PubMed Health⌕ Search

Biomedical subjects

C A Prescott

Publications and source records attributed to C A Prescott.

At least 73 records · Page 4Linked to original sources
PubMed1998

Latent class analysis of temperance board registrations in Swedish male-male twin pairs born 1902 to 1949: searching for subtypes of alcoholism.

BACKGROUND: Alcoholism is clinically heterogeneous. We have attempted to identify and validate subtypes of broadly defined alcoholism. METHODS: Latent class analysis (LCA) was applied to data on the number, age at onset and reasons for temperance board registration (TBR) in all male-male twin pairs of known zygosity born in Sweden from 1902-1949. RESULTS: Of the five classes identified, two were relatively common: single-cause registrant-drunk (SCR-D); and early-onset multiple-cause registrant (EO-MCR). In contrast to the SCR-D class, the EO-MCR class was characterized by: (i) earlier age at first TBR; (ii) higher number of TBRs; (iii) TBRs for drunk driving and alcohol-related crimes; (iv) much higher risk for alcohol-related imprisonment and hospitalization; (v) higher levels of neuroticism and novelty-seeking; and (vi) much greater risk for TBR in co-twins. In twin pairs concordant for TBR, concordance for LCA-derived class assignment far exceeded chance expectation, more so in monozygotic than in dizygotic pairs. CONCLUSIONS: Alcoholism is aetiologically as well as clinically heterogeneous. The two most common subtypes identified in these analyses bear substantial but imperfect resemblance to previously proposed typologies.

Alcoholism↗
PubMed1998

A population-based twin study of self-esteem and gender.

BACKGROUND: Self-esteem (SE), a widely used construct in the social sciences, is usually conceptualized as a reflection of socialization and interpersonal experiences that may differ considerably between the genders. METHODS: The Rosenberg self-esteem scale was assessed at personal interview in both members of 3793 unselected twin pairs (1517 male-male, 856 female-female and 1420 male-female) from the population-based Virginia Twin Registry. Gender effects on SE were assessed by both analysis of variance and biometrical twin modelling. RESULTS: The mean SE score was slightly but significantly lower in women v. men, and in women who grew up with a male v. a female co-twin. Twin modelling suggested that: (i) individual differences in self-esteem in both men and women were best explained by genetic and individual-specific environment factors; (ii) heritability estimates were similar in women (32%) and in men (29%); and (iii) the same genetic factors that influenced SE in women also influenced SE in men. Analyses supported the validity of the equal environment assumption for SE. The heritability of SE cannot be explained by the moderate correlation between SE and symptoms of depression. CONCLUSIONS: These results are inconsistent with prominent gender-related aetiological models for SE, which postulate that individual differences arise from socialization experiences both within and outside the home of origin which differ widely for the two genders. Instead, a significant proportion of the population variance in SE is due to genetically-influenced temperamental variables that are the same in men and women.

Adolescent↗
PubMed1998

Prediction of major depression and dysthymia from CES-D scores among ethnic minority adolescents.

OBJECTIVE: The Native Hawaiian Mental Health Research Development Program is an epidemiological longitudinal study of adolescents residing in Hawaii. This article examines the utility of the Center for Epidemiologic Studies-Depression Scale (CES-D) for predicting DSM-III-R diagnoses of major depression (MD) and dysthymic disorder (DD) and investigates whether prediction differs by gender and ethnicity. METHOD: Diagnostic Interview Schedule for Children interviews were conducted with 556 adolescents randomly selected from among more than 7,000 students who had completed the CES-D. RESULTS: Six-month prevalence rates were as follows: MD = 8.5%, DD = 4.7%, either (MDDD) = 9.9%. Prevalence rates were significantly higher among females, but after CES-D scores were accounted for, gender no longer predicted depression in most analyses. When a cutoff score of 16 was used, classification accuracy was lower for Native Hawaiians than non-Hawaiians. However, after group differences in gender and grade level were accounted for, the predictive validity of the CES-D did not differ by ethnicity. CES-D factor 1 scores identified MD, DD, and MDDD about as well as the total score or all three factors together. CONCLUSIONS: These results support the validity of the CES-D for screening for depression among adolescents of Native Hawaiian and other minority backgrounds.

