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Biomedical subjects

H M van Praag

Publications and source records attributed to H M van Praag.

At least 235 records · Page 13Linked to original sources

Correlates of suicide and violence risk 1: the suicide risk measure.

A measure of suicide risk was developed using items reported to discriminate suicidal patients from controls in various studies. The new self-report scale was administered to 82 outpatients, 157 inpatients, and 83 college students. Using total scores, significant differences were found between the college sample and the two patient samples. The scale also discriminated between patients who reported one or more past suicide attempts and those who reported none. An independent cross-validation showed that half of the items continued to discriminate between patient and control groups. Sensitivity and specificity estimates were also determined. The test does not attempt to predict a specific rare event, i.e., suicide. It attempts to describe the degree to which a given individual reveals a set of characteristics that are similar to a suicide prototype.

Bipolar Disorder↗

A self-report measure of violence risk, II.

A brief self-report scale designed to measure the risk of violence was developed. Scale scores were found to be significantly related to a history of violence, or violence as a reason for admission, in psychiatric inpatients. Internal reliability was found to be high. A group of psychiatric inpatients could be significantly discriminated from a normal group of individuals, both on total scale score as well as on each individual item. Sensitivity and specificity were also determined. The value of the scale is in its brevity, in its focus on overt behavior as well as feelings, and in the fact that it defines a profile of characteristics that have been found to be associated with violent behavior. It thus represents a useful tool for future research on human aggression.

Adult↗

The Suicide and Aggression Survey: a semistructured instrument for the measurement of suicidality and aggression.

Despite the rising concern with the increasing rate of violent and suicidal behaviors in this country and others, we remain relatively limited in our ability to rigorously define, classify, and measure these behaviors. In addition to our previous work in developing self-rating scales assessing aspects of aggressive behaviors, we have developed the Suicide and Aggression Survey (SAS), a new, comprehensive, semistructured interview and research tool, for the purpose of comprehensively evaluating and understanding the multiple constituents of these behaviors, and for assisting in predicting which individuals might be at high risk for suicide or violence. The present report describes the need for such an instrument and the theoretical models that have guided us in constructing it; one of these is a sequential description of the major classes of variables related to aggression and the other is a two-stage model of countervailing forces. Preliminary reliability data and a description of the structure of the interview are included.

Adolescent↗

Denosologization of biological psychiatry or the specificity of 5-HT disturbances in psychiatric disorders.

5-Hydroxytryptamine (5-HT) disorders have been reported to occur in a variety of psychiatric disorders. The situation has been called chaotic, the disturbances non-specific. We reject this viewpoint. 5-HT disturbances are non-specific only from a nosological/categorical viewpoint; they seem rather specific from a functional/dimensional point of view, correlating as they do with particular psychopathological dimensions, i.e. aggression-, anxiety- and possibly mood-disregulation, across diagnosis. The evolution of 5-HT research in psychiatry illustrates the importance of what we have called the functional approach, implying dissection of a given psychopathological syndrome in its component parts, i.e., the psychological dysfunctions, and searching for correlations between biological and psychological dysfunctions. The rigid preoccupation of biological psychiatry with the search for markers of disease entities has hampered progress. The functional approach should be incorporated in biological psychiatry, not as an alternative for the nosological approach but as its complement.

Anxiety Disorders↗

Plasma dexamethasone and cortisol levels in depressed outpatients.

We investigated the 1-mg dexamethasone suppression test (DST) in 41 outpatients with major depressive disorder assessing the role of dexamethasone blood level, age and basal cortisol on DST results. Non-suppressors (approximately 25% of patients) had lower dexamethasone levels, and post-dexamethasone cortisol was negatively correlated with plasma dexamethasone; these findings were more significant after covarying out age and basal cortisol, factors that were also significantly associated to non-suppressors. A subgroup of patients (n = 19) also had 0.75-mg and 2.0-mg DST to evaluate whether a threshold dexamethasone blood level existed; a dexamethasone blood level greater than 1.5 ng/ml converted all non-suppressors to suppressors. Implications of these findings are discussed.

Adult↗