with kappas of 0.46 to 0.67. Ninety-six percent of individuals identified by Department of Veterans Affairs patient treatment files as having an alcohol dependence diagnosis were correctly diagnosed by the telephone interview. The results of the present study provide additional evidence for the long-term reliability and validity of lifetime alcoholism diagnoses, and suggest that the reliability and validity of telephone interview assessments of alcoholism are as good as that of an in-person interview. Telephone administration of structured psychiatric interviews appears to be an attractive alternative to in-person interviewing for gathering information about alcoholism and alcohol-related problems.

Adult↗

Statistical methods in genetic research on smoking.

A growing body of evidence suggests that genetic factors have an important influence on the onset and course of smoking. Here we review some of the statistical methods that have been used to test for genetic influences on smoking behaviour, with a particular focus on studies of large national twin samples. We show how many of the hypotheses that have been tested using a genetic model-fitting approach have also been reformulated using logistic regression models that will be more familiar to epidemiologists. Such an approach is more easily extended to allow for sociocultural, as well as genetic, influences on smoking behaviour. Using either approach, data are consistent in indicating that certainly in men, and possibly in women, genetic factors play an important role in predicting which individuals who become cigarette smokers progress to being long-term persistent smokers.

Epidemiologic Methods↗

Effects of lifestyle, personality, symptoms of anxiety and depression, and genetic predisposition on subjective sleep disturbance and sleep pattern.

The effects on sleep pattern ('short-sleep' versus 'long-sleep') and subjective sleep disturbance of genotype, personality, symptoms of anxiety and depression, and lifestyle, were examined using survey data on a clinically unselected sample of adult Australian twin pairs, aged 17-88 years. When the effects of genotype, personality and symptoms were ignored, lifestyle variables appeared to account for roughly 4% of the variance in sleep disturbance, and 9% of the variance in sleep pattern. Significant genetic effects on sleep disturbance and sleep pattern were found, which were only partly explained by the effects of personality and symptoms of anxiety and depression. Much of the association between sleep disturbance and lifestyle appeared to be explained by separate effects of personality and symptoms of anxiety and depression on sleep and lifestyle ('genotype-risk-factor correlation'). There was little evidence for genetically determined differences in sensitivity to the lifestyle variables ('genotype x risk-factor interaction').

Adolescent↗

Interaction of marital status and genetic risk for symptoms of depression.

Depression scores (DSSI) were available for 1232 MZ and 751 DZ female twin pairs who completed a mailed questionnaire. Pairs were divided into those concordant for being in a marriage-like state, concordant for having no partners, and those discordant. The pattern of twin correlations differed according to marital status. Our results suggest that having a marriage-like relationship acts as a protective factor in reducing the impact of inherited liability to symptoms of depression in the general population.

Adolescent↗

Sex differences and non-additivity in the effects of genes on personality.

New large-sample data show that non-additive genetic effects, probably epistatic interactions between loci, and sex-limited gene expression are significant features of the genetic architecture of human personality as measured by questionnaire scales of extraversion and neuroticism. Three large data sets--new data on large samples (n = 20,554) of US twins, their spouses, parents, siblings and children, correlations for Australian twins (n = 7,532), and previously published twin data from Finland (n = 14,288)--are subjected to an integrated analysis to test alternative hypotheses about the genetic causes of family resemblance in personality. When allowance is made for differences in reliability of the scales, the combined data are consistent with the same model for variation. There are significant amounts of genetic non-additivity for both dimensions of personality. The evidence favours additive x additive epistatic interactions rather than dominance. In the case of neuroticism, there is especially strong evidence of sex differences in genetic architecture favouring a greater relative contribution of non-additive genetic effects in males. The data confirm previous claims to find no major contribution of the shared environment of twins and siblings to these dimensions of personality. Correlations between spouses are zero, and the correlations for very large samples of siblings and non-identical twins do not differ significantly.

Diseases in Twins↗

Molecular biology of alcohol dependence, a complex polygenic disorder.

Alcohol dependence, and the medical conditions which arise from prolonged excessive alcohol use, have no single cause. Like other complex diseases, they result from a combination of social, personal and genetic contributions; but within any society genetic variation has a substantial influence on individual risk. The genes presently known to affect alcohol dependence produce variation in alcohol metabolism; other genes which affect personality or susceptibility to intoxication are likely to be significant but so far reproducible evidence is scanty. Designs which include related subjects have advantages for the study of complex diseases, because any association effects can be placed in the context of overall heritability and because linkage analysis can also be included. Examples of our studies of alcohol metabolism, consumption and dependence are presented.

