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Biomedical subjects

F Earls

Publications and source records attributed to F Earls.

At least 37 records · Page 2Linked to original sources
PubMed1995

Psychometric properties of impulsivity measures: temporal stability, validity and factor structure.

Temporal stability, discriminant validity, and factor structure of an array of performance measures of impulsivity was assessed within samples of normal (N = 48) and behaviorally disordered children (N = 88) ages 6-16 (126 M, 10 F; mean age = 10.57 years; SD = 2.13). Using a relatively conservative standard for adequate temporal stability, 31% of the variables derived from these measures met criterion. Of these, 83% were able to discriminate groups after partialling out the effects of intellectual aptitude and age. Factor analysis yielded a two-factor solution interpreted as representing cognitive (inhibitory control) and motivational (insensitivity to punishment/nonreward) components of impulsivity.

Adolescent↗
PubMed1995

Person and environment in HIV risk behavior change between adolescence and young adulthood.

This article explores how personal and environmental variables influence change in human immunodeficiency virus (HIV)-related risk behaviors between adolescence and young adulthood. Repeated interviews with 602 youths from 10 cities across the United States provide the data. These interviews first occurred in 1984-1985 and 1985-1986 when the youths were adolescents and were repeated again in 1989-1990 and 1991-1992 when they were all young adults. A longitudinal multivariate analysis shows that 31% of the variance in HIV risk behaviors by inner-city young adults is predicted by a combination of adolescent risk behaviors, personal variables (suicidality, substance misuse, antisocial behavior), environmental variables (history of child abuse, poor relations with parents, stressful events, peer misbehavior, number of AIDS prevention messages), and interactions between variables (number of neighborhood murders with child abuse, number of neighborhood murders with substance misuse, and unemployment rates with antisocial behavior).

Adolescent↗
PubMed1994

Evaluating a community intervention to reduce the risk of child abuse: methodological strategies in conducting neighborhood surveys.

Building on the ecological approach to child abuse, the National Center on Child Abuse and Neglect is supporting a number of community-based prevention initiatives. One such program, based in Boston, is designed to build a caring community in which families can be empowered to break patterns of abusive and neglectful behavior. Independent evaluation is central to the program. A multi-level strategy has been designed, incorporating information from census and other databases, from random household surveys, and from families participating directly in services provided. This paper reports on the second level of the evaluation, designed to assess community social support, attitudes about parenting, perceptions of the neighborhood, and ways in which these may relate to child abuse. Perceptions of the extent of danger and disorganization in the neighborhood were significantly related to a sense of attachment to the community, and to disciplinary strategies. Parents who perceived more danger were stricter. They also tended to be born locally rather than being immigrants. Place of birth was associated with variation in parenting styles, suggesting that patterns of in- and out-migration are important variables in planning and executing a community based child abuse prevention program.

Adolescent↗
PubMed1994

The association of physical and sexual abuse with HIV risk behaviors in adolescence and young adulthood: implications for public health.

This paper explores the relationship between changes in HIV risk behaviors and physical and sexual abuse. A stratified random sampling procedure selected 602 youths from a sample of 2,787 patients seen consecutively at public health clinics in 10 cities. Face-to-face structured interviews conducted since 1984-85 provide a history of change in risk behavior from adolescence to young adulthood. Univariate and bivariate analyses assessed differences in demographic and number and type of risk behaviors between those experiencing single or multiple types of abuse and those with no abuse history at all. The results show that a history of physical abuse, sexual abuse, or rape is related to engaging in a variety of HIV risk behaviors and to a continuation or increase in the total number of these behaviors between adolescence and young adulthood. This information might help practitioners to both prevent initial involvement in HIV risk behaviors and to prevent continuation of behaviors as youths move into young adulthood.

Adolescent↗
PubMed1994

The test-retest stability of the five minute speech sample in parents of disadvantaged, minority children.

The test-retest stability of the Five Minute Speech Sample, a brief measure of Expressed Emotion (EE), was established in a community sample of predominantly low income, ethnic minority families with children aged from 3 to 14 years. Significant stability was established when Borderline responses were included in the scoring. There was some interchange between High-EE and Borderline-EE, but none of the time one Low-EE respondent gave a second speech sample that included a higher level of EE. Both English and Spanish speaking subjects had stable scores.

Adolescent↗
PubMed1993

Psychopathology in children of alcoholics.

