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Biomedical subjects

F Earls

Publications and source records attributed to F Earls.

At least 55 records · Page 3Linked to original sources
PubMed1989

Comprehensive health care for high-risk adolescents: an evaluation study.

This study was designed to evaluate the effectiveness of a large scale program to improve health care for high-risk adolescents. Seven clinics, funded to provide comprehensive primary care to adolescents, were compared to three non-funded clinics. The majority of the 2,788 adolescent patients sampled in these clinics were female (78 percent) and Black (71 percent). Each patient was initially interviewed at the time of a clinic visit and reinterviewed 12 months later; their medical records were systematically reviewed. As expected, the funded clinics detected and treated a wider range of medical and behavioral problems than the comparison clinics, a finding that was based on the self-reports of patients and confirmed by documentation in the medical records. However, improvements in life-style and in specific medical outcomes were not observed. To build on the limited success of this program, efforts are needed to encourage more males to receive care and to develop more specific interventions for patients in this age group.

Adolescent↗
PubMed1988

Problems and help seeking in high-risk adolescent patients of health clinics.

In this study, 2787 adolescents between the ages of 13 and 18 years living in inner-city communities were interviewed about their mental and physical health and their clinic use. The patients used consolidated mental and physical health clinics located in neighborhoods, hospitals, or schools; or traditional neighborhood or hospital health clinics. Analyses of selected patient problems reveal that less than one third of adolescent patients with suicide ideation, conduct disorder, and substance abuse or dependency sought or received care for those problems. Only half of the adolescents with major depression sought or received care for depression, and only two thirds of the sexually active females sought or received help with birth control. A special effort needs to be made to attract troubled youth to clinics and to identify and treat their problems, particularly when those problems involve mental health concerns.

Adolescent↗
PubMed1988

Psychopathology in children of alcoholic and antisocial parents.

In this controlled family study the frequency of psychiatric disorder in children of alcoholic parents was found to be higher than in children of nonalcoholic parents. The rate in children of two alcoholic parents was distinctly higher than in those of one alcoholic parent. Comparison was also made between children of antisocial parents (usually coexisting with alcoholism) and children of parents with alcoholism only; no significant differences in the rates of childhood disorder were found between these two groups. Structured diagnostic interviews independently administered to both parents and children between 6 and 17 years old were used to assess psychopathology in the children. The types of disorders in the children of alcoholic parents reflected a mixed diagnostic picture with the reports of both parents and children yielding similar results.

Adolescent↗
PubMed1988

The importance of regressive changes in the development of the nervous system: towards a neurobiological theory of child development.

In this paper we propose that theories of early personality development be revised to consider knowledge of neurodevelopment. Research findings are reviewed that have established the presence of regressive changes in the normal development of the brain. These regressive changes, consisting of neuronal death and process and synapse elimination, are theoretically linked to three precursors of personality: sex differences, temperamental traits and perceptual-motor coordination. Evidence supporting these hypotheses is provided from studies examining how the effects of genetic, environmental, and experiential factors on brain development may determine the development of these personality features.

Animals↗
PubMed1987

Rules for making psychiatric diagnoses in children on the basis of multiple sources of information: preliminary strategies.

Inherent in the structured diagnostic interviewing of children is the problem of how to resolve differences between the child's own report and that of the parent about the child. A related problem concerns the use of outside source of information about the child, such as information from the teacher. In this study, the authors review the decision-making process used in the assignment of summary psychiatric diagnoses based on the child and parent reports, as well as a number of other sources of information about the child. Provisional rules for making summary diagnoses of children are presented.

Adolescent↗
PubMed1987

Treatment-seeking for depression by black and white Americans.

This paper examines data from a psychiatric epidemiologic survey of 3004 households in St Louis to determine whether there are distinctions between black and white Americans in their propensities to seek treatment for episodes of depression and to discover those groups least likely to seek care. The process initiated by the experiencing of unusual or distressing signs or symptoms and completed by seeking treatment for those complaints is a complex one, involving several steps. Numerous factors may affect decisions regarding treatment-seeking including characteristics of the individuals themselves, characteristics of the symptoms, and attitudes and beliefs about the causes and proper treatment of psychiatric problems or mood. We, therefore, also examine the available epidemiologic data for some clues concerning those factors which may have contributed to the observed patterns of treatment-seeking. Significantly fewer blacks meeting psychiatric criteria for a diagnosis of depression had sought professional care. Moreover, severity of the problem was significantly related to treatment-seeking among blacks and it was among those with the least severe problems that the greatest differences were found. Whites did not significantly exceed blacks in seeking care when depressive episodes were long lasting, severe or frequent. Although there was some indication that blacks may be more tolerant of depressive symptoms, a considerable proportion of blacks who felt they had a troublesome problem had never sought professional care. There was little evidence to suggest that a fear of being stigmatized prevented blacks from seeking care. However, blacks were more likely to report that fear of treatment and of being hospitalized had prevented them from seeking care. A number of hypotheses generated by the epidemiologic data are presented. Once large-scale surveys such as this have delineated the patterns of health care utilization and identified those groups at high risk of not receiving care, anthropological concepts and problem-oriented field research may be extremely useful in testing hypotheses concerning those factors underlying the observed behavioral patterns.

