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Biomedical subjects

G A Bernstein

Publications and source records attributed to G A Bernstein.

30 records · Page 2Linked to original sources

Comorbidity and severity of anxiety and depressive disorders in a clinic sample.

Ninety-six children and adolescents with school refusal were evaluated with clinician and self-report rating scales for anxiety and depression. Patients meeting DSM-III-R criteria for both anxiety and depressive disorders scored significantly higher than those in the other three diagnostic groups (anxiety disorder only, depressive disorder only, and no anxiety or depressive disorder) on all anxiety and depression rating scales. Patients with no anxiety or depressive disorders scored lowest on all scales. Patients with pure depression and pure anxiety disorders were psychometrically similar, with scores that were intermediate between the other two groups. Demographic profiles and types of comorbid anxiety diagnoses within the diagnostic groups are presented.

Adjustment Disorders↗

Anxiety disorders of childhood and adolescence: a critical review.

The 1980s were a decade of advancement in the knowledge of anxiety disorders in children and adolescents; this sets the stage for research achievements in the 1990s. This review examines the anxiety disorders of childhood and adolescence (separation anxiety disorder, overanxious disorder, and avoidant disorder), including prevalence rates, demographic profiles, comparisons of clinical presentations in different developmental age groups, and comorbidity patterns. Fears and simple phobias, obsessive-compulsive disorder, post-traumatic stress disorder, and panic disorder in children and adolescents are also evaluated. The controversy of whether panic attacks occur in prepubertal children is addressed. A brief review of behavioral and pharmacological treatment studies is included. Future directions for research are suggested.

Adolescent↗

School phobia: patterns of family functioning.

Seventy-six families of children with school phobia were evaluated with the Family Assessment Measure. Mothers and fathers, as separate groups, rated clinically significant dysfunction in the parent-child relationship in the areas of role performance and values and norms. There were no significant differences between intact and single-parent families on ratings of family dysfunction. There was significantly less family dysfunction as rated by mothers and by children if the child had a diagnosis of pure anxiety disorder compared to families of school phobic children in other diagnostic categories.

Adolescent↗

Comparative studies of pharmacotherapy for school refusal.

Two studies compared alprazolam and imipramine in the treatment of school refusal. In an open label study (N = 17), two-thirds of the subjects completing a trial in both the alprazolam and imipramine groups showed moderate to marked global improvement in symptoms of anxiety and depression. In the double-blind, placebo-controlled study (N = 24), posttreatment scores calculated as change from baseline on the Anxiety Rating for Children were significantly different (p = .03) among the three treatment groups, with the active medication groups showing the most improvement. Additionally, on all depression rating scales, similar trends were evident with the alprazolam and imipramine groups demonstrating greater improvement than the placebo group. However, analyses of covariance (with pretreatment scores as the covariates) showed no significant differences among the three treatment groups on change in anxiety and depression scales. Thus, additional research is needed to determine whether trends in this study are explained by drug effect or baseline differences on rating scales.

Adjustment Disorders↗

Self-reported anxiety in adolescents.

In a study of 988 adolescents, female gender, somatic complaints, history of physical and sexual abuse, poor grades, use of street drugs, and family history related to depression were among factors that differentiated adolescents reporting high anxiety from those reporting low anxiety.

Adolescent↗

Pedigrees, functioning, and psychopathology in families of school phobic children.

Family pedigrees of six children with severe school phobia compared with those of a matched group of families of five children with psychiatric disorders showed a clustering of affective and anxiety disorders. Blind and independent family histories and structured interviews of parents and siblings demonstrated higher rates of depressive and anxiety disorders in first-degree relatives of children with school phobia. Parents of children with school phobia described more disturbance in family functioning on the Family Assessment Measure than did parents in the comparison group in the areas of role performance, communication, affective expression, and control.

Adolescent↗

Prophylaxis of neonatal conjunctivitis. An analytic review.

The recommendation by the Centers for Disease Control (CDC) that erythromycin and tetracycline ointments, as well as silver nitrate solution, are acceptable regimens for prophylaxis of gonococcal ophthalmia neonatorum (GON) has resulted in widespread local review of policies for ocular prophylaxis. The data concerning the efficacy and side effects of these agents are somewhat confusing or nonexistent. We discuss the etiologies of neonatal conjunctivitis and the topical and systemic agents used for prophylaxis of GON. We also review all studies that have compared the efficacy of one prophylactic agent with that of another agent or with no prophylaxis. It is found that all three agents have similar efficacy in preventing GON, although silver nitrate has been used more extensively in populations at high risk for GON. However, since Chlamydia trachomatis is the most common infectious cause of neonatal conjunctivitis in the United States at this time, and erythromycin appears to be very effective in prevention of neonatal conjunctivitis due to C. trachomatis, it may have an advantage over the other two agents. In addition, erythromycin use is associated with fewer ocular reactions than is silver nitrate.

Administration, Topical↗

Family dimensions in anxious-depressed school refusers.

The Family Adaptability and Cohesion Evaluation Scale II (FACES II) was administered to 46 adolescents with comorbid anxiety and major depressive disorders and to their parents in a treatment study of school refusal. FACES II measures cohesion and adaptability dimensions, as well as family type (balanced to extreme). Generally, adolescents and parents reported low cohesion (i.e.. disengagement) and low adaptability (i.e.. rigidity) on FACES II. Adolescents and parents described their ideal families as significantly less disengaged and less rigid than their own families. Fifty percent of adolescents, 38% of fathers, and 24% of mothers classified their families as the extreme type. Adolescents in extreme families, when compared with adolescents in more balanced families, reported significantly higher scores on two of three depression instruments and on a measure of somatic symptoms. Family therapy to improve cohesion and adaptability and treatments focused on improving depression and somatic symptoms may improve family functioning and decrease the severity and course of school refusal.

Adolescent↗

Caffeine effects on learning, performance, and anxiety in normal school-age children.

OBJECTIVE: The purpose of this investigation was to study the acute effects of caffeine on learning, performance, and anxiety in normal prepubertal children. METHOD: Twenty-one children were evaluated in a double-blind, placebo-controlled crossover design. Subjects were studied during four sessions, 1 week apart, under the following conditions: baseline, placebo, 2.5 mg/kg caffeine, and 5.0 mg/kg caffeine. Subjects were randomized to order of placebo and the two dosages of caffeine. Dependent measures included tests of attention, manual dexterity, short-term memory, and processing speed. Anxiety rating scales were also administered. Saliva samples were analyzed for caffeine levels. RESULTS: Caffeine improved performance on two of four measures of the Test of Variables of Attention and on a test of manual dexterity in the dominant hand. There was a trend toward increased current level of self-reported anxiety after caffeine on a visual analogue measure of anxiety. Children reported feeling significantly less "sluggish" after caffeine ingestion than after placebo ingestion. CONCLUSIONS: In a small sample size, there was indication that caffeine enhanced performance on a test of attention and on a motor task. Children also reported feeling less "sluggish" but somewhat more anxious. Because caffeine is so widely available and frequently consumed by children, these results are important and need replication.

Anxiety↗