PubMed Health⌕ Search

Biomedical subjects

D Shaffer

Publications and source records attributed to D Shaffer.

At least 37 records · Page 2Linked to original sources
PubMed1990

Adolescent suicide attempters. Response to suicide-prevention programs.

As part of a controlled evaluation of three suicide-prevention curricula delivered to 1438 ninth- and 10th-grade students, 63 adolescents were identified as having made a suicide attempt. Their attitudes about suicide and help seeking were compared with those of 910 nonattempters drawn from the same population. Reaction to the prevention program was assessed by comparing the responses of the 35 attempters exposed to the programs with responses of 524 exposed nonattempters. The impact of the programs was assessed by comparing 35 exposed attempters with 28 attempters from a control group. Self-identified attempters were less likely to endorse views consistent with the curricula at baseline, but there was little evidence that the programs were successful in influencing these views. There was some evidence that previous attempters were more upset by the programs than their nonattempter peers. The prevalence of suicide attempts as defined in this study by self-report was higher than that reported in studies using interview techniques.

Adolescent↗
PubMed1990

Uncommon troubles in young people: prevalence estimates of selected psychiatric disorders in a nonreferred adolescent population.

A two-stage epidemiologic strategy was used to estimate the lifetime prevalence of selected DSM-III-defined psychiatric disorders in a county-wide secondary school population (N = 5596). Screening tests used in the first stage included items based on DSM-III criteria for eating disorders and panic disorder, as well as the Leyton Obsessional Inventory-Child Version and the Beck Depression Inventory. Based on interviews (n = 356) by clinicians in the second stage, the lifetime prevalence of anorexia nervosa was 0.2%; bulimia, 2.5%; panic disorder, 0.6%; obsessive-compulsive disorder, 1.9%; major depression, 4.0%; dysthymic disorder, 4.9%; and generalized anxiety disorder, 3.7%. While rates of mental health service utilization varied greatly by diagnosis, only 41% of students who were assigned both a diagnosis and a rating of impairment had received any kind of clinical attention.

Adolescent↗
PubMed1990

Early childhood bereavement.

Acute bereavement responses in preschool children were prospectively assessed. Parentally bereaved subjects (26, 3- to 6-year-olds) were compared with matched, nonbereaved controls (N = 40). Bereaved subjects, particularly boys, were significantly more symptomatic (Child Behavior Checklist--Parent). On a newly standardized affect interview for preschoolers, bereaved children reported feeling more scared and less happy than controls. Bereaved children, especially girls, reported significantly more sadness when thinking about their parents. The ability to report these grieving emotions correlated significantly with improved functioning. Children from families experiencing a drop in income after the death were more symptomatic. Disturbance among subject parents and children was highly correlated. Issues of developmental capacity to grieve and the impact of environmental mediators are discussed.

Adaptation, Psychological↗
PubMed1990

Characterization of the repertoire of hypervariable regions in the Protein II (opa) gene family of Neisseria gonorrhoeae.

P.II outer membrane proteins of Neisseria gonorrhoeae are encoded by a family of closely related genes. Although the genes are highly conserved, major differences in sequence among them occur in two short regions, designated hypervariable regions 1 (HV1) and 2 (HV2). In this study, we determined the number and DNA sequence of the hypervariable regions in the P.II genes of strains FA1090. The FA1090 chromosome contained at least eleven P.II loci, having six different versions each of HV1 and HV2 among them. Southern blotting with HV-specific oligonucleotides showed that each version was present in one to three copies, and that there were nine unique combinations of HV1 and HV2 in the P.II genes. Although each of the versions of HV1 or HV2 had a unique DNA sequence, there were some similarities among them, particularly when certain ones were compared. Restriction fragments containing only the HV regions were cloned into an expression vector to demonstrate that the epitopes recognized by a set of monoclonal antibodies specific for different FA1090 P.II proteins were completely encoded by either HV1 or HV2.

Amino Acid Sequence↗
PubMed1990

Neonatal cranial ultrasound abnormalities: association with developmental delay at age one in low birth weight infants.

