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Biomedical subjects

G C Davis

Publications and source records attributed to G C Davis.

At least 19 recordsLinked to original sources
PubMed1995

Risk factors for PTSD-related traumatic events: a prospective analysis.

OBJECTIVE: The authors previously identified suspected risk factors for traumatic events related to posttraumatic stress disorder (PTSD) on the basis of data gathered retrospectively. In this study, they tested that model prospectively. METHOD: A random sample of 1,200 persons was drawn from all 21- to 30-year-old members of a large health maintenance organization. In 1989, 1,007 of these persons were interviewed, and suspected risk factors were measured. In 1992, 979 were reinterviewed, and the 3-year incidence of exposure to traumatic events was ascertained. RESULTS: Nineteen percent of the sample reported traumatic events during the 3-year follow-up. A history of past exposure to traumatic events signaled an increase in the liability to exposure during follow-up, independent of suspected risk factors. Two predictors of exposure, neuroticism and extroversion, identified retrospectively, also predicted exposure prospectively. The odds for exposure among males and persons with less than a college education were marginally significant. Early misconduct and a family history of psychiatric disorder-predictors of exposure in the retrospective data-were not significant predictors at 3-year follow-up. Blacks had a higher incidence of exposure during follow-up than whites. An exploratory reanalysis suggested that the discrepancy between the retrospective and prospective results may be explained by the inclusion of childhood exposure in the lifetime retrospective inquiry. CONCLUSIONS: The assumption that PTSD-related traumatic events are random phenomena was unsupported. Among young adults, those with less education, blacks, and those with high neuroticism and extroversion scores are more likely than others to be exposed to traumatic events and are thus at greater risk for PTSD.

Adult↗
PubMed1994

Analytical strategies for the determination of protein modifications.

Assessment of recombinant protein product purity and consistency has been successfully accomplished by using a battery of quantitative analytical methods. The development of analytical methods for product control requires an understanding of potential changes in protein structure which could be caused by degradation and modification. This paper will review some of the common mechanisms of protein degradation and common modifications which can occur during the fermentation/cell culture and purification processes. It will also present examples of analytical techniques which have successfully elucidated some of these changes in protein structure.

Animals↗
PubMed1994

Post-traumatic stress disorder in victims of civilian trauma and criminal violence.

Many individuals in the community suffer from PTSD and other stress reactions. Physicians, however, tend to diagnose post-traumatic symptoms as anxiety or depressive disorders rather than PTSD. Contacting and engaging patients after a disaster can be quite difficult. The chronic PTSD patient has been described as elusive and difficult to detect within the health care system. In one study, the time interval from trauma to psychiatric consultation was well over 3 years. A history of PTSD is often obscured by comorbid disorders or adjustment difficulties, such as depression, aggressive behavior, and drug and alcohol abuse. PTSD is a common problem, particularly in populations that are at high risk for exposure to traumatic events, such as the homeless, drug abusers, and those of specific professions. Although research on treatment of PTSD has revealed only modest benefits, early detection and intervention are important and might prevent poor adjustment and a chronic outcome. Clinicians should routinely inquire about history of unpleasant events and distasteful and unspeakable experiences, both recent and lifetime. Studies of various traumatic events consistently demonstrated that the presence of significant symptoms between 6 weeks to 6 months after exposure predicts chronic PTSD. Although early intervention might lead to the prevention of PTSD or its chronic course, there have been no randomized or controlled studies to support this hypothesis. Research on PTSD in victims of civilian trauma has only recently begun. Rape is the most extensively studied civilian trauma. Most studies reported that PTSD following rape is common. Further, characteristics of the rape event, such as rape by a stranger, use of physical force, display of weapons, and victim injury, are associated with a greater likelihood of PTSD, and symptoms at 3 months after the rape are predictive of a chronic course. Interest in the consequences of MVAs has increased dramatically, perhaps owing to the frequency of such accidents and the large number of PTSD damage claims. There is a great need to understand work environments better and the special risks associated with dangerous occupations, such as police, firefighters, rescue workers, and body handlers. Clinicians commonly attribute symptoms to a particular stressor, usually the most recent stressor or the stressor that represents the content of the symptoms. For example, nightmares about a recent auto accident and avoidance of expressways are interpreted as evidence that a recent auto accident is the cause of PTSD symptoms.(ABSTRACT TRUNCATED AT 400 WORDS)

Chronic Disease↗
PubMed1992

Migraine, major depression and panic disorder: a prospective epidemiologic study of young adults.

