Biomedical subjects

C M Grilo

Publications and source records attributed to C M Grilo.

At least 55 records · Page 3Linked to original sources

PubMed1999

Co-occurrence of mood and personality disorders: a report from the Collaborative Longitudinal Personality Disorders Study (CLPS).

The purpose of this study was to examine the relationship of subtypes and particular clinical features of mood disorders to co-occurrence with specific personality disorders. Five hundred and seventy-one subjects recruited for the Collaborative Longitudinal Personality Disorders Study (CLPS) were assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and the Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV). Percent co-occurrence rates for current and lifetime mood disorders with personality disorders were calculated. Logistic regression analyses examined the effects of clinical characteristics of depressive disorders (e.g., age at onset, recurrence, symptom severity, double depression, and atypical features) on personality disorder co-occurrence. In comparison with other DSM-IV personality disorders, avoidant, borderline, and dependent personality disorders (PDs) were most specifically associated with mood disorders, particularly depressive disorders. Severity and recurrence of major depressive disorder and comorbid dysthymic disorder predicted co-occurrence with borderline and to a lesser extent research criteria depressive personality disorders. The results are consistent with the view that a mood disorder with an insidious onset and recurrence, chronicity, and progression in severity leads to a personality disorder diagnosis in young adults.

Adolescent↗

PubMed1998

Frequency of personality disorders in two age cohorts of psychiatric inpatients.

OBJECTIVE: The authors examined the frequency of DSM-III-R personality disorders in adolescent and young adult psychiatric inpatients. METHOD: Structured diagnostic interviews were reliably performed with a series of 255 consecutively admitted inpatients (138 adolescents and 117 young adults). RESULTS: Most personality disorders were diagnosed in similar frequencies in the two study groups. Passive-aggressive personality disorder was diagnosed with lower frequency and dependent personality disorder with higher frequency in the young adult than in the adolescent group. CONCLUSIONS: The isomorphism of relative frequencies among psychiatric inpatients suggests that what is seen in adolescents are valid forms of most adult personality disorders.

Adolescent↗

PubMed1997

Personality disorders in adolescents with major depression, substance use disorders, and coexisting major depression and substance use disorders.

This study examined the presence of personality disorders in adolescent inpatients with major depression (MDD; n = 45), substance use disorders (SUD; n = 27), or both disorders combined (MDD-SUD; n = 42). A consecutive series of patients were given structured diagnostic interviews for Axes I and II disorders. The groups did not differ with regard to age, gender, ethnicity, socioeconomic status, psychiatric history, or global assessment of functioning. Borderline personality disorder was diagnosed more frequently in the MDD-SUD group than in the MDD or the SUD groups.

Adolescent↗

PubMed1997

Controlled study of psychiatric comorbidity in psychiatrically hospitalized young adults with substance use disorders.

OBJECTIVE: The purpose of this study was to examine DSM-III-R axis I and axis II comorbidity in psychiatrically hospitalized young adults with substance use disorders. METHOD: Structured diagnostic interviews were given to 117 consecutive inpatients. Seventy patients with substance use disorders and 47 patients without substance use disorders were compared. RESULTS: High rates of co-occurrence of axis I disorders were observed, but no disorder coexisted in the group with substance use disorders at a significantly higher rate than in the group without substance use disorders. Among axis II disorders, borderline personality disorder was diagnosed significantly more frequently in the group with substance use disorders. CONCLUSIONS: Significant additional diagnostic co-occurrence, defined as comorbidity, was observed only between borderline personality disorder and substance use disorders. The use of a relevant psychiatric comparison group allows for finer distinctions between covariation based on shared severity and comorbidity possibly based on shared pathophysiology.

Adolescent↗

PubMed1997

Report of the National Institutes of Health (NIH) Workshop on the Development of Research Priorities in Eating Disorders.

