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Biomedical subjects

L Kirisci

Publications and source records attributed to L Kirisci.

At least 37 records · Page 2Linked to original sources
PubMed1997

The Drug Use Screening Inventory for adults: psychometric structure and discriminative sensitivity.

The psychometric structure and characteristics of the adult version of the Drug Use Screening Inventory were examined in alcohol and drug abusers (n = 119) and normal controls (n = 119). It was found that each of the 10 DUSI domains is unidimensional. Inter-item, split half and internal reliability ranged from good to excellent. A score of 4 or higher on the Substance Use Domain correctly classified 80% of the substance abusers whereas a score of 3 or less accurately detected 100% of the normal control subjects. These results demonstrate that the DUSI is a practical and psychometrically sound screening instrument.

Adult↗
PubMed1997

Timing of paternal substance use disorder cessation and effects on problem behaviors in sons.

The developmental timing of paternal substance use disorder (SUD) offset on internalizing and externalizing problem behaviors was examined in prepubertal sons. Analyses revealed a significant main effect of the developmental timing of SUD offset on both internalizing and externalizing problems. No differences were found between sons of control-subject fathers and SUD+ fathers whose offsets occurred before the son's sixth birthday. However, when paternal SUD extended beyond the boys' sixth year, significant increases in internalizing and externalizing problem behaviors were found. The results suggest the importance of early parental SUD intervention in prevention of the intergenerational transmission of behavioral problems.

Age Factors↗
PubMed1997

Multivariate typology of adolescents with alcohol use disorder.

Adolescent patients qualifying for a DSM-II-R diagnosis of alcohol use disorder were studied to determine whether a multidimensional schema could classify subjects into subgroups. The Drug Use Screening Inventory was administered to 151 subjects. To test the concurrent validity of the subtypes, subjects also received a structured diagnostic psychiatric evaluation along with measures of personality, academic achievement, and drinking behavior. Two clusters were identified for each gender. Differences between clusters were reflected primarily on indicators of severity of disorder. Young women were more inclined toward affective disturbances, whereas conduct disorder was the most frequent disorder in young men. This study underscores the heterogeneity of the adolescent population qualifying for a diagnosis of alcohol use disorder. The differential pattern of alcohol involvement and comorbid psychopathology within clusters and between genders demonstrates the need for interventions tailored to specific clinical presentation.

Adolescent↗
PubMed1996

Posttraumatic stress disorder, depression, alcohol use disorders and quality of life in adolescents.

Posttraumatic stress disorder (PTSD) is a prevalent psychiatric disorder among adolescents. While the effects of PTSD on quality of life (QOL) have been systematically studied with adults, research on the consequences of PTSD with adolescents has been limited. Among the other psychiatric disorders often associated with PTSD, major depression and alcohol use disorders are prevalent and have their own substantial morbidities. This study was designed to examine and compare the effects of PTSD, major depression, and alcohol use disorders on quality of life during adolescence. The subjects were 540 adolescents (ages 12-18 years old) recruited from clinical and community sources. Psychiatric disorders characterizing the sample included one or more of the three disorders studied (n = 275), other psychiatric disorders (n = 121), or no psychiatric disorders (n = 144). Analysis of covariance was utilized to determine the individual main effects and relative effects sizes of the three primary disorders on QOL variables. PTSD showed significant adverse effects on psychological, physical, and social functioning. Major depression showed a similar pattern. In contrast, alcohol use disorders primarily affected role functioning. While PTSD, major depression, and alcohol use disorders all adversely influenced adolescent QOL, the patterns of their effects differed. Remedial treatment interventions designed to restore QOL for adolescents with these disorders may need to focus on different areas for adolescents with PTSD or major depression than for adolescents with alcohol use disorders.

Achievement↗
PubMed1996

Polydrug use in an inpatient treatment sample of problem drinkers.

