Biomedical subjects

John R McQuaid

Publications and source records attributed to John R McQuaid.

10 recordsLinked to original sources

PubMed2006

Relationships among childhood maltreatment, PTSD, and health in female veterans in primary care.

OBJECTIVE: Women with histories of childhood maltreatment (CM) have higher rates of physical health problems and greater medical utilization compared to women without abuse histories. This study examined whether current post-traumatic stress disorder (PTSD) symptoms mediate the relationship between CM and indicators of physical health and medical utilization in female veterans. METHOD: Respondents were 221 female veterans (56% of the potential sample), who received medical care from the San Diego VA Healthcare System during a 12-month period. Respondents provided self-report information about CM, PTSD symptoms, use of pain medication, and physical symptoms and functioning. Additional information about medical utilization was extracted from respondents' medical charts. Regression-based models were conducted to test whether PTSD symptoms mediate the relationships between CM and physical symptoms and between CM and medical utilization. RESULTS: Emotional abuse was associated with poorer role-physical functioning, increased bodily pain and greater odds of using pain medication in the past 6 months. Physical abuse was associated with poorer general health. Contrary to prediction, emotional neglect was associated with better role-physical functioning, and CM was not associated with increased healthcare utilization. PTSD was shown to mediate the relationship between emotional and physical abuse and health outcomes. CONCLUSIONS: PTSD, or psychopathology more generally, appears to be an important factor in the negative health impact of CM. Given that several empirically supported interventions are available for PTSD, there may be physical health benefits in early identification and treatment of psychopathology related to CM.

California↗

PubMed2006

Amygdala reactivity and mood-congruent memory in individuals at risk for depressive relapse.

BACKGROUND: According to cognitive diathesis-stress theories, a latent cognitive vulnerability to depression is activated by negative affect in individuals at risk for depressive relapse. This vulnerability can manifest as mood-congruent memory during sad mood and may involve amygdala response, which is implicated in memory for emotionally arousing stimuli. This study examined whether amygdala modulates memory for negatively valenced words before and after a sad mood induction in healthy individuals with and without a history of recurrent major depression. METHODS: Fourteen unmedicated remitted depressed (RD) and 14 matched never depressed (ND) individuals were scanned using functional magnetic resonance imaging (fMRI) while performing a self-referent encoding/evaluation task (SRET) preceding and following a sad mood challenge. After each SRET, participants' free recall was assessed. RESULTS: Following sad mood induction, bilateral amygdala response during encoding of valenced words predicted increased recall of negative self-referent words for a subset of RD participants. This association was not present before the sad mood induction and was not evident in individuals without a history of depression, regardless of mood state. CONCLUSIONS: These results are consistent with cognitive diathesis-stress theories and suggest a role for the amygdala in modulating mood-congruent memory during transient sad mood in individuals who are vulnerable to depression relapse.

Adult↗

PubMed2006

Disrupting life events and the sleep-wake cycle in depression.

BACKGROUND: Social rhythm disruption life events are significant predictors of mood relapse in bipolar patients. However, no research has examined the relationship between these events and their hypothesized mechanism of action: disrupted sleep-wake patterns. The goal of this study was to test whether participants with major depressive disorder have a greater disruption of daily sleep and motor activity following disrupting life events when compared to normal controls. METHOD: Over the course of 2 weeks, 39 normal controls and 39 individuals with major depressive disorder completed life events interviews and wore actigraphs to obtain estimates of sleep/wake activity. RESULTS: Statistically significant interactions indicated that the presence of at least one disrupting life event in the previous 4 months correlated with elevations in the amount of time spent awake after sleep onset [beta=0.45, deltaF(1,73)=4.80, p<0.05], and decreases in the percentage of time spent asleep [beta=-0.53, deltaF(1,73)=6.57, p<0.05], in depressed individuals but not in normal controls. CONCLUSIONS: The results indicated that depressed individuals may be more susceptible to the effects of life events on sleep than normal controls. This is the first study to date to correlate life events with objective measures of sleep. However, prospective longitudinal research is necessary to clarify the temporal relationship among these variables.

Adult↗

PubMed2005

Characteristics of life stressors predictive of substance treatment outcomes.

Most research and treatment focusing on the relationship between life stress and substance use have considered stress as a unitary construct despite the fact that stressors vary in terms of temporal characteristics (short-term vs. long-term) and domains (work, health). In contrast to most stressor domains, increasing evidence suggests that health stressors may reduce the risk of initiating substance use after treatment. We separately evaluated the effect of short-term stress events (discrete date of occurrence), long-term stressors (ongoing stressors lasting 2 weeks or longer), and health stressors on posttreatment alcohol and drug use. Veterans (N=195) were assessed while receiving addiction treatment and quarterly for 1 year. The odds of initiating posttreatment substance use were 2.5 times greater for participants experiencing severe (nonhealth) long-term stressors. In contrast, participants experiencing short-term health events or severe (nonhealth) short-term events were less likely to initiate posttreatment substance use (odds ratio=.28 and .44, respectively).

