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Biomedical subjects

David Katerndahl

Publications and source records attributed to David Katerndahl.

9 recordsLinked to original sources

Factors that predict how women label their own childhood sexual abuse.

Despite the psychological impact of child sexual abuse, many victims do not acknowledge that their experiences were "abuse". This study sought to identify factors that predict how women label their own experiences of childhood sexual abuse. This cross-sectional study was conducted in a family medicine clinic with adult female patients. Subjects completed structured interviews about their childhood environment and their sexual abuse history. Logistic regression analysis showed that labeling of abuse was dependent upon intercourse (beta = 7.43, p = .006), the frequency of abuse by the first perpetrator (beta = 5.08, p = .024), and paternal overprotection (beta = 6.69, p = .010). Findings suggest that the severity of abusive acts is most important and an over-protective father may enhance the victim's acknowledgment that sexual touching is abusive.

Adult↗

Predictors of development of adult psychopathology in female victims of childhood sexual abuse.

The purpose of this study is to identify predictors of resilience and adult mental disorders in women with a history of childhood sexual abuse. This cross-sectional study was conducted in a family practice center using adult female (age 18-40) patients. Outcome measures assessed the prevalence of major depressive episode, panic disorder, agoraphobia, substance abuse, posttraumatic stress disorder, borderline personality disorder, bulimia, and suicidality. Seventy-six percent of the 90 women with sufficient data met criteria for at least one adult disorder. Mental health was related to high SES, lack of family alcohol abuse, lower frequency of first perpetrator abuse, and few perpetrators. Specifics of the abuse were associated with development of borderline personality disorder, substance abuse, major depressive episode, suicidality, bulimia, agoraphobia, and panic disorder. Maternal violence against the father, substance abuse within the household of origin, and maternal care and overprotection were also important. The specifics about the abuse and the family environment during childhood are important predictors of adult psychopathology.

Adolescent↗

A randomized trial of the effects of remote intercessory prayer: interactions with personal beliefs on problem-specific outcomes and functional status.

OBJECTIVES: Investigate the relevance of interpersonal belief factors as modifiers of the effectiveness of intercessory prayer. DESIGN: Randomized clinical trial. SETTING/LOCATION: Community-dwelling adults recruited from seven local church groups. SUBJECTS: Eighty-six (86) male and female participants 18-88 years of age were randomly assigned to either treatment (n = 45) or control groups (n = 41). INTERVENTIONS: Several volunteers committed to daily prayer for participants in the intervention group. Intercessory prayer commenced for 1 month and were directed toward a life concern or problem disclosed by the participant at baseline. Participants were unaware of being prayed for. OUTCOMES MEASURES: Degree to which their problem had been resolved and the current level of concern they had about a specific life problem they described at baseline. Four component scores from the Medical Outcomes Study SF-20 were also used. RESULTS: No direct intervention effect on the primary outcomes was found. A marginally significant reduction in the amount of pain was observed in the intervention group compared to controls. The amount of concern for baseline problems at follow-up was significantly lower in the intervention group when stratified by subject's baseline degree of belief that their problem could be resolved. Prayer intervention appeared to effectively reduce the subject's level of concern only if the subject initially believed that the problem could be resolved. Those in the intervention group who did not believe in a possible resolution to their problem did not differ from controls. Better physical functioning was observed in the intervention group among those with a higher belief in prayer and surprisingly, better mental health scores were observed in the control group with lower belief in prayer scores. CONCLUSIONS: The results of the current study underscore the role of interpersonal belief in prayer efficacy and are consistent with the literature showing the relevance of belief in health and well-being in general. The relevance of interpersonal belief factors of the participants is recommended in future investigations.

Adult↗

Knowledge About Recommended Treatment and Management of Major Depressive Disorder, Panic Disorder, and Generalized Anxiety Disorder Among Family Physicians.

