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Biomedical subjects

L Gaston

Publications and source records attributed to L Gaston.

16 recordsLinked to original sources
PubMed1998

MMPI scales for diagnosing acute and chronic PTSD in civilians. Minnesota Multiphasic Personality Inventory.

To develop new Minnesota Multiphasic Personality Inventory (MMPI) scales for diagnosing acute and chronic posttraumatic stress disorder (PTSD), 237 civilians with PTSD or panic disorder (controls) completed the MMPI-R. All 399 items were submitted to chi-square analysis to select those differentiating acute or chronic PTSD from controls. The analyses yielded an MMPI Acute PTSD scale (32 items) and a MMPI Chronic PTSD scale (41 items). Discriminating between acute PTSD and controls, the MMPI Acute PTSD scale had a hit rate of 83% and the MMPI Chronic PTSD scale produced a hit rate of 75% to 80%. Cross-validation produced similar hit rates. These scales scores were not substantially influenced by gender or types of traumatic events, and only the MMPI Acute PTSD scale seemed to not be sensitive to co-morbidity.

Acute Disease↗
PubMed1997

The role of the alliance in the pharmacologic treatment of depression.

BACKGROUND: The purpose of this study was to determine the influence of the therapeutic alliance on the efficacy of pharmacotherapy for depression. METHOD: The sample consisted of 31 depressed outpatients treated with antidepressants. The alliance was measured by the patient and therapist versions of the California Pharmacotherapy Alliance Scale. Treatment outcome was measured by the Hamilton Rating Scale for Depression and the Beck Depression Inventory, and the Symptom, Sign, Side-Effect Checklist was also completed. RESULTS: The alliance measures accounted for between 21% and 56% of the variance in the three outcome measures. By averaging across outcome measures, therapist perceptions of the alliance predicted 41% of the variance in improvement in depressive symptoms, where patient perceptions predicted 25%. Scores on both alliance measures were lower than those reported in studies of psychotherapy. Patient attitude toward medication was correlated with somatic complaints, but not with depression scores. Therapist perception of patient hostility correlated with patient depression. Patients differed in the way their alliance and outcome interacted, so that the association might be positive or negative. CONCLUSION: Alliance is correlated with outcome in pharmacotherapy management of depression, although there may be interindividual variability across patients. In the pharmacotherapy of depression, therapist perception of alliance is a better predictor of symptom outcome than patient perception, while the reverse is usually found in psychotherapy.

Adult↗
PubMed1997

Overall maturity of object relations as assessed by the McGill Object Relations Scale.

The McGill Object Relations Scale (MORS) is an instrument for assessing levels of drive-based object relations along a continuum of positions representative of psychosexual development. Its theoretical foundations as well as empirical antecedents are presented, and its rating procedure is demonstrated through a case application. The MORS was applied, by five experienced psychiatrists, to 67 adult patients seeking psychoanalytic psychotherapy, in order to assess interrater reliability, internal structure, and construct validity. Results indicate that overall maturity of object relations stems from structural indices of self-object differentiation determined by a particular configuration of many positions, rather than from the thematic aspects included in the individual psychosexual positions.

Adult↗
PubMed1996

MMPI profiles of acute and chronic PTSD in a civilian sample.

In a treatment setting, a group of 165 subjects presenting with either acute or chronic posttraumatic stress disorder (PTSD) were compared to 72 subjects presenting with panic disorder only in order to determine whether the MMPI PTSD assessment strategy developed with Vietnam veterans could be validly used with civilians. Results indicated that the MMPI profile, codetype, diagnostic decision rule, and PK scale developed with samples of Vietnam veterans did not apply well to civilians, especially those presenting with acute PTSD. It is thus recommended that specific assessment strategies be developed for these populations.

Acute Disease↗
PubMed1995

Current concepts and controversies in the use of vitamin K.

Vitamin K is a fat-soluble vitamin crucial to the production of many proteins involved with the coagulation process. It is integral in the synthesis of coagulants (factors II, VII, IX and X) and anticoagulants (proteins C and S). It is generally recognised that routine administration of vitamin K (phytomenadione) shortly after birth will prevent major neonatal morbidity and mortality related to haemorrhage. Vitamin K supplementation during pregnancy is also recommended if mothers are on anticonvulsant therapy or prolonged treatment with certain antibiotics. These medications, if ingested by pregnant women, predispose the neonate to a bleeding tendency caused by vitamin K deficiency. Vitamin K treatment of pregnant mothers before premature delivery has also been suggested to reduce the incidence of severe intracranial haemorrhage (ICH) in premature neonates. Although further studies are pending, the data to date do not support using antenatal vitamin K for preventing ICH.

Anticonvulsants↗
PubMed1991

Psychological stress and psoriasis: experimental and prospective correlational studies.

