Biomedical subjects

Deborah Friedman

Publications and source records attributed to Deborah Friedman.

8 recordsLinked to original sources

PubMed2007

Brief report: testing the factorial invariance of the CBCL Somatic Complaints scale as a measure of internalizing symptoms for children with and without chronic illness.

OBJECTIVE: To examine the factorial invariance of the Somatic Complaints subscale of the Child Behavior Checklist as a measure of Internalizing Behavior Problems across a sample of children with and without spina bifida. METHODS: Multisample confirmatory factor analysis was used to compare mother and father report on the Somatic Complaints subscale across a sample of children with spina bifida and a matched comparison sample of able-bodied children ages 8 through 11 years (N = 68 for mother report in each group; N = 54 for father report in the spina bifida group and 53 for the able-bodied group). RESULTS: Although there were no significant between-group differences in the magnitude of factor loadings, significantly more variance in scores on the Somatic Complaints scale was unrelated to Internalizing Behavior Problems for the spina bifida group, compared to the able-bodied group. There were no between-group differences when father data were analyzed, but the latent variable of Internalizing Behavior Problems explained little variance in the Somatic Complaints scale for either group. CONCLUSIONS: Maternal report of Somatic Complaints on the CBCL does not appear to measure Internalizing Behavior Problems in the same manner across groups of children with and without spina bifida. This suggests that the Somatic Complaints subscale should be interpreted with caution when measuring Internalizing Behavior Problems within this population.

Anxiety↗

PubMed2006

Anti-inflammatory and immunosuppressive drugs and reproduction.

Rheumatic diseases in women of childbearing years may necessitate drug treatment during a pregnancy, to control maternal disease activity and to ensure a successful pregnancy outcome. This survey is based on a consensus workshop of international experts discussing effects of anti-inflammatory, immunosuppressive and biological drugs during pregnancy and lactation. In addition, effects of these drugs on male and female fertility and possible long-term effects on infants exposed to drugs antenatally are discussed where data were available. Recommendations for drug treatment during pregnancy and lactation are given.

Adult↗

PubMed2004

Pregnancy complications associated with childhood anxiety disorders.

To determine whether perinatal complications predict childhood anxiety disorders independently of parental psychopathology, we systematically assessed pregnancy and delivery complications and psychopathology in a sample of children (mean age=6.8 years) at high risk for anxiety disorders whose parents had panic disorder with (n=138) or without (n=26) major depression, and in contrast groups of offspring of parents with major depression alone (n=47), or no mood or anxiety disorders (n=95; total N=306). Psychopathology in the children was assessed by structured diagnostic interviews (K-SADS), and pregnancy and delivery complications were assessed using the developmental history module of the DICA-P. Number of pregnancy complications predicted multiple childhood anxiety disorders independently of parental diagnosis (odds ratio=1.6 [1.4-2.0]). This effect was accounted for by heavy bleeding requiring bed-rest, hypertension, illness requiring medical attention, and serious family problems. Associations remained significant when lifetime child mood and disruptive behavior disorders were covaried. Results suggest that prenatal stressors may increase a child's risk for anxiety disorders beyond the risk conferred by parental psychopathology alone.

Anxiety Disorders↗

PubMed2004

Parent functioning in families of preadolescents with spina bifida: longitudinal implications for child adjustment.

The purpose of this study was to test a strength-of-association model regarding possible longitudinal and bidirectional associations between parent functioning and child adjustment in families of children with spina bifida (n = 68) and families of able-bodied children (n = 68). Parent functioning was assessed across 3 domains: parenting stress, individual psychosocial adjustment, and marital satisfaction. Child adjustment was indexed by teacher-reported internalizing and externalizing symptoms, self-reported depressive symptoms, and observed adaptive behavior. Findings revealed that all 3 parent functioning variables predicted child adjustment outcomes, and that such results were particularly strong for externalizing symptoms. Associations between parent functioning and child adjustment tended to be in the direction of parent to child and were similar across both groups. These findings have implications for potential interventions targeted at helping families manage the transition into early adolescence in families of children with spina bifida as well as families of healthy children.

Adjustment Disorders↗

PubMed2002

Presence of prolonged dispersion of qt intervals in late survivors of childhood anthracycline therapy.

To determine the incidence of abnormal dispersion of QT intervals on an ECG the authors measured these intervals in long-term survivors after anthracycline treatment for childhood malignancies and compared the incidence to the traditional markers, prolonged QT and QTc intervals. Prolonged QT dispersion (QTd) and corrected QT dispersion (QTcd) have been associated with serious arrhythmias and sudden death in many forms of heart disease. The above intervals and shortening fraction (SF) on echocardiogram were determined in 64 late survivors who were 4-22 years post anthracycline therapy. They were divided into 2 groups: group I, 39 patients with normal function with SF >or= 29%, and group II, 15 patients with SF < 29%. An additional 10 patients had died and had SF < 29% at the time of death. They were divided into 2 groups: group III, 5 patients who died with heart failure after a mean of 12 years from of therapy, and group IV, 5 patients who had a sudden cardiac death after a mean of 9 years from end of therapy. In group I patients, the incidence of prolonged QT and QTc intervals was < 6%, whereas that of QTd and QTcd was > 38%. In group II patients, the presence of prolonged QT and QTc intervals was < 16%, whereas that of QTd and QTcd was > 40%. The QTc (p =.01), QTd (p =.02), and QTcd (p =.01) were significantly higher and SF (<.01) significantly lower in group IV compared to those alive (group I and II patients) with no significant difference in age, number of years of follow-up, precordial radiation dose, or anthracycline dose between the two. The combination of QTcd > 110 ms and diminished SF < 29% was found to be associated with sudden death. In summary, the long-term survivors of anthracycline therapy had a high incidence (>38%) of abnormally prolonged QT dispersion intervals, QTd and QTcd, even in those with normal QT and QTc on an ECG and normal shortening fraction on an echocardiogram.

