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Biomedical subjects

J I Tracy

Publications and source records attributed to J I Tracy.

13 recordsLinked to original sources
PubMed1997

The serotonin hypothesis of aggression revisited.

Many contemporary theorists believe serotonin (5-HT) neurotransmitter functioning plays a role in the regulation of human aggressive behavior. We argue that the evidence supporting this 5-HT hypothesis of human aggression is less compelling than commonly assumed, due to (a) conflicting study results, and (b) significant methodological limitations of existing studies. Recent models that integrate the role of psychological and contextual variables in 5-HT--associated aggression are reviewed. The need to incorporate psychometrically sound measures of aggression in 5-HT studies, to use experimental and longitudinal designs, and to test hypotheses drawn from multifactorial models in future research is advocated.

Aggression↗
PubMed1997

The effects of clozapine on symptom clusters in treatment-refractory patients.

Preliminary results of a double-blind clozapine study in a population of chronic psychotic patients at a state psychiatric facility are reported. Thirty "treatment-refractory" schizophrenic patients given a diagnosis according to DSM-III-R criteria (mean age of 44 +/- 9.1 years and a duration of illness of 24.9 +/- 8.8 years) who received 300 mg or 600 mg of clozapine and randomized in a double-blind fashion were analyzed. Subjects were evaluated using the Brief Psychiatric Rating Scale (BPRS) and the Clinical Global Impression (CGI) Scale on a weekly basis for 16 weeks. Based on the changes in their CGI scores at week 16 of clozapine treatment, subjects were retrospectively categorized as "improvers" (N = 12) and "nonimprovers" (N = 18). The two groups were compared for changes in total BPRS and BPRS factor scores. In terms of total BPRS scores, we expected a difference between the two groups because they were categorized based on changes in their CGI scores. However, the total BPRS scores in improvers showed a significant decrease by week 6 of clozapine treatment. On analyzing the four BPRS factors, the improvers showed improvement in the thinking disturbance factor by week 1 that remained steady from week 7. On the hostility-suspiciousness factor, the improvers showed an improvement across time when compared with nonimprovers. The withdrawal-retardation factor showed improvement in both groups across time, whereas the anxiety-depression factor was least influenced by clozapine. These observations suggested that all BPRS symptom factors did not uniformly contribute to improvement in overall psychopathology, which was observed as a decrease in total BPRS scores.

Adult↗
PubMed1996

A comparison of reading and demographic-based estimates of premorbid intelligence in schizophrenia.

Estimating premorbid intelligence in schizophrenia is difficult because the illness affects aspects of premorbid and postmorbid functioning. We evaluated two qualitatively different estimates of premorbid intelligence in a sample of schizophrenia patients and tested whether: (1) the two indices were related and produced similar IQ estimates, and (2) either index was related to a measure of cognitive deterioration. The Barona Index (BI, a demographically-based instrument) and the National Adult Reading Test (NART, a reading test of irregularly-spelled words) were utilized. Subjects (n = 40) were adult neuroleptic-medicated inpatients with a DSM-III-R diagnosis of chronic schizophrenia (n = 35) or schizoaffective disorder (n = 5). Paired t-tests revealed statistically equivalent BI and NART estimates for Full Scale and Verbal IQs, but significantly higher NART Performance IQs (t[35] = -3.34, p < 0.01). Correlational analyses suggested the two indices were associated but shared modest variance. BI correlations revealed expected associations with education and social position. NART IQs were related to education and a measure of cognitive status. Regression analyses supported the association between NART estimates and cognitive deterioration. Results suggest BI may be a better estimate of premorbid intelligence in schizophrenia as it is less influenced by potential consequences of the disease.

Adult↗
PubMed1996

Repetitive behaviors in schizophrenia: a single disturbance or discrete symptoms?

