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Biomedical subjects

D McKay

Publications and source records attributed to D McKay.

At least 19 recordsLinked to original sources
PubMed2001

Predictive validity of the overvalued ideas scale: outcome in obsessive-compulsive and body dysmorphic disorders.

Overvalued ideas have been theoretically implicated in treatment failure for obsessive-compulsive disorder (OCD). Until recently, there have not been valid assessments for determining severity of overvalued ideas. One recent scale, the Overvalued Ideas Scale (OVIS; Neziroglu, McKay, Yaryura-Tobias, Stevens & Todaro, 1999, Behaviour Research and Therapy, 37, 881-902) has been found to validly measure overvalued ideas. However, its predictive utility has not been determined. Two studies were conducted to examine the extent to which the OVIS predicts treatment response. Study 1 examined the response to behavioral therapy in a group of participants diagnosed with OCD. Residual gain scores showed a significant correlation between treatment outcome for compulsions and pretreatment OVIS scores (28.1% variance accounted). Pretreatment OVIS scores were not significantly correlated with residual gains in obsessions (1.7% variance accounted). The predictive utility of the OVIS was superior to a single item assessment of overvalued ideas available on the Yale-Brown Obsessive Scale in predicting outcome for compulsions. For this item, the variance accounted for compulsions was 6.3% and for obsessions was 3.9%. Study 2 examined the response to behavioral therapy in a group of participants diagnosed with body dysmorphic disorder (BDD), a condition ostensibly linked to OCD and presumed to present with higher levels of overvalued ideas. Residual gains scores showed a significant relationship between obsessions and OVIS (accounting for 34.8% of the variance), but not for compulsions (10.2% variance accounted). As in Study 1, the predictive utility of the OVIS was superior to the single item assessment (with 0.2% variance accounted for compulsions, 2.4% variance accounted for obsessions). Taken together, the studies reported here show that this OVIS is predictive of treatment outcome, and the predictive value depends on which symptoms are used to assess outcome. Further, the scale is more effective in predicting outcome than a widely used single item assessment.

Adolescent↗
PubMed2001

SOral gene therapy.

Explore the source record for details and available documents.

Acid Anhydride Hydrolases↗
PubMed2001

Comparison of two methods for serotyping Campylobacter spp.

Two serotyping schemes (Penner and Laboratory of Enteric Pathogens [LEP]) based on soluble heat-stable antigens were used to analyze 3,788 Campylobacter sp. isolates. A significant percentage (36.6%) was untypeable using LEP serotyping; greater cross-reaction was also observed. The relative discrimination capabilities of the techniques were similar. Penner serotyping fulfils more of the requisite criteria for typing methods.

Antigens, Bacterial↗
PubMed2000

The effect of fluvoxamine and behavior therapy on children and adolescents with obsessive-compulsive disorder.

OBJECTIVE: The efficacy of medications, consisting of serotonin partial and specific reuptake blockers, and behavior therapy, consisting of exposure and response prevention in addition to social skills training, cognitive therapy, and habit reversal, in the treatment of obsessive-compulsive disorder are well documented. The purpose of the study was to explore if adding behavior therapy to medication would enhance treatment efficacy. METHODS: Ten children/adolescents who had not previously responded to behavior therapy were randomly assigned to two groups: fluvoxamine alone or fluvoxamine with behavior therapy. All 10 patients received fluvoxamine for 10 weeks-five continued solely on fluvoxamine for one year and five engaged in behavior therapy for 20 sessions along with fluvoxamine and then continued solely on medication until the end of the year. RESULTS: Eight of 10 patients improved significantly on fluvoxamine at week 10 on the primary outcome variable, the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS). According to the other measurements-National Institute of Mental Health-Global Obses-sive-Compulsive Scale, Clinical Global Impression-Improvement (assessing level of im-provement from week to week), and Clinical Global Impression-Severity of Illness Scale (as-sessing how ill the patient is from week to week)-improvement was not as evident. According to the CY-BOCS, those who received a combination of fluvoxamine and exposure with response prevention showed significantly more improvement than those who only took medication. At two-year follow-up, all patients continued to improve, with those in the combined approach improving more than those in the medication-alone group. CONCLUSIONS: Future studies should determine the specific effect of each treatment group, combined and singularly. Reasons for discrepancy in improvement ratings as noted by the different instruments are discussed. The addition of behavior therapy to fluvoxamine seems to enhance treatment efficacy, according to the CY-BOCS.

Adolescent↗
PubMed2000

Borderline personality and obsessive-compulsive symptoms.

Diagnostic criteria for borderline personality disorder (BPD) are diverse, covering a broad range of symptoms. One criterion, self-mutilation, is a behavioral excess that may be considered a predictor of other psychopathological states. The present study sought to determine the extent to which two groups of BPD patients, those who mutilate and those who do not, differed on measures of general psychopathology, depression, anxiety, and obsessive-compulsive symptoms. Results indicate that the only source of significant variation was the level of obsessive-compulsive symptoms, with mutilators exhibiting greater symptomatology. The findings from this study support the idea that self-mutilation is a more severe form of psychopathology relative to the rest of the BPD population. These results are interpreted based on the affect regulation model of self-mutilation, and contrasted with contemporary models of impulse control in relation to obsessive-compulsive disorder.