The National Institutes of Health (NIH) Workshop on the Development of Research Priorities in Eating Disorders was convened in New York on April 24 and 25, 1996. The goals of the workshop were (1) to identify important unanswered questions in the study and treatment of eating disorders, (2) to discuss potentially fruitful approaches to answering these questions through basic and clinical research, and (3) to assist the NIH and other funding agencies in assigning priorities for research on eating disorders. The program consisted of a series of brief presentations by moderators, each followed by facilitated discussion of the topic with members of the audience. Three reporters (CMG, MJD, FMC) took detailed notes of the proceedings, which have been incorporated into this article. A summary of this workshop is presented, along with recommendations for future research that were identified by workshop participants.

Feeding and Eating Disorders↗

PubMed1996

The influence of sexual orientation on body dissatisfaction in adult men and women.

OBJECTIVE: Whereas gay culture's presumed emphasis on physical appearance may potentiate body dissatisfaction, lesbian culture's seeming lack of emphasis on appearance may protect against body dissatisfaction. We examined body dissatisfaction, associated psychosocial variables, and affiliation with the gay and lesbian community. METHOD: Self-report measures were administered to 257 subjects (69 lesbians, 72 heterosexual women, 58 gay men, and 58 heterosexual men). RESULTS: Compared with heterosexual men, gay men reported significantly more body dissatisfaction and more distress in many of the psychosocial areas related to body dissatisfaction. In contrast, lesbians and heterosexual women did not differ in these areas. Although affiliation with the gay community was associated with body dissatisfaction in gay men, affiliation with the lesbian community was unrelated to body dissatisfaction in lesbians. DISCUSSION: It seems that aspects of the gay community increase vulnerability to body dissatisfaction, yet the values of the lesbian community do not seem to be protective against body dissatisfaction.

Adult↗

PubMed1996

Gender differences in personality disorders in psychiatrically hospitalized young adults.

We examined gender differences in DSM-III-R personality disorders in psychiatrically hospitalized young adults. Structured diagnostic interviews were reliably performed on a consecutive series of 118 inpatients. Men were significantly more likely to meet criteria for cluster A, schizotypal, and antisocial personality disorders. To reduce variability due to axis I heterogeneity, we retested for gender differences in a subgroup of patients with major depression. Depressed men were more likely to meet criteria for cluster A, schizotypal, and cluster C personality disorders. Women were not observed to have a higher frequency of any personality disorder than men in either study group.

Adult↗

PubMed1996

Conduct disorder, substance use disorders, and coexisting conduct and substance use disorders in adolescent inpatients.

OBJECTIVE: The authors examined the association between conduct disorder and substance use disorders in adolescent inpatients. METHOD: Structured diagnostic interviews were given to 165 adolescent inpatients to assess the presence of DSM-III-R axis I disorders and personality disorders from axis II. Patients with conduct disorder (N = 25), substance use disorders (N = 24), and coexisting conduct and substance use disorders (N = 54) were compared to determine whether additional axis I and axis II disorders presented at significantly different rates. RESULTS: The groups with conduct disorder and coexisting conduct and substance use disorders had a higher proportion of male subjects than the group with substance use disorders alone. Patients with conduct disorder had an earlier age at first psychiatric contact and were diagnosed significantly more often with attention deficit hyperactivity disorder than the other two groups. Borderline personality disorder was diagnosed more frequently in the patients with substance use and coexisting conduct and substance use disorders than in the patients with conduct disorder. These differential co-occurrence patterns were observed for both male and female subjects. CONCLUSIONS: Conduct disorder and substance use disorders have high comorbidity rates with other psychiatric disorders in adolescent inpatients. The additional psychiatric comparison group (patients with coexisting conduct and substance use disorders) allowed for finer distinctions regarding psychiatric comorbidity. The validity of subtyping conduct disorder on the basis of the presence of a coexisting substance use disorder is suggested; conduct disorder patients without a coexisting substance use disorder are more likely to have attention deficit hyperactivity disorder.

Adolescent↗

PubMed1996

Gender differences in personality disorders in psychiatrically hospitalized adolescents.

OBJECTIVE: The authors examined gender differences in DSM-III-R personality disorders in adolescent psychiatric inpatients. METHODS: Structured diagnostic interviews were reliably performed with a series of 138 consecutively admitted adolescent inpatients. To reduce variability due to heterogeneity of axis I diagnoses, a subgroup of 87 patients with major depression was retested for gender differences. RESULTS: Females were significantly more likely than males to meet the criteria for borderline personality disorder. Narcissistic personality disorder was diagnosed only in males. A similar pattern was observed in the subgroup of patients with major depression. CONCLUSIONS: The findings suggest potentially important gender differences in personality disorders in adolescent inpatients.