Over the past 30 years in the United States, there have been marked secular increases in polydrug use. Alcohol and other substance use disorders are highly comorbid. Yet, little research has characterized patterns of polydrug use in persons with alcohol dependence. In particular, little is known about this population's use of alcohol and other drugs in combination or on the same day, which is termed simultaneous polydrug use (SPU). This research assessed patterns of SPU in 212 problem drinkers who participated in an alcohol treatment outcome study. Subjects were given a Time-Line Follow-Back interview that assessed the use of alcohol and nine other drug classes for each day of the 120 days before treatment entry. A majority of subjects (61%) reported SPU during this assessment interval. Subjects who reported SPU were disproportionately younger, male, and unmarried, compared with those who did not report SPU. The most common alcohol/drug combinations were alcohol with cocaine (60% of subjects who reported SPU), alcohol with marijuana (51% of SPU subjects), and alcohol with sedatives (31% of SPU subjects). The most common three-drug combination was alcohol, cocaine, and marijuana (23% of SPU subjects). Alcohol use and drug use were associated at the event level, significantly more than association predicted by the base rates of the individual behaviors. Time-Line Follow-Back data correlated highly with a questionnaire measure of SPU. Results indicate that polydrug use is an important focus for assessment and intervention in alcohol treatment programs.

Adult↗
PubMed1996

Executive cognitive functioning predicts reactive aggression in boys at high risk for substance abuse: a prospective study.

This study assessed the ability of executive cognitive functioning (ECF) to predict reactive aggression in boys at high and low risk for substance abuse using a 2-year prospective design. ECF is defined as the self-regulation of goal-directed behavior. Reactive aggression involves impulsive hostile reactions committed with little forethought. ECF was measured using five neuropsychological tests in 198 10- to 12-year-old boys with (SA+) and without (SA-) a paternal history of substance abuse/dependence. Reactive aggression was measured, 2 years later, using a composite index of items derived from two self-report measures. It was hypothesized that ECF would predict reactive aggression, and that this relation would be stronger for the SA+ compared with the SA- boys. SA+ subjects demonstrated lower ECF scores and higher reactive aggression scores, compared with SA- controls. ECF predicted reactive aggression in the SA+ group (beta = 0.37, p = 0.001), but not in the SA- group (beta = 0.09, p = NS). This suggests that compromised ECF may be a risk factor for reactive aggression in SA+ youth. The hypothesis that the relation between ECF and reactive aggression is a manifestation of a mild dysfunction of the prefrontal cortex is discussed.

Aggression↗
PubMed1996

Disproportionate lethality in psychiatric patients with concurrent alcohol and cocaine abuse.

OBJECTIVE: The aim of this study was to examine the association between active, concomitant cocaine and alcohol abuse and the prevalence and severity of current suicidal and homicidal behavior among hospitalized psychiatric patients. METHOD: Three groups of patients--with cocaine and alcohol abuse (N = 38), alcohol abuse only (N = 38), and cocaine abuse only (N = 25)--consecutively admitted to a psychiatric and substance abuse dual-diagnosis unit were comparatively examined for the presence of current suicidal and homicidal behavior. RESULTS AND CONCLUSIONS: Logistic regression analysis revealed that the alcohol and cocaine abuse group had a higher likelihood of associated current homicidal behavior than the alcohol-only and the cocaine-only groups.

Adult↗
PubMed1995

Impact of DSM-III axis III on the diagnosis of physical disorders in ambulatory psychiatric patients.

In the present study, the effectiveness and utility of DSM-III axis III in terms of adequate identification of physical disorders in psychiatric outpatients is appraised empirically. To this effect, the presence of physical disorders in diagnostic statements recorded in clinical charts is compared in a large medical center for two psychiatric outpatient samples, one from the nonmultiaxial DSM-II era and one after the implementation of the multiaxial DSM-III. In the earlier sample, 11% of the patients were diagnosed as having physical disorders. In the DSM-III sample, 42% of the patients were so diagnosed. The latter figure is consistent with the 40% average prevalence of physical disorders reported in careful studies of the physical condition of ambulatory psychiatric patients.