Using a dismantled time-series design, 18 subjects with psoriasis symptoms on the scalp were randomly assigned to four groups and six dropped out: meditation (N = 5); meditation and imagery (N = 4); waiting list (N = 5); and no treatment control group (N = 4). Treatment lasted 12 weeks, with 4 weeks pre- and post-baseline periods. An assessment control group was also used during baseline periods (N = 4). The severity of psoriasis symptoms was reliably rated by dermatologists. A time-series multivariate regression analysis controlling for extraneous factors influencing psoriasis symptoms, revealed a significant difference between the mean psoriasis ratings of treatment and control groups after treatment (partial r = 0.30, p less than 0.01). No additional impact was associated with the use of the imagery technique (partial r = 0.06, p less than 0.05). Four subjects in the treatment groups, two in each condition, succeeded in clinically improving their psoriasis symptoms and none deteriorated. The practice of meditation may be clinically effective for some patients in reducing their psoriasis symptoms. For one of the control groups, the relation between psychological stress and psoriasis was examined prospectively over a period of 20 weeks using standardized measures. A time-series multivariate statistical method indicated an average positive correlation between the severity of psoriasis symptoms and psychological distress (partial r = 0.31, p less than 0.01) and the impact of adverse life events (partial r = 0.23, p less than 0.05); there were, however, important individual differences. Stress reduction techniques can thus be regarded as part of the treatment offered to some patients suffering from psoriasis.

Adult↗
PubMed1990

Impact of supervised apartments on the functioning of mentally disordered adults.

The impact on the mentally disordered of living in supervised residences remains unclear. The present investigation followed a group of supervised apartment residents and a matched comparison group for two years. Symptomatology, psychosocial functioning, stress, social support, quality of life, and life satisfaction were measured at six month intervals. Readmission and consultations in the emergency room were documented for all subjects for the two year period. Neither readmission rates, emergency room consultations, nor measures of functioning, other than symptomatology, differed for the two groups. It is argued that supervised apartments are stressful environments that may lead to deterioration in mentally disordered persons.

Adolescent↗
PubMed1989

Alliance and outcome in late-life depression.

Older adults who met criteria for major depressive disorder were randomly assigned to behavioral, cognitive, or brief dynamic therapy. Symptoms were equally reduced across the three treatment conditions. Early in treatment, alliance ratings were obtained from both therapists and patients and were related to outcome. We calculated one therapist alliance composite score and five patient alliance factor scores. In general, no agreement was found between therapists' and patients' judgments of alliance. Levels of alliance were found to be not significantly different across the three treatment conditions. For the sample as a whole, only the patient factor of Patient Commitment was found to be associated with depressive symptoms after treatment, with the strongest findings in the cognitive therapy condition. The Patient Commitment factor uniquely contributed to outcome over and above the contribution of initial symptomatology and symptomatic change at midpoint in therapy. Expected trends of association with outcome were observed for the therapist alliance composite score in brief dynamic therapy and for the patient factor of Patient Working Capacity in both cognitive and brief dynamic therapy. Findings are discussed in terms of their theoretical and clinical implications.

Aged↗
PubMed1987

Psoriasis and stress: a prospective study.

In previous works, stress has been found to be related to psoriasis but only retrospectively and/or by means of nonstandardized measures. In our study the relationship between psoriasis and stress was examined prospectively over a period of 20 weeks by means of standardized measures. A multivariate statistical method indicated a positive correlation between the severity of psoriasis symptoms and psychologic distress (partial r = 0.31; p less than 0.01) and the impact of adverse life events (partial r = 0.23; p less than 0.05). According to these results, stress reduction could be regarded as part of the treatment offered to some patients suffering from psoriasis.

Adult↗
PubMed1987

Community programs for chronic patients: towards a conceptual framework.

Community services for persons suffering from major psychological disorders have often been developed without prior consideration of the results of studies measuring the effectiveness of such programs or of the problems presented by this population once they leave hospital. In this article we attempt to develop a conceptual framework useful for planning and evaluating community programs. To do so, we examine the role and objectives of these programs, the characteristics of the clientele, and the importance of appropriate research in the planning and implementation of effective community services for chronic psychiatric patients.

Chronic Disease↗
PubMed1987

[The componants of efficiency of community treatment programs for people with mental disorders.].

Community programmes are designed to help clients establish themselves permanently in the community to succeed, these programmes must include several treatment components each addressing a specific problem presented by the clients. These components include : drug therapy, an intervention to encourage clients to take medications as prescribed ; an intervention to train staff and clients to evaluate symptoms aetiology ; a stable relationship ; social skills training ; vocational training or an intervention which aims to help clients participate regularly in an activity of their choice ; stress innoculation ; problem solving ; an intervention to reduce the use of alcohol ; residences which will provide support to the clients.

English Abstract↗
PubMed1982

[Anti-stress intervention with a health and social service clientele.].

The present study concerns an anti-stress intervention involving a social and health services clientele. This category of the population represents the individuals who are statistically the most affected by stress. The anti-stress intervention used consists in assisting the individual to work towards the modification of his "stressors" and to permit him to reduce psycho-physiological tension as a result of the practice of progressive relaxation. Results demonstrate that a portion of this clientele is effectively more anxious than the mean of the population and that the intervention permits a significant reduction of situational anxiety as measured by the STAI.

English Abstract↗