Adult↗
PubMed1987

A comparison of clinical and psychological effects of fentanyl and nalbuphine in ambulatory gynecologic patients.

Drug dosages, length of stay (LOS), and incidence of psychological side effects of fentanyl and nalbuphine were compared in a randomized, double-blind study using unpremedicated female day-surgery patients undergoing diagnostic laparoscopy. Patients received either fentanyl 1.5 micrograms/kg (F group; n = 142), low-dose nalbuphine 300 micrograms/kg (LN group; N = 103), or high-dose nalbuphine 500 micrograms/kg (HN group; n = 41), intravenously (IV) before anesthesia consisting of thiopental, N2O, O2, and a succinylcholine infusion. Additional IV intraoperative and IM postoperative opioids were given if required for signs of inadequate anesthesia or postoperative pain. The patients' clinical and psychological status was evaluated at 20-min intervals postoperatively by a team of trained interviewers. The low- and high-dose nalbuphine groups clinically resembled the fentanyl group in terms of dosing frequency and patients' self-ratings of postoperative analgesia. Length of stay and postoperative sedation were significantly greater with nalbuphine. The incidence of psychological side effects, including dreaming and postoperative anxiety, was also greater with nalbuphine. However, patient acceptance of nalbuphine was high and was similar to that observed in patients given fentanyl.

Ambulatory Care↗
PubMed1987

Sex differences in psychiatric disorders: origins and developmental influences.

Differential vulnerabilities to acquire specific types of psychiatric disorders exist for males and females. Alcoholism, antisocial personality and completed suicide predominate in males, while depression, anxiety, eating disorders, and attempted suicide are more common in females. In this paper evidence is explored to support developmental linkages between these disorders in adults and disorders in childhood and adolescence. The findings of this review support the assumption that various disorders of children showing sex differences in prevalence rates are precursors of adult disorders with a similar sex ratio. Longitudinal studies of personality development also provide data supporting the idea that sex-related behavioral predispositions originating early in life may contribute to differences in prevalence rates at subsequent points in the life cycle. Biological and social mechanisms that help explain the nature of these vulnerabilities are explored in some detail. The biological mechanisms considered relate to the pre- and postnatal effects of androgens on the brain and hormonal mechanisms associated with sex chromosomal aberrations. The social factors considered include differences in the rearing of male and female infants, and variations in life-style. Research directions to further explore sex differences in psychiatric disorders are suggested. Such studies are important because they may lead to a better understanding of genetic-brain-behavioral relationships. Secular trends in sex-related socialization practices may also explain why changes in the incidence and age of onset of some types of psychiatric disorder are occurring.

Adolescent↗
PubMed1984

The relation of temperament and social factors to behavior problems in three-year-old children.

Using data obtained during an epidemiological survey of the total population of three-year-old children on the island of Martha's Vineyard, an investigation was made of the relationship of temperament characteristics and social factors to behavior adjustment in 90 children. The analyses show that according to mothers' reports, inflexibility, a temperament characteristic of the child, negative parent-child interaction and high family stress are most highly associated with poor behavior adjustment. A path analysis suggested the hypothesis that flexibility of the child and positive parent-child interaction curtail the overall adverse effect of high family stress on behavioral adjustment in children.

Child Behavior Disorders↗
PubMed1983

An application of the pictorial scale of perceived competence and acceptance within an epidemiological survey.

The Perceived Competence and Acceptance Scale for Younger Children (PCS) was examined in the course of an epidemiological survey of psychological disorders in children. Eighty-three children, aged 6 and 7 years, were administered several measures including the WISC-R, the WRAT, the Lie Scale for Children, and the PCS. Teachers provided ratings from a parallel version of the PCS and reported on the behavioral and social development of each child through the Child Behavior Checklist. Investigation of the psychometric characteristics of the PCS substantially replicates findings reported by its developers. The size and direction of correlations among the cognitive competence subscale of the PCS, achievement measures, and the Lie Scale indicate that children tend to more accurately report about this domain than others included in the PCS. Children who reported atypically high or low PCS levels were not found to differ from the remainder of the sample on two clinical indices. Children who tended to exaggerate PCS levels, as compared to teacher ratings, had significantly more behavior problems in school and were seen by two observers as more apt to be currently maladjusted.

Achievement↗