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Biomedical subjects

H R Searight

Publications and source records attributed to H R Searight.

At least 19 recordsLinked to original sources
PubMed2001

Conduct disorder: diagnosis and treatment in primary care.

Conduct disorder is a common childhood psychiatric problem that has an increased incidence in adolescence. The primary diagnostic features of conduct disorder include aggression, theft, vandalism, violations of rules and/or lying. For a diagnosis, these behaviors must occur for at least a six-month period. Conduct disorder has a multifactorial etiology that includes biologic, psychosocial and familial factors. The differential diagnosis of conduct disorder includes oppositional defiant disorder, attention-deficit/hyperactivity disorder (ADHD), mood disorder and intermittent explosive disorder. Family physicians may provide brief, behaviorally focused parent counseling, pharmacotherapy and referral for more intensive family and individual psychotherapy.

Adolescent↗
PubMed2000

Adult ADHD: evaluation and treatment in family medicine.

Attention-deficit/hyperactivity disorder (ADHD) affects 30 to 50 percent of adults who had ADHD in childhood. Accurate diagnosis of ADHD in adults is challenging and requires attention to early development and symptoms of inattention, distractibility, impulsivity and emotional lability. Diagnosis is further complicated by the overlap between the symptoms of adult ADHD and the symptoms of other common psychiatric conditions such as depression and substance abuse. While stimulants are a common treatment for adult patients with ADHD, antidepressants may also be effective. Cognitive-behavioral skills training and psychotherapy are useful adjuncts to pharmacotherapy.

Adult↗
PubMed1999

Anorexic eating attitudes and behaviors of male and female college students.

This study examined gender differences in eating attitudes and behaviors in a sample of 471 undergraduate college students. The prevalence of symptomatology indicative of anorexia was determined using the Eating Attitudes Test (EAT-26). In addition, the family climate, parent-child dynamics, and self-concept of students with and without maladaptive eating attitudes and behaviors were compared, and the relationship between eating attitudes/behaviors and current psychological distress was examined. Anorexic symptomatology was found for 20% of the females and 10% of the males. In general, students without symptomatic attitudes and behaviors had a more positive self-concept and reported less psychological distress than did those with eating disturbances. The findings suggest that eating problems may be more prevalent among males than previously estimated.

Adolescent↗
PubMed1998

The relationship of child adjustment to husbands' and wives' marital distress, perceived family conflict, and mothers' occupational status.

Measures of marital distress, perceived family conflict, and child adjustment were obtained from 74 pairs of husbands and wives with at least one child age 6 to 12 in order to determine the relationship between wives' occupational status, marital distress, family conflict, and child adjustment. Results revealed a strong and significant relationship between husbands' and wives' perceived family conflict and child maladjustment. No significant main effects or interactions were found between mothers' occupational status, or husbands' or wives' marital distress and child adjustment. The results support the downward extension to children of the previously reported relationship between perceived family conflict and adolescent adjustment.

Adult↗
PubMed1997

Behavioral and psychiatric aspects of HIV infection.

Primary care physicians frequently care for patients who test positive for human immunodeficiency virus (HIV) infection or who have acquired immunodeficiency syndrome. These patients often have concomitant behavioral and psychiatric problems that complicate their clinical care. Counseling before and after HIV testing provides the physician the opportunity for patient risk assessment and education about reducing transmission. Physicians should watch their HIV-infected patients closely for signs indicating mental status, and emotional or negative behavioral changes. Prompt recognition and early treatment are the best ways to diminish the impact of these changes on patients' lives and to improve their outlook and sense of well-being. Standard psychopharmacotherapy and careful attention to side effect profiles can help these patients maintain more constructive and positive lifestyles.

AIDS Dementia Complex↗
PubMed1995

Perceived family functioning among adolescent psychiatric inpatients: validity of the family-of-origin scale.

The Family-of-Origin Scale (FOS) is a 40 item, ten subscale self-report instrument designed to assess perceptions of family health. The scale, based on the dimensions of Autonomy and Intimacy, has demonstrated reliability and validity with adolescents. The FOS was administered to 100 adolescent psychiatric inpatients concurrently with the Brief Symptom Inventory (BSI) to examine the scale's discriminant and construct validity. When compared with 100 non-clinical adolescents, the psychiatric inpatients perceived their family as less healthy on all FOS dimensions. Perceived family health on the FOS was negatively and moderately correlated with the BSI dimensions. The findings provide psychometric and clinical support for the FOS with adolescents.

Adolescent↗
PubMed1995

Patterns of neuropsychological functioning among patients with multi-infarct and Alzheimer's dementia: a comparative analysis.

Cognitive and neuropsychological tests are often employed to help describe the functioning of patients with multi-infarct dementia (MID) or patients with dementia of the Alzheimer's type (DAT). In this study, the Halstead-Reitan Neuropsychological Battery (HRNB), Wechsler Adult Intelligence Scale-Revised (WAIS-R), and Wechsler Memory Scale (WMS) were completed by 20 MID patients and 62 patients with DAT. Total scores on these measures did not differentiate DAT and MID patients. Contrary to clinical observations, cognitive tasks assessing social judgment did not differentiate between the groups. However, MID patients demonstrated greater variability in test scores. Compared with DAT patients, the MID patients demonstrated better preserved memory as shown on the WMS in comparison to the WAIS-R IQ.

Aged↗
PubMed1995

Attention-deficit/hyperactivity disorder: assessment, diagnosis, and management.