Adult↗
PubMed1995

Aggressivity in adolescent alcohol abusers: relationship with conduct disorder.

Several longitudinal and retrospective studies have documented an association between premorbid aggression and an increased risk for an alcohol-use disorder in adulthood. However, few data are available examining the relationship between trait aggressivity, alcohol use behavior, and the presence of an early-onset alcohol use disorder diagnosis among the adolescent population. To address this deficiency, this study had three goals. First, the relationship between aggressivity and adolescent alcohol consuming behavior was examined. Second, the presence and magnitude of trait aggressivity were determined among adolescents who met psychiatric diagnostic criteria for alcohol abuse/dependence (ALC), while controlling for the presence of a conduct disorder (CD). Third, because CD is overrepresented among adolescent alcohol abuse cases and is a priori defined by the presence of certain aggressive behaviors, the simultaneous contributions of CD and ALC on trait aggressivity were also investigated through structural equation modeling. The results confirm the salience of heightened aggressivity as an essential feature of this early-onset alcohol-abusing population and indicate the importance of addressing this behavioral domain in prevention and treatment efforts.

Adolescent↗
PubMed1994

Heterogeneity of adolescent alcoholism.

Adolescent alcoholics in treatment were classified into two broad clusters. The larger group consisted of youth who demonstrated behavioral dyscontrol and hypophoria, whereas the smaller group consisted of individuals with primarily negative affect. These two clusters differed with respect to age of first drug use, age of first substance abuse diagnosis, severity of substance use, behavior disturbance, and psychiatric disorder. Difficult temperament loaded on the negative affect factor. In a second study, it was observed that difficult childhood temperament led to a number of different first diagnoses in the adolescents. No specific psychiatric outcome followed a difficult temperament. These results illustrate the heterogeneity of the adolescent alcoholic population and suggest that there are many developmental pathways to this outcome where a predisposing risk factor is a difficult temperament makeup.

Adolescent↗
PubMed1994

A neuropsychologic profile of adolescent alcoholics.

Male and female adolescents who qualified for a DSM-III-R diagnosis of Alcohol Abuse or Dependence and a control sample of nonalcohol-abusing male and female adolescents were administered a battery of intellectual, achievement, and neuropsychologic tests. Alcohol-abusing adolescents were found to have significantly lower verbal and full-scale IQ scores than controls. Furthermore, alcohol-abusing adolescents were found to have a trend toward lower age-standardized scores on achievement tests of reading ability and spelling. Surprisingly, alcohol-abusing adolescents made less perseverative errors and commission errors on a learning and memory task than controls. Control males performed worse on the Wisconsin Card Sort than alcoholic males, whereas alcohol-abusing females performed worse than control females. In addition, alcoholic subjects scored better than controls on a measure of visual memory sensitivity. The results indicate that adolescent alcohol abusers in general have poorer language skills than adolescents who do not abuse alcohol. However, in contrast to results obtained from studies of adult alcoholics, there is little evidence of significant brain damage as revealed by using neuropsychologic test performance.

Adolescent↗
PubMed1994

Statistical approaches in alcohol research: a comparative survey of two major alcohol journals with four major psychiatric journals.

This study surveyed and compared the statistical methods used in two major alcohol journals with those used in four major psychiatric journals. The alcohol specialty journals were Alcoholism: Clinical and Experimental Research and Journal of Studies on Alcohol. The psychiatry journals studied were the American Journal of Psychiatry, British Journal of Psychiatry, Archives of General Psychiatry, and Acta Psychiatrica Scandinavica. The aim of this study was to examine the extent to which alcohol researchers use statistical methods and their level of statistical sophistication. A second aim focused on the extent to which alcohol researchers are attentive to design and sample size issues. Comparisons between papers published in the four psychiatry journals and the two alcohol specialty journals published in 1990 revealed that the percentage of articles without any numerical results was substantially different among the journals: 21% of the psychiatry journals and 7% in the alcohol journals. There was a significant difference in favor of the alcohol journals with respect to frequency of intermediate statistical techniques. The number of papers published in the two alcohol journals using 20 or fewer subjects was similar to the four psychiatric journals. However, the alcohol journals contained more articles in which > 400 subjects were studied.