OBJECTIVE: To assess psychopathology in 125 and 158 children who are offspring of alcoholic and control parents. METHOD: Parents and children were interviewed by means of structured interviews. Parents were interviewed about themselves and about their children. Teacher reports were obtained. A total of 158 young people ages 6 to 18 years were in the study, although some of the analyses use only 125. RESULTS: Children of alcoholic parents showed higher rates of oppositional and conduct disorders but not attention deficit disorder. Children of alcoholic parents did not have significantly higher rates of depression, but they may be at risk for anxiety. These children also showed increased incidence of alcohol and other substance use but not abuse or dependence as defined by DSM-III. Few differences were detected with respect to self-esteem and achievement tests among the groups. There were no differences in the rates of psychopathology between offspring of alcoholic versus antisocial parents. CONCLUSION: These data indicate that children of alcoholics exhibit high rates of psychopathology and may be at risk specifically for oppositional and conduct disorders but not for depression. There are few differences between alcoholics and controls with respect to self-esteem and achievement tests.

Adolescent↗
PubMed1993

Diagnostic decision making in psychiatry.

The purpose of this article is to examine the consequences of and possible responses to uncertainty in psychiatric diagnosis. Uncertainty is inevitable because of the overlap in characteristics, or test results, between populations with and without a psychiatric disorder. As a result, there is never one correct method of identifying cases and noncases (i.e., case definition). In this paper principles of decision analysis and clinical epidemiology are used to develop a framework for thinking about the consequences of different diagnostic schema and for choosing among them. The framework illustrated here involves choosing an external validator, choosing a separator, and choosing a cutoff. This framework is applied to the problems facing three hypothetical researchers, and the consequences for their research of different diagnostic choices are explored. It is demonstrated how the relevance of research to clinicians and policy makers rests on the choice of the case definition process. The prevalent use of structured psychiatric interviews has not been accompanied by adequate attention to the problem of determining a diagnosis once the information is obtained. It is argued that more attention must be given to this process if we are to make optimal use of available resources for research and treatment.

Decision Making↗
PubMed1993

Early determinants of delinquency and violence.

The past several decades have resulted in an explosion of knowledge about the development of young children, knowledge that is often underused in the policy-making process. This paper reviews established risk factors for later delinquency and violence that are present prior to school age. The results suggest that established population-based efforts in education and health should be expanded, in anticipation of reducing violent behavior. More intensive intervention efforts that provide a continuum of services for children and families during a vulnerable development period also are warranted. New research directions also are described.

Child↗
PubMed1992

Ethical principles governing research in child and adolescent psychiatry.

This paper examines the ethical principles governing research in child and adolescent psychiatry. The guidelines for protection of children and adolescents are research subjects are discussed. These include the principle of nonmaleficence and beneficence (the risk-benefit ratio), the principle of autonomy (informed consent and confidentiality), and the principle of justice (fair distribution of benefits and burdens of research). In the light of recent national efforts to help promote responsible research practice, the ethical standards relating to the protection of scientific integrity as well as research advocacy, training, and stewardship are also discussed.

Adolescent↗
PubMed1992

The influence of mental health problems on AIDS-related risk behaviors in young adults.

This paper explores how symptoms of mental health problems influence acquired immune deficiency syndrome-related risk behaviors, and how changes in those symptoms relate to risk behaviors engaged in by young adults. Repeated interviews with 602 youths since 1984 provide a history of change in behaviors. Mental health symptoms during adolescence (alcohol/drug [r = .28]; conduct disorder [r = .27]; depression [r = .16]; suicide [r = .14]; anxiety [r = .16]; and posttraumatic stress [r = .09]) are associated with higher numbers of risk behaviors (specifically, prostitution, use of intravenous drugs, and choice of a high-risk sex partner) during young adulthood. Changes in mental health symptoms between adolescence and young adulthood are related to the number of risk behaviors engaged in by young adulthood (total number of symptoms [B = .10], alcohol/drug abuse or dependence [B = .34], depression [B = .20], suicidality [B = .35], anxiety [B = .13], and posttraumatic stress [B = .14]). Changes in symptoms of mental health problems are associated specifically with those risk behaviors that are initiated primarily in young adulthood: intravenous drug use, prostitution, and choice of risky partners. The findings show that prevention and treatment of mental health problems are important components of preventive interventions for human immunodeficiency virus infection in high-risk teens and young adults.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Changes in acquired immunodeficiency syndrome-related risk behavior after adolescence: relationships to knowledge and experience concerning human immunodeficiency virus infection.

