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Biomedical subjects

A Holman

Publications and source records attributed to A Holman.

7 recordsLinked to original sources
PubMed1998

A hierarchical classes analysis (HICLAS) of primary care patients with medically unexplained somatic symptoms.

This study used a clustering model, Hierarchical Classes Analysis (HICLAS), to examine patient groupings in a multiethnic sample of 1456 patients using primary care services at a university-affiliated community clinic in southern California. Somatic symptoms, psychiatric diagnoses and disability were studied using a survey instrument that included portions of the Composite International Diagnostic Interview (CIDI), the Diagnostic Interview Schedule (DIS) and the RAND-MOS Short Form Health Survey's (SF-36) 'physical functioning' dimension. HICLAS identified 11 clusters of patients with distinct patterns of medically unexplained somatic symptoms. These patient clusters varied with respect to psychiatric diagnoses and symptoms, gender, immigration status and disability. Results of this study suggest that the type of presenting symptom(s) and their various combinations may have diagnostic and prognostic value in primary care settings. These new findings may lead to further refinement of current diagnostic constructs for somatizing syndromes.

Adolescent↗
PubMed1998

DSM-IV hypochondriasis in primary care.

The object of this study was to assess the prevalence and correlates of the DSM-IV diagnosis of hypochondriasis in a primary care setting. A large sample (N = 1456) of primary care users was given a structured interview to make diagnoses of mood, anxiety, and somatoform disorders and estimate levels of disability. The prevalence of hypochondriasis (DSM-IV) was about 3%. Patients with this disorder had higher levels of medically unexplained symptoms (abridged somatization) and were more impaired in their physical functioning than patients without the disorder. Of the various psychopathologies examined, major depressive syndromes were the most frequent among patients with hypochondriasis. Interestingly, unlike somatization disorder, hypochondriasis was not related to any demographic factor. Hypochondriasis is a relatively rare condition in primary care that is largely separable from somatization disorder but seems closely intertwined with the more severe depressive syndromes.

Adolescent↗
PubMed1998

Somatisation disorder in primary care.

BACKGROUND: Somatisation is a common and frustrating clinical problem in primary care. METHOD: Using structural diagnoses and functional measures, we examined the prevalence and associated features of somatisation disorder defined by three current nosologies and an abridged construct in subjects using primary care services. RESULTS: Somatisation disorder, diagnosed according to the standard criteria, was found to have a very low prevalence (range 0.06-0.5%), while more than one-fifth of the sample (22%) met the criteria for the abridged diagnosis. There was poor agreement between succeeding versions of the DSM system for identifying cases of somatisation disorder, each system ending up with rather disparate sets of individuals as well as variable levels of psychopathology and disability. CONCLUSIONS: According to these data, standard somatisation disorder diagnoses add little to the prediction of disability/psychopathology beyond the contributions of an abridged construct of somatisation.

Adolescent↗
PubMed1994

Optimism in children's judgments of health and environmental risks.

Although optimistic bias has been well documented for adults, little is known about how children view their own risks vis-à-vis those of their peers. Two studies of 6th graders examined optimism and the degree of differentiation in perceived risks across diverse health, lifestyle, and environmental problems. The findings revealed perceptions of relative invulnerability and highly differentiated risk assessments. The strongest levels of optimism emerged for controllable and stigmatizing events such as illicit drugs, smoking, and AIDS. The effects of gender, assessment context, and methodological variations were minimal. Discussion focused on the implications for health-promoting interventions with school-age children, the need for developmental information about risk perception processes, and the difficulty of distinguishing realistic from biased optimism.

Adolescent↗
PubMed1994

Preadolescents' perceptions of AIDS before and after Earvin Magic Johnson's announcement.

Compared sixth graders' AIDS concerns before and after Magic Johnson announced that he tested HIV-positive. Examined perceptions of self/other vulnerability (optimistic bias) using questionnaires (Study A) and interviews (Study B). Also examined AIDS worries mentioned in open-ended interviews (Study C). Studies A and B revealed a substantial degree of optimistic bias. Study C showed that AIDS is a prime concern of school-age students, mentioned under free or context-cued conditions by about 50%. There was little detectable effect of the publicity; the sole before--after difference in three studies was one increase in self- and other-vulnerability to AIDS--an increase attributable, with marginal significance, only to girls. Discussed implications for health promotion and differences between assessment approaches.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Abridged somatization: a study in primary care.

OBJECTIVE: We examined the prevalence, correlates, and predictive value of an abbreviated somatization index, based on specific symptom thresholds, in primary care patients using services at a university-affiliated clinic. METHOD: We interviewed 1456 patients with a survey instrument that included the Composite International Diagnostic Interview (CIDI) to elicit symptoms and diagnoses of several psychiatric disorders as well as demographic information and a measure of disability. Statistical analyses examined the relationship of abridged somatization with physical functioning and various demographic and diagnostic factors. RESULTS: About one fifth of this primary care sample met the abridged somatization criteria. "Somatizers," defined according to these criteria, had significantly higher levels of psychiatric comorbidity and disability than "nonsomatizers". Analyses taking into account the number and type of organ/body systems represented by the unexplained symptoms showed that this dimension adds specificity to the prediction of outcomes. Thus, regardless of the total number of medically unexplained symptoms, abridged somatization with unexplained symptoms attributable to four or more organ/body systems showed the strongest association with disability and psychopathology. CONCLUSIONS: Abridged Somatization is a frequent syndrome in primary care that is strongly associated with psychopathology and physical disability. Our research also yielded a new series of abridged somatization subtypes (eg, "discrete" vs. "comorbid" and "simple" vs. "polymorphous") that may effectively separate among various psychopathologies, and may become useful tools for future research with somatizing patients.

Adolescent↗