We examined prospectively the risk for major depression (MDD) and panic disorder in persons with prior history of migraine. A random sample of 995 young adults was interviewed in 1989 and reinterviewed in 1990. A history of migraine at baseline increased fourfold the risk for MDD during the follow-up interval. A history of any anxiety disorder exacerbated the risk for MDD in persons with migraine. Persons with a history of migraine were twelve times more likely to become cases of panic disorder than those with no history of migraine. The risk for MDD and/or panic disorder was unrelated to whether or not migraine was active during the year preceding the baseline interview or in remission for more than one year. The findings suggest that migraine, major depression and anxiety disorders might share common predispositions.

Adult↗
PubMed1992

The meaning of pain management: a concept analysis.

As it relates to the person experiencing chronic nonmalignant pain, the conceptual meaning of pain management has not been clarified previously. This article describes a concept analysis of pain management that resulted in a definition of the term and three defining attributes: pain relief, pain modulation, and self-efficacy. A model case is provided with examples of borderline and related cases. The findings of this analysis will contribute to instrument development, theory testing, and an understanding that should positively impact the self-management of persons experiencing chronic nonmalignant pain.

Adaptation, Psychological↗
PubMed1992

Posttraumatic stress disorder in an urban population of young adults: risk factors for chronicity.

OBJECTIVE: Despite progress in epidemiologic research on posttraumatic stress disorder (PTSD), little is known about factors that distinguish chronic from nonchronic PTSD. In a previous report, the authors identified a set of personal predispositions associated with PTSD following traumatic events in a general population sample of young adults. The purpose of this analysis was to identify characteristics of chronic PTSD and examine whether any of the suspected risk factors for PTSD was associated specifically with chronic PTSD. METHOD: A random sample of 1,007 21- to 30-year-old members of a large health maintenance organization in the Detroit area was interviewed, using the National Institute of Mental Health Diagnostic Interview Schedule (DIS), revised for DSM-III-R. The analysis was performed on data from 394 respondents who reported traumatic events, of whom 93 met criteria for PTSD. Chronic PTSD was defined as duration of symptoms for 1 year or more. RESULTS: Persons with chronic PTSD (N = 53) had, on the average, a significantly higher total number of PTSD symptoms and higher rates of overreactivity to stimuli that symbolized the stressor and interpersonal numbing than persons with nonchronic PTSD. The rates of one or more additional anxiety or affective disorders and a variety of medical conditions were higher in persons with chronic than nonchronic PTSD. Family history of antisocial behavior and female sex were associated specifically with chronic PTSD. CONCLUSIONS: The findings suggest that chronic PTSD may be associated with specific risk factors and clinical features. Longitudinal data on the course of PTSD are needed to determine whether the distinct features and the medical and psychiatric histories of persons with chronic PTSD are complications attendant on a chronic course or coexisting disturbances that inhibit recovery.

Adult↗
PubMed1991

Traumatic events and posttraumatic stress disorder in an urban population of young adults.