Adolescent↗
PubMed1998

Stressful life events and major depression: risk period, long-term contextual threat, and diagnostic specificity.

Although stressful life events (SLEs) play a major role in many etiologic theories of major depression (MD), important questions remain about the nature of their association with the onset of depressive episodes. We assessed over the last year, in female twins ascertained from a population based registry, the occurrence of 15 classes of SLEs and the onset of DSM-III-R MD and 2-week generalized anxiety disorder (GAD). The sample contained 24,648 person-months, 316 onsets of MD, and 239 onsets of GAD. SLEs were rated on long-term contextual threat and dependence. Discrete time-survival analyses were employed. The association between SLEs and depressive onsets was usually strongest in the month of occurrence but extended for "difficulty-like" events for up to 6 months. The depressogenic effect of SLEs was strongly predicted by contextual threat level, although some low threat events significantly increased risk for MD. The risk for a depressive onset given the number of reported SLEs within one month was: no event, 0.9%; one, 3.4%; two, 6.8%; and three, 23.8%. Although a few events were relatively specifically depressogenic or anxiogenic, most SLEs increased risk for both MD and GAD. The risk period produced by SLEs range from short-lived to relatively prolonged. High threat events encompass most but not all of the depressogenic effects of SLEs. Multiple SLEs in the same month substantially increase the risk for a depressive onset. The specificity of most SLEs for depressive versus anxiety syndromes is modest.

Adult↗
PubMed1998

Cannabis use, abuse, and dependence in a population-based sample of female twins.

OBJECTIVE: The rate of cannabis use by women has been increasing in recent decades. This study examined the etiology of cannabis use and abuse among women and the possible role of genetic risk factors. METHOD: Unselected individual twins (N=1,934) from female-female pairs ascertained through a population-based registry, including both members of 485 monozygotic pairs and of 335 dizygotic pairs, were interviewed by telephone to assess lifetime cannabis use, heavy use, abuse, and dependence as defined by DSM-IV criteria. Biometric model fitting was performed with the Mx computer package. RESULTS: The prevalences of lifetime cannabis use, heavy use, abuse, and dependence were 47.9%, 6.7%, 7.2%, and 2.2%, respectively. Model fitting suggested that twins' resemblance for liability to cannabis use was due to both genetic and familial-environmental factors, while twins' resemblance for heavy cannabis use and abuse and symptoms of dependence resulted solely from genetic factors, with heritabilities ranging from 62% to 79%. The frequency of adolescent social contact between co-twins, which was greater among monozygotic than among dizygotic twins, predicted the twins' resemblance in cannabis use. However, further analyses suggested that the heritability of cannabis use was at most modestly inflated by such social factors. CONCLUSIONS: In women, genetic risk factors have a moderate impact on the probability of ever using cannabis and a strong impact on the liability to heavy use, abuse, and, probably, dependence. By contrast, the family and social environment substantially influences risk of ever using cannabis but plays little role in the probability of developing heavy cannabis use or abuse.

Adult↗
PubMed1998

Multivariate genetic analysis of the causes of temperance board registrations. In all Swedish male-male [correction of male-female] twin pairs born 1926-1949.

BACKGROUND: The Temperance Boards in Sweden registered individuals for three reasons: public drunkenness, driving under the influence of alcohol and committing a crime in connection with alcohol. We wanted to ascertain whether these three forms of alcohol-related problems result from similar or different genetic and environmental risk factors. METHOD: We conducted a trivariate twin analysis of these three causes of registration in all male-male [corrected] twin pairs of known zygosity born in Sweden, 1926-1949 (n = 5177 twin pairs). RESULTS: Prevalences of registration for public drunkenness, drink-driving and alcohol-related crime were, respectively, 9.0, 3.6 and 4.0%. The best-fitting model had one general genetic and one general familial-environmental factor with specific genetic risk factors for drink-driving and specific familial-environmental risk factors for alcohol-related crime. CONCLUSIONS: The three causes for alcohol registration in Sweden largely reflect the same genetic and environmental risk factors. Estimated heritabilities were similar for the three forms of registration. However, specific genetic risk factors exist for drink-driving and specific familial-environmental risk factors for alcohol-related crime. Genetic factors are somewhat less important and familial-environmental factors more important for public drunkenness than for drink-driving and alcohol related crime.

