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Biomedical subjects

J A Flaherty

Publications and source records attributed to J A Flaherty.

At least 19 recordsLinked to original sources
PubMed1992

Mental health consequences and correlates of reported medical student abuse.

OBJECTIVE: To assess the prevalence, correlates, and mental health consequences of reported medical training-related abuses. DESIGN: A longitudinal cohort study of 137 students surveyed from medical school entrance (time 1) through the winter of the fourth training year (time 4). SETTING: A state college of medicine. OUTCOME MEASURES: Reported training-related abuses (measured at time 4) and mental health status measured at times 1 and 4 (depressive and anxiety symptoms, hostility, problem drinking, escapist drinking, alcohol consumption levels, and gender role orientations). RESULTS: Seventy-two percent of students reported at least one abusive experience during medical training. Females were significantly more likely than males to report gender discrimination, exclusion from informal settings, discomfort from sexual humor, and unwanted sexual advances. Abuse was significantly related to most psychopathological outcomes, controlling for pre-existing psychopathology. Males low in masculinity and females low in femininity were most likely to report abuse. CONCLUSIONS: The data provide further support for the assumption that a high proportion of medical students not only experience the training process as abusive in nature but also suffer measurable psychopathological consequences. Efforts should be made to reform medical education, with a prominent focus on gender role-related issues.

Alcohol Drinking↗
PubMed1992

Shifts in problem drinking during a life transition: adaptation to medical school training.

This study addresses the course of alcohol-related problems in future physicians from the perspectives of occupational stress versus selection and life-span developmental frameworks. A cohort of medical students was surveyed at medical school entrance and during the early fall of the second training year. Self-report questionnaires assessed: alcohol-related problems (using a modified time-linked version of the MAST), pretraining psychosocial and psychopathological characteristics and experiences (symptomatic distress, motivations for drinking, personality attributes/deficits, familial history of problem drinking, family disruption and earlier parental bonding) and medical-training characteristics (perceived stressors and levels of social support). On the basis of MAST scores, respondents manifested the following drinking patterns: consistent nonproblem drinking (67.4%), problem exit or remission during medical training (19.4%), problem entrance or onset during medical training (6.3%) and problem chronicity involving problems before and during medical training (6.9%). Female students were overrepresented in the consistent nonproblem group. The major predictors of Time 2 problem onset and chronicity as opposed to problem remission involved pretraining factors: familial history of alcohol problems, Time 1 symptomatic distress and escape motives for drinking. Future reports will depict the prevalence and etiology of problem drinking manifested during the clinical portion of medical training.

Adaptation, Psychological↗
PubMed1991

A biopsychosocial treatment approach to the management of diabetes mellitus.

The relationship among recent life stress, social support, a patient's locus of control, and the control of blood glucose is evaluated in persons with diabetes mellitus, using objective measures of these psychosocial variables. Short-term [fasting blood sugar (FBS)] and long-term [glycosylated hemoglobin (Hgb A-1C)] control measures are taken at two points in time in order to evaluate the effects of the psychosocial variables on change in diabetes control. For life events, a significant positive association was found between the number of recent life events and blood glucose control. Decrease in social support predicted a worsening of longer-term (Hgb A-1C) control over time. An external locus of control within the patient was associated both with poor short-term control at time one and prediction of poorer long-term control over time. The implications of these findings are discussed in support of a biopsychosocial approach to the management of diabetes mellitus.

Blood Glucose↗
PubMed1990

Gender differences in medical student distress: contributions of prior socialization and current role-related stress.

Gender differences in psychological distress among future physicians are addressed from contrasting role-related stress and socialization-based vulnerability perspectives. A medical student cohort was surveyed at medical school entrance and after one year of training, focusing on earlier familial relationships, personality and social support resources, perceived medical school stressors and alcohol consumption and depressive and anxiety symptomatology. Relative to socialization perspectives, the sexes manifested more similarities than differences at time 1, although the females manifested lower overall psychopathology, but greater perceived paternal overprotection in childhood. Relative to role stress perspectives, both sexes reported increased psychopathology by the time 2 point. The sexes did not differ in perceived medical school-related stressors, while females manifested better social supports at time 2. The psychosocial predictors of increased subjective distress for both sexes included perceived earlier familial relationships and medical school stressors. The only predictor of increased drinking (by males) was time 1 drinking level. Future research on gender roles and distress should assess both male and female modes of psychopathology and should address antecedents of role entrance in addition to the (presumed) consequences of role incumbency.