Adult↗

ADH genotypes and alcohol use and dependence in Europeans.

We have tested for effects of alcohol dehydrogenase (ADH) genotypes on self-reported alcohol consumption and symptoms of alcohol dependence, recorded on three occasions up to 15 years apart, in 377 male and female subjects of European descent. ADH2 genotype had significant effects on both consumption and dependence in the men, but not in the women. The effects of ADH3 genotype were considerably less than those of ADH2, but significant results could be demonstrated when the combined genotypes were considered. The direction of the effects on alcohol consumption and dependence risk were consistent with reports on Asian subjects, and with the in vitro properties of ADH isoenzymes. As with previous studies on the relationship between ADH type and alcohol use, population stratification cannot be excluded as a contributing factor in these results.

Adolescent↗

Predictive factors of age at menopause in a large Australian twin study.

Various studies have investigated potential predictors of age at natural menopause but have produced inconsistent results. The relationship between age at natural menopause and socioeconomic, reproductive, and health behavioral factors was evaluated using longitudinal data from 5961 Australian female twins, aged 17 to 88 years at the time of study. The sample consisted of women voluntarily enrolled in the Australian Twin Registry. Failure-time analysis was the principal statistical method used to handle censored observations. Kaplan-Meier estimates showed the overall median age at natural menopause to be 51 years (95% confidence interval, 50-51). Median age at menopause was earlier for women with earlier birth year, women with late age of menarche, women who had no children, or women who were smokers. Differences in age at menopause between social, occupational, and educational groups were statistically significant (Mantel-Cox test, p < 0.001) for education, major occupational classification, combined income, and self-rated social class, with higher age at menopause for higher levels of each variable. A Cox proportional hazards model was used to estimate the odds ratio of the occurrence of natural menopause among different sub-groups, adjusted to reflect simultaneous effects of all other significant covariates. This large study provided clear trends of association in predictors relating to age at menopause. These trends may help to resolve uncertainties and conflicting results identified in studies of comparable white samples. The nature of the twin data also sets a solid background for future analyses of genetic and environmental variance components using statistical modeling or related methods.

Adolescent↗

Smoking, obesity, and hypertension alter the dose-response curve and test sensitivity of carbohydrate-deficient transferrin as a marker of alcohol intake.

Serum carbohydrate-deficient transferrin (CDT) is a specific and comparatively sensitive marker of excessive alcohol use; however, reports of its sensitivity vary according to the population or patient groups studied and their average alcohol intake. We have characterized the dose-response curve between alcohol intake and CDT concentrations in a study of 1400 men and women from a community-based twin registry. Our results show that mean CDT increases with increasing reported alcohol consumption even within the range of alcohol use considered to be nonhazardous. We found significant effects of sex, age, smoking, previous alcohol dependence, body mass index, and diastolic hypertension on the alcohol-CDT dose-response curve. These variables either affect test sensitivity or require adjustment of reference intervals. The results also provide insight into the physiological and biochemical factors that affect CDT concentration.

Adult↗

Characteristics of interview refusers: women who decline to participate in interviews relating to eating.

OBJECTIVES: The aim of this study was to compare the eating habits and weight ranges of 27 women who refused to participate in a semistructured interview on eating with 25 women who agreed to participate, to determine if there were any systematic differences between the two groups. METHOD: The women had previously completed a general psychiatric interview that also included a lifetime DSM-III-R diagnosis of eating disorders. About 2 years after this interview, the women were asked to participate in an interview that would specifically examine eating behaviors. RESULTS: In contrast to the results of previous studies, this study found that there was no difference between women who refused or agreed to participate in an interview about eating, in terms of their eating problems or weight ranges. CONCLUSIONS: It seems that eating or weight problems need not be overrepresented in groups who refuse to participate in surveys about eating, thereby undermining the accuracy of prevalence rates in the general population. Suggestions for achieving this representation are discussed.

Adult↗

The consistency of recalled age at first sexual intercourse.

