Biomedical subjects

Kimberly A Wilson

Publications and source records attributed to Kimberly A Wilson.

8 recordsLinked to original sources

PubMed2006

Lifetime prevalence and pseudocomorbidity in psychiatric research.

CONTEXT: Comorbidity is the rule rather than the exception with psychiatric disorders and is consequently of great interest to both researchers and clinicians. However, many studies of psychiatric comorbidity have been based on lifetime prevalence with mixed-age samples, a practice that (1) biases the assessment of epidemiologic comorbidity and (2) creates the appearance of comorbidity even when disorders are randomly associated. This bias is what we refer to as pseudocomorbidity. OBJECTIVES: To clarify the source of the problem and to discuss strategies that might be adopted to deal hereafter with lifetime prevalence data. METHODS: A simulated example is presented to show that even when there is only random association between disorders, there will appear to be nonrandom comorbidity when lifetime prevalence is used with mixed-age samples. An actual example relating psychosis to phobia is presented to show the bias that can result and to illustrate one way of dealing with lifetime prevalence data. CONCLUSIONS: Use of lifetime prevalence with mixed-age samples, used almost exclusively in psychiatric research, generates problematic results, especially when used for assessment of comorbidity, and should be viewed with some skepticism. Hereafter, we recommend that any future use of lifetime prevalence should require determination of the age of onset, even if only by retrospective report. Comorbidity then should be reported by age.

Adolescent↗

PubMed2005

Unique contributions of anxiety sensitivity to avoidance: a prospective study in adolescents.

Examination of the prospective relation between anxiety sensitivity (AS) and behavioral avoidance is largely absent from the literature. In a longitudinal study of a community sample of 2246 adolescents, participants completed the Anxiety Sensitivity Index (ASI; Reiss, Peterson, Gursky, & McNally (1986). Behaviour Research & Therapy, 24, 1-8), State-Trait Anxiety Inventory (STAI; Spielberger (1983). STAI: Manual for the Stait-Trait Anxiety Inventory. Palo Alto: Consulting Psychologists Press), and the Fear Questionnaire (Marks & Matthews (1979). Behaviour Research & Therapy, 17, 263-267) on an annual basis. To stringently test AS's ability to prospectively predict behavioral avoidance, linear regression was used to test whether AS factors predicted variance in follow-up behavioral avoidance scores after controlling for gender, trait anxiety, panic attacks, and baseline avoidance. Results indicted that the mental and physical subscales of the ASI predicted change in behavioral avoidance. The findings of the study are consistent with the view that AS may serve as a precursor to avoidant behavior and that, regardless of whether or not acute panic has been experienced, those who fear autonomic arousal may be more likely to avoid situations in which those sensations may be present.

Adolescent↗

PubMed2005

Cognitive therapy for obsessive-compulsive disorder.

A multiple baseline across subjects design was used to test the efficacy of cognitive therapy for obsessive-compulsive disorder (OCD). Six people with OCD received 10-18 sessions of weekly, outpatient cognitive therapy. Assessment included both structured interviews and diary data. For three to four of the six patients, stable baseline periods were followed by reductions of symptoms during intervention. Two clients met stringent criteria for Jacobson and Truax's (J. Consulting Clin. Psychol. 59 (1991) 12) recovered status at posttest according to the Yale-Brown Obsessive-Compulsive Scale (Arch. Gen. Psychiatry 46 (1989) 1006). For the group, large pretest-posttest effect sizes were found.

Adult↗

PubMed2005

A prospective evaluation of agoraphobia and depression symptoms following panic attacks in a community sample of adolescents.

In a community sample of high schoolers who experienced their first panic attack, we examined the prospective relationships among pre-panic vulnerabilities, panic attack severity, and post-panic agoraphobia and depression symptoms. Students were evaluated yearly over 4 years to test the following four hypotheses: (1) pre-panic anxiety sensitivity, negative affect, and childhood behavioral inhibition will serve as vulnerabilities that predict agoraphobia and depression symptoms following a panic attack; (2) these vulnerabilities will lead to more severe panic attacks; (3) severe and spontaneous panic attacks will predict subsequent agoraphobia and depressive symptoms; and (4) the interaction between panic severity and vulnerabilities will be associated with worse outcomes following a panic attack. Results supported the first three hypotheses, but no evidence emerged for an interactive effect. Findings are discussed in light of recent modernized classical conditioning models that address factors contributing to development of more severe panic related psychopathology after panic attacks.

