Biomedical subjects

J M Cyranowski

Publications and source records attributed to J M Cyranowski.

7 recordsLinked to original sources

PubMed2004

Personality pathology and outcome in recurrently depressed women over 2 years of maintenance interpersonal psychotherapy.

BACKGROUND: Empirical data on the impact of personality pathology on acute treatment outcome for depression are mixed, in part because of challenges posed by assessing trait-like personality patterns while patients are in an active mood episode. To our knowledge, no previous study has examined the effect of personality pathology on maintenance treatment outcome. By maintenance treatment we refer to long-term treatment provided to prevent depression recurrence among remitted patients. METHOD: Structured Clinical Interviews for the DSM-III-R Personality Disorders (SCID-II) were obtained on a sample of 125 recurrently depressed women following sustained remission of the acute mood episode and prior to entering maintenance treatment. SCID-II interviews were then repeated following 1 and 2 years of maintenance interpersonal psychotherapy. RESULTS: At the pre-maintenance assessment, 21.6% of the sample met SCID-II personality disorder criteria. Co-morbid personality pathology was related to an earlier age of onset, more previous depressive episodes, and a greater need for adjunctive pharmacotherapy to achieve remission of the acute mood episode. Co-morbid personality pathology predicted both higher rates of depression recurrence and a shorter time to recurrence over the 2-year course of maintenance treatment. Notably, among those patients who remained depression-free, continuous levels of personality pathology steadily declined over the 2-year course of maintenance therapy. CONCLUSIONS: Results highlight the need for early and effective intervention of both episodic mood disorder and inter-episode interpersonal dysfunction inherent to the personality disorders. Future maintenance treatment trials are needed to clarify the relationship between episodic mood disorder and personality function over time.

Adult↗

PubMed2000

Adolescent onset of the gender difference in lifetime rates of major depression: a theoretical model.

Prepubescent boys are, if anything, more likely than girls to be depressed. During adolescence, however, a dramatic shift occurs: between the ages of 11 and 13 years, this trend in depression rates is reversed. By 15 years of age, females are approximately twice as likely as males to have experienced an episode of depression, and this gender gap persists for the next 35 to 40 years. We offer a theoretical framework that addresses the timing of this phenomenon. First, we discuss the social and hormonal mechanisms that stimulate affiliative needs for females at puberty. Next, we describe how heightened affiliative need can interact with adolescent transition difficulties to create a depressogenic diathesis as at-risk females reach puberty. This gender-linked vulnerability explains why adolescent females are more likely than males to become depressed when faced with negative life events and, particularly, life events with interpersonal consequences.

Adolescent↗

PubMed2000

Beyond artificial, sex-linked distinctions to conceptualize female sexuality: comment on Baumeister (2000)

The authors comment on three aspects of R. F. Baumeister's (2000) theoretical article on female sexuality. Questioning the predominance of nature versus cultural factors in accounting for sexual outcomes for men and women, the authors draw attention to the similarities (as opposed to differences) in the sexual attitudes, behaviors, and responses of men and women, and directly question the suggestion of "controlling" women's sexual attitudes, behaviors, responses, etc. to meet social needs for change.

Acculturation↗

PubMed2000

Influence of panic-agoraphobic spectrum symptoms on treatment response in patients with recurrent major depression.

OBJECTIVE: The authors tested the hypothesis that a lifetime history of panic-agoraphobic spectrum symptoms predicts a poorer response to depression treatment. METHOD: A threshold for clinically meaningful panic-agoraphobic spectrum symptoms was defined by means of receiver operating characteristic curve analysis of total scores on the Structured Clinical Interview for Panic-Agoraphobic Spectrum in a group of 88 outpatients with and without panic disorder. This threshold was then applied to a group of 61 women with recurrent major depression, who completed a self-report version of the same instrument, in order to compare treatment outcomes for patients above and below this clinical threshold. RESULTS: Women with high scores (> or =35) on the Panic-Agoraphobic Spectrum Self-Report were less likely than women with low scores (<35) to respond to interpersonal psychotherapy alone (43.5% versus 68.4%, respectively). Women with high scores also took longer (18.1 versus 10.3 weeks) to respond to a sequential treatment paradigm (adding a selective serotonin reuptake inhibitor when depression did not remit with interpersonal psychotherapy alone). This effect was only partially accounted for by the higher likelihood that patients with high scores required the addition of antidepressants. Although four domains from the Panic-Agoraphobic Spectrum Self-Report were individually associated with a longer time to remission, only stress sensitivity emerged as significant in multivariate regression analyses. CONCLUSIONS: A lifetime burden of panic-agoraphobic spectrum symptoms predicted a poorer response to interpersonal psychotherapy and an 8-week delay in sequential treatment response among women with recurrent depression. These results lend clinical validity to the spectrum construct and highlight the need for alternate psychotherapeutic and pharmacologic strategies to treat depressed patients with panic spectrum features.

Adult↗

PubMed1999

Men's sexual self-schema.

Sexual self-schemas are cognitive generalizations about sexual aspects of oneself. In Part 1, a measure of men's sexual self-schema is developed. Studies of test-retest and internal consistency reliability and validity studies of factor analysis, internal structure, convergent and discriminant validity, process, group difference, and change are provided. The construct consists of 3 dimensions: passionate-loving, powerful-aggressive, and open-minded-liberal traits. In Part 2, the data suggest that men's sexual schema is derived from past sexual experience, is manifest in current sexual experience, and guides future sexual behavior. In Part 3, the data document the cognitive processing aspects of sexual schema. Consistent with the investigators' schema research with women, these data substantiate the importance of cognitive representations of sexuality.

Adult↗

PubMed1998

Schemas, sexuality, and romantic attachment.

One's self-views are powerful regulators of both cognitive processing and behavioral responding. Sexual self-schemas are cognitive generalizations about sexual aspects of the self. The bivariate sexual self-schema model, which posits independent effects of positive and negative components of women's sexual self-views, was tested. Three hundred eighteen female undergraduates completed anonymous questionnaires, including the Sexual Self-Schema Scale and assessments of sexual responses and romantic attachment patterns. Results extended knowledge of positive-negative schema group contrasts and distinguished the response patterns of the aschematic and co-schematic groups. As predicted, aschematics reported low levels of sexual desire, arousal, and anxiety, and weak romantic attachments, whereas co-schematics endorsed conflicting positive and negative responses to sexual-romantic cues. In addition, path analyses supported the bivariate model. Finally, findings are related to theories of attachment representations within the cognitive hierarchy of the self.

Adult↗

PubMed1995

Women's sexuality: behaviors, responses, and individual differences.

Classic and contemporary approaches to the assessment of female sexuality are discussed. General approaches, assessment strategies, and models of female sexuality are organized within the conceptual domains of sexual behaviors, sexual responses (desire, excitement, orgasm, and resolution), and individual differences, including general and sex-specific personality models. Where applicable, important trends and relationships are highlighted in the literature with both existing reports and previously unpublished data. The present conceptual overview highlights areas in sexual assessment and model building that are in need of further research and theoretical clarification.

Female↗