It is widely believed that people can remember the age at which they first had sexual intercourse. Questions about age at onset are routinely asked in population sexual behaviour surveys and in clinical history-taking. However, there are limited test-retest data, especially with regard to individual differences in unreliable recall. In this study, telephone interviews and follow-ups an average of 15 months later were conducted with 570 non-virgin subjects aged between 28 and 73 years. Test-retest correlations for recalled age at first intercourse were 0.85 for females and 0.91 for males. Consistency was slightly lower among older people and women with a history of sexual abuse. There were no significant associations between consistency of recall and measures of personality, educational background or history of alcohol dependence and depression.

Adult↗

Genetic and environmental contributions to alcohol dependence risk in a national twin sample: consistency of findings in women and men.

BACKGROUND: Genetic influences on alcoholism risk are well-documented in men, but uncertain in women. We tested for gender differences in genetic influences on, and risk-factors for, DSM-III-R alcohol dependence (AD). METHOD: Diagnostic follow-up interviews were conducted in 1992-3 by telephone with twins from an Australian twin panel first surveyed in 1980-82 (N = 5889 respondents). Data were analysed using logistic regression models. RESULTS: Significantly higher twin pair concordances were observed in MZ compared to DZ same-sex twin pairs in women and men, even when data were weighted to adjust for over-representation of well-educated respondents, and for selective attrition. AD risk was increased in younger birth cohorts, in Catholic males or women reporting no religious affiliation, in those reporting a history of conduct disorder or major depression and in those with high Neuroticism, Social Non-conformity, Toughmindedness, Novelty-Seeking or (in women only) Extraversion scores; and decreased in 'Other Protestants', weekly church attenders, and university-educated males. Controlling for these variables, however, did not remove the significant association with having an alcoholic MZ co-twin, implying that much of the genetic influence on AD risk remained unexplained. No significant gender difference in the genetic variance in AD was found (64% heritability, 95% confidence interval 32-73%). CONCLUSIONS: Genetic risk-factors play as important a role in determining AD risk in women as in men. With the exception of certain sociocultural variables such as religious affiliation, the same personality, sociodemographic and axis I correlates of alcoholism risk are observed in women and men.

Adult↗

Modeling genetic and environmental influences in the etiology of conduct disorder: a study of 2,682 adult twin pairs.

The etiology of conduct disorder (CD) was examined retrospectively in a sample of 2,682 male, female, and unlike-sex adult twin pairs from the community-based Australian Twin Register. Model-fitting analyses indicated a substantial genetic influence on risk for CD, accounting for 71% of the variance (95% confidence interval [CI] = 32-79%). There was not a statistically significant effect of the shared environment in the best-fitting model of CD, but a modest effect of the shared environment on the risk for CD could not be rejected (95% CI = 0-32%). The magnitude of genetic and environmental influences for CD liability did not vary significantly for boys and girls, and the specific genetic and environmental mechanisms important for the development of CD appeared to be largely the same for both sexes. The fit of a multiple-threshold model raises the possibility that CD may not necessarily be a discrete entity but rather an extreme of the normal variation in conduct-disordered behavior found in the general population.

Adult↗

A preliminary investigation into resistance to synthetic pyrethroids by the sheep biting louse (Bovicola ovis) in New Zealand.

Increasing reports of failure of synthetic pyrethroids for the control of Bovicola ovis on sheep lead to a preliminary investigation into the insecticide resistance status of this pest during 1994. Eighteen strains of lice from North and South Island flocks experiencing failure of synthetic pyrethroid treatments to control lice were exposed to cypermethrin (high-cis) in a treated surface (contact) bioassay. Lice from a group of hermit sheep were chosen as a reference susceptible strain against which resistance of field strains was measured and resistance factors (RFs) calculated. Low to moderate resistance to cypermethrin (high-cis) was demonstrated, with RFs ranging from 1.0 to 12.4.

Journal Article↗

Participation bias in a sexuality survey: psychological and behavioural characteristics of responders and non-responders.