This paper explores the extent of change in acquired immunodeficiency syndrome (AIDS) risk level and in the numbers of AIDS-related risk behaviors in 602 inner-city adolescents as they enter young adulthood. Youths' risk level for human immunodeficiency virus (HIV) infection during adolescence was categorized as high (engaging in prostitution, male homosexual or bisexual activity, or injectable drug use or having ulcerative sexually transmitted diseases), moderate (having six or more sex partners in a 1-year period or nonulcerative sexually transmitted diseases), or low (none of the above). Although a proportion at high or moderate risk during adolescence did move to lower risk levels by young adulthood, the overall risk level stayed fairly stable: 45% were at high or moderate risk levels during adolescence, and 35% were at those levels by young adulthood. Then change in the total number of risk behaviors engaged in by the youths was examined. Knowledge about AIDS or HIV infection and its prevention was not associated with any change in risk behavior, nor were the number of sources of information about the epidemic, acquaintance with those who are infected, estimates of personal risk, or exposure to HIV-test counseling. In fact, youths whose risk behaviors increased the most were more likely to know someone who had died of AIDS and to estimate their own risk as high. Most youths reported that they did not use condoms regularly, disliked them, and had little confidence in their protective ability. Changes in preventive strategies and further research on the causes of behavior change are needed.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Not fear, nor quarantine, but science: preparation for a decade of research to advance knowledge about causes and control of violence in youths.

Both the single case I encountered in the Boston Globe and several sources of national data give a picture of young Black males as a group at extraordinarily high risk for injury and premature death. It is a consequence of violent behavior most often directed toward them by individuals of the same race and of similar age. I do not believe, however, that focusing on the behavioral characteristics of this subgroup will gain us much in controlling the very high costs in life and well-being they incur. Rather, we need to concentrate our attention on the social contexts in which these young men grow up, on the quality of housing and public schools available to them, on their access to firearms, and on opportunities for legitimate employment available to them. This is an urgent, pressing need for which there exists no formula for success. Many communities across the country are making an effort to find ways of coordinating such needs into a common and sustained strategy. We are clearly at the beginning stage of a campaign. In morally isolating ourselves from this segment of the population, we confer on it the status of being quarantined. Public fear and distrust assume the appearance of a rational response. Gradually these young men and their would-be families become functionally obsolete in society. As a matter of policy, the environments they inhabit are neglected, and, predictably, they deteriorate. It is in this sense that our science policy in regard to violence may be ahead of public policies that regulate (or fail to regulate) the environments in which violence breeds most extensively. The fact that public health, bolstered by the basic developmental and sociological sciences, is poised to take on a leadership role in combating this modern epidemic is welcome news. Recalling the successes of public health campaigns to control infectious diseases, such as tuberculosis, may only be relevant in providing us with a sense of what constitutes a campaign to combat violence. The key actors in this important endeavor appear to be ready for a period of intense cooperation and forging of new knowledge. Now that we have failed in our effort to meet the 1990 objective for a reduction in violent death, the challenge is indeed a weighty one.

Adolescent↗
PubMed1990

Behavioral risks for human immunodeficiency virus infection in adolescent medical patients.

This paper is an examination of the extent to which adolescents in primary care indicated behavioral risk for human immunodeficiency virus infection, and the degree to which their clinic records reflected either awareness of such conditions or interventions for them. Levels of risk were assigned to the youths based on known risk factors in adult populations and arbitrarily selected natural breaks in the frequency of sexual behaviors. Of the sample, 3% were at high risk for human immunodeficiency virus infection because the adolescents engaged in prostitution, injectable drug use, male homosexual behavior, or had a sexually transmitted disease associated with genital ulcers or sores; 16% were at moderate risk because the youths had more than six sexual partners in the year preceding the interview or had nonulcerative forms of sexually transmitted disease; and the remainder were at low risk. Fewer than half of the youths at risk for human immunodeficiency virus infection sought or received help for any of their problem behaviors, while virtually all sought and received help for sexually transmitted diseases. Because a high proportion of the youths engaging in risky behaviors had sexually transmitted diseases, the most promising approach for prevention of human immunodeficiency disease infection is through health clinics that treat sexually transmitted diseases. These clinics could screen the youths for associated behavioral risk factors, and then offer preventive or interventive services.

Adolescent↗
PubMed1989

Epidemiology and child psychiatry: entering the second phase.

Recent progress in epidemiological studies describing the prevalence, distribution, and possible determinants of psychiatric disorders in children have pointed the way toward a new, experimental phase for research. Such investigations would be formal in design, use principles of a preventive trial, and exploit all current knowledge about the role of risk factors and causal mechanisms. This paper proposes the prevention of conduct disorder as the most productive starting point for this new phase.

Adolescent↗