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Biomedical subjects

M B Balter

Publications and source records attributed to M B Balter.

At least 37 records · Page 2Linked to original sources
PubMed1984

Anxiety disorders: prevalence and treatment.

A method is reported for classifying survey respondents according to syndromes resembling some of the anxiety disorders as defined by DSM III, using responses to a standard clinical symptom checklist administered on a large scale in the U.S.A. by trained survey interviewers in the 1979 National Survey of Psychotherapeutic Drug Use. These syndromes ('agoraphobia/panic', 'other phobia', and 'generalized anxiety') have several characteristics consistent with their DSM III diagnostic counterparts. They show 1-year prevalence rates of 1.2%, 2.3%, and 6.4%, respectively, roughly in accord with the limited relevant epidemiological data available. The prevalence of these anxiety syndromes is lower than clinical lore suggests. The very low prevalence of use of antidepressants (8%) and the much higher rate of use of anti-anxiety agents (55%) among agoraphobics are surprising. The infrequent use of anti-anxiety agents among respondents with generalized anxiety (27%) also is noteworthy. These findings suggest that the majority of persons with serious anxiety disorders still do not receive treatment or the most appropriate treatment, although other possible interpretations of the data also are considered.

Adolescent↗
PubMed1983

Symptom checklist syndromes in the general population. Correlations with psychotherapeutic drug use.

Using symptom checklists administered on a large scale by survey interviewers in the 1979 National Survey of Psychotherapeutic Drug Use, we developed a method for classifying survey respondents by syndromes. These syndromes had symptoms and other characteristics consistent with their DSM-III diagnostic counterparts and showed one-year prevalence rates in accord with available epidemiologic data: Major Depression, 5.1%; Agoraphobia-Panic, 1.2%; Other Phobia, 2.3%; and Generalized Anxiety, 6.4%. However, the anxiety-related syndromes occurred less frequently than clinical lore might suggest. The data showed a very low rate of antidepressant use and a higher rate of antianxiety agent use among Major Depressives (11% and 23%) and Agoraphobics (8% and 55%). Also noteworthy were the infrequent use of antianxiety agents among respondents with Generalized Anxiety (27%) and the low frequency of both antianxiety (19%) and antidepressant (3%) drug use among persons with high distress who did not qualify for any syndrome. These findings suggest that the majority of persons with serious psychiatric disorders still do not receive treatment or the most appropriate treatment.

Adolescent↗
PubMed1983

Evaluating a household survey measure of psychic distress.

This paper describes a study to assess the validity of a brief household survey measure of psychic distress (PSYDIS). The measure classifies persons according to their pattern of scores on four dimensions, including anxiety and depression. Study subjects were interviewed first as respondents from the general population in a cross-sectional household survey. Then, according to their ratings on PSYDIS, subsamples were selected for psychiatric evaluation in a clinic a few weeks later. The survey ratings of 287 persons were compared with evaluations of the same persons by experienced psychiatrists. Overall levels of concordance ranged from 76% to 80%, depending on the psychiatric criterion used. Concordance was very high for women; it was lower for men and for persons classified as High on PSYDIS. We than applied two analytic strategies for increasing agreement between the clinical judgements and the clinical ratings. Strategy number I augmented the symptom checklist data with additional survey data on the subject's history of episodes of distress. Strategy II revised procedures for constructing the PSYDIS typology by (1) using more rigorous cutting point scores on the component scales, and (2) using a non-typological method of classification. The first strategy improved agreement between the clinic and survey measures; the second did not. The paper also compares PSYDIS with other brief symptom checklist measures.

Anxiety↗
PubMed1982

Assessing comprehension in a survey of public reactions to complex issues.

This paper reports results of research to develop household interview procedures for obtaining reasonably informed public judgements about ethical issues in biomedical research. We describe (1) an interviewing strategy designed to enhance comprehension among survey respondents, and (2) a composite comprehension index based on three types of information from the interview. Using data from a cross-section sample, we identify subgroups that differ significantly with respect to scores on the comprehension index, and we then describe the observed levels of comprehension in terms of the operations defining the index. The results demonstrate both the feasibility and limits of obtaining informed rather than naive judgements about complex issues from lay respondents.

