Adolescent panic attacks are associated with increased risk of personality disorder as a young adult.
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Comment↗
Biomedical subjects
Andrew J Baillie
Publications and source records attributed to Andrew J Baillie.
Predictive gender and education bias in Kessler's psychological distress Scale (k10).
BACKGROUND: Kessler's Psychological Distress Scale (K10) is a ten-item measure of psychological distress that has been used in recent epidemiological research and as a screen for mental disorders. Moderate relationships have been reported between the K10 and measures of related constructs, such as diagnoses of mental disorders and associated disability. However, it is unclear whether the validity of the K10 is consistent across important demographic, cultural, and socio-economic groups such as gender and educational history or whether there is evidence of predictive bias or inconsistency across these groups. METHODS: Differential validity or predictive bias in the relationship between K10 scores and disability days, SF12 Mental Component Summary (MCS) scores, and 1-month Composite International Diagnostic Interview (CIDI) diagnoses of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Anxiety and Depressive disorders due to gender and completing secondary school were examined using hierarchical linear and logistic regression analyses in the Australian National Survey of Mental Health and Wellbeing data set. RESULTS: Very small slope and/or intercept biases in the relationship between the K10 and disability days, the SF12 MCS, and 1-month CIDI diagnoses of anxiety and depression were found [effect sizes, the ratio of variance explained to unexplained variance (Cohen's f2), varied from 0.0001 to 0.004]. CONCLUSION: Gender and educational predictive biases in the relationship between the K10 and disability days, SF12 MCS, and 1-month diagnoses were found to be very small and are unlikely to have any practical impact. This analysis adds to evidence supporting the use of the K10 in epidemiological research.
Adolescent↗
The structure of alcohol dependence in the community.
BACKGROUND: Although dependence on alcohol appears to be a reliable unitary construct, abuse has not found a similar level of support as a separate construct. This paper describes a confirmatory factor analysis of the DSM-IV alcohol abuse and dependence criteria in a general population sample. METHODS: Data from alcohol drinkers (n = 7746) were obtained from a cross-sectional study of a large, representative sample of the Australian general population. One- and two-factor solutions for the DSM-IV criteria for abuse and dependence (assessed by CIDI-Auto) were compared using confirmatory factor analysis. RESULTS: Approximately 74% of Australians had used alcohol 12 or more times in the past year and 19% met at least one DSM-IV alcohol abuse or dependence criterion. Overall 6% met criteria for an alcohol use disorder (1.9% abuse, 4.1% dependence). More men than women met criteria for an alcohol use disorder and the prevalence of alcohol use disorders decreased with increasing age. Both one- and two-factor solutions from the confirmatory factor analyses provided an adequate fit to the data for the overall sample. The correlation between the abuse and dependence factors in the two-factor model was extremely high (0.95). CONCLUSION: Alcohol abuse and dependence criteria were most parsimoniously described by a single continuous construct incorporating all eleven abuse and dependence criteria.
Adolescent↗
Panic attacks as risk markers for mental disorders*.
OBJECTIVE: This paper extends previous epidemiological findings linking panic attacks with future episodes of depression and examines whether this relationship is independent of the effects of gender and neuroticism. METHODS: Composite International Diagnostic Interview (CIDI) DSM-IV diagnoses from a stratified multi-stage population survey of 10,641 Australian adults were analysed using logistic regression to examine the relationship between lifetime panic attacks, gender, neuroticism and mental disorders. RESULTS: People who experienced full CIDI DSM-IV panic attacks more than 12 months ago were 4 times more likely to meet criteria for current Depressive Disorder than those who reported no attacks. Those with panic attacks in the past 12 months were 13.3 times more likely to report current Depressive Disorders. A similar pattern was also present for non-panic Anxiety Disorders (odds ratio=7.5 for lifetime, but not 12-month panic attacks, and 21.46 for 12-month panic attacks) and for Substance Use Disorders (2.1 and 4.6, respectively) suggesting a broader relationship with psychopathology than previously reported. For each of these groupings of mental disorders, panic attacks accounted for significant variability over and above the effects of gender, neuroticism, and comorbid Anxiety Disorders. CONCLUSIONS: Panic attacks are associated with current and future Anxiety, Depressive, and Substance Use Disorders, and this relationship is not solely accounted for by differences in gender and neuroticism.
Adult↗
A new approach in the determination of the minimal clinically meaningful difference.
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Data Interpretation, Statistical↗
Predicting who benefits from psychoeducation and self help for panic attacks.
UNLABELLED: Self-help and psychoeducation have been identified as effective methods for delivering treatment, yet not everyone benefits from these brief interventions. Therefore it is clinically and economically useful to identify who is likely to require more intensive assistance. This paper develops a prognostic scale which predicts who will recover from panic attacks and who will require more assistance. METHOD: Random regression models were used to evaluate the relationship between predictive variables, baseline severity, and the rate of improvement in 117 people with DSMIV panic attacks who participated in a trial of a psycho-educational booklet, a self-help workbook, and brief group CBT over a 9-month period. ROC analysis was used to choose cut-off points on a scale made up of significant predictors. RESULTS: Panic disorder and agoraphobia symptom measures were predicted by baseline social anxiety, and general mental health. There was no significant effect on the outcome for baseline depression or anxiety sensitivity. While general mental health (SF12 Mental Component scores) was predicted by the age at first panic attack, neuroticism, panic disorder and/or agoraphobia symptoms and a positive screen for alcohol use disorders. A prognostic scale based on simple additive scoring was equivalent to standard scores and significantly better than chance at predicting who would recover and who required face-to-face therapy. CONCLUSIONS: The prognostic scale may be used to guide the choice of psychoeducation, self-help or face-to-face therapy as the first step in stepped care.
Adult↗