Adolescent↗

PubMedDate not supplied

Collecting and managing multisource and multimethod data in studies of pediatric populations.

OBJECTIVE: To provide recommendations for the collection and management of multisource and multimethod data in studies of children and adolescents with pediatric conditions. METHODS: We discuss limitations of single-source and single-method data collection strategies. We review strategies for collecting and managing multisource and multimethod data, including coverage of the literature on level of agreement across sources, strengths and weaknesses of various source and method aggregation strategies, and methods of examining discrepancies between sources. RESULTS: Multisource and multimethod data collection strategies enable researchers to rule out alternative explanations for their findings and pose research questions that would probably not be testable with single-source, single-method data sets. CONCLUSIONS: We emphasize the utility of multisource and multimethod data and provide recommendations for future work.

Adolescent↗

PubMedDate not supplied

A longitudinal study of pubertal timing, parent-child conflict, and cohesion in families of young adolescents with spina bifida.

OBJECTIVE: To study longitudinal associations between perceived pubertal timing and family conflict and cohesion during the transition to adolescence in 68 families of children with spina bifida and 68 matched families with able-bodied children. Children were 8 or 9 years old at Time 1 and 10 or 11 years old at Time 2. METHODS: Family conflict and cohesion were assessed with observational data and maternal, paternal, and child reports on questionnaires. Perceived pubertal timing was assessed with maternal report. RESULTS: Consistent with the literature on typically developing young adolescents, prospective longitudinal analyses revealed that early maturity was associated with higher levels of conflict and decreases in cohesion in families with able-bodied children. Contrary to these findings, perceived pubertal timing had less of an impact (or the opposite impact) in families of children with spina bifida. Findings were robust across respondents and methods of data collection. CONCLUSIONS: Findings based on multimethod and multisource data suggest that familial response to developmental change differs across context (spina bifida vs. able-bodied). Possible reasons for differential responses to the adolescent transition are reviewed. Services are likely to be enhanced if health professionals routinely discuss adolescent developmental issues with parents and youths during clinic visits.

Adaptation, Psychological↗

PubMedDate not supplied

The fetal Doppler mechanical PR interval: a validation study.

OBJECTIVE: To evaluate the accuracy of pulsed Doppler-derived fetal PR interval measurements obtained by physicians participating in a multicenter prospective fetal echocardiographic study. METHODS: Echocardiograms on healthy fetuses were performed and evaluated by 15 pediatric cardiologists/perinatologists across the United States who are participating in a larger clinical trial involving fetuses at risk for autoantibody-associated congenital heart block. Prior to enrolling women in the main trial, each physician was provided with a teaching tape to demonstrate how the pulsed Doppler-derived PR interval is measured. The procedure involves placing a gated pulsed Doppler sample volume in the left ventricle at the junction of the anterior leaflet of the mitral valve and the left ventricular outflow tract in an apical 5-chamber view, and simultaneously obtaining left ventricular filling and emptying. Time intervals are measured from the onset of the mitral A wave (atrial systole) to the onset of the aortic pulsed Doppler tracing (ventricular systole). This represents the mechanical PR interval. Each physician measured the pulsed Doppler-derived fetal PR interval on 5 different subjects recruited from the physician's specific site. To validate each physician's technique, the tapes were sent to a central facility and the same intervals were remeasured by an experienced central reader (D.M.F.). A physician was determined to have adequate ability to measure the fetal PR interval if all 5 measurements were within +/- 30 ms of the central reader's measurements, where 30 ms corresponds to 25% of the mean observed in normative PR interval data. This difference was deemed to be the minimum clinically important difference in Doppler PR interval. RESULTS: Fourteen of the 15 physicians were considered to have adequate ability to measure the fetal PR interval according to our established criterion. The overall mean difference between the physicians and the central reader's measurements was -0.26 +/- 11.04 ms (p = 0.84). In addition, 95% of the observed differences were included in the interval (-22.23 to 21.81), which is well within our clinically acceptable range of +/- 30 ms. CONCLUSIONS: The pulsed Doppler assessment of the mechanical PR interval in the fetus can be accurately performed after minimal training. This technique may be a valuable tool for identification of early and potentially reversible conduction abnormalities in fetuses at risk for more advanced and permanent forms of heart block associated with maternal antibodies to SSA/Ro-SSB/La.

Arrhythmias, Cardiac↗