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Biomedical subjects

D K Snyder

Publications and source records attributed to D K Snyder.

At least 19 recordsLinked to original sources
PubMed2000

Effects of posttraumatic stress and acculturation on marital functioning in Bosnian refugee couples.

Forty Bosnian refugee couples living in the United States completed a translated version of the PTSD Symptom Scale--Self Report, the Behavioral Acculturation Scale, the Marital Satisfaction Inventory--Revised, and a demographic questionnaire. Posttraumatic stress disorder (PTSD) symptomatology was the best predictor of marital functioning and was related negatively to acculturation. After controlling for PTSD, acculturation did not predict marital functioning. Wives' marital satisfaction was best predicted by husbands' PTSD, husbands' acculturation, and their own PTSD. Husbands' marital satisfaction was not predicted significantly by any of these variables. These findings suggest several implications for mental health professionals dealing with refugees and other traumatized populations.

Acculturation↗
PubMed2000

Computer-assisted judgment: defining strengths and liabilities.

Clinicians often fail to recognize limitations in their own subjective judgments, make use of well-developed mechanical-prediction methods, or carefully evaluate which computer-based aids warrant their consideration. This article addresses issues regarding computer-based test interpretations (CBTIs) and computer-based decision making. Comments highlight conclusions reached by other contributors to this Special Section, additional literature bearing on these observations, and implications for consumers of computer-assisted techniques and researchers developing or evaluating these methods. The future of computer-assisted assessment depends on educating clinicians and researchers to be better consumers of existing as well as emerging technologies in this domain.

Decision Making, Computer-Assisted↗
PubMed2000

Relationship satisfaction of Mexican American and non-Hispanic white American interethnic couples: issues of acculturation and clinical intervention.

Despite the increasing prevalence of interethnic marriages, remarkably little empirical literature exists for guiding clinical interventions offered to these couples. This study compared the marriages of 72 couples with one Mexican-American partner and one non-Hispanic White American partner, 75 Mexican-American couples, and 66 non-Hispanic White couples. Overall, the interethnic couples were more similar to non-Hispanic White couples than they were to Mexican-American couples across multiple domains, with the latter group indicating modestly higher levels of relationship distress. Among interethnic couples, Mexican-American wives' level of acculturation related significantly to both their own marital- and parental-role orientation and to distress in their relationships with children, as well as to their husbands' marital distress regarding child rearing and the couple's interactions regarding finances. Implications for clinical interventions with Mexican- and White-American interethnic couples are discussed.

Acculturation↗
PubMed2000

Reliability and equivalence of the Spanish translation of the Marital Satisfaction Inventory--Revised (MSI-R).

This study examined the reliability and linguistic equivalence of the Spanish translation of the Marital Satisfaction Inventory--Revised (MSI-R) in a sample of 86 bilingual Mexican American couples. Overall, findings provided preliminary support for using this translation of the MSI-R with respondents whose preferred language is Spanish. Coefficients of internal consistency and temporal stability for scales constituting the Spanish MSI-R averaged .72 and .75, respectively. Linguistic equivalence coefficients for respondents completing the MSI-R in both languages averaged .69. Multivariate analyses of variance indicated no significant effect for language of administration on MSI-R scale scores. Discussion emphasizes caveats in using the Spanish MSI-R and directions for further research.

Adult↗
PubMed1997

Parental influence on gender and marital role attitudes: implications for intervention.

This study examined parental influence on specific attitudes toward marital and parental roles and nonspecific gender-role attitudes. Respondents included 173 young adults (127 women and 46 men) and their parents. Young adults' scores on the Role Orientation scale of the Marital Satisfaction Inventory and on masculinity and femininity scales from two self-report inventories (the MMPI-2 and the Personal Attributes Questionnaire) were correlated with their parents' scores on a subset of these same measures. Results indicated that (a) marital and parental role attitudes among young adults are strongly related to specific marital role attitudes of their parents but only modestly related (for women) or unrelated (for men) to nonspecific gender-role attitudes of their parents; (b) broader gender-role attitudes of young men are moderately correlated with their father's attitudes but generally uncorrelated with their mother's attitudes regarding gender roles; and (c) the relationship of young women's gender-role attitudes to both maternal and paternal attitudes is generally weaker and more complex than for young men. Clinical implications of these findings for assessment and intervention with distressed couples are discussed.