BACKGROUND: Concerns have been raised about whether primary care physicians appropriately manage mental disorders. We assessed family physicians' knowledge of appropriate management of major depressive disorder (MDD), panic disorder, and generalized anxiety disorder (GAD). METHOD: Active members of the Texas Academy of Family Physicians (N = 3553) were mailed a questionnaire in 2002 asking them to indicate which treatments they felt were effective for MDD, panic disorder, and GAD and also to indicate how they had treated their last patient with each disorder. Their treatment strategies were then compared with current guidelines. RESULTS: 574 physicians (16%) responded. The percentage of respondents scoring at or above 80% for knowledge of effective treatments was 88.3% for MDD, 16.8% for panic disorder, and 12.5% for GAD (p <.001 for MDD vs. panic disorder or GAD). Only 0.3% of MDD patients, 1.4% of panic disorder patients, and 4.0% of GAD patients were not prescribed at least 1 of the effective treatments. Referral rates to mental health providers were high for all 3 conditions. CONCLUSIONS: There were significant gaps in physician knowledge of current guidelines on treating panic disorder and GAD, but not MDD. However, most patients with one of the disorders were either referred to a mental health provider or treated with an effective modality.

Journal Article↗

Panic-related outcomes in patients with a personal physician.

BACKGROUND AND OBJECTIVES: Although having a regular source of care is associated with positive health behaviors, its effect in specific disorders is not known. This study assessed differences in outcomes of patients with panic attacks, including symptoms, health care utilization, and treatment for panic symptoms based on the presence and specialty of a self-defined personal physician. METHODS: In this community-based study, 97 subjects with Diagnostic and Statistical Manual, Third Edition, Revised (DSM-IIIR) panic attacks were interviewed concerning total and recent health care utilization for panic symptoms, total and current treatment for panic symptoms, and panic-related outcomes such as quality of life, psychiatric symptoms, work disability, substance abuse, and perceived control. RESULTS: Although the absence of a personal family physician was not related to outcomes, the specialty of the personal physician was associated with significant differences in recent health care utilization and treatment for panic and in panic-related outcomes. Having a mental health provider was associated with more utilization and treatment but worse outcomes. However, such differences could generally be explained by differences in preexisting psychiatric disorders and the severity of panic symptoms. CONCLUSIONS: Compared with having a mental health provider, having a family physician was associated with fewer recent ambulatory visits, particularly to mental health settings, and less-frequent current use of prescription, over-the-counter, or illicit drugs for panic. Yet, when corrected for panic severity and prior mental disorders, there was no difference in these outcomes.

Adult↗

Panic plaques: panic disorder & coronary artery disease in patients with chest pain.

BACKGROUND: The purpose of this systematic review was to identify characteristics of the chest pain associated with the presence of panic disorder, to determine the strength of the association between panic disorder and coronary artery disease (CAD), and to determine the association between panic disorder and known cardiovascular risk factors. METHODS: Potential studies were identified via computerized search using MEDLINE and PSYCINFO databases, and review of bibliographies. MeSH headings used included "panic disorder" with "chest pain," "panic disorder" with "coronary disease or cardiovascular disorders or heart disorders," and "panic disorder" with "cholesterol or essential hypertension or tobacco smoking." Studies had to base their diagnosis of panic disorder on criteria from the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, and objective criteria of CAD and risk factors had to be used. Only case-control and cohort studies were included. RESULTS: The relative risk of panic disorder in patients with nonanginal chest pain is 2.03 [confidence interval (CI), 1.41 to 2.92]. Concerning the relationship between panic disorder and CAD, studies conducted in emergency departments found a relative risk of 1.25 (CI, 0.87 to 1.80). However, there is an inverse relationship between the prevalence of CAD in the study and the prevalence of panic disorder among the patients with CAD (r = -.469, P =.086). Panic disorder has also been linked to cardiac risk factors. CONCLUSIONS: Panic disorder and CAD are correlated in noncardiology settings, and recurrent panic attacks may actually cause CAD. Recognition of either condition should lead the family physician to consider the other, resulting in increased vigilance and possible screening.

Chest Pain↗