Children and adolescents with attention-deficit/hyperactivity disorder (AD/HD) frequently present to family physicians for evaluation and treatment. Recently, revised criteria for diagnosis of this condition were presented in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders. Attention-deficit/hyperactivity disorder is often difficult to differentiate from other disruptive behavior syndromes, such as oppositional defiant disorder and conduct disorder. Using a systematic process of differential diagnosis and integrating the mental status examination with history and teacher and parent reports, the family physician will be able to diagnose AD/HD with greater accuracy. Treatment with stimulant medication and behavioral strategies yields positive outcomes with these children.

Adolescent↗
PubMed1994

The HIV-positive psychiatric patient and the duty to protect: ethical and legal issues.

UNLABELLED: A small, yet significant, percentage of HIV-positive patients have a concomitant psychiatric or neurological disorder associated with impaired judgment. Clinical problems such as psychoses, certain personality disorders, and dementias are associated with disinhibition of impulses and diminished capacity for self-monitoring. These deficits in reasoning and judgment may prevent the patient from comprehending the significance of their HIV status and the consequences of sexual behavior or needle sharing. There are indications that the Tarasoff duty-to-protect may apply to this situation. METHOD: Available data about the prevalence of HIV risk behavior and HIV infection among psychiatric patients are reviewed. The applicability to these situations is described. RESULTS: When an HIV patient engages in high risk sexual behavior with identifiable partners and refuses to notify them of their HIV status, physicians and mental health professionals may have a legal and ethical duty to warn. CONCLUSION: A decision model for this clinical dilemma is presented. Clinical strategies for these patients may include ongoing supervision and monitoring as well as possible quarantine.

AIDS Dementia Complex↗
PubMed1994

Informed consent: clinical and legal issues in family practice.

While patient informed consent is an important clinical and legal dimension of specialty medical care, many important issues arise in primary care. Family physicians are in a unique position to implement informed consent discussions in the ethical spirit in which the doctrine was intended. Because of their long-term relationships with patients and sensitivity to psychosocial issues, family physicians can engage patients in collaborative health care decision making. Primary care physicians are optimally suited to assess patients' understanding of medical information and their competence. Instead of viewing the informed consent process simply as a necessary legal requirement, it should be a method for educating patients and allowing them to participate in their health care decision making.

Comprehension↗
PubMed1993

Residential versus day treatment for children: a long-term follow-up study.

Adults and adolescents, who as children, received day or residential treatment were followed up ten years after treatment completion. No differences were found between the two treatment modalities on follow-up ratings of personal and social adjustment. This pattern was not influenced by gender, IQ, or presenting problem. Overall, about two-thirds of the children demonstrated improvement at follow-up. As expected, individuals demonstrating higher levels of personal and social adjustment at initial assessment were functioning better at outcome. However, the magnitude of therapeutic gain was not significantly different for mild versus moderate-to-severe presenting problems. Suggestions for future research are included.

Adolescent↗
PubMed1993

The relationship of psychological adjustment to perceived family functioning among African-American adolescents.

The Family-of-Origin Scale for adolescents (FOS) is a 40-item ten subscale instrument designed to assess perceived psychological health in the respondent's family. To date, the FOS has been used exclusively with white adolescents. The FOS was administered concurrently with the Langner Symptom Survey (LSS), a measure of adjustment, to 135 African-American adolescents. The LSS exhibited moderate, yet significant, correlations with the FOS: A total score, two superordinate dimensions, and six subscales. The results lend modest support for the construct validity of the FOS.

Adaptation, Psychological↗
PubMed1993

The relationship of family structure and family conflict to adjustment in young adult college students.

This study examined whether the structural intactness of the family and/or perceived family conflict was related to young adult adjustment as assessed by measures of ego identity status and psychological distress. The physical-wholeness model holds that family structure is the major variable affecting adjustment, while the psychological-wholeness model posits family conflict as the critical variable. In the present study, undergraduate college students (N = 285) were classified as belonging to an intact two-parent family or a nonintact family, and as coming from homes characterized by low, medium, or high levels of conflict. A statistically significant relationship between family conflict and adjustment was observed; there was no significant association between family structure and adjustment. Individuals from families perceived as being low or medium in level of conflict reported fewer psychiatric symptoms and demonstrated higher levels of ego identity than did those from families perceived as high in conflict. These findings support the psychological-wholeness model. It is suggested that future research be directed toward developing more refined measures of interpersonal conflict.

Adaptation, Psychological↗
PubMed1993

Physician-patient sexual contact: ethical and legal issues and clinical guidelines.

Although sexual relationships between mental health professionals and patients have been the subject of research, ethical writing, and legislation during recent years, there has been comparatively little attention given to this problem in primary care medicine. An estimated 11% of family physicians have had sexual contact with at least one of their patients. Recently, the American Medical Association presented ethical guidelines addressing this issue. Acceptable conditions under which a physician may become involved with a former patient are not well addressed by these guidelines. Although sexual involvement with patients appears to exist on an ethical continuum, it inevitably results in diminished patient autonomy. Sexual contact between patients and mental health professionals is now explicitly illegal in many states, but comparable legislation has not been enacted for nonpsychiatric physicians. There is evidence that when sexual contact between a physician and a patient occurs, the patient suffers long-term psychological consequences.

Ethics, Medical↗
PubMed1992

Ethnography and family medicine: issues and overview.

Ethnography is a qualitative research model generally associated with anthropology. Ethnographic methods include inductively oriented strategies such as participant observation, structured interviews, and open-ended interviews. Issues in family medicine such as patient compliance, doctor-patient relationships, and patients' subjective experience of illness may be optimally studied with ethnography. Because it is inductive, ethnography is cognitively similar to clinical reasoning. Making use of ethnography provides family physicians with a greater array of research methods compatible with clinical practice.

Anthropology, Cultural↗