Adult↗
PubMed1997

Differential assessment of financial and relationship distress: implications for couples therapy.

This study examined the role of financial conflicts, problem-solving communication deficits, and global relationship distress among couples in marital therapy and couples seeking assistance at a nonprofit agency providing financial counseling services. Analyses comparing these two groups of couples with each other and with a third group of couples from the general community yielded a two-component model for differential assessment and intervention with couples experiencing financial concerns. Differences in findings for husbands and wives provided additional implications for effective interventions with these couples.

Communication↗
PubMed1995

Persistent lipolytic effect of exogenous growth hormone during caloric restriction.

PURPOSE: In previous studies in which obese volunteers were calorically restricted to 24, 18, or 12 kcal/kg of ideal body weight (IBW) per day, we observed that the growth-hormone-induced acceleration of body fat loss was variable and that the severity of caloric restriction modulated the magnitude of fat loss and the anabolic response to growth hormone. The present study was undertaken to characterize the effects of caloric restriction to 15 kcal/kg IBW per day on the metabolic response to growth hormone and to determine whether acceleration of body fat loss by growth hormone could be reproduced under conditions predicted to be optimal. PATIENTS AND METHODS: Eleven obese subjects were studied during two 38-day periods of caloric restriction. During one of these periods they received injections of growth hormone, 0.05 mg/kg IBW, for 28 days. Measurements of nitrogen balance, body fat content, insulin like growth factor I (IGF-I), free fatty acids, and glycerol concentrations were performed. RESULTS: Growth hormone injections caused an approximate 2.5-fold increase in IGF-I concentrations so that the mean IGF-I concentration was significantly greater during the injections than during diet alone (growth hormone 69.3 +/- 29.3 nmol/L; diet alone 26.6 +/- 7.6 nmol/L; P < 0.001). Growth hormone also caused nitrogen sparing, and the mean daily nitrogen balance was significantly greater during the injections (growth hormone 36.9 +/- 121.1 mmol/day; diet alone -122.3 +/- 125.9 mmol/day; P < 0.001). This nitrogen-sparing response to growth hormone attenuated over the 4 weeks of the injections. Growth hormone had a persistent lipolytic effect manifested by increases in glycerol concentrations, and body fat loss was greater during injections than during diet alone (fraction of weight lost as fat during injections 0.77 +/- 0.07; diet alone 0.63 +/- 0.06; P < 0.001). CONCLUSION: We conclude that growth hormone exerts anabolic effects that attenuate over time during caloric restriction but maintains its lipolytic effect despite hyperinsulinism and results in accelerated fat loss.

Adipose Tissue↗
PubMed1994

Methimazole-induced agranulocytosis treated with recombinant human granulocyte colony-stimulating factor (G-CSF).

A 35-year-old female hematology technician with Graves' disease developed agranulocytosis a few days after starting therapy with Tapazole (methimazole). Because of a recent report of use of recombinant human granulocyte colony-stimulating factor (G-CSF) in patients with propylthiouracil-induced agranulocytosis, 5 micrograms/kg/day G-CSF was administered and her granulocyte count returned to normal after three doses, on the sixth day after the last dose of methimazole. We conclude that in patients with drug-induced agranulocytosis, the use of G-CSF, in addition to discontinuation of the offending drug, hastens recovery and reduces morbidity.

Adult↗
PubMed1993

Predicting couples' response to marital therapy: a comparison of short- and long-term predictors.

This study identified predictors of couples' response to marital therapy at termination and 4 years posttreatment for 55 couples receiving either behavioral or insight-oriented marital therapy. Couples were more likely to remain maritally distressed at termination if either spouse reported high levels of negative marital affect or depressive symptomatology at intake. Couples were more likely to be divorced or maritally distressed 4 years after completing therapy if spouses' intake measures reflected high levels of negative marital affect, poor problem-solving skills, low psychological resilience, high levels of depression, low emotional responsiveness, or if neither spouse was employed at a semiskilled or higher level position. Termination measures of negative marital affect and poor communication skills also predicted couples' status at 4-year follow-up. Joint contingency tables relating predictors to outcome were constructed.