Relationships between abnormalities on neonatal serial cranial ultrasound and cognitive development at age one year were examined in 153 low birth weight (LBW) infants. Infants with complex injury (persistent parenchymal echogenicity, lucency, or persistent ventricular enlargement) scored significantly lower on the Bayley Mental Development Index than noninjured infants. Nine of 11 infants with complex injury had severe developmental delay in contrast to 3/110 of the noninjured. Adjusting for birth weight, gestational age, head circumference and social class, infants with complex injury were 33 times more likely to be severely delayed than noninjured infants. Risk for severe delay associated with LBW appeared to be indirect, through increased probability of ultrasonographic abnormality. The poorest developmental outcome was seen in infants with both complex perinatal brain injury and either very LBW or very young gestational age. However, very LBW infants with normal neonatal ultrasounds were at negligible risk for severe delay at age one.

Birth Injuries↗
PubMed1989

Neurological soft signs and school achievement: the mediating effects of sustained attention.

A group of 115 black male adolescents drawn from a clinically unselected birth cohort, half of whom were known to have had neurological soft signs at age 7, were examined at age 17 to determine the relation between soft signs and performance on standard tests of school achievement and sustained attention. Three signs measured at age 17--dysgraphesthesia, difficulties with rapid alternating movements (dysdiadochokinesis), and motor slowness--were related to lower concurrent and past IQ and to impaired performance on laboratory and paper-and-pencil measures of sustained attention. The relation between signs and the attentional measures remained significant after IQ was statistically controlled. The three age 17 soft signs as well as age 7 signs were related to impaired performance on standardized tests (age 17) of school achievement. Most of the relation between signs and school achievement could be accounted for by the variance signs shared with sustained attention. One sign, mirror movements, was unrelated to all other attentional and cognitive measures.

Achievement↗
PubMed1989

The struggle to be thin: a survey of anorexic and bulimic symptoms in a non-referred adolescent population.

Ninety-one per cent of a county-wide high school population (N = 5596) completed the Eating Symptoms Inventory (ESI) and the Eating Attitudes Test (EAT). Being female, older and heavier are far more strongly associated with anorexic and bulimic symptoms than is social class. ESI approximations of the DSM-III criteria for anorexia nervosa or bulimia suggest that while both conditions are rare (less than 1%), bulimia is the more prevalent disorder.

Adolescent↗
PubMed1989

A national survey of school-based, adolescent suicide prevention programs.

A national survey of suicide prevention programs was conducted to determine the number, distribution and content of school-based, curriculum programs for adolescents. One hundred fifteen programs were identified. The total number of students and schools targeted for prevention efforts more than doubled during the academic years 1984/1985 to 1986/1987. Content of the programs was similar, with nearly all including information on suicide warning signs and other facts, as well as on accessing community mental health resources. Most included a separate component for school staff and parents. Ninety-five percent subscribed to the view that suicide is most commonly a response to extreme stress or pressure and could happen to anyone. Possible negative implications of this "stress model" of suicide were discussed. While this survey plays an important first step in providing a description of these programs, more evaluative research is needed to determine what effect, if any, these programs have on suicidal behavior.

Adolescent↗
PubMed1989

Pediatric management of suicidal behavior.

Emergency evaluation of the adolescent suicide attempter presents the pediatrician with a complex challenge. The attempter is acutely ill, in a psychosocial crisis, and may have one or more major mental disorders and a highly disturbed family. The adolescent rarely has planned the attempt for more than a few minutes, and usually does not know the dangerousness of the chosen method. Suicide attempts are quite common among adolescents and suicide quite rare, yet the risk of later death among attempters is substantial. Suicide is associated with a variety of problems and diagnoses, and in most ways attempters do not differ from other emotionally troubled adolescents. Suicide attempters and their families are often quite resistant to treatment, and this resistance seems to increase with the number of problems identified. How should the clinician proceed? We have stressed the importance of rapid evaluation of parent and adolescent to identify individual and family risk factors (Table 1). As the number of risk factors increases, greater caution should be exercised. A short hospitalization can allow a more thorough evaluation of complicated cases. Brief, problem-oriented therapy (Table 2) is most likely to be accepted by the family and can result in rapid improvement. A smaller number of adolescents will require long term care.

