Biomedical subjects

L Y Martin

Publications and source records attributed to L Y Martin.

7 recordsLinked to original sources

PubMed1992

An extension of the acquaintanceship procedure in family studies of mental disorder.

The acquaintanceship procedure is a method for obtaining a control group matched to relatives of probands on demographic variables. Relatives are asked to name six acquaintances who are the same gender, and who are about the same age and social class as themselves. An acquaintance is randomly selected from this list and contacted for recruitment. Rates of mental disorder in this group are assumed to approximate general population rates in a group with these demographic characteristics. This report focuses on an extension of the acquaintanceship procedure in which "super-normal" controls are used in a family study design. Two questions were addressed: (1) Does the acquaintance group (n = 166), as a whole, show a higher rate of illness than the relatives of acquaintances with no mental disorder (n = 129)? (2) Is there a relationship between mental disorder in acquaintances and in providers of acquaintance names? The prevalence of mental illness was significantly greater among acquaintances compared to relatives of "never ill" acquaintances. There was no evidence of assortative selection. We concluded that using the relatives of well acquaintances is a cost-effective control selection methodology which maximizes the detection of intergenerational transmission in family studies of mental disorder.

Adult↗

PubMed1991

Effects of phototherapy on non-seasonal unipolar and bipolar depressive spectrum disorders.

In a group of 17 patients with non-SAD depressive disorders we compared the response of bipolar spectrum versus unipolar patients to treatment with light therapy. The main hypothesis was that bipolar spectrum depressed patients would preferentially respond to bright light therapy as compared to unipolar depressed patients. All patients were treated with either 400 or 2500 lux phototherapy for 2 h on seven consecutive days. All outcome measures, which included the SIGH-SAD, CGI, and the Anxiety and Depressive Factors of the SCL-90, showed significant improvement in the bipolar vs. the unipolar spectrum patients. Unexpected this occurred regardless of the intensity of the light. These changes were judged to be quite clinically significant. All patients showing response were noted to have maintained their response at a 3-month follow-up.

Bipolar Disorder↗

PubMed1991

Cognitive-behavior therapy for panic disorder delivered by psychopharmacologically oriented clinicians.

A cognitive-behavioral treatment program for panic disorder was delivered by staff members of a psychiatric center that traditionally utilizes pharmacological methods. Psychiatrists, a nurse practitioner, and psychologists not previously exposed to behavioral techniques were trained by a behavioral psychologist to utilize a treatment program consisting of breathing control, cognitive restructuring, and exposure to panic-eliciting somatic cues. Of the 24 patients treated as part of this training in panic control therapy, 14 were panic-free after treatment and three additional patients showed moderate improvement and decreased frequency of panic. A case example is presented to demonstrate the application of behavioral techniques to individual patients. Discussion is focused on issues surrounding training in behavioral methods and problems in exporting behavioral technology to centers that emphasize psychopharmacological approaches to treatment.

Adult↗

PubMed1990

Familial transmission of simple phobias and fears. A preliminary report.

Preliminary data from a blind direct interview family study indicate a significantly higher risk for simple phobia among first-degree relatives (n = 49) of simple phobic probands (who had no other anxiety disorder) as compared with first-degree relatives (n = 119) of never mentally ill controls (31% vs 11%, relative risk = 3.3). Female relatives were more likely to be affected than male relatives (48% vs 13%), though this difference did not reach conventional significance in an age-corrected analysis. Significant between-group differences were not found in risks for (1) other anxiety, affective, and substance abuse disorders, and (2) simple irrational fears that did not meet disorder criteria. The results suggest that simple phobia is a highly familial disorder that does not transmit increased risk for other phobic or anxiety disorders. The specificity of increased risk among the relatives of simple phobics is consistent with the distinction between simple phobia, social phobia, and agoraphobia. However, complete delineation of the transmissional relationship between these illnesses requires assessment of the extent to which risk for simple phobia can be transmitted by individuals with other phobic or anxiety disorders. Replication of these preliminary findings in larger clinically and epidemiologically selected samples is needed.

Adult↗

PubMed1989

Reliability of anxiety assessment. I. Diagnostic agreement.

Test-retest reliability of lifetime anxiety disorder diagnoses was determined using the Schedule for Affective Disorders and Schizophrenia-Lifetime Anxiety version. The subjects were 104 patients at an anxiety research clinic. Reliability ranged from good to excellent (kappa = +.60 to +.90) for generalized anxiety, social phobic, panic, agoraphobic, and obsessive-compulsive disorders. Simple phobia showed poor agreement. Current episodes showed better agreement than past episodes, particularly for social phobia and obsessive-compulsive disorder. Major sources of disagreement (variance in subject report, rate error, criterion ambiguity) were reviewed for each diagnosis and implications for DSM-IV are proposed.

Adult↗

PubMed1989

Reliability of anxiety assessment. II. Symptom agreement.

Accurate assessment of "subdisorder" anxiety symptoms, ie, anxiety symptoms central to DSM-III-R-diagnosed anxiety disorders but not meeting disorder criteria because of insufficient frequency, duration, or accompanying subjective distress or impairment, may be critical to case identification in genetic, epidemiologic, and high-risk studies. However, concerns that the mild and often transient nature of these phenomena will foster unreliability have discouraged their use. We assessed the test-retest reliability of "subdisorder" anxiety symptoms in 104 outpatients with anxiety. Good to excellent agreement was found for lifetime occurrence of any panic attack, the spontaneous and situationally predisposed subtypes of panic, and five nonsocial irrational fears (public transportation, driving oneself, crowds, situations associated with death [eg, dead bodies and funerals], and cats and dogs). Four social and three additional nonsocial fears were considered to have adequate reliability. However, agreement on stimulus-bound panic, "near" panic attacks, persistent generalized anxiety, and the remaining nine nonsocial and six social irrational fears was only fair to poor. The major source of unreliability was variation in information reported by the subject to the rater.

Ambulatory Care↗

PubMedDate not supplied

Interpreting risks to the public.

Human beings have always lived with risks and have coped as best they could, according to their perceptions of the relative dangers and the mechanisms available to them. Being conscious of risks helps us to confront and cope with them, but it also has negative effects. The multiplicity of threats and the urgency with which they are presented make it difficult to sort out those that we as individuals can control from those that we cannot. Consequently, we are in danger of surrendering to feelings of helplessness and apathy, which paralyze us in the act of coping even in situations in which personal action can make a difference. The challenge for those of us engaged in interpreting risks to the public is to do so in such a way that we convey a sense of relative risk; and, cumulatively over time, we need to "accentuate the positive" in the sense of communicating that it is well worth the effort for people to control those risks they can control. Risks over which individuals fell they have no control contrast with those related to daily lifestyle decisions. The public is aware of the risks associated with these decisions, but because of some overriding fears, the daily lifestyle choices receive lower priority than they deserve from the public. As health professionals, we can improve ways of presenting the most serious and most controllable threats and reach broader audiences with key messages.

Environmental Exposure↗