Adult↗
PubMed1991

Long-term effectiveness of behavioral versus insight-oriented marital therapy: a 4-year follow-up study.

Four-year follow-up data regarding marital status and marital accord were obtained for 59 couples receiving either behavioral (BMT) or insight-oriented (IOMT) marital therapy in a controlled outcome study. Although no significant group differences had been observed between the 2 treatment conditions at either termination or 6-month follow-up, by 4-year follow-up a significantly higher percentage of BMT couples had experienced divorce (38% for BMT couples compared with 3% for IOMT couples). Results are compared with previous outcome research in this area, and recommendations are made for further research.

Behavior Therapy↗
PubMed1991

Variables controlling the secretion of insulin-like growth factor binding protein-2 in normal human subjects.

Insulin-like growth factor binding protein-2 (IGFBP-2) is one of a family of IGFBPs that are present in extracellular fluids, and binds both IGF-II and IGF-I with high affinity. These studies were conducted to determine the nutritional and hormonal variables that regulate plasma IGFBP-2 concentrations in humans. The mean plasma IGFBP-2 concentration for 38 normal adult subjects was 150 +/- 61 micrograms/L and was 4.7-fold greater than their mean fasting IGFBP-1 value. Mean IGFBP-2 values in cord sera of 26 normal term infants was 3.8-fold greater than the normal adult mean value. Likewise, the mean value for 44 hypopituitary adults was increased 2-fold compared to normal. There was no suppression of IGFBP-2 values in acromegaly. Normal adult subjects showed minimal fluctuations (less than 2-fold changes) in plasma IGFBP-2 concentrations during a 48-h sampling period. These changes were significantly less than the changes that occurred in plasma IGFBP-1 during the same interval. Plasma IGFBP-2 did not change significantly post prandially or after a glucose infusion. Extreme insulin deficiency, after 9 days of fasting, was associated with a 1.7-fold increase in plasma IGFBP-2. Administration of GH, which is known to cause a major decrease in plasma IGFBP-1 and in IGFBP-2 in hypophysectomized animals, did not result in a change in calorically restricted normal adult subjects, suggesting that a normal caloric intake is required for GH to suppress IGFBP-2. In summary, these results show that plasma IGFBP-2 is regulated differently than IGFBP-1. Acute stimulation of insulin secretion does not suppress IGFBP-2, and there is much less daily fluctuation compared to IGFBP-1. These findings suggest that plasma IGFBP-2 levels are more stable than IGFBP-1, and therefore IGFBP-2 may serve as a larger reservior that is available for IGF transport.

Acromegaly↗
PubMed1990

Personality correlates of marital dissatisfaction: a comparison of psychiatric, maritally distressed, and nonclinic samples.

This study examined the relationship between personality functioning as assessed by the Minnesota Multiphasic Personality Inventory (MMPI) and individuals' reports of marital distress on the Marital Satisfaction Inventory (MSI). Both the MMPI and MSI were administered to a total sample of 90 couples with 30 couples from each of three sources: couples in marital therapy, couples in which one partner was psychiatrically hospitalized or in individual outpatient psychotherapy, and nonclinic couples from the general population. Replicated scale-by-scale correlations between the two instruments generally indicated a positive but modest association between individuals' scores on the MMPI and self-reported marital distress. Both bivariate and multiple regression analyses employing either individual scales or conjoint configural analyses of couples' MMPI profiles consistently identified scale 4, Psychopathic deviance (Pd), as the best predictor of relationship distress across a broad spectrum of marital functioning. However, both individual MMPI scales and complex configural approaches misclassified a large percentage of couples across all three samples. Clinical implications of results are discussed.

Adult↗
PubMed1990

Anabolic effects of growth hormone in obese diet-restricted subjects are dose dependent.

