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Biomedical subjects

E J Susman

Publications and source records attributed to E J Susman.

At least 37 records · Page 2Linked to original sources
PubMed1993

Serum and saliva cortisol relations in adolescents during pregnancy and the early postpartum period.

The purpose of this investigation was to examine: (1) relations between serum and saliva cortisol in adolescents in pregnancy and early postpartum and (2) short-term consistency of serum and saliva cortisol across three samples, 20 minutes apart, as well as the long-term consistency from pregnancy to early postpartum. Pregnant adolescents (n = 40), ages 14 to 19 years, were enrolled in this study. Subjects were seen at 20 weeks gestation or earlier (T1), 34-36 weeks gestation (T2), and 2-3 weeks postpartum (T3). Blood samples were drawn at T1 and T3, at 0, 20, and 40 minutes. Saliva samples were collected across the same 40-minute period at T1, T2, and T3. Spearman rho (rs) correlation coefficients between serum and saliva ranged from 0.72 to 0.77 (T1), and 0.42 to 0.60 (T3) (p < or = 0.05). Short-term consistency between serum cortisol samples was 0.86-0.97 at T1 and 0.60-0.82 at T3. Short-term consistency for saliva cortisol samples was 0.70-0.96 at T1, 0.91-0.95 at T2, and 0.64-0.89 at T3. Long-term consistency (T1 to T3) for serum and saliva cortisol was low. Individual differences as well as dramatic changes in the endocrine environment in pregnancy and the early postpartum period may explain the more moderate serum-saliva correlations in the postpartum period.

Adolescent↗
PubMed1993

Cortisol reactivity and anxiety and depression in pregnant adolescents: a longitudinal perspective.

The purpose of this investigation was to examine: (1) the relations among cortisol reactivity (short term changes in cortisol concentration) and anxiety and depression symptoms in adolescents during pregnancy and early postpartum, and (2) cortisol reactivity and psychosocial variables as predictors of anxiety and depression symptoms in pregnancy and early postpartum. Cortisol reactivity, an index of hypothalamic-pituitary-adrenal activity, was hypothesized to be a vulnerability factor for poor physical and mental health outcomes in adolescents. Forty adolescents aged 14 to 19 years (M = 17.3, SD = 1.3) were enrolled in the study and were seen at < 20 weeks gestation (T1), 34-36 weeks gestation (T2), and 2-3 weeks postpartum (T3). Blood was drawn for cortisol at T1 and T3. Psychological assessments of anxiety and depression symptoms, life optimism, and self-worth were administered at T1, T2, and T3. There were significant correlations among cortisol reactivity and anxiety and depression symptoms at T1 and T3, but the correlations were the reverse of the hypothesized direction. Pregnant adolescents with increased cortisol reactivity (cortisol concentrations that increased across a 40-min period) had fewer symptoms of anxiety and depression than other adolescents. Longitudinal analyses showed that anxiety and depression symptoms at T1 were a stronger predictor of postpartum anxiety and depression than was cortisol reactivity, life optimism, self-worth, or age at pregnancy.

Adolescent↗
PubMed1992

Participation in biomedical research: the consent process as viewed by children, adolescents, young adults, and physicians.

We examined the capacity of children, adolescents, and young adults to assent and consent to participation in biomedical research, and what physician-investigators believe is important for patients in these age groups to know about such participation. The sample included 44 male and female subjects, ranging in age from 7 to 20 years, who were hospitalized to treat either pediatric cancer or obesity. The participants completed a structured interview that assessed knowledge of research participation using the elements outlined in the federal guidelines for informed consent. The study subjects were most knowledgeable about those elements of consent that assessed concrete information (e.g., freedom to ask questions, time elements involved, and the benefits of participation). They were less knowledgeable about those elements of informed consent that assessed abstract information (e.g., scientific vs therapeutic purpose of the study, and alternative treatments). Chronologic age was not related to knowledge of the elements of informed consent. The strategies that the study subjects used to reason about participation in research appeared to parallel their reasoning about other physical phenomena.

Adolescent↗
PubMed1992

The relationship of serum and salivary cortisol in a sample of healthy elderly.

