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Biomedical subjects

C Z Garrison

Publications and source records attributed to C Z Garrison.

16 recordsLinked to original sources
PubMed1992

Major depressive disorder and dysthymia in young adolescents.

A two-stage epidemiologic study conducted between 1986 and 1988 in the southeastern United States investigated the frequency of major depressive disorder and dysthymia in 12-14 year olds. In stage one, the Center for Epidemiologic Studies Depression Scale, a life event schedule, and a family cohesion scale were administered to a community sample of 3,283 adolescents. In stage two, 488 mother-child pairs were interviewed utilizing the Schedule for Schizophrenia and Affective Disorders in School Age Children. Although mean Center for Epidemiologic Studies Depression Scale scores were significantly higher in females (25.60) than in males (19.50), prevalence estimates based on a summary of mother and child symptom reports for Diagnostic and Statistical Manual of Mental Disorders, Third Edition, major depressive disorder were similar: 9.04% in males and 8.90% in females. The prevalences of dysthymia were 7.98% in males and 5.00% in females. Previous investigations have reported lower rates and a female preponderance of major depression. Disagreement between mothers and children regarding the presence of symptoms may explain this contradiction. Significant odds ratios were found between major depression and not living with both natural parents (odds ratio (OR) = 3.89), undesirable life events (OR = 1.09), and perceived family cohesion (OR = 0.96). Not living with both natural parents (OR = 14.67) and socioeconomic status (OR = 0.44) were significant correlates of dysthymia.

Adolescent↗
PubMed1992

Role of delayed feeding and of feeding increments in necrotizing enterocolitis.

In spite of a number of studies on necrotizing enterocolitis, there remains controversy concerning prevention regimens, especially with regard to enteral alimentation. This report is of a matched case-control study of the relationship of necrotizing enterocolitis to timing of first feeding, size of feeding volumes and increments, and a risk factor index in 59 case patients with necrotizing enterocolitis and 59 matched control patients. Comparison with control patients showed that case patients were fed earlier, received full-strength formula sooner, and received larger feeding volumes and increments. More highly stressed infants, as measured by the risk index, were more vulnerable to larger feeding increments. Among case patients there was significant correlation of age at first feeding and age at diagnosis (p < 0.0001) even after control for birth weight and risk index score, indicating that delayed feeding was related to delayed onset of disease. These analyses support the theory that earlier, more rapid feeding places stressed infants at greater risk for the development of necrotizing enterocolitis, and that infants with more severe respiratory problems are more vulnerable to such feeding practices.

Birth Weight↗
PubMed1992

An epidemiologic study of smoking and primary infertility in women.

OBJECTIVE: To determine the relationship between cigarette smoking and primary female infertility. DESIGN: Retrospective, case-control study. SETTING: Population-based and randomly selected from eight geographic areas in the United States. PARTICIPANTS: Women, 20 to 54 years of age, who were randomly selected to serve as the control group of the Cancer and Steroid Hormone Study were used for this study. Within this group, there were 483 women who were classified as having experienced primary infertility and 2,231 women eligible to serve as controls. Primary infertility, defined as 24 consecutive months of unprotected intercourse without conception, was documented from a calendar of each women's reproductive and contraceptive history. RESULTS: Smoking one pack of cigarettes per day (odds ratio = 1.36) and starting to smoke before 18 years of age (odds ratio = 1.30) were significantly associated with increased risk of infertility. Life table and proportional hazards analysis indicated that smoking did not significantly increase the time required to conceive among infertile women. CONCLUSIONS: Number of cigarettes smoked and age when the women began smoking contributed to infertility in this study. It is reasonable, therefore, to recommend that women stop smoking when they are attempting to become pregnant.

Adult↗
PubMed1991

Suicidal behaviors in young adolescents.

