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Biomedical subjects

L Jacobsberg

Publications and source records attributed to L Jacobsberg.

15 recordsLinked to original sources
PubMed1996

Distress reduction during the structured clinical interview for DSM-III-R.

In an attempt to assess the influence of standardized diagnostic interviews on psychological distress in research volunteers, the Visual Analogue Scale (VAS) was used to measure anxiety and depression during the Structured Clinical Interview for DSM-III-R, Non-patient version (SCID). Subjects were 50 adults with concerns related to the human immunodeficiency virus who were seeking testing and treatment in research trials. Repeated measures analysis of variance showed significant decreases in distress by the end of the interview: 72% of subjects reported diminished anxiety, and 54% reported diminished depression. Thus, the SCID appeared to provide a positive interview experience, a finding that may serve to reassure subjects, their families, and review boards regarding participation in studies that employ structured interviews.

Adult↗
PubMed1995

Axis II diagnoses among volunteers for HIV testing and counseling.

OBJECTIVE: The authors' goal was to investigate the rate of personality disorders (axis II diagnoses in DSM-III-R) among adults at risk for AIDS. METHOD: The Personality Disorder Examination was administered to 260 volunteers for HIV testing and counseling. RESULTS: Thirty-seven percent of the subjects who subsequently tested seropositive for HIV and 20% of those who tested seronegative were given DSM-III-R axis II diagnoses on the Personality Disorder Examination. Thirty percent of the HIV-positive subjects who knew their serostatus before they were tested were given DSM-III-R axis II diagnoses. CONCLUSIONS: The meaningful rates of axis II diagnoses that preexisted determination of HIV status and the relation of these diagnoses to subsequently determined serostatus underscore the importance of adequately assessing the occurrence of personality disorder in individuals at risk for HIV infection.

AIDS Serodiagnosis↗
PubMed1995

Diagnostic agreement between the SCID-II screening questionnaire and the Personality Disorder Examination.

Instruments to assess personality disorders offer reliability, but at the cost of large amounts of a skilled clinician's time to make assessments. The Structured Clinical Interview for DSM-III Axis II (SCID-II; Spitzer, Williams, Gibbon, & First, 1990), incorporates a self-report screening questionnaire, reducing the number of items needing evaluation by the interviewer. However, false negative responses may cause clinically important areas to be overlooked. To establish the rate of false negative responses, we compared participant self-report on the SCID-II with Axis II diagnostic assessment done by clinicians using the Personality Disorder Examination (Loranger, Susman, Oldham, & Russakoff, 1987). The false negative rate was low for every diagnosis, supporting validity of following up with clinician questioning only those diagnostic elements endorsed in the self-report. Avoidant and dependent personality disorders were accurately self-reported. This, an efficient assessment instrument for personality disorders might combine self-report of those disorders where self-report is reliable, with clinician assessment where needed.

Adult↗
PubMed1993

Severity of psychiatric symptoms after HIV testing.

OBJECTIVE: The authors were interested in the psychiatric effects of serological testing for HIV and what information feasibly available at intake might predict more severe psychiatric symptoms 1 year later. METHOD: HIV testing in a private office setting was offered to adults at perceived risk for HIV infection but without AIDS. At entry, then 6 and 12 months later, subjects were counseled by psychiatric nurses and assessed by the Hamilton Rating Scale for Depression, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, and Brief Symptom Inventory. RESULTS: Mean scores on all measures of psychiatric symptoms were lower at follow-up among both 106 HIV-positive and 222 HIV-negative adults. One year after HIV testing, 121 (37%) of the 328 subjects had scores associated with psychopathology. These elevated scores were not predicted by serostatus but by initial psychopathological scores (N = 150), annual income less than +15,000 (N = 114), being female (N = 46), and history of injection drug use (N = 32) and heterosexual risk factors (N = 60) as compared to males having sex with males (N = 236). CONCLUSIONS: Before the development of more severe physical symptoms, on average, knowledge of HIV infection does not increase psychiatric morbidity; however, regardless of serostatus, a notable percentage of at-risk adults have sustained high levels of psychiatric symptoms. Counseling during the HIV testing process provides an opportunity to identify these individuals for closer study and indicated psychiatric treatment.

AIDS Serodiagnosis↗
PubMed1992

Relationships over 1 year between lymphocyte subsets and psychosocial variables among adults with infection by human immunodeficiency virus.

To examine relationships between immune and psychosocial variables among adults infected with human immunodeficiency virus type 1, 221 subjects without acquired immunodeficiency syndrome were assessed for degree of depression, anxiety, psychiatric symptoms, social support, stressful life events, hardiness, hopelessness, bereavement, and intrusive and avoidant thoughts about acquired immunodeficiency syndrome. At entry, none of 22 psychosocial variables significantly correlated with lymphocyte subsets. Among subjects seen 6 and 12 months later, severity of physical symptoms was associated with greater emotional distress, but the CD4 cell count was predicted by neither clinical ratings of psychopathology and global functioning nor by standardized self-report measures of constructs used in psychoimmune research. We conclude that among our sample, physical symptoms contributed to emotional distress, but emotional distress did not contribute to the CD4 cell count, a marker of disease progression.

Adolescent↗
PubMed1992

Predictors of posttraumatic stress disorder after burn injury.