The purpose of this study was to assess the validity of salivary cortisol as an index of adrenocortical activity in older adults. Serum and salivary cortisol samples were collected in a sample of 36 healthy older adults (mean age = 66.64). The relationship of serum and salivary cortisol levels was assessed using correlation and regression analyses. In addition, the stability of serum and salivary levels over repeated samplings was assessed. The findings indicate that salivary measures of cortisol covary with serum levels, and both measures remain stable over repeated samplings. The utility of salivary cortisol as a marker of physiological reactivity is discussed. Future research is recommended to explore the emotional correlates of physiological reactivity in older adults.

Aged↗
PubMed1991

A multimethod approach to the assessment of physical abuse.

Numerous and heterogeneous symptoms of maladjustment have been documented among victims of physical abuse. Much of the well-controlled, theoretically guided research is rooted in methodology designed to search for group differences between abused children and a comparison group. Given the recognized methodological problems in constructing appropriate comparison groups for abused children, this study is designed to examine alternative methodological approaches. The purpose of the study is to utilize a case study to illustrate the utility of a multimethod approach to highlight intraindividual variation in the impact of abuse. This study of physically abused twin boys demonstrates that differential patterns of findings are revealed by standardized assessment in comparison to behavioral observation. The results underscore intraindividual variation in the impact of abuse. It is suggested that innate temperamental factors interact with parent-child interaction patterns to account for such intraindividual variation.

Child↗
PubMed1990

The life span perspective: a developmental approach to community health nursing.

Following the nursing theorists' tradition of using an interdisciplinary approach to community health model building, the concepts of the life span perspective on human development were applied to the practice of community health nursing. As with the perception of individual development from this perspective, communities are viewed as evolving over time, with changes occurring across levels of influence--human, societal, historical, and cultural. These levels are interdependent, and factors from any one or more can affect the growth and functioning of the community. Implied in this interdependence is the ability not only to intervene in a community's development, but to go beyond this and recognize that a community has a degree of control over its own development. To be accurate and thorough in working with communities, the community health nurse who takes a life span perspective must be cognizant of the fact that communities do exist in a continual, multilevel, interactive manner that develops through time. Demonstrating the practical use of this perspective, a model for the assessment phase of the nursing process as applied to community study was developed. A pilot study was performed using this model, and initial results suggest that taking a life span perspective toward community health is both valid and practical, and warrants further scholarly investigation.

Community Health Nursing↗
PubMed1988

Physiological and behavioral aspects of stress in adolescence.

Gonadal and adrenal hormone levels appear to be linked to the stressors experienced by young adolescents. Adjustment problems were accompanied by a profile of lower gonadal steroids and higher adrenal androgen levels, primarily androstenedione. Later gonadal maturation may be a result of stress suppressing the reproductive axis. Higher levels of androstenedione may be indicative of chronic levels of stress. However, the findings for androstenedione are complicated by the fact that androstenedione was related to cortisol only in males. Furthermore, androstenedione as a weak androgenic has low potential for affecting behavior, directly. Cortisol levels were related to the frequency of distress behavior in a challenging situation. The relations disappeared with experience in the setting. These findings are consistent with prior animal and human studies. However, while distress behavior in a challenging situation decreased over the one-year period, cortisol levels did not. Sustained physiological arousal in a challenging situation may have long-term implications for the mental health of adolescents. A question for further exploration is whether individual differences in reactivity in one challenging situation, like the clinic visit, is predictive of reactivity in other settings. Adolescence appears to be an ideal period of development in which to examine the interactions between environmental and physiological causes and sequelae of stress. It is characterized by measurable changes in hormonal status and physical maturation and behavior. Studying the intricate interactions between these two sets of changes has only just begun. A larger question yet to be examined is whether interaction between hormones and behavior are unique to adolescence or whether they are indicative of hormone-behavior processes characteristic of the entire life-span. Adjustment and social stressors, adrenal activation, and reproductive maturation may constitute a "vicious" cycle of interrelated factors during adolescence. Adjustment problems could cause activation of the adrenal glands which would cause gonadal suppression and later maturation. The latter could constitute an added stressor reentering the cycle and potentiating the "abnormality". In our population of normal adolescents, this cycle is obviously active within a normal range. In these adolescents stress arising from either endogenous or exogenous sources was not a debilitating force. Rather, they fell within a normal range with various degrees of adjustment, adrenal activation and gonadal maturation.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1987

Developmental processes in early adolescence. Relations among chronologic age, pubertal stage, height, weight, and serum levels of gonadotropins, sex steroids, and adrenal androgens.

