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Biomedical subjects

C G Watson

Publications and source records attributed to C G Watson.

At least 37 records · Page 2Linked to original sources
PubMed1994

A comparison of combat's effects on PTSD scores in veterans with high and low moral development.

This study was designed to explore the effects of moral development on the relationship between combat intensity and severity of posttraumatic stress disorder. The effect of combat intensity on PTSD Interview total scores and several individual stress disorder symptom ratings was substantial in a Low Moral Development sample, but negligible in a High Moral Development group. These data suggest that moral development may blunt the effect of combat severity on PTSD. These effects were strongest on items that describe reexperiencing of the trauma and exaggerated arousal. Possible interpretations of the results and several caveats were discussed.

Adult↗
PubMed1994

A comparison of four PTSD measures' convergent validities in Vietnam veterans.

We compared the convergent validities of four commonly used post-traumatic stress disorder (PTSD) measures in 80 help-seeking Vietnam veterans by contrasting their intercorrelations. When scored as continuous severity or frequency measures, the Mississippi Scale for Combat-related PTSD's and the Post-Traumatic Stress Disorder Interview's (PTSD-I's) concordances with other measures were similar to one anothers' and generally larger than those of either the Diagnostic Interview Schedule (DIS) PTSD module or the MMPI PTSD scale. However, when used only to identify stress disorder's presence or absence, the four techniques' concordances were nearly identical. This suggested that the four measures have similar convergent validities when used simply to identify PTSD, but that the PTSD-I and Mississippi scale offer better convergent validity than the MMPI or DIS instruments when used as severity measures.

Adult↗
PubMed1993

Two studies of reported pretraumatic stressors' effect on posttraumatic stress disorder severity.

We contrasted in two studies the effects of military trauma on Vietnam veterans who reported high and low premilitary stress. In the first, we administered the Posttraumatic Stress Disorder Interview (PTSD-I), a premilitary modification of the Social Readjustment Rating Scale, and the Military Stress Scale to hospitalized veterans. Premilitary stress appeared to reduce the impact of combat on several trauma-reexperiencing ratings, although the relevant evidence was inconsistent. In the second study, the premilitary stress main effects and the premilitary stress/combat interactions on four PTSD-I factors were nonsignificant. Thus, the severities of most PTSD symptoms increased with trauma intensity, but not with milder premilitary stress. The inconsistent data on the impact of pretraumatic stress on the trauma severity/PTSD relationships suggest further study.

Adult↗
PubMed1993

Ethics for medical group managers: patient-centered or bottom-line?

Many physicians hire financial directors and accountants to manage their bottom line. While most of us had courses in financial and operations management, ethics was not a major part of the curriculum. This professional paper will define several ethical theories. After applying these to three moral issues--marketing, fee setting and rationing--it will outline a values clarification plan and finally will conclude by providing a framework for making moral decisions, realizing, of course, that the study of ethics offers no right or wrong responses.

Advertising↗
PubMed1993

Ethics for medical group managers: patient-centered or bottom-line?

Many physicians hire financial directors and accountants to manage their bottom line. While most of us had courses in financial and operations management, ethics was not a major part of the curriculum. This professional paper will define several ethical theories. After applying these to three moral issues--marketing, fee setting and rationing--it will outline a values clarification plan and finally will conclude by providing a framework for making moral decisions, realizing, of course, that the study of ethics offers no right or wrong responses.

Advertising↗
PubMed1993

Endothelin-1 gene expression in human pheochromocytoma.

We examined expression of human endothelin-1 (ET-1) in adrenal tissues removed from five patients with pheochromocytomas and two patients with aldosterone-producing adenomas. The pheochromocytomas contained a 2.3 kilobase ET-1 transcript, which was not found int he aldosteronomas. Constitutive expression of ET-1 varied in magnitude among the pheochromocytomas but was generally at a low level. Immunohistochemical staining of the pheochromocytomas with an antiserum to human ET-1 showed the presence of immunoreactive ET-1 as well. The presence of ET-1 messenger ribonucleic acid and ET-1 immunoreactivity in human pheochromocytomas suggests a possible paracrine role for this peptide in human chromaffin cells.

Adenoma↗
PubMed1993

Success of unilateral neck exploration for sporadic primary hyperparathyroidism.