In previous studies growth hormone (GH) injections [0.1 mg/kg ideal body wt (IBW) every other day] produced significant increases in plasma insulin-like growth factor I (IGF-I) concentrations and nitrogen retention, which were attenuated when 12 kcal/kg IBW was ingested. The present study was done to determine whether doubling the GH dose would enhance its anabolic effects and facilitate fat loss. Eight women (33-83% over IBW) were fed 12 kcal/kg IBW for 14 wk. They received GH or vehicle injections, each for 5 wk during either weeks 2-6 or 9-13. GH improved nitrogen balance (GH, 3.6 +/- 123.2 mmol/d; vehicle, -132.0 +/- 117.9 mmol/d; means +/- SD; p less than 0.001). Plasma IGF-I increased from 32.1 +/- 9.6 to 79.4 +/- 22.1 nmol/L by day 5 of GH (p less than 0.001) and remained elevated until GH injections were discontinued. No significant effect of GH on mean body fat loss was observed. GH can induce significant anabolic responses even when caloric intake is decreased to 12 kcal/kg IBW. The degree and duration of these anabolic responses are dependent on the GH dose given.

Adolescent↗
PubMed1990

Insulin-dependent regulation of insulin-like growth factor-binding protein-1.

In previous studies it has been determined that food ingestion or glucose infusion suppresses serum insulin-like growth factor-binding protein-1 (IGFBP-1) concentrations in normal subjects. It has not been determined, however, whether glucose-dependent suppression is due to enhancement of insulin-stimulated glucose transport, to some other insulin-mediated effect, or to a direct effect of glucose. These studies were undertaken to determine if infusion of other nutrients or energy sources that activate glycolysis, but not insulin secretion, could lead to suppression of the plasma concentrations of this protein. After infusion of 50 g glucose over 4 h, the mean plasma IGFBP-1 concentration fell from 44.3 +/- 13.8 to 17.4 +/- 8.1 micrograms/L (P less than 0.001). In contrast, when 50 g fructose were infused over 4 h, IGFBP-1 decreased from 44.6 +/- 7.4 to only 32.7 +/- 6.7 micrograms/L (P less than 0.01). Comparison of these changes showed that the mean decrease after glucose infusion was significantly greater than that after fructose (P less than 0.01). In contrast to these decreases, infusion of an isocaloric amount of triglycerides resulted in no significant change in IGFBP-1 concentrations (from 49.8 +/- 14.1 to 40.2 + 10.4 micrograms/L; P = NS). Concomitant measurements of immunoreactive C-peptide during the glucose and fructose infusions showed that plasma C-peptide levels rose from 1.6 +/- 0.2 to 3.9 +/- 0.7 nM (P less than 0.001) during the glucose infusion, whereas the maximum increase was from 1.7 +/- 0.4 to only 2.3 +/- 0.4 nM (P less than 0.05) during the fructose infusion. The difference between these mean changes was also significant. The change in C-peptide correlated inversely with the changes in IGFBP-1 during the glucose infusion (r = -0.68); P less than 0.001), but not during fructose infusion (r = -0.31). The results of this study suggest that insulin stimulation of cellular metabolic pathways is an important variable regulating the suppression of plasma IGFBP-1 concentrations. Activation of noninsulin-dependent glycolytic pathways appears to result in an equivalent degree of suppression, whereas provision of other energy substrates has no effect. We conclude that both insulin and glucose are important regulators of plasma concentrations of IGFBP-1 in vivo, and in this way they may significantly influence IGF action.

Adult↗
PubMed1989

Behavioral versus insight-oriented marital therapy: effects on individual and interspousal functioning.

This study compared the effects of behavioral marital therapy (BMT) and insight-oriented marital therapy (IOMT) on both interspousal and intrapersonal functioning in a controlled outcome study. A total of 79 couples seeking treatment for relationship distress were randomly assigned to BMT, IOMT, or a treatment-on-demand (TOD) waiting-list control group. Results indicated the significance in individual and relationship functioning. Both treatment approaches produced significant effects from intake to termination that were substantially maintained at the 6-month follow-up. Behavioral and insight-oriented therapies resulted in significant improvements in self-reports of global marital accord and, to a lesser extent, in the reduction of overall psychological distress and in the enhancement of self-concept, with no significant differences between treatment conditions. The magnitude of these effects in comparison with those reported in previous marital outcome studies and in more general psychotherapy research is discussed, and possible mechanisms for the equivalence of these technically divergent treatment approaches are explored.

