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Biomedical subjects

K S Dawson

Publications and source records attributed to K S Dawson.

11 recordsLinked to original sources

Psychopathology in substance abusing women reporting childhood sexual abuse.

This study compared MMPI-2 profiles and evaluated the ability of the MMPI-2 and its two new post-traumatic stress scales (PK and PS) to discriminate women in outpatient substance abuse treatment reporting positive (n = 24) and negative (n = 69) child sexual abuse histories. T-tests revealed significantly higher mean scores for the sexual abuse group for the following scales: F, 1, 2, 3, 4, 6, 7, and 8. A discriminant analysis yielded a linear function of L, F, 3, 5, 8, and PK that correctly categorized 75% with positive histories and 77% with negative histories. The optimal cutoff PK score was 17, which correctly classified 75% and 46% of those reporting positive and negative abuse histories, respectively. These findings support early identification of abuse survivors among substance abusing women and suggests that the MMPI-2 may be useful in patient-treatment matching.

Adolescent↗

The evaluation of a consultation service for delivery of substance abuse services in a hospital setting.

OBJECTIVE: This study evaluated the institutional impact of a substance abuse consultation service in a hospital setting. METHOD: Treatment and matched comparison groups were compared on five outcome variables: length of stay, total cost, reimbursement, readmission, and appropriateness of care. The treatment group consisted of patients with discharge diagnoses falling into targeted Diagnostic Resource Groups (DRGs) and who received a substance abuse consultation. The comparison group consisted of patients with the same targeted DRGs, a coexisting substance abuse diagnosis, and who did not receive a substance abuse consultation. RESULTS: No statistically significant differences were found for the five outcome variables. Findings closely approached statistical significance for rate of readmission with treatment patients being less likely to be readmitted during the 12 months following the consultation. CONCLUSIONS: Although cost savings were not found during the hospitalization when the substance abuse consultation was provided, the data suggests that the consultation may reduce the need for readmission during the year following discharge.

Adolescent↗

The effects of animal-assisted therapy on anxiety ratings of hospitalized psychiatric patients.

OBJECTIVE: Animal-assisted therapy involves interaction between patients and a trained animal, along with its human owner or handler, with the aim of facilitating patients' progress toward therapeutic goals. This study examined whether a session of animal-assisted therapy reduced the anxiety levels of hospitalized psychiatric patients and whether any differences in reductions in anxiety were associated with patients' diagnoses. METHODS: Study subjects were 230 patients referred for therapeutic recreation sessions. A pre- and posttreatment crossover study design was used to compare the effects of a single animal-assisted therapy session with those of a single regularly scheduled therapeutic recreation session. Before and after participating in the two types of sessions, subjects completed the state scale of the State-Trait Anxiety Inventory, a self-report measure of anxiety currently felt. A mixed-models repeated-measures analysis was used to test differences in scores from before and after the two types of sessions. RESULTS: Statistically significant reductions in anxiety scores were found after the animal-assisted therapy session for patients with psychotic disorders, mood disorders, and other disorders, and after the therapeutic recreation session for patients with mood disorders. No statistically significant differences in reduction of anxiety were found between the two types of sessions. CONCLUSIONS: Animal-assisted therapy was associated with reduced state anxiety levels for hospitalized patients with a variety of psychiatric diagnoses, while a routine therapeutic recreation session was associated with reduced levels only for patients with mood disorders.

Adult↗

Perinatal substance abusers. Psychological and social characteristics.

Forty perinatal substance abusers were administered multiple psychosocial, addiction, and psychological measures before beginning treatment. Results indicate that these patients are limited intellectually, educationally, financially, and emotionally. Psychiatric comorbidity was high, with 45% having non-substance abuse axis I diagnoses and 75% having confirmed (by two or more tests) axis II pathology. The most frequently identified axis I disorders were depression and anxiety. The most frequently detected personality disorders were antisocial, borderline, paranoid, and dependent. The average IQ was 87 (low average range) and nearly one third of the sample were found to be somewhat impaired intellectually. These data suggest that treatment programs must take psychological characteristics into account if they are going to succeed in helping these women achieve and maintain abstinence.

Anxiety Disorders↗

Stage III breast cancer: is neoadjuvant chemotherapy always necessary?

