Biomedical subjects

H R Steinberg

Publications and source records attributed to H R Steinberg.

12 recordsLinked to original sources

PubMed1996

The utility of the SCL-90-R for the diagnosis of war-zone related posttraumatic stress disorder.

A scale for assessing war-zone-related posttraumatic stress disorder (WZ-PTSD scale) was derived from the Symptom Checklist-90-R by identifying items that best discriminated Vietnam theater veterans with and without PTSD (N = 202). The 25-item WZ-PTSD scale had excellent internal consistency, and signal detection analyses revealed that its diagnostic utility was comparable to or exceeded that of several established PTSD scales and measures of global distress. In a cross-validation sample (N = 99), the diagnostic utility of the WZ-PTSD scale was stable, whereas other PTSD scales performed more poorly. The WZ-PTSD scale appears to be a valuable new measure of PTSD that can be particularly useful in archival data sets or in any situation where other PTSD measures are not available.

Adult↗

PubMed1996

Current and lifetime psychiatric disorders among veterans with war zone-related posttraumatic stress disorder.

Previous research has found high rates of psychiatric disorders among veterans with war zone-related posttraumatic stress disorder (PTSD). However, many studies in this area are methodologically limited in ways that preclude unambiguous interpretation of their results. The purpose of this study was to address some of these limitations to clarify the relationship between war zone-related PTSD and other disorders. Participants were 311 male Vietnam theater veterans assessed at the National Center for PTSD at the Boston Veterans Affairs Medical Center. The Clinician-Administered PTSD Scale and the Structured Clinical Interview for DSM-III-R were used to derive current and lifetime diagnoses of PTSD, other axis I disorders (mood, anxiety, substance use, psychotic, and somatoform disorders), and two axis II disorders (borderline and antisocial personality disorders only). Participants also completed several self-report measures of PTSD and general psychopathology. Relative to veterans without PTSD, veterans with PTSD had significantly higher rates of current major depression, bipolar disorder, panic disorder, and social phobia, as well as significantly higher rates of lifetime major depression, panic disorder, social phobia, and obsessive-compulsive disorder. In addition, veterans with PTSD scored significantly higher on all self-report measures of PTSD and general psychopathology. These results provide further evidence that PTSD is associated with high rates of additional psychiatric disorders, particularly mood disorders and other anxiety disorders. The implications of these findings and suggestions about the direction of future research in this area are discussed.

Adult↗

PubMed1981

Evaluating the costs and benefits of a diagnostic technology: the case of upper gastrointestinal endoscopy.

Medical technology assessment has been proposed as a way to encourage more appropriate use of medical technologies, which may in turn lower medical care costs. The application to a diagnostic technology of techniques for medical technology assessment is discussed, using upper gastrointestinal endoscopy as an example. Several generic problems are often encountered when performing an assessment of a diagnostic technology. These problems include the need to weigh relatively concrete data on clinical and economic costs against less quantifiable data on the value of the information gained from the procedure. In the case of upper gastrointestinal endoscopy, data on morbidity (approximately two cases per 1,000 cases), mortality (approximately one case per 20,000 cases), changes (approximately +290 per procedure), and costs (between +69 and +128 per procedure) are relatively easily determined. Less easily calculated is the marginal diagnostic gain from endoscopies performed for the wide variety of conditions for which an endoscopy may be indicated. It is concluded that, in the case of diagnostic technologies, technology evaluations may be most useful as a heuristic tool. Because of the difficulty in weighing costs and benefits, however, formal evaluations of diagnostic technologies are not likely in the near future to contribute to medical care cost containment.

California↗

PubMed1973