Biomedical subjects

Gemma Gladstone

Publications and source records attributed to Gemma Gladstone.

7 recordsLinked to original sources

PubMed2006

Assessing personality traits associated with depression: the utility of a tiered model.

BACKGROUND: We sought to develop a refined measure of eight personality traits or constructs observed in those who develop depression. We report the psychometric properties of the derived Temperament and Personality (T and P) questionnaire, as well as a pilot study examining its capacity to differentiate over-represented personality traits in those with depression. METHOD: The factor structure of the T&P measure was examined in a general practice sample of 529 subjects. We imposed a range of factorial solutions to determine how higher-order molar constructs arborized to eight lower-order constructs. Scale scores generated at each derived tier were contrasted for 52 out-patients with major depression and control subjects from the general practice sample to pursue over-represented personality constructs, and to clarify if an optimal number of constructs could be identified. RESULTS: In the factor analysis, some 90% of the items loaded on their a priori construct. The questionnaire showed high internal consistency, test-retest reliability and minimal sensitivity to mood state effects. Analyses rejected the hypothesis that risk to depression might be generally affected by individuals merely scoring high on all 'normal' personality styles, whether higher-order or lower-order traits. CONCLUSIONS: Findings suggest that, while identified constructs linked well with the widely accepted theoretical model of personality (the Five Factor Model) at one tier, such a fixed model may be too inflexible. We therefore detail potential advantages to using a multi-tiered model of personality traits in application studies.

Adolescent↗

PubMed2005

Measuring a behaviorally inhibited temperament style: development and initial validation of new self-report measures.

An inhibited temperament early in life has been implicated as a risk factor for the later development of clinically meaningful anxiety and possibly depression. Most empirical investigations study young children, with fewer data obtained from older subjects. Two self-report measures, the Adult Measure of Behavioral Inhibition (AMBI) and the Retrospective Measure of Behavioral Inhibition (RMBI), were developed and evaluated psychometrically. Both instruments were multifactorial with satisfactory psychometric properties. Results indicated that the RMBI performed favorably as a measure of (retrospectively reported) childhood temperament, with good construct and discriminant validity. Designed as a measure of trait behavioral inhibition in adulthood, the AMBI also performed as a measure of contemporaneous anxiety proneness. Although the identified factor structure of both measures requires further examination in independent samples, current results support their use as valid measurement tools for studies examining the link between normal range temperament and psychopathology, especially where more rigorous prospective methods are unavailable. The RMBI may be a particularly useful instrument in this regard.

Adolescent↗

PubMed2004

Capacity of the 10-item Depression in the Medically Ill screening measure to detect depression 'caseness' in psychiatric out-patients.

The 10-item Depression in the Medically Ill (DMI-10) screening measures has been demonstrated to be useful in medically ill and general practice patients. Its usefulness as a screening or monitoring measure in depressed psychiatric out-patients is now reported. One hundred subjects-currently depressed or recovered from a recent episode-completed the measure, with scores for those 69 currently meeting DSM-IV depression caseness criteria compared with 31 non-depressed subjects. A cut-off score of 10 or more had high sensitivity and specificity for discriminating between 'cases' and 'non-cases'. The discriminating capacity of each item was also quantified. We conclude that the DMI-10 is brief, gender non-specific and less intrusive than many depression screening measures in clinical practice with depressed patients, with the currently established cut-off score similar to that established in medically ill samples. Analyses suggest useful items for clinicians to determine depression caseness status.

Adult↗

PubMed2003

Valid assessment of the clinical features of depression by relatives appears to slip under the RADAR.

OBJECTIVE: We report on the development of an observational measure designed for completion by relatives, the Recent Appearance of Depression Assessed by Relatives (RADAR), and consider its validity. METHOD: One hundred and one patients with a current major depressive episode had a relative or close friend complete the RADAR, while psychiatrists and research assistants collected extensive data. RESULTS: Correlated against both patient self-report and psychiatrist-rated depression severity measures, RADAR scores evidenced poor validity overall. Recent Appearance of Depression Assessed by Relatives scores also failed to differentiate depressive subtypes, in that scores for patients with melancholic depression were not significantly higher than for those with non-melancholic depression. CONCLUSIONS: Results are consistent with previous findings of poor agreement between clinicians and corroborative witnesses in assessing clinical depressive features, and argue against reliance on corroborative witness reports.

Adult↗

PubMed2003

What's the use of worrying? Its function and its dysfunction.

OBJECTIVE: To provide an overview of theory and research regarding the phenomenology and function of worry. METHOD: A systematic literature search focusing on conceptualizations of worry as a cognitive activity and worry research over the last 20 years was conducted. RESULTS: Worry can be both functional and dysfunctional. Disruption to daily functioning, perceived uncontrollability, pervasiveness and extensive coverage of worry themes (including "remote" events and the presence of meta-worry), all have specificity to more severe and dysfunctional worry. CONCLUSIONS: Research investigating both the relationship between worry and anxiety and the attributes of severe worriers, has brought attention to its role in fostering emotional disturbance and has clarified factors relevant to treatment.

Anxiety↗

PubMed2002

Measuring psychomotor agitation by use of an actimeter: a pilot study.

BACKGROUND: Psychomotor agitation is variably defined, with differing emphases on subjective and motor components. We assess the utility of an actimeter to inform us about aspects of the motor component. METHODS: A wrist actimeter measured motor activity of three inpatients with agitated depression. RESULTS: For each patient, diurnal activity patterns were observed, with activity generally elevated in mornings and late afternoons. Each patient also evidenced a clear decline in motor activity in the mid-evening, with little or no activity recorded during 'sleep' hours. Thus, psychomotor agitation (like motor activity) appears to require a conscious state. LIMITATIONS: Actimeters measure any baseline activity together with any superimposed movement component (which may range from movement changes to medication effects), making it difficult to disentangle components. We studied few patients and for brief intervals.

Aged↗

PubMed2002

Recognizing the anxious face of depression.

"Anxious depression" is used variably both by researchers and clinicians to describe admixtures of anxiety and depressive symptoms. The authors sought to determine the best model for conceptualizing anxious depression by studying a sample of depressed patients referred to a tertiary referral unit. Anxiety and depression were assessed using a comprehensive set of mixed symptoms that were subsequently refined to provide separate anxiety and depressive factors, and patients were trichotomized into groups of low, medium, and high anxiety on the basis of their total anxiety factor scores. Associations between the constructs of anxiety and depression in different depressive subgroups were explored, and the severity of depressive symptoms and other clinical variables across the three anxiety groupings was assessed. Depression variables were not linearly associated in a consistent pattern with anxiety-defined groups, arguing against a simple interdependence model driven by a higher-order variable such as depression severity. By contrast, the state anxiety categories were linked strongly with lifetime anxiety disorder prevalence, with some associations linear and with others evidencing a trend break association. The authors found support for a model of anxious depression, whereby anxiety both predisposes to nonmelancholic depression and contributes to its presentation by shaping its clinical features. Such a model and its definition assist in clarifying the cause of anxious depression and its treatment.

Adolescent↗