Adult↗

PubMed2005

A randomized, controlled trial of cognitive behavioral social skills training for middle-aged and older outpatients with chronic schizophrenia.

OBJECTIVE: The number of older patients with chronic schizophrenia is increasing. There is a need for empirically validated psychotherapy interventions for these patients. Cognitive behavioral social skills training teaches cognitive and behavioral coping techniques, social functioning skills, problem solving, and compensatory aids for neurocognitive impairments. The authors compared treatment as usual with the combination of treatment as usual plus cognitive behavioral social skills training. METHOD: The randomized, controlled trial included 76 middle-aged and older outpatients with chronic schizophrenia, who were assigned to either treatment as usual or combined treatment. Cognitive behavioral social skills training was administered over 24 weekly group sessions. Blind raters assessed social functioning, psychotic and depressive symptoms, cognitive insight, and skill mastery. RESULTS: After treatment, the patients receiving combined treatment performed social functioning activities significantly more frequently than the patients in treatment as usual, although general skill at social functioning activities did not differ significantly. Patients receiving cognitive behavioral social skills training achieved significantly greater cognitive insight, indicating more objectivity in reappraising psychotic symptoms, and demonstrated greater skill mastery. The overall group effect was not significant for symptoms, but the greater increase in cognitive insight with combined treatment was significantly correlated with greater reduction in positive symptoms. CONCLUSIONS: With cognitive behavioral social skills training, middle-aged and older outpatients with chronic schizophrenia learned coping skills, evaluated anomalous experiences with more objectivity (achieved greater cognitive insight), and improved social functioning. Additional research is needed to determine whether cognitive insight mediates psychotic symptom change in cognitive behavior therapy for psychosis.

Activities of Daily Living↗

PubMed2004

Measuring cognitive insight in middle-aged and older patients with psychotic disorders.

The study examined the psychometric properties, factor structure and validity of a recently developed measure of insight, the Beck Cognitive Insight Scale (BCIS) and tested the relationship between the BCIS and psychiatric symptoms in a sample of middle-aged and older patients with schizophrenia or schizoaffective disorder. The BCIS measures the ability of respondents to observe and question their cognitive processes, whereas other insight scales focus primarily on knowledge about the presence of an illness and need for treatment. Participants were 164 middle-aged and older outpatients with schizophrenia or schizoaffective disorder who completed a battery of measures assessing insight, symptoms of schizophrenia and symptoms of depression. The results of a confirmatory factor analysis (CFA) supported the two-factor structure previously reported for the BCIS, with one factor labeled self-reflectiveness and the other labeled self-certainty. The BCIS showed adequate reliability and a moderate correlation with the Birchwood Insight Scale (IS). The BCIS correlated with some PANSS subscales measuring symptoms of schizophrenia, but did not correlate at a significant level with symptoms of depression. The findings suggest that middle-aged and older outpatients with schizophrenia or schizoaffective disorder respond on the BCIS in a manner similar to a younger inpatient population. This instrument is a promising tool for measuring the role of cognitive change in a broad range of patients experiencing psychosis.

Adult↗

PubMed2004

Prevalence and demographic correlates of childhood maltreatment in an adult community sample.

PURPOSE: This study had two aims: (1) to determine the prevalence of five categories of retrospectively reported childhood maltreatment in an adult community sample and (2) to examine relationships between three theoretically and practically chosen demographic variables and childhood maltreatment. METHOD: Participants were a representative sample of 967 adult men and women in the metropolitan Memphis, Tennessee area. They completed a telephone survey that included a reliable, valid questionnaire assessing five types of childhood maltreatment (i.e., emotional abuse, emotional neglect, physical abuse, physical neglect, and sexual abuse) and demographic questions. Simultaneous logistic regression analyses were used to identify demographic correlates of specific trauma types. RESULTS: Prevalence of childhood maltreatment ranged from approximately 30% for women to over 40% for men. Approximately 13% of participants reported multiple forms of maltreatment. The most common forms of trauma for both men and women were physical abuse, physical neglect, and emotional abuse, all of which were highly likely to co-occur. Race, sex, and current educational level were each associated with an increased likelihood of childhood maltreatment; differential relationships with particular maltreatment types were also observed. IMPLICATIONS: These findings highlight the importance of research on the prevalence of and risks for multiple types of childhood maltreatment, particularly in the somewhat neglected area of emotional abuse and neglect. These findings can be used to highlight the need for preventive interventions aimed at the negative sequelae of childhood maltreatment and to tailor preventive interventions to the needs and expectations of those at high risk.