BACKGROUND: Few studies of sexual attitudes and behaviour have quantified the direction and magnitude of participation bias, primarily because information on non-responders is difficult to obtain in cross-sectional surveys. METHOD: Australian adult twins (n = 9112) aged 17-52 years enrolled in a national, longitudinal research register were asked to participate in a postal survey concerning their sexual behaviour and attitudes. Individual consent was determined by separate return of a consent form; 27% explicitly refused, 19% initially agreed to receive a questionnaire, but subsequently did not return consent forms and 52% explicitly consented. Participation data were matched to social, psychological and behavioural information in a longitudinal data set. RESULTS: People who explicitly consented had higher levels of education, attended church less often, had less conservative sexual attitudes and voting preferences, were more likely to smoke cigarettes and drank alcohol more often than people who explicitly refused. On standard personality scales, responders were more novelty-seeking and reward-dependent and less harm-avoidant than refusers. Structured psychiatric telephone interview data from 3674 individuals showed that, compared to refusers, responders had higher lifetime prevalence of major depression, alcohol dependence and childhood conduct disorder and also reported an earlier age at first sexual intercourse and higher rates of sexual abuse. In general, those who had initially agreed to receive the sex questionnaire but were subsequently lost were more similar to consenters than to refusers. CONCLUSIONS: Effect sizes on most measures were small. The broad profile suggests that postal surveys of sexual attitudes and behaviour may overestimate sexual liberalism, activity and adversity, although this bias should not seriously compromise population estimates.

Adolescent↗

The responses of Lucilia cuprina to odours from sheep, offal and bacterial cultures.

The responses of gravid female Lucilia cuprina to odours from sheep urine, faeces and gut mucus, and to odours from liver/sodium sulphide mixtures was tested using a bioassay which measured the movement and probing response of walking flies. The same bioassay was used to test the response to odours from cultures of bacteria isolated from liver/sodium sulphide and liver/water mixtures. A significant movement towards odours from faeces, gut mucus and urine was observed. Odours from cultures of the bacteria Proteus mirabilis, Dermatophilus congolensis and Serratia marcescens also elicited significant movement. A probing response was elicited by odours from gut mucus, fresh urine, liver/sodium sulphide mixtures and cultures of P.mirabilis, D.congolensis and gram-positive species. Odours from cultures of Pseudomonas aeruginosa, Enterobacter aerogenes and Citrobacter freundii did not elicit significant movement or probing. The movement and probing responses are discussed with reference to the possible uses of the substances tested as a bait for attracting L.cuprina.

Animals↗

Genetics and developmental psychopathology: 1. Phenotypic assessment in the Virginia Twin Study of Adolescent Behavioral Development.

We introduce an overlapping cohort sequential longitudinal study of behavioral development and psychopathology in a representative sample of 1412 pairs of twins aged 8 through 16 years. Multiple phenotypic assessments involve a full psychiatric interview with each child and each parent, and supplementary parental, teacher, and child interview material and questionnaires. For the first wave of assessments, the numbers of reported DSM-III-R symptoms of Major Depressive Disorder (MDD), Separation Anxiety Disorder (SAD), Overanxious Disorder (OAD), Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), and Attention Deficit Hyperactivity Disorder (ADHD), assessed through interviews, confirm patterns of age and sex trends found in other epidemiological samples, but underscore their dependence on whether the child or the parent is the informant. Correlations across domains for symptoms reported by the same informant are often as large as correlations across informants for the same domain of symptoms. Factor analyses of these symptom counts, taking account of informant view and unreliability of assessment, show the high degree of correlation between SAD and OAD, between MDD and OAD, and between CD and ODD. ADHD symptoms are relatively independent of the other domains, but show moderate correlations with CD, ODD, and MDD. Factorially derived dimensional questionnaire scales, based on child, parental, and teacher reports, show patterns of relationship to symptom counts consistent with both convergent and discriminant validity as indices of liability to clinical symptoms. Across informants, questionnaire scales provide as good a prediction of symptoms as do clinical interviews. Multitrait-multimethod confirmatory factor analysis reveals the patterns of relationship between symptoms of psychiatric disorder in children taking due account of informant and unique sources of variance. Gender differences are consistent within the correlated clusters of ODD/CD and MDD/SAD/OAD, although there are disorder-specific age trends. There are large informant-specific influences on the reporting of symptoms in clinical interviews. Dimensional questionnaire scales provide a useful source of additional information. In subsequent analyses of genetic and environmental etiology of childhood psychopathology we must expect that results may differ by informant and method of assessment. Multivariate and developmental analyses that explore the sources of these differences will shed new light on the relationship between genetic and environmentally influenced vulnerability and the manifestation of psychopathology in specific circumstances.

Adolescent↗