Adolescent↗

PubMed1996

Comorbidity of DSM-III-R axis I and II disorders among female inpatients with eating disorders.

Structured diagnostic interviews were used to determine DSM-III-R axis I and II diagnoses among 136 female psychiatric inpatients. To distinguish comorbidity of eating disorders with axis I and II disorders from simple diagnostic overlap, the frequency and distribution of diagnoses among the 31 patients with an eating disorder and the 105 without an eating disorder were compared. Social phobia, substance use disorders, borderline personality disorder, and avoidant personality disorder were diagnosed in a significantly larger proportion of the group with eating disorders. Future studies should focus on interpreting the meaning of the co-occurrence of these disorders in patients with eating disorders.

Adolescent↗

PubMed1995

Sociocultural influences on eating attitudes and behaviors, body image, and psychological functioning: a comparison of African-American, Asian-American, and Caucasian college women.

Eating attitudes and behaviors, body image, and psychological functioning were evaluated in 98 female college students: 36 African-Americans, 34 Asian-Americans, and 28 Caucasians. African-Americans had significantly higher body mass index than either Asian-American or Caucasians. In contrast, Caucasians reported greater levels of disordered eating and dieting behaviors and attitudes and greater body dissatisfaction than did Asian-Americans and African-Americans who differed little on these measures. The nature of variability in these eating behaviors and attitudes and body image was also examined within each of the three groups. A generally consistent pattern emerged within each racial group: low self-esteem and high public self-consciousness were associated with greater levels of problematic eating behaviors and attitudes and body dissatisfaction. A history of being teased about weight and size was associated with problematic eating behaviors and attitudes and body dissatisfaction in African-Americans and Caucasians but not in Asian-Americans. The findings suggest that there exist important racial differences on various aspects of eating, dieting, and body image in college women. Contrary to hypothesis, the degree of acculturation and assimilation within the African-American and Asian-American groups was unrelated to variability in these domains.

Acculturation↗

PubMed1995

Psychiatric comorbidity in adolescent inpatients with substance use disorders.

OBJECTIVE: To assess DSM-III-R Axis I and Axis II co-occurrence and comorbidity in adolescent inpatients with substance use disorders (SUD). METHOD: A consecutive series of 138 adolescent inpatients were reliably assessed with structured diagnostic interviews for Axis I disorders and Axis II personality disorders. To determine significant co-occurrence of diagnoses, comparisons were between 69 patients with SUD and 69 patients without SUD. RESULTS: Disruptive behavior disorders were diagnosed significantly more frequently in patients with SUD than in those without SUD. Conduct disorder was diagnosed more frequently and oppositional defiant disorder was diagnosed less frequently in the SUD patients than in the non-SUD patients. Anxiety disorders were diagnosed less frequently in the SUD group. Cluster B personality disorders and borderline personality disorder were diagnosed more frequently in the SUD group. CONCLUSIONS: The findings replicate previous research showing high rates of co-occurrence of other psychiatric disorders in adolescent inpatients with SUD. The use of a relevant psychiatric comparison group allows for finer distinctions regarding significant comorbidity and the psychopathological implications thereof.

Adolescent↗

PubMed1994

Binge eating antecedents in normal-weight nonpurging females: is there consistency?

We examined the situational antecedents of binge eating episodes and tested for consistency in the antecedents. We evaluated the antecedents of two successive binges via structured interviews with 50 normal-weight nonpurging females who regularly binge. Cluster analysis yielded two categories of binge-promoting situations: solitary negative affect situations and social eating situations. When this empirically derived classification of binge situations was used, the two successively occurring binges did not systematically fall into the same cluster. Consistency on other measures was also modest. Implications of these findings for conceptual models of binge eating and treatment, including the prospect of individually tailored interventions, are discussed.

Adult↗

PubMed1994

The social self, body dissatisfaction, and binge eating in obese females.

