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Biomedical subjects

Karen Steinberg

Publications and source records attributed to Karen Steinberg.

7 recordsLinked to original sources
PubMed2006

Cognitive-behavioral therapy for pathological gamblers.

Few studies have evaluated efficacy of psychotherapies for pathological gambling. Pathological gamblers (N = 231) were randomly assigned to (a) referral to Gamblers Anonymous (GA), (b) GA referral plus a cognitive- behavioral (CB) workbook, or (c) GA referral plus 8 sessions of individual CB therapy. Gambling and related problems were assessed at baseline, 1 month later, posttreatment, and at 6- and 12-month follow-ups. CB treatment reduced gambling relative to GA referral alone during the treatment period and resulted in clinically significant improvements, with some effects maintained throughout follow-up ( ps = .05). Individual CB therapy improved some outcomes compared with the CB workbook. Attendance at GA and number of CB therapy sessions or workbook exercises completed were associated with gambling abstinence. These data suggest the efficacy of this CB therapy approach.

Adolescent↗
PubMed2006

Systematic review of the efficacy of meditation techniques as treatments for medical illness.

BACKGROUND: Meditative techniques are sought frequently by patients coping with medical and psychological problems. Because of their increasingly widespread appeal and use, and the potential for use as medical therapies, a concise and thorough review of the current state of scientific knowledge of these practices as medical interventions was conducted. PURPOSE: To systematically review the evidence supporting efficacy and safety of meditative practices in treating illnesses, and examine areas warranting further study. Studies on normal healthy populations are not included. METHODS: Searches were performed using PubMed, PsycInfo, and the Cochrane Database. Keywords were Meditation, Meditative Prayer, Yoga, Relaxation Response. Qualifying studies were reviewed and independently rated based on quality by two reviewers. Mid-to-high-quality studies (those scoring above 0.65 or 65% on a validated research quality scale) were included. RESULTS: From a total of 82 identified studies, 20 randomized controlled trials met our criteria. The studies included 958 subjects total (397 experimentally treated, 561 controls). No serious adverse events were reported in any of the included or excluded clinical trials. Serious adverse events are reported in the medical literature, though rare. The strongest evidence for efficacy was found for epilepsy, symptoms of the premenstrual syndrome and menopausal symptoms. Benefit was also demonstrated for mood and anxiety disorders, autoimmune illness, and emotional disturbance in neoplastic disease. CONCLUSIONS: The results support the safety and potential efficacy of meditative practices for treating certain illnesses, particularly in nonpsychotic mood and anxiety disorders. Clear and reproducible evidence supporting efficacy from large, methodologically sound studies is lacking.

Chronic Disease↗
PubMed2004

Prospective association of anxiety, depressive, and addictive disorders with high utilization of primary, specialty and emergency medical care.

The empirical evidence concerning the relationship of psychiatric disorders to health care utilization and costs is mixed and primarily retrospective. Therefore, a case-control study was conducted to prospectively examine the association of psychiatric disorders with health care utilization in an adult primary care internal medicine patient population, controlling for the effects of medical morbidity, adverse events, age, race, gender, employment status, and health insurance coverage. Samples of primary care high utilizer (HU; 125 men, 125 women with primary care visits in 1998 above the 95th percentile) vs. mid-range utilizer (MU; 125 men, 125 women; two primary care visits in 1998) patients were compared using archival automated medical record data from the index year (1998), and from the following year (1999) for prospective analyses. HU (compared to MU) participants were younger, had higher medical and psychiatric morbidity, and had higher levels of outpatient specialty medical care utilization. In multivariate analyses, (a) anxiety disorder diagnoses uniquely contributed to identifying HU patients, and (b) after controlling for initial primary care utilization status, anxiety, depressive and addictive disorders were prospectively associated with medical illness complexity and primary, specialty, and emergency medical care utilization. Although behavioral health disorders (including addictive as well as depressive and anxiety diagnoses) and high utilization of primary health care services are related, these prospective findings suggest that behavioral health disorders make an independent contribution to non-psychiatric health care utilization.

Adolescent↗
PubMed2002

DNA banking for epidemiologic studies: a review of current practices.

To study genetic risk factors for common diseases, researchers have begun collecting DNA specimens in large epidemiologic studies and surveys. However, little information is available to guide researchers in selecting the most appropriate specimens. In an effort to gather the best information for the selection of specimens for these studies, we convened a meeting of scientists engaged in DNA banking for large epidemiologic studies. In this discussion, we review the information presented at that meeting in the context of recent published information. Factors to be considered in choosing the appropriate specimens for epidemiologic studies include quality and quantity of DNA, convenience of collection and storage, cost, and ability to accommodate future needs for genotyping. We focus on four types of specimens that are stored in these banks: (1) whole blood preserved as dried blood spots; (2) whole blood from which genomic DNA is isolated, (3) immortalized lymphocytes from whole blood or separated lymphocytes, prepared immediately or subsequent to cryopreservation; and (4) buccal epithelial cells. Each of the specimens discussed is useful for epidemiologic studies according to specific needs, which we enumerate in our conclusions.

Biological Specimen Banks↗