BACKGROUND: Unilateral neck exploration for primary hyperparathyroidism (PHPTH) is controversial because of concern about missed multiglandular disease. METHODS: In patients with sporadic PHPTH our approach has been arbitrarily to surgically explore the right neck first unless preoperative or intraoperative evidence suggests left-sided parathyroid pathologic condition. When an adenoma is identified and a normal ipsilateral gland is confirmed on histologic examination, the contralateral side is not explored. A 15-year series of 371 patients with sporadic PHPTH was reviewed retrospectively to determine the efficacy of this strategy. RESULTS: At operation unilateral exploration was possible in 125 patients (34%). Of these 122 had a single adenoma and two patients had parathyroid carcinoma. One patient with unrecognized hyperplasia required subsequent subtotal parathyroidectomy. There were no major complications. Bilateral surgical exploration was required in 246 patients including 18 with hyperplasia, 4 with double adenomas, and 4 with parathyroid cancer. Bilateral surgical exploration failed in 18 patients (14 persistent and 4 recurrent PHPTH) and was complicated by one recurrent nerve palsy and two cases of permanent hypocalcemia. Operative time was significantly shorter in the unilaterally explored group. CONCLUSIONS: When possible, unilateral exploration for PHPTH is safe and effective, avoids obliterative scarring of the contralateral neck, and may reduce morbidity and operative time.

Adenoma↗
PubMed1992

The comparative concurrent validities of the Shipley Institute of Living Scale and the Henmon-Nelson Tests of Mental Ability.

This study compared the abilities of the Shipley Institute of Living Scale and the Henmon-Nelson Tests of Mental Ability to predict Wechsler Adult Intelligence Scale-Revised (WAIS-R) scores in psychiatric hospital patients. The Henmon-Nelson DIQs accounted for about 50% more WAIS-R Verbal and Full Scale IQ variance than did the Shipley IQs, apparently because of their higher correlations with the Information, Vocabulary, and, perhaps, Similarities subtests. Because Henmon-Nelson scores were more variable and generally higher than their WAIS-R counterparts, statistical adjustments were needed to optimize Wechsler IQ estimates. Therefore, regression formulae and a conversion table for the estimation of WAIS-R Full Scale IQs from Henmon-Nelson and Shipley intelligence scores also are presented.

Adult↗
PubMed1992

Do computer-administered Minnesota Multiphasic Personality Inventories underestimate booklet-based scores?

We ran meta-analyses that compared the Minnesota Multiphasic Personality Inventory scale scores produced in 770 booklet and 762 computer administrations described by nine studies. While most of the differences were small, the computer-based scores significantly underestimated their booklet counterparts on 8 of the 13 scales. The average underestimate was about three-quarters of a T-score point and accounted for around 4% of the reliable variance. These findings suggest that separate norms and profile sheets for computer-administered MMPIs might be helpful.

Adult↗
PubMed1991

The PTSD interview: rationale, description, reliability, and concurrent validity of a DSM-III-based technique.

This paper describes the PTSD Interview (PTSD-I). It was developed to meet four specifications: (a) close correspondence to DSM-III standards; (b) binary present/absent and continuous severity/frequency outputs on each symptom and the entire syndrome; (c) administrable by trained subprofessionals; and (d) substantial reliability and validity. It was written to meet the first three criteria. It demonstrated very high internal consistency (alpha = .92) and test-retest reliability (Total score r = .95; diagnostic agreement = 87%). It correlated strongly with parallel DIS criteria (Total score vs. DIS diagnosis rbis = .94, sensitivity = .89, specificity = .94, overall hit rate = .92, and kappa = .84). Earlier studies revealed correlations with a military stress scale and Keane et al.'s MMPI PTSD subscale. It is apparently the only PTSD instrument that meets all of the above criteria.

Adult↗
PubMed1991

A factor analysis of the DSM-III post-traumatic stress disorder criteria.

The authors factor analyzed DSM-III-based post-traumatic stress disorder symptom ratings made on 131 Vietnam-veteran PTSD patients. Five factors--termed Intrusive Thoughts and Their Effects, Increased Arousal, Impoverished Relationships, Guilt, and Cognitive Interference--emerged. The factor structure gave more support to Laufer, Brett and Gallops' conceptualization of PTSD than to the Horowitz, DSM-III, or DSM-III-R systems. It also generated suggestions for future editions of the diagnostic manual.

Adult↗
PubMed1991

Pneumocystis carinii infection presenting as necrotizing thyroiditis and hypothyroidism.