Adaptation, Psychological↗
PubMed1989

Dietary carbohydrate content determines responsiveness to growth hormone in energy-restricted humans.

To determine if diet composition influences responses to GH, we fed 11 obese women diets containing 12 Cal/kg ideal BW (IBW) for 2 5-week study intervals. Nonprotein calories were supplied to 6 subjects as 72% carbohydrate (high carbohydrate diet), and 5 subjects received 80% of their nonprotein calories as lipid (high lipid diet). Protein intake was constant (1.0 g/kg IBW) in both groups. During 1 study interval we gave injections of GH (0.1 mg/kg IBW) every other day for 3 weeks (weeks 2-4), and in the other interval injections of vehicle were given. Subjects ingesting the high carbohydrate diet excreted significantly less urinary nitrogen [660.2 +/- 124.1 mmol/day (mean +/- SD)] than those who received high lipid (794.2 +/- 198.5 mmol/day; P less than 0.001), and GH injections reduced nitrogen excretion in the high carbohydrate subjects (532.8 +/- 123.8 mmol/day), but not in the high lipid subjects (743.7 +/- 126.6 mmol/day). The subjects receiving the high carbohydrate diet had a significant increase in serum insulin-like growth factor-I (IGF-I; from 36.2 +/- 9.7 to 55.9 +/- 6.6 nmol/L) and urinary C-peptide excretion (from 43.9 +/- 25.6 to 60.8 +/- 29.4 nmol/day) in response to GH. The IGF-I response attenuated slowly over the 3-week treatment interval. On the other hand, the high lipid group had lesser increases in IGF-I (from 31.0 +/- 6.5 to 41.7 +/- 8.8 nmol/L) and C-peptide excretion (from 24.3 +/- 28.9 to 29.8 +/- 32.8 nmol/day), and IGF-I concentrations declined to control values after only 5 days of GH injection. We believe that this initial IGF-I response was due to an antecedent 35-Cal balanced diet. The mean increment in serum FFA 4 h after GH injection was significantly less in subjects fed the high lipid diet (0.53 +/- 0.40 meq/L) than in those fed the high carbohydrate diet (0.83 +/- 0.43 meq/L). GH injections produced more body fat loss than injections of vehicle whether expressed as percent body fat lost (GH, 3.7 +/- 1.0%; vehicle, 2.8 +/- 0.7%, P less than 0.05) or as the fraction of weight lost as fat (fat loss/weight loss; GH, 0.81 +/- 0.13; vehicle, 0.64 +/- 0.08; P less than 0.005). There was an inverse correlation between the percentage of body fat lost and mean urinary C-peptide excretion during GH injections (r = -0.70; P less than 0.05), suggesting that stimulation of insulin secretion by GH might antagonize the tendency of GH to promote fat loss.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1988

Generalized dysfunction in clinic and nonclinic families: a comparative analysis.

This study examined the relationship of self-reported marital distress to parental descriptions of emotional or behavioral disturbance of their children using two multidimensional measures of relationship satisfaction and personality functioning in children and adolescents. Data were collected from three independent samples of couples in marital therapy, parents of psychiatrically hospitalized children or adolescents, and nonclinic couples from the general population. Using a split-half cross-validation procedure, parents' reports of their children's emotional or behavioral difficulties were consistently and positively related to their descriptions of dissatisfaction with the parent-child relationship and with reports of spousal conflict over childrearing, but not with measures of global marital distress or spousal conflict in areas not related to childrearing. Discrepancies in spouses' descriptions of their marriage or child were unrelated to individual measures of relationship functioning or child/adolescent psychopathology. Implications for clinical assessment and future research are discussed.

Adolescent↗