Adult↗

PubMed2004

Affective state and EEG sleep profile in response to rapid tryptophan depletion in recently recovered nonmedicated depressed individuals.

BACKGROUND: The current study examines whether a tryptophan-free amino acid drink (TFD) causes a transient mood relapse in unmedicated patients recently recovered from major depression. TFD is thought to reduce cerebral serotonin, a neurotransmitter implicated in depression. Some studies report that TFD reverses the antidepressant and REM-suppression effects of selective serotonin reuptake inhibitors (SSRIs). METHODS: Following an average of 10 weeks of Cognitive Behavioral Therapy (CBT), 13 recovered patients who achieved 50% or greater reduction on the initial Hamilton Rating Scale of Depression (HRSD) underwent a double-blind challenge with the TFD and a control drink. In order to demonstrate the central physiological effects of the TFD on REM sleep in these patients, all night polygraphic sleep recordings were obtained before and after the TFD and control drink. RESULTS: Relative to the control drink, TFD decreased REM latency and plasma concentrations of tryptophan but had no statistically significant effect on mood symptoms as measured by the HRSD, Beck Depression Inventory (BDI), and Profile of Mood States (POMS). LIMITATIONS: High participant attrition, a physiologically active control drink, physical side effects in response to both drinks, and low statistical power may be methodological considerations that limit interpretation of findings. CONCLUSIONS: The failure to find a transient mood relapse after the TFD may suggest that: (a) nonpharmacological recovery from depression does not occur via serotonergic mechanisms, (b) participant variables may be operating, or (c) CBT alters psychological responses to unfavorable biological states.

Adult↗

PubMed2003

Relationship of tinnitus questionnaires to depressive symptoms, quality of well-being, and internal focus.

Twenty percent of people endure tinnitus to a degree that their quality of well-being and productivity in life are impaired, and up to 60% report depression. Four measures are widely used to assess tinnitus-related distress, yet the relationship among all four measures or their relationship to relevant psychiatric variables has yet to be studied. This study assessed the association between the four commonly used measures of tinnitus and their relationship to depressive symptoms, quality of well-being, and internal focus. Sixty-five people with tinnitus completed the following measures: Iowa Tinnitus Handicap Questionnaire (THQ); Tinnitus Reaction Questionnaire (TRQ); Tinnitus Handicap Inventory (THI); Tinnitus Questionnaire (TQ); Hamilton Rating Scale for Depression (HRSD); Beck Depression Inventory (BDI); Quality of Well-Being Scale (QWBS); Modified Somatic Perception Questionnaire (MSPQ); and Private Self-Consciousness Scale (PSCS). All the tinnitus measures were highly intercorrelated (r = .76-.90; all p values < .001), and related to depressive symptoms (r = .48-.66; p < .001) and QWBS (r = .37-.48; all p values < 0.008). The tinnitus measures correlated with the MSPQ (r = .37-.52; all p values < .01) but not with the PSCS. When controlling for the shared variance between tinnitus measures, the THQ independently predicted the HRSD, whereas the TRQ independently predicted the BDI.

Adult↗

PubMed2002

The Parent Threat Inventory: development, reliability, and validity.

OBJECTIVE: The goal was to develop a retrospective inventory of parental threatening behavior to facilitate a better understanding of such behavior's role in the etiology of psychological distress. METHOD: Inventory items were developed based on theory and 135 students' responses to a question eliciting examples of threatening parental behavior. Following item development, two additional student samples (n = 200 and n = 603) completed batteries of self-report measures. Responses were used to eliminate unstable or redundant items from the inventory and to examine the inventory's psychometric properties. RESULTS: Factor analysis of the inventory revealed three factors, accounting for 66.2% of variance; this factor structure is compatible with theory, and consistent across maternal behavior scores, paternal behavior scores, and combined maternal and paternal scores. Cronbach's coefficient alphas indicated acceptable internal consistency; Pearson correlation coefficients indicated acceptable 4-week test-retest reliability. Moderate intercorrelations with two retrospective measures of childhood experiences suggested construct validity. Regression analyses demonstrated the ability of the inventory to predict both anxious and depressive symptomatology and lifetime symptoms of anxiety and depressive disorder. Normative data on combined parent scores, maternal scores, and paternal scores are also presented. CONCLUSIONS: Initial psychometric testing of the Parent Threat Inventory (PTI) suggests it is a reliable and valid tool for investigating the developmental antecedents of adult psychological distress. Further research should focus on addressing two limitations: (1) lack of normative and psychometric data on men and women suffering from clinical disorders, and (2) lack of validation by parental reporting.

Adolescent↗