Adult↗
PubMed1990

Psychosocial assets and mental health of minority medical students.

In this study, black, white, and Hispanic medical students are compared in terms of their psychosocial assets and mental health status when they entered medical school and after a year of medical training. The data show that the minority students entered medical school with some distinct advantages over the white students. The minority students reported greater social supports, higher self-esteem, lower anxiety, and more internal locus of control. After one year, however, the blacks manifested slightly lower self-esteem and higher levels of hostility and external locus of control. The Hispanics continued to report higher self-esteem and greater social supports but showed increased external locus of control and higher alcohol consumption. Policy implications for improvements in pre-entrance enrichment programs are discussed.

Black or African American↗
PubMed1990

Alcohol-related problems of future physicians prior to medical training.

Time 1 data are presented from an ongoing longitudinal study of drinking patterns and problems of future physicians from medical school entrance through 2.5 years of training. The data in this report address the prevalence and psychosocial correlates of alcohol-related problems experienced prior to medical school training. A group of 167 students (91% of the cohort) was surveyed. Self-report questionnaires included: alcohol-related problems (the MAST), earlier parent-child relationships, personality characteristics (external locus of control, self-esteem, dependency, masculinity-femininity), life events, social supports, motivations for drinking and symptomatic distress. The male students manifested a higher mean level of alcohol problems, and the sexes differed at the trend level when the MAST was scored to distinguish "problem" from "nonproblem" drinkers (with 18.4% of the students reporting 5 or more problem points and 7.4% reporting 4 problem points). The significant correlates of alcohol problems included: perceived lack of earlier maternal affectivity (for men) and perceived lack of earlier paternal affectivity (for women), and lack of emotional support (for men). Moreover, escape motives for men were the motives most highly correlated with alcohol problems. Symptomatic distress (anxiety and hostility) was significantly correlated with alcohol-related problems in men but not women. Future reports will depict the psychosocial experiences and alcohol-related problems manifested by this cohort during medical training.

Adult↗
PubMed1990

Mental health attitudes and practices of Soviet immigrants.

A survey of mental health knowledge, attitudes and help-seeking practices was conducted with 415 Soviet immigrants to Israel. The purpose of the study was two-fold: to provide data for mental health services and outreach programs designed for this immigrant group and to obtain a "proxy window" into these attitudes and behaviors in the Soviet Union itself. The results show that almost 20% of the immigrants reported consultation to formal agents in Israel and about half of these reported similar consultation in the USSR. An almost equal proportion consulted the family. Univariate and multivariate analysis show that demoralization, marital status, and religiosity were significantly associated with help-seeking. The second part of the survey explored Soviet immigrant attitudes to mental illness and the mentally ill by means of case vignettes and social situations, respectively. The respondents were able to detect abnormal behavior, but did not label it as psychopathology. Their overall tolerance of such behavior was low. These attitudes did not change over time nor seem to be influenced by reported abuses of psychiatry in the USSR.

Adult↗
PubMed1989

Somatic symptoms among older Soviet immigrants: an exploratory study.

This exploratory study investigates the overlap of somatization and depressive symptoms among older Jewish-Soviet immigrants to the United States. It has been suggested that this group has depression often masked by somatic complaints. In order to test this hypothesis fifty-five respondents completed the Symptom Checklist 90, PERI Demoralization Scale and the Social Support Network Inventory. The somatization subscale was found to be significantly higher among older Soviet immigrants than in a depressed group, yet the depression subscale was significantly lower. Compared to a group of normal controls both the depression and somatization subscales were significantly elevated. Somatization, depression, and demoralization were elevated in Soviet immigrants. The results of this study are discussed in the context of the available literature on cross-cultural psychiatry and somatization. The clinical relevance of these findings is highlighted.

Acculturation↗
PubMed1988

"Tragic man" and "tragic woman": gender differences in narcissistic styles.