Schizophrenia patients often display multiple repetitive behaviors. We investigated relations among nine repetitive behaviors and evaluated the hypothesis that these behaviors are varied manifestations of a single underlying biobehavioral disturbance. Nine repetitive behaviors from the Elgin Behavioral Rating Scale were assessed in 400 schizophrenia patients residing at a state hospital. A majority of patients were smokers (76.3%) and very few had pica (3%). Several other repetitive behaviors showed substantial frequency. A principal components analysis revealed eight of nine behaviors shared at least 10% of their variance with a single, common component. However, a principal factor analysis suggested a five-factor model best represented the data. The five factors and items identifying them were: (1) 'oral consumption' behaviors-polydipsia and smoking; (2) 'Kluver-Bucy' behaviors-bulimia and hypersexuality; (3) 'movement' behaviors-mannerisms/postures and pacing; (4) 'bizarre use of objects'-bizarre grooming and hoarding; (5) 'Pica'. Associations among repetitive behaviors varied. Symptoms such as smoking and polydipsia appeared reliably related, and others such as pica appeared discrete and independent. Overall, the data did not support the 'single disturbance' hypothesis and suggested a multifactorial model is needed to characterize repetitive behavior disturbances in schizophrenia.

Adult↗
PubMed1996

Clock drawing in schizophrenia.

The Clock Drawing Test, a task sensitive to cognitive decline in neurological groups, was administered to 27 patients with schizophrenia. Clock drawings were scored for over-all global performance and the frequency of specific qualitative errors. Mean global performance scores indicated a small proportion of the sample was below the threshold typically used to identify dementia, and the patients displayed qualitative Clock Drawing deficits not fully represented in the global performance measure. Qualitative analyses indicated that size errors, graphic difficulty, and spatial planning problems were most common. Lastly, duration of illness was not related to global performance, suggesting that the latter might not reflect deterioration but the stable trajectory of impairment that may be constant through the schizophrenia illness.

Adult↗
PubMed1995

Transient fluctuations in cognitive functioning in schizophrenia based on single-case study methods.

The stability of cognitive performance in four schizophrenia patients was examined over a short time period. A cognitive battery highly sensitive to organismic state (the Repeatable Cognitive-Perceptual-Motor Battery, RCPM) was utilized. Single-case statistical methods tested for within-individual change across five assessments at two week intervals. All four subjects showed statistically significant post-baseline variation in a global measure of impairment (average impairment rating score) and in at least 50% of the individual tests having adequate test-retest reliability. Data are interpreted as providing suggestive evidence of transient fluctuations in performance within a stable window of impaired cognitive functioning. These fluctuations appear substantial enough to influence both research and clinical outcomes. The benefits of the single-case methodology employed are discussed. The data suggest that significant transient fluctuations in cognitive performance can be observed in schizophrenia in domains purported to represent vulnerability markers of the disorder. The importance of accounting for these transient fluctuations in the attempt to identify enduring, trait-like characteristics of cognitive functioning in schizophrenia is discussed.

Adult↗
PubMed1995

Expectations and motives for substance use in schizophrenia.

This study examined the internal reliability of standardized measures of substance use expectancies and motives in a schizophrenia population (n = 70) and the relationship of these expectancies and motives to alcohol and drug use disorders. Internal reliabilities were uniformly high for the subscales of the expectancy and motive measures. Analyses of the relationship between substance use disorders and expectancies revealed strong substance-specific expectations. Alcohol expectancies were related to alcohol disorders but not to drug disorders; cocaine expectancies were related to drug but not to alcohol disorders; and marijuana expectancies were more strongly related to drug than to alcohol use disorders. In contrast, motives were related to substance use disorders, and self-reported substance use problems were related to expectancies and motives in a non-specific manner. These results suggest that expectancy and motive questionnaires developed for the primary substance abuse population may be valid for psychiatric populations. Research on motives and expectancies may help to clarify the functions of substance abuse in persons with schizophrenia.

Adult↗
PubMed1994

Polydipsia and water intoxication in psychiatric patients: a review of the epidemiological literature.