Alcoholic Intoxication↗
PubMed1998

Cocaine use, abuse and dependence in a population-based sample of female twins.

BACKGROUND: Although cocaine use in women has increased substantially over the past half-century, we understand little about the aetiology in women of cocaine use and abuse, and know almost nothing about the role of genetic factors. METHOD: We obtained by telephone interview a history of lifetime cocaine use, abuse and dependence from 1934 individual twins from female-female pairs ascertained through a population-based registry, including both members of 485 monozygotic (MZ) and 335 dizygotic (DZ) pairs. RESULTS: The prevalence of lifetime cocaine use, abuse and dependence were 14.0%, 3.3% and 2.3%. Probandwise concordance rates, in MZ and DZ twins, respectively, were: cocaine use 54% and 42%; cocaine abuse 47% and 8% and cocaine dependence 35% and 0%. In MZ and DZ twins, odds ratios were: cocaine use 14.2 and 6.7 and cocaine abuse 40.8 and 2.7. Biometrical model-fitting suggested that twin resemblance for liability to cocaine use was due to both genetic and familial-environmental factors while twin resemblance for cocaine abuse and symptoms of dependence was due solely to genetic factors. Estimated heritabilities were: cocaine use 0.39, cocaine abuse 0.79 and symptoms of dependence 0.65. CONCLUSIONS: The vulnerability to cocaine use and particularly cocaine abuse and dependence in women is substantially influenced by genetic factors.

Adult↗
PubMed1997

Temperance board registration for alcohol abuse in a national sample of Swedish male twins, born 1902 to 1949.

BACKGROUND: Temperance boards were established in Sweden to register and follow up individuals who were seen in legal or medical settings with problems of alcohol abuse. These records, available in a large epidemiologic twin population, have provided an objective and validated measure of alcohol abuse. METHODS: We examined Swedish temperance board registrations from 1929 to 1974 (n = 2516 individual twins) in all male-male Swedish twin pairs of known zygosity from the population-based Swedish Twin Registry; these twin pairs were born from 1902 to 1949 (n = 8935 pairs). RESULTS: The lifetime prevalence and probandwise concordance rates for temperance board registrations were 13.2% and 47.9%, respectively, in monozygotic twins and 14.6% and 32.8%, respectively, in dizygotic twins. Model fitting suggested that genetic and familial-environmental risk factors accounted for 54% (95% confidence interval [CI], 47%-61%) and 14% (95% CI, 8%-19%) of the liability to temperance board registration, respectively; these estimates were stable across birth cohorts. High genetic liability was reflected by large numbers of temperance board registrations and registrations for criminal alcohol use. Elevated familial-environmental liability was indicated by an early age at first registration. CONCLUSIONS: Genetic factors are of major etiologic importance for alcohol abuse in men, while familial environmental factors play a significant but less important role. The etiologic importance of these factors has remained constant in Sweden for men who were born in the first half of the 20th century.

Adult↗
PubMed1997

Laparoscopic cholecystectomy-related bile duct injuries: a health and financial disaster.

OBJECTIVE: This study was designed to evaluate the total costs associated with repair of laparoscopic cholecystectomy (LC)-related bile duct injuries. SUMMARY BACKGROUND DATA: The popularity of LC with both patients and surgeons is such that this procedure now exceeds open cholecystectomy by a ratio of approximately 4 to 10:1. However, costs associated with LC-related injuries, particularly regarding treatment patterns, have up to now not been explored fully. METHODS: The complete hospital and interventional radiology (IR) billing records for 49 patients who have completed treatment for laparoscopic cholecystectomy-related bile duct injuries were divided into 8 categories. These records were totaled for comparison of costs between patient groups that experienced different injuries and treatment patterns. RESULTS: Patients with LC-related bile duct injuries were billed a mean of $51,411 for all care related to repair of their bile duct injury. Patients incurred an average of 32 days of inpatient hospitalization and 10 outpatient care days. Postoperative treatment included long-term chronic biliary intubation averaging 378 days. Two patients (4%) died as a result of their LC-related complications. Patients with bile duct injuries that were recognized immediately at the time of the initial surgery ultimately experienced a total cost for their repair and hospitalization of 43% to 83% less than for patients in whom recognition of the injury was delayed (p < 0.019 to 0.070). In addition, the total hospitalization and outpatient care days was reduced by as much as 76% with early recognition of an iatrogenic injury. CONCLUSIONS: Repair of cholecystectomy-related bile duct injuries can run 4.5 to 26.0 times the cost of the uncomplicated procedure and carries a significant mortality rate. Intraoperative recognition of such an injury with immediate conversion to an open procedure for definitive repair can result in significant cost savings and relates directly to a decreased morbidity, mortality, length of hospitalization, and number of outpatient care days.