Adolescent↗
PubMed1988

Conduct disorder and cognitive functioning: testing three causal hypotheses.

The sample consisted of black adolescents who were members of the Columbia-Presbyterian chapter of the Collaborative Perinatal Project from birth to age 7. At age 17, subjects and their parents were administered a battery of instruments that included standardized psychiatric diagnostic interviews as part of a call-back study. Results from least-squares and logistic regression analyses were compatible with the hypothesis that deficiencies in cognitive functioning are causally related to adolescent conduct disorder as defined by DSM III. The results suggested that the relation of cognitive functioning to psychiatric status appears to be specific to conduct disorders. The results were incompatible with a "third" variable hypothesis (third factors included neurological status and environmental disadvantage) and the hypothesis that conduct problems lead to deficits in cognitive functioning. The 3 most (and equally) important factors in accounting for age-17 conduct disorder were cognitive functioning, parent psychopathology, and early aggression. A closer look at the data tentatively suggested that a broad deficiency in acculturational learning, rather than narrowly focused social cognitive differences or native endowment, constitutes a key element in the link between cognitive functioning and conduct disorder. Test bias was ruled out as a possible explanation for the results.

Adolescent↗
PubMed1988

The epidemiology of teen suicide: an examination of risk factors.

The information presented here is on the incidence of suicide in the United States and in other countries where reporting procedures are reliable. The problem of underreporting is discussed and put into perspective. Secular trends in suicide incidence are presented, and it is shown how these have varied a great deal for different age groups. Age, ethnic, and cultural differences in incidence are demonstrated, and explanatory theories for these differences are put forward. The phenomenon of cluster suicide is described, and possible explanations for this are discussed. The limitations of death certificate data and the advantages (and limitations) of the psychological autopsy method are presented. Results from previous psychological autopsy studies on epidemiologically sound samples are summarized. Results (preliminary) from a current psychological autopsy study on consecutive adolescent suicides in the New York Metropolitan area are presented. Family history data and diagnostic profiles of completed suicides are emphasized.

Adolescent↗
PubMed1988

Studies in small bowel transplantation. Prevention of graft-versus-host disease with preservation of allograft function by donor pretreatment with antilymphocyte serum.

Donor pretreatment with antilymphocyte serum (ALS) effectively prevents graft-versus-host disease (GVHD) in a unidirectional (parent-to-F1 hybrid) rat small bowel transplantation model. ALS must be administered prior to or at the time of transplantation, and the intraperitoneal route is more effective than subcutaneous administration. Donor pretreatment with ALS uniformly prevents GVHD without impairing subsequent allograft function as measured by absorption of dietary energy and nitrogen, weight gain, and bowel morphology. These rodent studies suggest that ALS treatment of donors as well as recipients in small bowel transplantation may be a highly effective, simple, and easily applicable method to prevent or ameliorate GVHD in human small bowel transplantation.

Animals↗
PubMed1988

Prediction of intellectual deficits in children with acute lymphoblastic leukemia.

Possible predictors of reported lower cognitive functioning in irradiated children with acute lymphoblastic leukemia (ALL) were investigated. Thirty-four subjects, 5-14 years old, with ALL in continuous complete remission and without evidence of current or past central nervous system disease, were examined 9-110 months after diagnosis, using standard measures of intelligence and academic achievement. Subjects with a history of post-irradiation somnolence syndrome were significantly older at diagnosis than nonsomnolent subjects. Intelligence (IQ) was found to be unrelated to history of somnolence syndrome. IQ and achievement were unrelated to age at irradiation, irradiation-examination interval, and radiation dosages. The strongest predictor of IQ by far is parental social class. The importance of controlling for social class differences when searching for treatment effects on IQ and achievement is stressed.

Achievement↗