Cross-sectional data are presented on 108 young adolescents (56 boys, 52 girls), ages 9 to 14 years. The measures were: for all subjects, pubertal stage (Tanner criteria for genital/breast and pubic hair stage); height and weight; serum hormone concentrations for gonadotropins (luteinizing hormone and follicle-stimulating hormone), sex steroids (testosterone, estradiol, and the computed testosterone to estradiol ratio), adrenal androgens (dehydroepiandrosterone, dehydroepiandrosterone sulfate, and androstenedione), and testosterone-estradiol binding globulin. In addition, testicular volume for boys and menarchial status for girls are reported. The study goal was to provide interrelations among these measures, based on the same sample, and examine their interchangeability. Results suggest that it would be reasonable to compare research across as well as within studies based on different markers. Multiple regression analysis showed that the strongest hormone correlates of pubertal development were androgen levels (primarily testosterone in boys and primarily dehydroepiandrosterone sulphate and androstenedione in girls). Estradiol level in girls was the strongest correlate only for menarchial status. Level of testosterone-estradiol binding globulin, which was lower at successive pubertal stages for boys and showed no consistent differences for girls, may be a useful measure for studying the developmental processes and gender differences during puberty.

Adolescent↗
PubMed1987

Developmental processes in early adolescence: relationships between adolescent adjustment problems and chronologic age, pubertal stage, and puberty-related serum hormone levels.

Relations between adolescent psychosocial adjustment problems and markers of biologic development, including chronologic age, pubertal status, and serum hormone levels, were examined in 56 normal boys and 52 normal girls, ages 9 to 14 years. Adolescent psychosocial adjustment was assessed by adolescent self-ratings of various aspects of self-image (Offer Self-Image Questionnaire for Adolescents) and parent ratings of adolescent behavior problems (Child Behavior Checklist). The pubertal status measure used in the analyses was Tanner genital stage for boys and Tanner breast stage for girls. The hormone measures, determined by radioimmunoassay, were serum levels of gonadotropins (luteinizing hormone and follicle stimulating hormone), sex steroids (testosterone and estradiol), and adrenal androgens (dehydroepiandrosterone and its sulfate, and androstenedione). The testosterone/estradiol ratio also was computed. Overall, findings were stronger, more consistent, and more generalized for boys than for girls. For boys, adjustment problems typically were associated with a multivariate profile that may be characteristic for later maturers: relatively low sex steroid levels, or lower pubertal stage, and relatively high adrenal androgen (androstenedione) levels, frequently in conjunction with higher chronologic age. Univariate relations predominated for girls; that is, associated with adjustment problems for girls were relatively high levels of gonadotropins, relatively low levels of dehydroepiandrosterone sulfate, and relatively high levels of androstenedione on their own or in conjunction with lower pubertal stage. Higher levels of androstenedione, a steroid particularly responsive to stress, were associated with adjustment problems in both boys and girls. This relation may reflect the stress of later maturation, which could result from environmental factors, such as adolescent self-comparisons with same-age peers, or endogenous effects of hormones.

Adolescent↗
PubMed1987

Hormones, emotional dispositions, and aggressive attributes in young adolescents.

Relations among hormone levels, emotional dispositions, and aggressive attributes were examined in 56 boys and 52 girls, age 9 to 14 years. The adolescents represented all 5 stages of pubertal development. Serum levels of gonadotropins, gonadal steroids, adrenal androgens, and testosterone-estradiol binding globulin were assessed. Levels of these hormones were related to stage of pubertal development and were assumed to represent relatively stable biological characteristics. The emotional dispositions assessed were adolescent self-reported anger, nervousness, sadness, and impulse control. The aggressive attributes assessed were mother-reported acting out and aggressive behavior problems and rebellious and nasty characteristics. Hormone levels were related to emotional dispositions and aggressive attributes for boys but not for girls. For example, higher levels of androstenedione in boys were related to higher levels of acting-out behavior problems. Level of testosterone-estradiol binding globulin was negatively related to sad affect and acting out behavior.