Adult↗
PubMed1997

Religion, psychopathology, and substance use and abuse; a multimeasure, genetic-epidemiologic study.

OBJECTIVE: The authors sought to 1) understand the sources of familial resemblance for religiosity, 2) clarify the relationship between religiosity and current psychiatric symptoms, current substance use, lifetime psychiatric disorders, and lifetime substance dependence, and 3) explore the stress-buffering properties of religiosity. METHOD: Data were obtained by personal interview of 1,902 twins from female-female pairs in the population-based Virginia Twin Registry. Measures included 1) 10 items reflecting a range of religious behavior and beliefs, 2) a scale of institutional conservatism of current religious affiliation, 3) previous history of stressful life events, 4) current psychiatric symptoms and substance use, and 5) lifetime psychiatric disorders and substance dependence. Statistical methods used included factor analyses, Cox and linear regression, and twin modeling. RESULTS: Personal devotion and personal and institutional conservatism were all strongly familial, and model fitting suggested that this familial resemblance was due largely to the effect of environmental factors. None of the dimensions of religiosity was strongly associated with lifetime psychopathology or current symptoms, but low levels of depressive symptoms were related to high levels of personal devotion. By contrast, personal devotion and personal and institutional conservatism were significantly and inversely associated with current levels of drinking and smoking as well as lifetime risk for alcoholism and nicotine dependence. Personal devotion, but not personal or institutional conservatism, buffered the depressogenic effects of stressful life events. CONCLUSIONS: The dimensions of religiosity are not strongly related to risk for psychiatric symptoms and disorders. However, religiosity may be one of the more important familial-environmental factors that affect the risk for substance use and dependence. Religious devotion but not conservatism assists in coping with stress.

Adaptation, Psychological↗
PubMed1997

Predictors of problem drinking and alcohol dependence in a population-based sample of female twins.

OBJECTIVE: To identify characteristics associated with problem drinking (PD) and alcohol dependence (AD) in women. METHOD: Subjects were 2,163 white women aged 17-55 from the population-based Virginia Twin Registry. Measures were selected from a clinical interview and questionnaires to reflect five domains associated with alcoholism in prior studies; demographic characteristics, personality, health, and personal and family history of psychopathology. Logistic and linear regression analyses were used to predict PD and DSM-III-R defined AD. RESULTS: Multiple regression models accounted for 19% of the variance in PD (significant predictors included: higher parental education-particularly among younger women, being the primary breadwinner, less frequent church attendance, higher scores on measures of neuroticism, extraversion and interpersonal dependency, history of major depression and social phobia, paternal PD and maternal treatment for emotional problems); 9% of the variance in diagnosis of AD (predicted by generalized anxiety, paternal depression and maternal PD); and 20% of the variance in number of symptoms of AD (predicted by the interaction of younger age and less-educated parents, higher neuroticism and mastery, lower optimism, generalized anxiety and agoraphobia, and maternal PD). CONCLUSIONS: Personality characteristics and parental psychopathology are important predictors of PD and AD independent of their effect on risk for affective and anxiety disorders. Many characteristics found to be associated with PD and AD in bivariate analyses were not significant when considered in the context of other predictors. Future studies of the etiology of alcoholism among women should simultaneously study measures from a variety of domains.