OBJECTIVE: The authors' goal was to examine subjective and objective predictors of posttraumatic stress disorder (PTSD). METHOD: Hospitalized burn patients were assessed 1 week after injury with both objective predictors (percent of burned area and facial disfigurement) and subjective predictors (emotional distress and perceived social support). The patients were then assessed 2, 6, and 12 months later for development of PTSD. RESULTS: Among 51 patients, 18 (35.3%) met PTSD criteria at 2 months. High rates of PTSD were also found at 6 months (N = 16, 40.0% of the 40 available patients) and 12 months (N = 14, 45.2% of the 31 available patients). PTSD was predicted by subjective variables assessed at baseline, but patients with more severe burns were not more likely to develop PTSD. CONCLUSIONS: The DSM-III-R diagnosis of PTSD relies on an objective evaluation of the stressor's severity. The prospective data in this study support those who argue that evaluations of the severity of the stressor might also take into account subjective factors.

Adult↗
PubMed1992

Detection of alcoholism among burn patients.

To determine the prevalence of alcoholism among patients at a large inpatient burn center, a semistructured interview for diagnosing alcoholism--the CAGE questionnaire--was administered. Of 124 patients interviewed, 24 (19 percent) were found to have an alcohol problem based on responses to the CAGE questionnaire. However, when patients' charts were reviewed at discharge, only seven of the 24 subjects were described as having an alcohol-related problem. Of the 22 subjects whose alcoholism was detected by the CAGE questionnaire and for whom blood alcohol screens had been obtained on admission, only seven had a positive screen. About 70 percent of the patients with alcoholism were missed by blood alcohol screens on admission and by the usual procedures for gathering patient information on admission and during hospitalization. The study found that use of the CAGE questionnaire greatly increased the detection of alcoholism in burn patients.

Adolescent↗
PubMed1991

Effectiveness of psychoeducational interventions in reducing emotional distress after human immunodeficiency virus antibody testing.

To examine the effectiveness of three psychoeducational interventions in reducing emotional distress after voluntary serologic testing for human immunodeficiency virus-1,307 physically asymptomatic adults were randomly assigned to standard counseling, counseling plus a three-session interactive video program, or counseling plus six individual sessions of stress prevention training. Subjects were evaluated using five standardized distress measures at entry and 3 months later. Among the 204 human immunodeficiency virus-seronegative subjects, mean distress measures decreased significantly after all three interventions without differential treatment effects. Among the 103 human immunodeficiency virus-seropositive subjects, mean distress measures decreased significantly after the stress prevention training and did not significantly increase in the other two interventions. We conclude that stress prevention training is particularly helpful after notification of human immunodeficiency virus seropositivity.

Adult↗
PubMed1990

Suicidal ideation and HIV testing.

To examine the effect of human immunodeficiency virus antibody testing on suicidal ideation among physically asymptomatic subjects at perceived risk for infection, 244 men and 57 women completed the Beck Depression Inventory 2 weeks before and 1 week and 2 months after notification. All subjects received extensive pretest and posttest counseling. Among the 49 seropositive subjects, rates of suicidal ideation on item 9 of the Beck Depression Inventory were 28.6% at entry and 27.1% and 16.3% at the two follow-up assessments; none reported increased suicidal ideation at 2 months. Among the 252 seronegative subjects, suicidal ideation decreased from 30.6% at entry to 17.1% and 15.9% at 1 week and 2 months after notification, respectively. Suicidal ideation correlated with modified Beck Depression Inventory scores (r = .50 to .55). Among the 4.7% of seropositives and seronegatives with suicidal wishes or intent at any assessment, average modified Beck Depression Inventory scores (mean, 17.1) suggested a clinical depression.

AIDS Serodiagnosis↗
PubMed1990

Voluntarily informing others of positive HIV test results: patterns of notification by infected gay men.

Forty gay men who had recently learned that they were infected with human immunodeficiency virus (HIV) were interviewed to determine the frequency with which they voluntarily informed physicians, dentists, friends, family members, and current and past sexual partners of their positive test results. Ninety percent of the subjects informed a personal physician, and 48 percent of the subjects who sought dental care informed the dentist. Sixty-six percent of subjects with at least one current sexual partner notified every current sexual partner, although notification was not associated with a greater likelihood of safer sex practices. Ninety percent of the subjects who had past sexual partners made no attempt to inform them. Sixty-eight percent confided in at least one friend, but only 35 percent told a family member.

AIDS Serodiagnosis↗
PubMed1989

Neuropsychological function in physically asymptomatic, HIV-seropositive men.

Twenty asymptomatic, HIV-seropositive homosexual men and a control group of 20 seronegative homosexual men were evaluated for evidence of neuropsychological impairment. Two-tailed paired t-tests of group differences revealed that the seropositive patients had significantly lower scores on two of 20 neuropsychological measures. Ten seropositive patients had scores two standard deviations below the sample, compared with three seronegative patients, a significantly different distribution (p = .04). The HIV-infected group exhibited lower mean scores on 17 of 20 variables (binomial probability, p less than .005). The 10 seropositive patients with scores that fell below the cut-off had significantly lower mean T4/T8 ratios than the 10 seropositive patients with scores above the cut-off (p = .02). The data suggest that a subpopulation of HIV-infected adults may exhibit subtle neuropsychological impairment before they develop clinical signs of cognitive deficit or immunosuppression.

AIDS Dementia Complex↗