The narcissistic personality style is assumed to be highly prevalent in contemporary society, but little epidemiologic attention has been directed to its relative occurrence among different segments of the population. This study addresses gender differences in the manifestation of narcissistic personality traits and their differential association with low self-esteem and dysphoric mood. A Narcissistic Traits Scale was developed and administered along with measures of self-esteem and depressive symptomatology to a population of medical students. The data show no sex differences in overall narcissistic styles but demonstrate sex differences in the prevalence of given traits and in their differential association with low self-esteem and dysphoric mood. The clinical and research implications of these findings are discussed, along with suggestions for future research utilizing more representative community samples.

Adolescent↗
PubMed1988

Developing instruments for cross-cultural psychiatric research.

The growth of cross-cultural psychiatry is now occurring at a time when psychiatry in general is emphasizing diagnostic clarity and the use of quantifiable and reliable methods of collecting clinical and research data. It is now imperative that cross-cultural psychiatry also examine its methods for developing instruments for use in cross-cultural research. This paper outlines a method for developing instruments designed in one culture for use in a second, and particular attention is given to cross-cultural validity or equivalence. Five types of equivalence are enumerated and defined: content, semantic, technical, criterion, and conceptual equivalence. These concepts are illustrated by examples from the authors' experience in research on internal migrants in Peru.

Cross-Cultural Comparison↗
PubMed1987

The process of acculturation: theoretical perspectives and an empirical investigation in Peru.

World-wide migratory patterns have led to an increasing interest in acculturation processes and their psychosocial and psychiatric sequelae. This paper reviews alternative theoretical approaches to the study of acculturation and identifies gaps in the current knowledge base. We then present empirical research on acculturation processes experienced by both Indian rural to urban migrants and White-Mestizo non-migrants in Lima, Peru. The study examined overall acculturation and five sub-dimensions: language use, customs, sociability, perceived discrimination and ethnic identity. The data show that second generation migrants are more highly acculturated across sub-areas and perceive less ethnic discrimination than first generation migrants. The first generation varied in acculturative level across sub-dimensions as a function of their age at the time of migration. Contrasts between the migrant and dominant group depicted a two-way process of culture change, but a process characterized by an inequality in the content exchanged in each direction. Socio-demographic correlates of acculturation were also found. These results are discussed in terms of the potential psychological consequences of alternative acculturative adaptations within the Peruvian social-structural context.

Acculturation↗
PubMed1987

Adult psychosocial assets and depressive mood over time. Effects of internalized childhood attachments.

This paper discusses contrasting assumptions in psychiatric epidemiological research regarding the relative significance of childhood and adult social experiences as etiological factors in adult psychopathology. It delineates a set of hypotheses that relate internal parental representations to subsequent depressed mood and to psychosocial assets assumed to mediate the relationships between parental representations and mood states. These hypotheses were prospectively tested using a cohort of medical students surveyed at medical school entrance and 7 months later. The data show that earlier paternal affectivity perceived at time 1 is inversely predictive of time 2 depressed mood, holding time 1 mood constant, whereas earlier maternal and paternal overprotection perceived at time 1 are directly predictive of time 2 depressed mood, holding time 1 mood constant. In addition, parental representations at time 1 are significantly linked to particular personality characteristics at time 1 and 2. However, it is not clear whether these personality characteristics are antecedents or consequences of depressed mood. The paper concludes with a discussion of theoretical and methodological issues involved in the retrospective assessment of remote social experiences as etiological factors in adult psychopathology.

Child Development↗
PubMed1986

The role of recent life events and social support in the control of diabetes mellitus. A pilot study.

This study evaluated objectively the relationship between recent life events, social support systems, and blood glucose control in diabetic patients using both short-term [fasting blood sugar (FBS)] and long-term [glycosylated hemoglobin (Hgb A-1C)] measures of control. We found that a higher number of life events was associated with a higher percentage of abnormal FBS and Hgb A-1C results, and that improved social support was associated with a smaller percentage of abnormal Hgb A-1C scores. These pilot findings are discussed in connection with a biopsychosocial approach to the understanding and management of diabetes mellitus.

Adult↗