A two-stage epidemiologic study investigated the frequency of suicidal behavior in children 12-14 years of age. In the first stage, the Center for Epidemiologic Studies Depression Scale, a three-item suicide scale, a life-event schedule, and a family environment scale were administered during 1986 to a southeastern US community sample of 1,542 seventh and eighth grade students. In the second stage, 226 mother-child pairs were interviewed utilizing the Schedule for Schizophrenia and Affective Disorders in School Age Children (K-SADS). Subjects interviewed included students with high depression scores and a random sample of the remaining students. Prevalence estimates for moderate to severe suicidal ideation (K-SADS score greater than or equal to 4) were 4.0% (95% confidence interval (CI) 0.6-16.4%) in males and 8.7% (95% CI 2.4-23.3%) in females. The prevalences of suicide attempts were 1.9% (95% CI 0.0-13.2%) in males and 1.5% (95% CI 0.6-12.7%) in females. Significant relations were found between major depression and both suicide ideation (odds ratio = 6.19, 95% CI 1.53-24.94) and suicide attempts (odds ratio = 9.80, 95% CI 1.89-50.86). The undesirable life-events score was also a significant predictor of suicide ideation and suicide attempts.

Adolescent↗
PubMed1991

A longitudinal study of suicidal ideation in young adolescents.

As part of a longitudinal study of depression and suicidal ideation in adolescents, a three-item suicide screen was administered to 1,073 students for 3 consecutive years starting at the beginning of the 7th or 8th grades. Each year over 70% of respondents reported no suicidal thoughts, and less than 5.5% attained high suicide ideation scores. Blacks and females had higher scores, respectively, than did whites and males. The individual students' suicide scores were less stable than the overall distributions with 1- and 2-year correlations reaching 0.35 and 0.28, respectively. Only one student received a high score all 3 years. The best predictors of a given year's suicide score was the previous years' depression scores. Gender, undesirable life events, family adaptability, and family cohesion were significant but less consistent predictors.

Adolescent↗
PubMed1991

The CES-D as a screen for depression and other psychiatric disorders in adolescents.

The performance of the Center for Epidemiologic Studies Depression Scale (CES-D) as a screen for depression was explored in a two-stage epidemiological study of adolescents. The study consisted of a CES-D screening stage completed by a school sample of 2,465 young adolescents and a structured psychiatric interview stage completed by 332 mother-adolescent pairs. Adolescents with interview validated depression had elevated screening scores (mean = 31.10, SD = 11.30) compared with individuals with no disorder (mean = 21.01, SD = 11.77). Using receiver operating characteristic curves, a cut point of 12 for males produced the best overall screening characteristics (sensitivity = 0.85, specificity = 0.49), while for females, a cut point of 22 was optimal (sensitivity = 0.83, specificity = 0.77).

Adolescent↗
PubMed1991

The assessment of suicidal behavior in adolescents.

All available assessment instruments (N = 29) used to study suicidal behaviors in adolescents and young adults (age 12-20) were collected and reviewed. Instruments were found to vary substantially in purpose, format, informat, and theoretical orientation. The items from these tools (N = 461) were categorized according to behavior type (thoughts, feelings, or actions) and content categories (death/life-related, disease-promoting/preventing, injury-producing/reducing, person-reducing/enhancing, and factual information). The majority of the items were found to assess thoughts and were focused on death-related content. Recommendations include the need for more rigorous validation of instruments, clearer operational definitions, additional normative information, and expansion of the pool of available items to encompass a broader array of self-destructive behaviors.

Adolescent↗
PubMed1990

A longitudinal study of depressive symptomatology in young adolescents.

As part of a longitudinal study of depression in adolescents, the Center for Epidemiologic Studies Depression Scale (CES-D) was administered to 550 students 3 times, at the beginning of the seventh, eighth, and ninth grades. Blacks and females had higher scores than did whites and males. Scores of blacks and males declined more over the 3 year period than did those of females and whites. The stability of individual students' depression scores was less consistent than the overall distributions with 1 and 2 year correlations reaching only 0.53 and 0.36, respectively. The best predictor of subsequent year CES-D scores was the previous year's score. Undesirable life events and family adaptability were significant but less important predictors.