To ascertain the prevalence of posttraumatic stress disorder (PTSD) and risk factors associated with it, we studied a random sample of 1007 young adults from a large health maintenance organization in the Detroit, Mich, area. The lifetime prevalence of exposure to traumatic events was 39.1%. The rate of PTSD in those who were exposed was 23.6%, yielding a lifetime prevalence in the sample of 9.2%. Persons with PTSD were at increased risk for other psychiatric disorders; PTSD had stronger associations with anxiety and affective disorders than with substance abuse or dependence. Risk factors for exposure to traumatic events included low education, male sex, early conduct problems, extraversion, and family history of psychiatric disorder or substance problems. Risk factors for PTSD following exposure included early separation from parents, neuroticism, preexisting anxiety or depression, and family history of anxiety. Life-style differences associated with differential exposure to situations that have a high risk for traumatic events and personal predispositions to the PTSD effects of traumatic events might be responsible for a substantial part of PTSD in this population.

Adult↗
PubMed1991

Migraine, psychiatric disorders, and suicide attempts: an epidemiologic study of young adults.

To determine the prevalence of migraine and the risks for psychiatric disorders and suicide attempts associated with it, we studied a random sample of 1,007 young adults from a large Health Maintenance Organization in the Detroit, MI area. The lifetime prevalence of migraine was 7% in males and 16.3% in females. The rate of migraine was higher in persons with lower education and was equal in whites and blacks. Persons with migraine were at increased risk for affective and anxiety disorders, nicotine dependence, and alcohol or illicit drug abuse or dependence. There was a consistent trend toward higher psychiatric comorbidity in migraine with aura than in migraine without aura. Coexisting anxiety, which generally preceded migraine, was associated with a marked increase in the odds of major depression. Persons with migraine had higher rates of suicide attempts than persons without migraine. The odds ratio for suicide attempts, adjusted for coexisting major depression and other psychiatric and substance use disorders, in migraine with aura was 3.0 (95% confidence interval, 1.4-6.6). The coexistence of migraine with major depression, anxiety disorders, and suicide attempts has important clinical and research implications.

Adaptation, Psychological↗
PubMed1990

Pain management in the older adult with rheumatoid arthritis or osteoarthritis.

The study's major purpose was to explore the pain management of the older adult with rheumatic disease. Medication, rest, heat, distraction, exercise, and talking with others were methods most often used by older adults (n = 31). Methods identified by them as most helpful included medication, rest, and heat. When the pain management techniques of those adults 65 and over were compared with those of younger adults (n = 51), several differences were noted. The combined number of methods used by the younger group was significantly greater, and they rated relaxation techniques as being significantly more helpful. Increasing the elderly arthritis patient's repertoire of pain management modalities and measuring the ongoing individual effectiveness of the individual and combined methods used are identified as needs to be addressed in improving pain management.

Adult↗
PubMed1989

Measurement of the chronic pain experience: development of an instrument.

Development and testing of the Chronic Pain Experience Instrument (CPEI) were initiated to address the need for a valid and reliable instrument for the accurate clinical assessment of, as well as for the empirical investigation of, the chronic pain experience, that is, the personal response to living with nonmalignant persistent pain. When tested with persons with rheumatic disease (N = 160), the 16-item CPEI demonstrated high internal consistency, adequate stability, and moderate construct validity. Analysis included coefficient alpha, interitem correlations, item-scale correlations, Pearson r, factor analysis, and predictive modeling. Additional testing of the CPEI is suggested prior to its clinical application.

Activities of Daily Living↗
PubMed1989

The clinical assessment of chronic pain in rheumatic disease: evaluating the use of two instruments.

Health care professionals are becoming increasingly aware of the complex nature of chronic pain. Measurement instruments are needed which will assist in better understanding the patient's response to the pain. The McGill Pain Questionnaire (MPQ) and an expanded version useful in comprehensive clinical assessment, the McGill Comprehensive Pain Questionnaire (MCPQ), are currently-available tools for assessing chronic pain. The major purposes of this study were to test the discriminant and concurrent validity of the MPQ and to describe the major responses of the person with rheumatic disease to chronic pain using both instruments. Two sample groups were used: (1) 30 patients with chronic pain related to rheumatic disease, and (2) 30 patients with acute pain related to a surgical procedure. The MPQ's Affective Subscale discriminated between acute and chronic pain, and its Present Pain Intensity (PPI) Scale correlated moderately with the Visual Analogue Scale (VAS), another commonly-used scale for measuring pain intensity. While the MCPQ was useful in describing the patient's response to chronic pain, administration was time-consuming, and its open-ended format makes validity and reliability testing impossible. The information gained through the use of the MCPQ was helpful in determining what living with chronic pain means to the individual. Such information should be useful in the future development of a valid and reliable instrument for more efficiently measuring the chronic pain experience. Such an instrument would be useful in coordination with the MPQ which focuses on pain description.