We examined the relationship of the social self to body dissatisfaction and to binge eating in two clinical samples of obese females. In the first study, with 32 nonbingeing obese females, social self measures of Public Self-Consciousness and Social Anxiety were positively correlated with body dissatisfaction. Self-esteem was negatively correlated with body dissatisfaction. In the second study, 11 obese binge eaters were compared with 11 matched nonbingeing obese females. Binge eaters were characterized by significantly higher levels of social anxiety and body dissatisfaction than the obese nonbingeing controls. These findings support the hypothesized links of social self concerns to body dissatisfaction and to binge eating in obese females.

Adult↗

PubMed1994

Stress-induced cortisol response and fat distribution in women.

Recent studies have shown an association between uncontrollable stress and abdominal fat distribution. It has been suggested that changes in cortisol secretion might represent one possible mechanism for this relationship. This study investigated whether body fat distribution, determined by waist-to-hip ratio (WHR), is related to salivary cortisol levels in response to laboratory stressors. Subjects were 41 overweight women with a Low or a High WHR. Multiple measures of cortisol and mood were obtained during a session of stressful tasks (eg., timed arithmetic) and during a time-matched, control rest session. Also, background life stress and psychological trait variables were assessed. Compared to Low WHR subjects, High WHR subjects secreted significantly more cortisol during the stressful session after 60 minutes of stress, and considering the total area under the curve of secretion. This difference was not seen on the rest day. In terms of background and psychological measures, High WHR subjects were characterized by poorer coping skills and differences in mood reactivity. Specifically, although all subjects became more angry in response to the stressful session, High WHR subjects showed smaller increases in anger. This could indicate that they are more likely to evidence a helpless reaction to uncontrollable stress. These findings support the hypothesis that cortisol secretion might represent a mechanism for the observed association between stress and abdominal fat distribution. Furthermore, differences in coping and appraisal may suggest that a particular psychological pattern might influence the reactivity of the adrenal-cortical system to stress, and subsequent fat distribution.

Abdominal Fat↗

PubMed1994

Physical activity and obesity.

Obesity is a major public health problem. Secular increases in the prevalence of obesity appear to be paralleled by decreases in physical activity. Although physical activity and weight are associated, the exact nature of the relationship remains uncertain. Research strongly suggests that exercise is a critical component of any program for weight control and health improvement. Potential mechanisms linking exercise and weight are discussed. For some persons, the health improvement derived from increased activity may not depend on weight loss. Modest levels of activity may be sufficient to achieve both the weight and health benefits of exercise.

Combined Modality Therapy↗

PubMed1994

Longitudinal investigation of the abstinence violation effect in binge eaters.

This study, guided in part by G. A. Marlatt and J. R. Gordon's (1985) abstinence violation effect (AVE) model, examined whether variability in cognitive and emotional reactions to binges accounts for recurrence of binge eating. Attributional, cognitive, and affective reactions to two successive binges, as well as the latencies between each binge and a subsequent binge, were evaluated through a series of structured phone interviews with 50 nonpurging normal-weight female bingers. Reported mood after binging was unrelated to binge latency. However, when Ss made more intense internal, global, and uncontrollable causal attributions for a binge, a subsequent binge followed significantly sooner. Within-subject variations in AVEs across binges prospectively predicted within-subject variations in the speed with which another binge followed. Analyses suggested that cognitive states (e.g., AVE and guilt) evoked by particular events were better predictors of how quickly binging repeats than were stable differences in attributional style.

Adolescent↗

PubMed1994

Eating disorders: a women's health problem in primary care.

Eating disorders pose a significant risk to the health and psychological well-being of adolescent girls and adult women, yet a sizeable number of health care practitioners do not routinely assess for eating disorders. This paper provides an overview of what is currently understood about the nature and assessment of eating disorders. Diagnostic features, psychiatric comorbidity, and medical complications of anorexia nervosa, bulimia nervosa, and binge eating disorder are discussed. We suggest ways that health care providers can incorporate assessment for eating disorders and referral for treatment into their routine clinical care practices.

Feeding and Eating Disorders↗