Adolescent↗
PubMed1987

Reasoning about illness in ill and healthy children and adolescents: cognitive and emotional developmental aspects.

Anxiety level, perception of control over illness, stage of cognitive development, and stage of reasoning about illness were examined in pediatric oncology, obese, and healthy children and adolescents. Among the groups, there were no mean differences with regard to any of these measures. Older participants in the higher stages of cognitive development were higher on stage of reasoning about illness in general and their own illness than were younger and less cognitively mature participants. In the pediatric oncology and obese groups, participants higher on perception of control over illness were higher on stage of reasoning about illness in general and their own illness, in particular, than those lower on perception of control. Anxiety level was not related to stage of reasoning about illness, but participants higher on anxiety were lower on perception of control over illness. Clinical implications of the findings are discussed.

Adolescent↗
PubMed1985

Child-rearing, marital, recreational and work role integration and climacteric symptoms in midlife women.

This study investigated relationships between the roles women enact during midlife and the frequency and severity of symptoms they report at the climacteric. A sample of 185 healthy, middle-aged women completed measures assessing climacteric symptoms, adjustment to the marital role, and degree of participation in child-rearing, recreational, and work roles. Findings indicated that the more roles women enact, the less likely they are to experience climacteric symptoms. Adjustment to the marital role and an active recreational role were the best predictors of infrequent and mild climacteric symptoms. The number of hours worked was negatively related to recreational involvement and marital role adjustment but did not relate to climacteric symptoms. The child-rearing role was not related to symptoms. These findings indicate that successful marital adaptation and active role participation may be significantly related to diminished climacteric symptoms formation of midlife women.

Adaptation, Psychological↗
PubMed1980

Children with serious illness: behavioral correlates of separation and isolation.

The deleterious effects of separation have been demonstrated in experimental animal studies and in naturalistic case studies of children. In this study extensive observational and physiological records were obtained on four preschool children who were receiving chemotherapy for childhood cancer. The findings generally parallel those reported in the subhuman primate literature. The children's behavior followed a sequence of agitation followed by behavioral depression. The findings underscore the seriousness of parent-child separation and the need to develop intervention strategies to ameliorate these deleterious effects.

Adaptation, Psychological↗
PubMed1980

Relation of conceptual tempo to social behaviors of Head Start children.

The relation of reflection-impulsivity and motor inhibition to naturally occurring social and self-regulatory behavior of 121 urban Head Start boys and girls was examined. Correlations between the Kansas Reflection-Impulsivity Scale for Preschoolers, motor inhibition tasks, and classroom behavior were computed for two groups of Head Start classes that differed in race and the amount of adult-imposed classroom structure. In the less structured classes, impulsive children were less aggressive, less assertive, and less likely to show understanding of others or to engage in such prosocial behavior as cooperation, helping, and sharing than were their reflective peers. Impulsive children were higher than reflectives on two indices of self-regulation: responsibility during clean-up time and waiting patiently during delays. Impulsivity was not related to behavior in highly structured classes. Motor inhibition was not consistently related to the observational measures.

Aggression↗
PubMedDate not supplied

The role of sex hormone replacement therapy on self-perceived competence in adolescents with delayed puberty.

The objective of the present study was to determine the role of sex steroids in the development of self-perceived competence during adolescence. The Harter Self-Perception Scale was administered to 56 adolescents with delayed puberty who were receiving depo-testosterone (males) or conjugated estrogens (females) administered in 3-month blocks alternating with placebo. Treatment was given at three dose levels approximating early, middle, and late pubertal replacement levels. Hormone treatments had a significant positive effect for both males and females in one subscale domain--perceived job competence. Significant positive hormone effects were also obtained for perceptions of romantic appeal and close friendship in females and perception of athletic abilities in males. It can be inferred from the results of this study that the hormonal changes associated with sexual maturation have targeted influences on specific domains of self-perceived competence and that there are clear gender differences.

Adolescent↗