Adult↗
PubMed1999

The Overvalued Ideas Scale: development, reliability and validity in obsessive-compulsive disorder.

The presence of overvalued ideas in obsessive-compulsive disorder (OCD) has been theoretically linked to poorer treatment outcome [Kozak, M. J. & Foa, E. B. (1994). Obsessions, overvalued ideas and delusions in obsessive-compulsive disorder. Behaviour Research and Therapy, 32, 343-353]. To date, no measures have been developed which quantitatively assess levels of overvalued ideas in obsessive-compulsives. The present studies examined the psychometric properties of a scale developed to measure this form of psychopathology, the Overvalued Ideas Scale (OVIS). In study 1, 102 patients diagnosed with OCD were administered a battery of instruments including the OVIS at baseline and two weeks later, prior to initiating treatment. Results indicate that the OVIS has adequate internal consistency reliability (coefficient alpha = 0.88 at baseline), test-retest reliability (r = 0.86) and interrater reliability (r = 0.88). Moderate to high levels of convergent validity was found with measures of obsessive-compulsive symptoms, a single item assessment of overvalued ideas and psychotic symptoms. Medium levels of discriminant validity with measures of anxiety and depression was obtained in this study. Individuals determined to have high OVI showed greater stability of this pathology than those with lower OVI, suggesting that overvalued ideas are stable for extreme scorers. In study 2 a total of 40 patients participated who were diagnosed with OCD. The same battery of instruments was administered as in study 1, as well as the Beck Depression Inventory and Beck Anxiety Inventories. Results were similar to that obtained in study 1, including a relative lack of discriminant validity with self-report measures of depression and anxiety. It is suggested that further research with the OVIS may show predictive value in treatment outcome studies of OCD.

Adult↗
PubMed1999

Survival of life on asteroids, comets and other small bodies.

The ability of living organisms to survive on the smaller bodies in our solar system is examined. The three most significant sterilizing effects include ionizing radiation, prolonged extreme vacuum, and relentless thermal inactivation. Each could be effectively lethal, and even more so in combination, if organisms at some time resided in the surfaces of airless small bodies located near or in the inner solar system. Deep within volatile-rich bodies, certain environments theoretically might provide protection of dormant organisms against these sterilizing factors. Sterility of surface materials to tens or hundreds of centimeters of depth appears inevitable, and to greater depths for bodies which have resided for long periods sunward of about 2 A.U.

Environment↗
PubMed1999

Two-year follow-up of behavioral treatment and maintenance for body dysmorphic disorder.

Recent research has suggested that body dysmorphic disorder (BDD) is part of the obsessive-compulsive compulsive spectrum of disorders. As such, it has been hypothesized that these disorders respond in a similar manner to obsessive-compulsive disorder when behavioral interventions are used. A continuation of follow-up was conducted with a group of patients with BDD following treatment. Ten patients completed an intensive behavioral therapy program and either participated in a 6-month maintenance program or served as controls. At 12-, 18-, and 24-month follow-up assessments, patients participating in the maintenance program were more effective at managing limited symptom return and had significantly lower anxiety and depression. Both groups remained improved for acute symptomatology and behavioral avoidance. The results suggest that maintenance programs following behavioral treatment are effective in preventing symptom relapse and assist in patient self-management of lapses typically associated with BDD.

Adult↗
PubMed1997

Body dysmorphic disorder: a preliminary evaluation of treatment and maintenance using exposure with response prevention.

In recent investigations, body dysmorphic disorder (BDD) has been shown to share common etiological and symptom presentation to obsessive-compulsive disorder (OCD). When treating BDD, there have been some investigations suggesting that exposure with response prevention is effective in alleviating symptoms. Ten patients diagnosed with BDD participated in a study examining the effects of treatment and maintenance using exposure with response prevention. They received a standard behavior therapy protocol which consisted of exposure in vivo and in imagery, with response prevention. Symptom severity, depression, anxiety, and avoidance were assessed weekly during treatment. Following treatment, a 6-month maintenance program was instituted for five patients, with the other five serving as controls. Patients in the maintenance program were assessed bi-weekly with all measures and a 6-month follow-up was conducted. Patients improved for measures of avoidance, BDD symptoms, depression and anxiety when using exposure with response prevention. Although all patients remained symptom free at follow-up, those in the maintenance program continued to improve. Based on these results, BDD appears to be amenable to exposure with response prevention treatment. Additional treatment gains can be obtained when structured maintenance programs are implemented.

Adult↗
PubMed1997

A maintenance program for obsessive-compulsive disorder using exposure with response prevention: 2-year follow-up.

Recent literature has emphasized the importance of instituting procedures for preventing relapse in obsessive-compulsive disorder (OCD). This study presents data documenting the effect of a maintenance program on the long term (2-year) adjustment of a group of patients with OCD treated with exposure and response prevention. Results indicate that patients maintained their gains for the 2-year follow-up period on measures of anxiety associated with avoidance (Behavioral Avoidance Tests), obsessions, compulsions, and anxiety. Further, patients were able to effectively manage situations defined as lapses (limited symptom return) effectively without additional therapist intervention. However, as in a previous report, treatment gains for depression were not well established. It is concluded that sessions prior to treatment termination which focus on relapse prevention methods focus on additional psychological symptoms aside from the acute disturbance of OCD.

Adult↗