Attitude to Health↗
PubMed1981

Addict careers. I. A new typology.

The notion that narcotic addicts constitute a homogeneous class has little utility for research on etiology, prevention, and intervention. Historically, various classification schemes have been suggested, tailored to particular applications. In this paper a new typology of addict careers is developed, based on the concepts of opportunity and motivation to use narcotics. The question addressed is: During the first decade of addiction, how much time is occupied by (1) narcotic addiction, (2) incarceration, (3) nonaddiction in the community? Preaddiction correlates of the typology are examined in a sample of addicts who became known to police during the past quarter century.

Adolescent↗
PubMed1981

Addict careers. II. The first ten years.

The varying life-styles of narcotic addicts in Baltimore during the first decade of their addictive careers are examined with respect to the following: (1) periods of addiction, (2) transitions from addiction, (3) periods of nonaddiction. Emphasis is upon the relationship between aspects of the life-styles and the characterization of addicts according to a typology based on the concepts of opportunity and motivation to use narcotics. What emerges is a general hypothesis linking social class, associated competencies, and pattern of addiction.

Black or African American↗
PubMed1981

Addict careers. III. Trends across time.

A study of Baltimore narcotic addicts who have come to the attention of authorities during a 25-year period provides the basis for an analysis of changes across time in the personal characteristics and life-style attributes of the addict population. Trends are presented wih respect to (1) racial composition, (2) social status, (3) residential stability, (4) educational attainment, (5) occupational stability, (6) juvenile delinquency, (7) criminality, (8) age at onset of addiction, and (9) drug of choice. Also examined are changes in the distributional composition of a typology of addict careers based on concepts of opportunity and motivation to use narcotics.

Adolescent↗
PubMed1978

Minor tranquilizers: clinical correlates of use in an urban population.

Rapid growth in the production and prescription of minor tranquilizers has stimulated increasing concern that we live in an "overmedicated" society. Data regarding drug use from a health survey in Oakland, Calif, show that (1) 20% took a minor tranquilizer or sedative during the previous year, 10% daily for a week or more; (2) use was related directly to the amount of distress and dysfunction, to psychologic more than to other types of disturbance, but not to situational stress alone; and (3) taking tranquilizers was only one aspect of a complex pattern of coping behaviors including the almost universal use of some medication, most often a "nonpsychotropic" type.

Adaptation, Psychological↗
PubMed1978

Psychic distress, life crisis, and use of psychotherapeutic medications: national household survey data.

Findings are reported from a nationwide survey of a cross-section probability sample (N = 2,552) of US adults. Data on psychic distress were obtained from a shortened version of the Hopkins symptom checklist, data on life crises from a shortened version of the Holmes-Rahe social readjustment rating scale. Methods for collecting data on use of psychotherapeutic medications were validated in a separate study. Data are presented on the prevalence of high levels of psychic distress and life crisis among various age, sex, and other demographic subgroups; on the relation between life crisis and psychic distress; and on the relation of life crisis and psychic distress to use of psychotherapeutic medications and alcohol. The findings suggest an illness behavior model for the use of psychotherapeutic medications in outpatient practice, and the lend little support to a "self-indulgent consumer" interpretation.

Adolescent↗
PubMed1978

Hospital surveys of prescribing practices with psychotherapeutic drugs. A critical examination.

Hospital surveys of psychotherapeutic drug prescribing in the United States have been generally critical of the treatment practices of physicians and have been used to support claims that psychotherapeutic drugs are overprescribed and misused. This report examined several recent multihospital surveys of psychotherapeutic drug use and concludes that the surveys have failed to provide sufficient information to determine the appropriateness of treatment practices. The limitations of these surveys and the need to develop more adequate information about physician prescribing patterns are discussed.

Drug Prescriptions↗