Adolescent↗
PubMed1996

Childhood parental loss and alcoholism in women: a causal analysis using a twin-family design.

Childhood parental loss may be an important risk factor for psychiatric illness in adulthood. While this association has been carefully examined for depression, little is known about the role of parental loss in predisposing to alcoholism. We examined an epidemiological sample of female twin pairs with the same history of continuity or disruption in parent-child relationships (N=1018 pairs; mean age 30 years), using a range of definitions of alcoholism. Childhood parental loss through separation, but not death, substantially increased the risk in adulthood for all definitions of alcoholism. Furthermore, both paternal and maternal alcoholism substantially increased the probability of parental separation from their children. Proposing a structural equation twin-family model that incorporates childhood parental loss as a specified environmental risk factor, we examined how much of the association between childhood parental loss and alcoholism was causal (i.e. mediated by environmental factors) v. non-causal (mediated by genetic factors, with parental loss serving as an index of parental genetic susceptibility to alcoholism). Both the causal and non-causal paths were significant for all definitions of alcoholism. However, the causal-environmental pathway consistently accounted for most of the association. While a significant proportion of the association is due to non-causal genetic mechanisms, childhood parental loss (or the familial discord that precedes or follows it) is probably a direct and significant environmental risk factor for the development of alcoholism in women.

Adult↗
PubMed1995

Cleft larynx: repair with a posterior cartilage graft.

A 4-year-old child presenting with airway obstruction caused by oedema in redundant mucosa associated with an Evans Type 2 laryngeal cleft had the cleft repaired via a laryngofissure. The defect in the posterior lamina of the cricoid cartilage was repaired with a costal cartilage graft to produce a near normal post-operative contour to the subglottic lumen.

Child, Preschool↗
PubMed1995

A survey of ear and hearing disorders amongst a representative sample of grade 1 schoolchildren in Swaziland.

A representative sample of Grade 1 (first year school entry) schoolchildren in Swaziland were surveyed during a single week to determine the prevalence of ear and hearing disorders: 79.8% had both normal ears and normal hearing, 16.8% had an ear disorder, but 80% of them had normal hearing. The most common disorder was impacted wax, with a prevalence rate of 74/1000. Middle ear disorders were common and the prevalence rate for children with active middle ear disease was 30/1000 (17/1000 having a hearing loss), and for children with inactive ear disease, the prevalence was 21/1000 (5/1000 having a hearing loss); 8/1000 children were found to have a sensorineural hearing loss, 5.3/1000 unilateral and 2.1/1000 bilateral. Improved treatment of acute otitis media, which is also common in the pre-school age group, could reduce the sequelae of the disorder, which has a deleterious effect on hearing and impairs educational achievement once the children enrol at school.

Acoustic Impedance Tests↗
PubMed1995

Peak nasal inspiratory flow measurement: an investigation in children.

Theoretically measurement of peak nasal inspiratory flow (PNIF) has promise as a method to objectively evaluate children with nasal airway obstruction. This study establishes normative data for children up to 8 years of age. PNIF increases linearly from a mean value of 30 l/min in early infancy up to a mean value of 80 l/min at age 8 years, apart from a dip at 3 years. There is a reasonably linear incremental rise with increasing height and weight. However, since results depend on both the degree of co-operation of the child and on the subjective impression of the observer as to when a maximal inspiratory effort has been made, there may be drawbacks to its use as a routine clinical method of nasal airway obstruction assessment.

Body Height↗
PubMed1995

Pharyngeal and pharyngolaryngeal bands: report of an unusual combination of congenital anomalies.

Multiple abnormal pharyngeal and pharyngolaryngeal bands were present in a child presenting with diffuse interstitial pulmonary fibrosis. The soft palate was fused to the posterior pharyngeal wall. Instead of there being facial pillars, a muscular band on either side extended from the base of the tongue to the lateral pharyngeal walls. There was neither tonsil nor adenoid tissue present. The epiglottis was tethered to the posterior pharyngeal wall by bands from its lateral aspects. The right arytenoid mound was tethered to the posterior wall of the hypopharynx. It is postulated that these arose from a failure of development of the second branchial pouch.

Branchial Region↗