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Biomedical subjects

M Cloitre

Publications and source records attributed to M Cloitre.

28 records · Page 2Linked to original sources

Expressive characteristics of anxiety in depressed men and women.

This study was aimed at identifying the expressive, movement, and social behaviors associated with anxiety in the syndrome of major depression. The sample consisted of 97 hospitalized male and female depressed patients. Expressive and social behaviors were evaluated prior to treatment in a structured videotaped interview. Anxiety was measured using a multi-vantaged approach including doctor's rating, nurse's rating, patient self-report, and a separate video rating. Results indicate that anxiety was significantly associated with agitation, distressed facial expression, bodily discomfort, and poor social interaction in both sexes. Men and women differed in certain respects: anxiety was highly related to motor retardation in women only, and to hostility in men only. Differences in the pattern of expressive behavior between high and low anxious, depressed patients were clearly significant, and several were large enough to serve as clinical indicators. These findings help to characterize the expressive features of anxiety in the context of severe depression, and add to the growing literature on sex differences in depression.

Adult↗

Reaction time to threat stimuli in panic disorder and social phobia.

Two studies assessed response time among clinically anxious subjects and normal controls when presented with threat, positive and neutral stimuli under perceptual (lexical decision) and semantic (category decision) task conditions. In Study 1, panic disorder subjects' (n = 14) performance was compared to that of matched normal controls (n = 14) while in Study 2 social phobic subjects (n = 24) were compared to matched normal controls (n = 24). Relative to matched normal controls, panic disorder subjects but not social phobics tended to show greater slowing in performance on the more cognitively complex (category) task. A second finding, consistent across both studies was that, compared to the normal control groups, both panic and social phobic groups showed significantly slowed responses to threat words in both the perceptual and semantic tasks. Such findings are directly counter to the predictions of a mood congruence hypothesis. This apparent contradiction is resolved by a review of the literature which indicates that mood-related facilitation effects are obtained only in tasks which tap awareness of threat information rather than speed of response. It is suggested that while anxiety may produce enhanced awareness of threat, it may inhibit responsiveness to it. The results of these studies are seen as consistent with ethological theories of inhibited motoric responses under certain threat conditions. Furthermore, the findings suggest that caution is indicated in interpreting slowed reaction time to threat stimuli in tasks such as the Stroop color naming task as purely the result of attentional processes.

Adult↗

Problems of recall and misclassification with checklist methods of measuring stressful life events.

The prevalent use of life event category checklists to facilitate event recall may be one reason that previous studies find that life events play only a small and ambiguous role in the development of health problems. In this study, 136 persons with temporomandibular pain disorder syndrome (TMPDS) and 131 healthy controls reported the occurrence of life events in 10 monthly interviews, using an event category checklist. At the end of the study, they reported retrospectively and in detail about life events over the previous monthly periods. Only one quarter of the event categories appeared in both the monthly interviews and retrospective report for the same period. Detailed analyses revealed problems of inaccuracy inherent in checklists that exacerbate problems of recall. The findings indicate that checklist category approaches should not be used when the goal is to understand the role of stress in adverse health outcomes. Suggestions are made about more adequate methods.

Facial Pain↗

Is major depression comorbid with temporomandibular pain and dysfunction syndrome? A pilot study.

There is a lack of information about the precise strength of the relationship between chronic pain and depression. In a prior study, women with temporomandibular pain and dysfunction syndrome (TMPDS) had much higher scores than did controls on a measure of nonspecific psychological distress. The question arose as to whether rates of clinical depression are also unusually high in TMPDS patients. Their former treating clinician rates cases for likely lifetime presence or absence of depression. A subset of those rated as likely depressed then had their diagnoses verified independently through a structured clinical interview by a psychiatrist and clinical psychologist. Results revealed a minimum lifetime prevalence rate for major depression of 41%. A rate of this magnitude in TMPDS cases is clearly much higher than would be found for women of similar background in the general population.

Adult↗

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↗

Anxiety and depression: discrete diagnostic entities?

Some forms of anxiety and affective disorder, such as panic disorder and major depression, appear distinct, while other forms, such as generalized anxiety disorder and chronic depression or dysthymia, may lie on a continuum and blend with each other. However, even panic disorder and major depression have many common features. Moreover, for reasons not yet clear, they occur together frequently, and their combined occurrence in the same patient has been associated with greater severity and chronicity, decreased treatment responsiveness, and, possibly, increased familial prevalence of anxiety and/or depression. Finally, studies of primary care patients suggest the frequent occurrence of a mixed anxiety-depressive disorder that may often be subsyndromal by DSM-III-R criteria but is nevertheless associated with prominent distress and/or impairment.

Anxiety Disorders↗

Childhood trauma as a correlate of lifetime opiate use in psychiatric patients.

Associations have been reported between childhood sexual and/or physical abuse and adult substance abuse in general. This study investigated the relationship between childhood abuse and opiate use in particular among 763 consecutively admitted psychiatric inpatients. Patients were interviewed about demographic information, alcohol and drug use, and history of interpersonal violence. Opiate users were 2.7 times more likely to have a history of childhood sexual and/or physical abuse than nonopiate users, after controlling for diagnostic and sociodemographic variables. Opiate use was higher among those reporting physical abuse alone (24.1%) or both physical and sexual abuse (27%) than among those reporting sexual abuse alone (8.8%). Implications of these findings are discussed.

Adolescent↗