Activities of Daily Living↗
PubMed1988

Depressed mothers as informants in family history research--are they accurate?

A sample of 333 mother-child dyads was used to examine the association between major depression in mothers and children's symptoms. Findings based on children's self-reports were compared to findings based on mothers' reports about the children. Children's data support a depression-specific transmission. In contrast, mothers' data show an increased risk for all psychiatric syndromes covered in the study (including depression, anxiety, oppositionalism, inattention, hyperactivity, impulsivity, and antisocial acts). Results from multivariate analysis support the hypothesis that the discrepancy between mothers and children is in part a function of the tendency of depressed mothers to view their children as more symptomatic. The use of probands as informants may lead to an overestimation of familial aggregation, if the affected probands suffer from major depression or depressive symptoms.

Adolescent↗
PubMed1987

Searching for evidence on the validity of generalized anxiety disorder: psychopathology in children of anxious mothers.

The diagnostic validity of generalized anxiety disorder (GAD) is tested by examining the relationship between GAD in mothers and children's overanxious disorder (OAD), separation anxiety (SA), and anxious symptoms in 331 mother-child dyads from a geographically based probability sample. Data on the relationship between mothers' major depressive disorder (MDD) and children's depression are presented for comparison. The National Institute of Mental Health (NIMH) Diagnostic Interview Schedule (DIS) was used in mothers and the NIMH Diagnostic Interview Schedule for Children (DISC), in children. Children of mothers with GAD were not at increased risk for OAD, SA, or anxious symptoms. In contrast, MDD in mothers conferred a risk for OAD in younger children and of MDD in older children. Additionally, older children of depressed mothers exhibited significantly more depressive symptoms. The presence of diffuse anxiety in children of mothers with MDD may represent a nonspecific response pattern in psychiatrically vulnerable children. Like GAD in adults, these anxiety symptoms in children may constitute a prodromal manifestation of other disorders and transient responses to life stressors.

Adolescent↗
PubMed1987

Posttraumatic stress disorder. The stressor criterion.

Posttraumatic stress disorder (PTSD) was officially introduced into psychiatric nomenclature in 1980, when it was incorporated into DSM-III. There is as yet little empirical research on the validity of the diagnosis. Literature on disasters, civilian and wartime, and on more ordinary stressful life events does not support the view that extreme stressors form a discrete class of stressors in terms of the probability of psychiatric sequelae or the distinctive nature of subsequent psychopathology. Extraordinary stressors are like more ordinary stressful events with respect to their complex differential effects upon individuals. Personal characteristics and the nature of the social environment modify the likelihood and form of the response of individuals to all types of stressors.

Humans↗
PubMed1987

Posttraumatic stress disorder: the etiologic specificity of wartime stressors.

The authors examined the effects of wartime stressors in a sample of 69 Vietnam veterans who were psychiatric inpatients in a Veterans Administration hospital. Participation in atrocities and the cumulative exposure to combat stressors, each independently of the other, conferred a significant risk for posttraumatic stress disorder. In contrast, the effect of these war experiences on the onset of panic, major depression, and mania was not significant. The results indicate that extreme stressors are uniquely linked with posttraumatic stress disorder's characteristic cluster of symptoms but challenge DSM-III's implicit assumption that the reexperienced trauma is the stressor responsible for posttraumatic stress disorder.

Adult↗