Adolescent↗
PubMed1989

Epidemiology of depressive symptoms in young adolescents.

Center for Epidemiologic Studies Depression Scales, completed by 677 junior high school students, were used to investigate the significance and measurement of depressive symptoms in young adolescents. Responses differentiated transient and more persistent symptoms. Few students noted the most persistent symptoms (less than 15% for any one item). Minority race, lower social economic status, lower school grade, family constellation, and poorer school progress were associated with higher depressive symptom scores. Findings from this study suggest that high persistent depressive symptomatology is not a universal adolescent experience and that persistent depressive symptoms may be associated with other adverse events.

Adolescent↗
PubMed1989

The study of suicidal behavior in the schools.

The studies reviewed indicate that suicidal behavior is infrequent among school children (12%), but increases progressively among junior high (35%), high school (65%), and college students (50-65%). Though considerable, these values are lower than those of similar-age psychiatric populations. Estimates of the rate of actual attempts were 3% for elementary students, 11% for high school students, and 15-18% for college students. Most were low-lethality attempts for which medical or other attention was not sought. Accordingly, the vast majority of suicide attempts will not be uncovered by investigations dealing solely with clinical or medically identified populations. The most commonly identified correlates of suicidal behaviors included depressive symptoms, social problems, family disorganization and problems, life stress, and poor problem-solving skills. Academic problems were not as important. These findings must be interpreted in light of methodological constraints. Response rates have been low, samples have been small, minorities have been underrepresented, nonstudents have been ignored, and volunteers of unreported characteristics have predominated. The representativeness of such groups is questionable. The definition and categorization of behaviors have varied considerably, making between-study comparisons difficult. The differences among thoughts, threats, and attempts (the most frequently used categories) have often not been taken into account. Rather, in analyses, these behaviors have been treated as if they were homogeneous entities and grouped together. Where attempters have been separated from ideators, they too have been treated as a single entity. Many deliberately survived attempts are manipulative and oriented toward the benefits the individual survivors expect. Such attempts probably differ substantially in nature from those attempts where survival is not intended. Understanding of this phenomenon could be enhanced by a comparison of the characteristics of those with high- and low-lethality attempts. Similarly, a third group of behaviors--that of chronic behavior patterns that potentially hasten death (alcoholism, drug abuse, self-mutilation, and risk taking)--has not been adequately addressed in terms of its relationship to more discrete suicidal events. Data have generally been obtained via anonymous self-administered questionnaires. The accuracy of retrospective self-reports on emotionally laden events is suspect. Only in two instances have self-reported questionnaire data been validated via interviews with subjects alone or subjects and their families. The time frames on which the referent behaviors has been collected have included "last week", "last month", "last year", "lifetime", and not specified. The longer the interval between the occurrence of the behavior and the report, the greater the likelihood that some reporting inaccuracies may occur.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1989

Knowledge, perceived risk, and beliefs about AIDS among high school and college students in South Carolina.

Our study reveals that high school and college students in South Carolina have a fairly high level of knowledge about AIDS. High school students have lower level of knowledge about AIDS than college students. High school students also have higher perception of risk of acquiring HIV infection and do not consider the AIDS epidemic as a very serious health threat. School-based AIDS education is critically needed to increase students' knowledge about AIDS and to develop skills which will help them adopt and maintain risk prevention behaviors. Physicians play a very important role in developing effective school-based AIDS education and prevention programs.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Evaluating interrater agreement through "case-control" sampling.

An approach to evaluating interrater agreement is presented that is based on "case-control" sampling scheme, in which individuals are classified by one rating method and stratified prior to being classified by a second rating method. A new estimate of the kappa interrater agreement index that is based on the case-control scheme is also presented. Power and other economic considerations are discussed, indicating that the new approach may be useful in practice.

Biometry↗