Alcoholism↗
PubMed1994

Fitting a two-parameter logistic item response model to clarify the psychometric properties of the Drug Use Screening Inventory for adolescent alcohol and drug abusers.

The suitability of fitting a two-parameter logistic item response model to the Drug Use Screening Inventory (DUSI) was assessed. In a sample of 846 adolescents, each of the 10 domains was found to be unidimensional. Invariance of the item parameters across different groups was also observed. The reliability coefficient, based on item response theory, was found to be superior. The results of these analyses indicate that the DUSI has sound psychometric properties.

Adolescent↗
PubMed1994

Usefulness of DSM-III axis III in psychiatric inpatients: an actuarial comparison with the DSM-II period.

This study is a retrospective evaluation of the usefulness of DSM-III axis III (physical disorders) and its ability to enhance clinical case description in general psychiatric patients. The subjects of this study consisted of two samples of 75 inpatients; each was randomly selected and age-matched to represent DSM-II (1975-1979) and DSM-III (1981-1985) periods, respectively. The results indicated a substantial and statistically significant difference in the frequency of physical disorders recorded at intake before (9.3%) and after (46.7%) the implementation of DSM-III. DSM-III axis III may significantly enhance the recording of physical disorders in psychiatric inpatients.

Adult↗
PubMed1993

Subtypes of early age onset alcoholism.

Forty-three adolescents qualifying for a DSM-III-R diagnosis of alcohol abuse/dependence were classified according to the internalizing-externalizing behavior dimension. Two clusters were identified. The majority of subjects clustered into a group characterized by behavioral dyscontrol and hypophoria (history of suicide attempts) (cluster 2), whereas the other group was primarily featured by negative affect (cluster 1). Cluster 2 subjects demonstrated more severe alcohol and drug use-related problems, behavioral disturbances, and general psychopathology; lower prevalence of depressive disorders; and less severe anxiety disorders. These results, implicating two variants of adolescent alcohol abuse/dependence, suggest the need to tailor differential treatments to adolescents with alcohol abuse/dependence based on personality characteristics and clinical presentation.

Adolescent↗
PubMedDate not supplied

Coping capacity in female adolescent substance abusers.

Female adolescents who qualified for a DSM-III-R diagnosis of Psychoactive Substance Use Disorder were not distinguishable from depressed and conduct disorder subjects on measures of coping but were differentiable from normal controls. Age of onset of substance use, interval between age of first use and age of diagnosis of abuse, and severity of substance use involvement did not correlate with coping capacity. These findings indicate that deficient coping is not specifically related to drug abuse but rather, where present, is concomitant to comorbid psychopathology among females who have a substance abuse disorder.

Adaptation, Psychological↗
PubMedDate not supplied

Norms and sensitivity of the adolescent version of the drug use screening inventory.

The distribution and the statistical accuracy of scores on the Drug Use Screening Inventory (DUSI) and the discriminative power of the DUSI for identifying individuals who qualify for a DSM-III-R diagnosis of Psychoactive Substance Use Disorder (PSUD) were examined in 846 adolescents. The subjects with PSUD had higher mean scores, and the distribution of their scores approximated a normal distribution in each of the 10 domains measured by the DUSI. All of the DUSI domains yielded more precise trait estimates for the subjects who had more severe PSUD. Within the normal sample, using a score of 30 on the overall problem density index as the cutoff score, the DUSI correctly classified 95% of the normal sample and 81% of the PSUD cases.

Adolescent↗