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Biomedical subjects

H E Hutton

Publications and source records attributed to H E Hutton.

8 recordsLinked to original sources

Audio computer assisted self interview and face to face interview modes in assessing response bias among STD clinic patients.

BACKGROUND: Audio computer assisted self interview (ACASI) may minimise social desirability bias in the ascertainment of sensitive behaviours. The aim of this study was to describe the difference in reporting risk behaviour in ACASI compared to a face to face interview (FFI) among public sexually transmitted diseases (STD) clinic attendees. STUDY DESIGN: Randomly selected patients attending a public STD clinic in Baltimore, Maryland, sequentially took an ACASI formatted risk behaviour assessment followed by an FFI conducted by a single clinician, with both interview modalities surveying sexual and drug use behaviours. Binary responses were compared using the sign test, and categorical responses were compared using the Wilcoxon signed rank test to account for repeated measures. RESULTS: 671 (52% men, mean age 30 years, 95% African American) of 795 clinic attendees screened consented to participate. Subjects affirmed sensitive sexual behaviours such as same sex contact (p = 0.012), receptive rectal sexual exposure (p < 0.001), orogenital contact (p < 0.001), and a greater number of sex partners in the past month (p < 0.001) more frequently with ACASI than with an FFI. However, there were no differences in participant responses to questions on use of illicit drugs or needle sharing. CONCLUSIONS: Among STD clinic patients, reporting of sensitive sexual risk behaviours to clinicians was much more susceptible to social desirability bias than was reporting of illegal drug use behaviours. In STD clinics where screening of sexual risk is an essential component of STD prevention, the use of ACASI may be a more reliable assessment method than traditional FFI.

Adult↗

Psychiatric issues in the management of patients with HIV infection.

Approximately 1 million persons are now infected with human immunodeficiency virus (HIV) in the United States. Evidence exists that psychiatric disorders are common in patients with HIV and that these patients may not receive optimal care because their psychiatric disorders are a barrier to medical care, communication with clinicians, and adherence to medical recommendations. We describe herein a complex case seen at The Johns Hopkins Hospital with several psychiatric conditions that are common in our HIV clinic population. We describe the collaborative treatment of the patient by a multidisciplinary team including both medical and mental health practitioners. We briefly describe a coherent diagnostic and treatment approach to patients in HIV clinics and the supporting rationale from the literature. We discuss the need for comprehensive evaluation, a multidisciplinary treatment team, and therapeutic optimism.

Adult↗

HIV risk behaviors and their relationship to posttraumatic stress disorder among women prisoners.

OBJECTIVE: This study assessed HIV risk behaviors and their association with psychiatric disorders among women prisoners. METHODS: HIV risk behaviors practiced in the five years before incarceration were ascertained with the Risk Behavior Assessment interview for 177 inmates at the Maryland Correctional Institution for Women. The Structured Clinical Interview for the DSM-IV was used to determine the occurrence of posttraumatic stress disorder (PTSD), major depression, and dysthymic disorder among the women. Regression models were used to determine the association between HIV risk behavior and psychiatric disorders. RESULTS: HIV risk behaviors in the five years before incarceration included never or rarely having used condoms (56 percent of the women), injection drug use (42 percent), sexual intercourse with a partner who used injection drugs (42 percent), prostitution (30 percent), needle sharing (30 percent), receptive anal sex (19 percent), and having more than 100 sex partners (7 percent). After the analysis adjusted for age, education, race, HIV status, and addictive disorders, a lifetime occurrence of PTSD was associated with the practice of anal sex (odds ratio=1.7; 95 percent confidence interval=1.26 to 2.16; p<.02) and prostitution (OR=1.56; 95% CI=1.17 to 1.95; p<.03). CONCLUSIONS: HIV risk behaviors before incarceration were highly prevalent among the women in this study. Rates of PTSD, depression, and dysthymic disorder were also high. PTSD was associated with prostitution and receptive anal sex, and the disorder may contribute to high rates of risky sexual behavior. Targeted HIV risk reduction efforts among women prisoners should include evaluation for PTSD; conversely, women prisoners with a diagnosis of PTSD should be evaluated for prior HIV sexual risk behaviors.

Adult↗

The utility of the Megargee-Bohn typology in a forensic psychiatric hospital.

The utility of the Megargee-Bohn MMPI typology (Megargee & Bohn, 1979) was examined in 1007 male forensic psychiatric inpatients. The 10 profile types were identified although the proportions differed as expected from the original sample. Comparison of demographic, clinical, and forensic characteristics revealed significant differences between 9 of the profile types. Our findings indicate that the typology can reliably and usefully describe different categories of patients in our setting. The typology can also be used to make inferences about treatment needs. Our findings support the continued development of an MMPI-based actuarial system for criminal populations as has been done for psychiatric populations.

Adult↗

Ethnic differences on the MMPI Overcontrolled-Hostility Scale.

The effects of race and the validity of Megargee, Cook, and Mendelsohn's (1967) Overcontrolled-Hostility (O-H) Scale were examined using 412 male forensic psychiatric inpatients. Regression analysis using the total study sample indicated that the only predictor of O-H score was race, with Black patients scoring higher than White patients. In fact, Black patients scored at least 5 T scores higher than the White patients, and approximately 43% of the Black patients received O-H scores greater than 69. The race effect could not be explained by prehospitalization employment status or education. Pattern of criminal history and clinical problems were examined via analyses of variance (ANOVAs) in a subsample of 224 subjects. None of the descriptors of the overcontrolled-hostile personality were identified as related to O-H scores. The results of this study suggest that Black patients are more likely to be incorrectly labeled as overcontrolled-hostile personalities.

Adult↗

Epidemiology of anorexia nervosa in Monroe County, New York: 1960-1976.

The Monroe County Psychiatric Case Register and hospital records were used to investigate the incidence of anorexia nervosa in Monroe County, New York, during the periods 1960-1969 and 1979-1976 to determine whether the number of newly diagnosed cases has increased over time. The results support the general clinical impression of a recent increase in the incidence of anorexia nervosa. This pattern of overall change was accounted for by the sharp increase in the number of females with the disorder, particularly those aged 15-24. The data also suggest that the disorder occurs more often in the higher socioeconomic levels.

Adolescent↗