Extrapulmonary Pneumocystis infection has been increasingly reported in patients with acquired immune deficiency syndrome (AIDS), in particular, recently in association with the increasing use of aerosolized pentamidine. This report describes the unusual presentation of extrapulmonary Pneumocystis infection as a thyroid neck mass and clinical hypothyroidism in a 37-year-old man with hemophilia and AIDS. This case differs from the previously reported single case of isolated thyroid pneumocystosis in the presence of a rapidly enlarging neck mass, lack of previous Pneumocystis, and prior prophylaxis with aerosolized pentamidine. The pathologic and electron microscopic description of the peculiar flocculent necrotic thyroid material is contrasted with typical pulmonary alveolar findings in Pneumocystis pneumonia (PCP), the differential diagnoses of a rapidly expanding neck mass, and diagnostic difficulties of hypothyroidism in patients with AIDS are discussed. Finally, it is emphasized that use of aerosolized pentamidine, although successful for prevention of pulmonary PCP, may be insufficient to prevent extrapulmonary infection.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Poorly differentiated ('insular') thyroid carcinoma. Report of two cases and review of the literature.

The clinical, histopathologic, immunohistochemical, and electron microscopic findings of two cases of poorly differentiated ("insular") thyroid carcinoma are reported and compared with the 25 cases previously described in the literature. These 27 cases occurred in eight men and 19 women, aged from 34 to 77 years. All but 2 presented with a thyroid mass. Eleven (41%) of the 27 patients experienced local recurrences following surgery, 17 (63%) had development of cervical lymph node metastases, 5 (19%) had development of mediastinal lymph node metastases, 11 (41%) had pulmonary metastases, and 9 (33%) had bone metastases, and 9 (33%) had bone metastases. At least 15 patients (56%) are known to have died of their disease, usually within 8 years of diagnosis. Pathologically, the tumors are distinctive and grow as solid islands (insulae) of small cells separated by artifactually created clefts. In some instances, small follicles are also noted within the insulae. All tumors were positive on immunostaining for thyroglobulin. In view of the propensity for local recurrences and lymphatic and hematogenous dissemination, a total thyroidectomy and neck dissection would seem advisable. Additionally, adjuvant external beam irradiation, systemic chemotherapy, and/or radioactive iodine therapy should also be considered.

Adenocarcinoma↗
PubMed1990

A factor analysis of Ellis' irrational beliefs.

In an effort to identify, organize, and operationally define the philosophies that underlie Albert Ellis' self-defeating beliefs, the authors factored an 11-item irrational-values self-report instrument given to 190 psychiatric patients. Four factors emerged and were named to reflect the contents of their items--"I need to control a dangerous world," "Self-assertion is painful," "I need affirmation," and "I lack control over my fate."

Humans↗
PubMed1990

The construct validity of an aftereffect-based subtyping system for alcoholics.

In an earlier project, we identified five alcohol-consumption aftereffect factors, which were named Hangover, Euphoria, Flushing, Seizures, and Sleepiness. In this study (N = 100) we assessed the construct validities of the five, using 47 MMPI, self-report, and recidivism criteria. The number of significant relationships between the factors and the criteria substantially exceeded chance. The Hangover factor related to social maladjustment and to the MMPI Psychopathic Deviate, Paranoia, Psychasthenia, Hypomania, and Masculinity-Femininity scales. The Euphoria factor was associated with a high number of job losses, but a low incidence of certain physical sequelae. The Flushing factor was associated with high consumption, late development of alcoholism, many physical complaints, and older age. The Seizure factor correlated with high consumption, facial puffiness, tremors, and lack of defensiveness on the MMPI. The Sleepiness factor was associated with a good prognosis and several mild MMPI elevations. These findings suggest that the factors may provide the basis for a useful alcoholism subtyping system and that additional research on them should prove fruitful.

Adult↗
PubMed1990

What does the Keane et al. PTSD scale for the MMPI measure?

The correlations of the Keane, Malloy, and Fairbank (1984) MMPI PTSD scale with DSM-III-based post-traumatic stress disorder symptom, section, and factor score ratings, and with combat history, were studied to determine what aspects of the disturbance it measures (N = 61). The scale's correlations with the various symptom criteria were both substantial and strikingly consistent. However, its relationships with trauma history measures were modest and frequently nonsignificant. The data suggest that the scale is a moderately strong measure of the various PTSD symptoms, but is related only weakly to trauma history.

Adult↗
PubMed1990

Schizophrenic birth seasonality and the age-incidence artifact.

Lewis (1989) dismisses a large number of articles in which schizophrenic winter birthrate excesses have been reported as the result of either design problems or the age-incidence artifact. We review about 20 studies in which the effects of age incidence have been controlled in one way or another. The majority support the conclusion that the seasonality effect is due neither to artifact nor deficient research design. We also correct two significant errors in Lewis' description of our prior work.

Adult↗