Polydipsia among chronic psychiatric patients is poorly understood and underdiagnosed. It may have three stages: simple polydipsia, polydipsia with water intoxication, and physical complications. Epidemiological surveys have used staff reports and polyuria measures to identify polydipsic patients. Water intoxication has been screened by chart review, weight, or serum sodium data. According to these surveys, polydipsia, not explained by medically induced polyuria, may be present in more than 20% of chronic inpatients. Up to 5% of chronic inpatients had episodes of water intoxication although mild cases may have been missed. Single time point surveys show that 29% of polydipsic patients had presented water intoxication. Methodologically limited clinical studies suggest that polydipsia with water intoxication rather than simple polydipsia may be associated with poor prognosis in schizophrenia. Epidemiological surveys found polydipsia with water intoxication to be associated with chronicity, schizophrenia, smoking, some medications, male gender, and white race. New pathophysiological models need to elucidate these findings.

Chronic Disease↗
PubMed1994

Models of functional organization as a method for detecting cognitive deficits: data from a sample of social drinkers.

Literature on the cognitive deficits associated with social drinkers' chronic use of alcohol at moderate to heavy levels is equivocal. As an alternative to detecting impairment through measures of mean performance levels, the functional organization of cognitive skills in infrequent and heavy alcohol users was compared. Subjects (N = 364) were adolescent and young adult participants in a longitudinal study of health status and psychoactive substance use. LISREL was used to identify group invariance in the number and nature of cognitive components underlying performance. Results showed that a model with three cognitive components (general intelligence/abstraction, spatial relations/visual-motor speed, and immediate memory) best represented performance in both infrequent use and heavy use groups. There were some group differences in the role of unspecified processing components, but no clear evidence for alcohol-related shifts in functional organization was found. The hypothesis of cognitive compensation, which highlights methodological problems in deficit-detection research, is evaluated with respect to the potential value of using changes in functional organization, that is, the latent structure of performance, to uncover the neurotoxic effects of alcohol or other drug use. More definitive tests of the compensation hypothesis will require prospective, within-subject comparisons of functional organization in clinical as well as nonclinical samples.

Adolescent↗
PubMed1993

Depression and category learning.

This article explores the relationship between depression and category learning. We predicted that depression would impair categorization performance on criteria-attribute tasks, which require systematic hypothesis testing, but not on family-resemblance tasks, which allow processing strategies that are likely preserved in depression. These predictions were confirmed in 2 experiments using different stimuli, tasks, and S populations. We discuss some implications of the empirical connections among depression, the use of less sophisticated cognitive strategies, and category learning.

Adult↗
PubMed1992

Reports of physical symptoms and alcohol use: findings from a primary health care sample.

The relationship between alcohol consumption and physical health was examined in a primary health care sample of 366 adults. Unlike many previous studies that relied on static measures of medical diagnoses, the data reported here are repeated assessments of self-reported symptoms and alcohol use over 12 months. The results suggest, first, that drinking patterns in non-alcoholic samples fluctuate over time, and, second, that abstainers who have more prior illnesses or worse current health consistently report the greatest number of physical symptoms. The data highlight the importance of accounting for the health status of abstainers before comparing them with users of alcohol, and suggest that the presence of physical symptoms in addition to objective indices of health (e.g. the need for medication) may play a role in the initiation or maintenance of abstinence.

Aged↗
PubMed1990

Cognitive functioning in young "social drinkers": is there impairment to detect?

Literature on the cognitive effects of nonexcessive alcohol use suggests that relatively high-quantity-per-occasion use may be related to subsequent decreases in sober-state abstracting skills in adults, but provides no clear prediction for youth. The need to identify persistent alcohol-intake effects on cognition is particularly acute for the period of adolescence and young adulthood because even slight damage may impair developmentally significant skills. We examine the relation between multiple measures of neuropsychological status and both continuous and categorical measures of alcohol-use patterns in an age- and sex-stratified sample of 1,308 18-, 21-, and 24-year-olds. The results of correlational and hierarchial regression analyses suggest that cognitive performance bears little direct relation to drinking behaviors in young nonclinical males and females. Although the data provide no strong support for the hypothesis of a causal relationship between alcohol use and cognitive functioning, there is a slight suggestion that frequent high-quantity consumption may become a salient parameter of use as subjects age. Prospective longitudinal data are needed to explore the directional causality of effects.

Adolescent↗