Adolescent↗

PubMed2004

Changes in caffeine consumption as a signal of pregnancy.

OBJECTIVES: The purpose of this prospective study was to examine caffeine consumption and other signals of early pregnancy. STUDY DESIGN: One hundred and five pregnant, nonsmoking, coffee drinkers ages 18-40 were enrolled by the ninth week after their last menstrual period (LMP). Participants kept daily diaries of beverage and caffeine consumption and symptoms. Urine samples were collected to assess hormone metabolites. Descriptive statistics were generated. RESULTS: During the first trimester, 96% of subjects decreased or quit drinking coffee, 65% of whom reported a unique aversion to coffee. The mean daily caffeine consumption at LMP from coffee alone was 119 mg (S.D., 105), with a range 1-574 mg. There was a 59% decrease of mean daily consumption of caffeine from coffee between weeks 4 and 6, from 96 to 39 mg. The vast majority of subjects experienced nausea (98%) and appetite loss (93%); vomiting was less prevalent (54%). The most common dietary aversions included meat, coffee, spicy foods, and dairy products. Hormone metabolite patterns are reported. CONCLUSION: Signals of early pregnancy included an aversion to coffee in addition to nausea and vomiting, which resulted in decreased caffeine consumption. These symptoms often interfered with daily life and lasted beyond the first trimester for many. Consideration should be given that a decrease in caffeine consumption may be a signal for a healthy pregnancy and acting as a confounder.

Adolescent↗

PubMed2004

Parent-reported predictors of adolescent panic attacks.

OBJECTIVE: To identify parent-reported risk factors for adolescent panic attacks. METHOD: Structured diagnostic interviews were obtained from 770 parents of participants in a school-based risk factor study for adolescent panic. Parent-reported risk factors assessed included characteristics of the child (negative affect, separation anxiety disorder [SAD], childhood chronic illness, and childhood loss) as well as characteristics of the parent (parental panic disorder or agoraphobia [PDA], parental major depression, and parental chronic illness). RESULTS: Bivariate predictors of adolescent panic attacks included parent history of PDA, parent history of chronic illness, child negative affect, and child SAD. Using signal detection methods, three subgroups of participants at risk for panic attacks were identified. Fifty-eight percent of adolescents with panic attacks belonged to one of these high-risk groups. Adolescents with a positive parental history of PDA were at highest risk: 24% of this group experienced panic attacks. Among those without a positive parental history of PDA, those with high childhood negative affect or history of SAD were at increased risk for panic attacks (14% and 20%, respectively). CONCLUSIONS: The use of parent-reported data provides cross-validation for previously identified risk factors of adolescent panic attacks. Signal detection results suggest there are multiple paths (equifinality) to the development of adolescent panic attacks.

Adolescent↗

PubMed2003

Connections among symptoms of obsessive-compulsive disorder and posttraumatic stress disorder: a case series.

Theoretical, clinical, and empirical implications of the functional connections between symptoms of obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) are abundant. As such, four cases are presented here of men and women who met criteria for comorbid OCD and PTSD. All had been diagnosed with treatment-resistant OCD and were seeking treatment from an OCD specialty clinic or institute, all reported a history of traumatic experiences prior to the onset of OCD, and all appeared to demonstrate negative treatment outcomes. Upon examination, it appeared that symptoms of OCD and PTSD were connected such that decreases in OCD-specific symptoms related to increases in PTSD-specific symptoms, and increases in OCD-specific symptoms related to decreases in PTSD-specific symptoms. Speculations about the function of OCD symptoms in relation to post-traumatic psychopathology are put forth; and theoretical, research, and treatment implications are discussed.

Adult↗

PubMed2002

Marital interaction of agoraphobic women: a controlled, behavioral observation study.

Married couples with a female agoraphobic spouse (n = 22) were compared with demographically similar community control couples (n = 21) on self-report and observational measures of marital interaction. Consistent with hypotheses, husbands of agoraphobic women were more critical of their wives than were control husbands, and clinical couples were less likely to engage in positive problem solution than control couples. Contrary to hypothesis, clinical husbands were not less supportive than control husbands. Where general measures of marital distress were concerned, clinical couples, relative to control couples, evinced more distress by self-report, by their higher rate of negative nonverbal behavior, and by their longer sequences of negative exchanges.

Adaptation, Psychological↗