Optimal management of locally advanced breast cancer is controversial. Claims of superiority for neoadjuvant systemic therapy are based on comparisons with outdated historical control groups who received no chemotherapy. Between 1978 and 1987, 118 patients with locally advanced breast cancer underwent treatment and follow-up at the Medical College of Virginia. Median follow-up was 44 months (range 3-119 months). Actuarial 5-year survival for the entire group was 54%. This compares favorably with recent series using neoadjuvant chemotherapy in which 5-year survival rates of 40-65% have been reported. Primary tumor size larger than 9 cm, metastases to more than 50% of regional lymph nodes, and the presence of inflammatory disease were significant prognostic indicators. This series represents a contemporary control group of patients with locally advanced breast cancer in whom conventionally accepted guidelines for local and postoperative systemic adjuvant therapy were used. Until the optimal sequence of therapy is determined by prospective randomized trials, series such as this may serve as more appropriate controls to which the results of new therapies could be compared.

Adenocarcinoma↗

Comparison of questionnaire screening and urine toxicology for detection of pregnancy complicated by substance use.

OBJECTIVES: To compare the efficacy of structured questionnaire screening and prenatal urine toxicology for the detection of substance use by pregnant women, and to describe substance use patterns in a group of women presenting to a university-based obstetric clinic. METHODS: All patients presenting to our obstetric clinic for their first prenatal visit were evaluated for evidence of current use of alcohol or any illicit substances. Nursing personnel administered an extensive questionnaire, which included detailed questions about past and current substance use patterns. Urine samples were examined by a commercial laboratory for alcohol and a number of illicit substances. Current users were defined as those who admitted use within the past 30 days or who had positive urine toxicology. RESULTS: Fifty-eight of 302 patients (19.2%) were identified as current users of alcohol or illicit substances. Only 17 of 41 women (41.5%) with toxicologic evidence of recent use admitted to current use. Only 17 of 34 (50.0%) admitting to current use had toxicology positive for any substance. Patients with a history of multiple past substance use were significantly more likely to have positive urine toxicology than those without such a history (26.1 versus 7.4%; P < .005). Among current users, multiple substance use (34.5%) and cigarette smoking (52%) were common. CONCLUSION: A screening combination of structured questionnaire and universal urine toxicology identifies more current users than either technique alone, and neither is clearly superior to the other. A history of multiple substance use may be an important indicator of current use.

Adolescent↗

Interpreting plots of a multidimensional dose-response surface in a parallel coordinate system.

The dose-response surface for a combination of drugs is a multidimensional figure. Consequently, it is not possible to view such a surface using orthogonal axes when the number of dimensions exceeds 3. Parallel axes have been used to represent hyperdimensional figures. This paper reports on the use of parallel coordinate axes to plot the dose-response surface and its contours of constant response (isobols) for a combination of drugs. It is shown that patterns formed by intersecting line segments in the parallel system can aid in the interpretation of the fitted dose-response surface. More generally, analytic results are developed that permit the ready visualization and characterization of interaction effects of a polynomial model.

Biometry↗

Attitude toward recovery and completion of a substance abuse treatment program.

This study tested the ability of the Recovery Attitude and Treatment Evaluator (RAATE; Mee-Lee, Hoffmann, & Smith, 1992) to predict attrition from treatment for pregnant and postpartum substance abusing women. During the first month of treatment, the RAATE was completed by both the clinician and the patient. Three types of discharge status were considered: completion of the treatment program, dropping out of the program, and being administratively discharged. No group differences were found concerning the clinician version of the RAATE. Initial analyses of the patient version revealed that subjects who completed the program had lower ratings of resistance to treatment and continuing care compared to those who dropped out; further analysis suggested that those who completed less than 1 month of treatment exhibited the highest resistance. These results suggest the RAATE is a potentially effective tool for predicting early attrition from substance abuse treatment in this population.

Adult↗

Perinatal substance abusers: factors influencing treatment retention.

This study investigated the association between two demographic and two psychological variables and treatment retention for 65 perinatal substance abusers. Subjects who lived in the community while attending day treatment were 6.125 times more likely to drp out than subjects who lived in a program-operated shelter (p < .0001). An interaction was found for pregnancy status and antisocial personality disorder (p < .0478). Subjects who were both pregnant and antisocial were 4.876 times more likely to remain in treatment than those who were neither pregnant nor antisocial. Degree of "treatment resistance," measured by the MMPI Negative Treatment Indicators (TRT) Scale, did not predict dropout. These findings indicate that supportive housing can play an important role in preventing dropout for perinatal substance abusers. Additionally, pregnancy may present a "window" of opportunity for treating a hard to reach population, drug abusing women with comorbid ASP.

Adult↗