Biomedical subjects

M Rubio-Stipec

Publications and source records attributed to M Rubio-Stipec.

At least 37 records · Page 2Linked to original sources

PubMed1994

The cross national epidemiology of obsessive compulsive disorder. The Cross National Collaborative Group.

Data on the epidemiology of psychiatric disorders from different parts of the world using similar methods and diagnostic criteria have previously not been available. This article presents data on lifetime and annual prevalence rates, age at onset, symptom profiles, and comorbidity of obsessive compulsive disorder (OCD), using DSM-III criteria, from community surveys in seven countries: the United States, Canada, Puerto Rico, Germany, Taiwan, Korea, and New Zealand. The OCD annual prevalence rates are remarkably consistent among these countries, ranging from 1.1/100 in Korea and New Zealand to 1.8/100 in Puerto Rico. The only exception is Taiwan (0.4/100), which has the lowest prevalence rates for all psychiatric disorders. The data for age at onset and comorbidity with major depression and the other anxiety disorders are also consistent among countries, but the predominance of obsessions or compulsions varies. These findings suggest the robustness of OCD as a disorder in diverse parts of the world.

Adolescent↗

PubMed1993

The Spanish translation and cultural adaptation of the Diagnostic Interview Schedule for Children (DISC) in Puerto Rico.

This article illustrates a comprehensive cross-cultural adaptation model used to translate into Spanish and to culturally adapt the Diagnostic Interview Schedule for Children (DISC). The process strived to identify similar phenomena to those identified by the original English version in a dissimilar context. To attain cross-cultural equivalency five important dimensions were addressed: semantic, technical, content, criterion and conceptual. To meet this challenge various steps were taken, including bilingual committee, back-translation, reliability and validity testing. The result is an instrument which could be used, not only in Puerto Rico, but also in other Spanish-speaking child and adolescent populations after appropriate cultural adaptations.

Adolescent↗

PubMed1993

The prevalence of ataques de nervios in the Puerto Rico disaster study. The role of culture in psychiatric epidemiology.

This paper presents one of the few epidemiological studies of a popular category of distress, ataques de nervios (attacks of nerves), in the cross-cultural psychiatric literature. As part of a major study of the psychological consequences of the 1985 floods and mudslides which caused considerable damage and death in Puerto Rico, a question was added to the Diagnostic Interview Schedule/Disaster Supplement concerning ataques de nervios. This additional item provided the opportunity to carry out the first study of this important Puerto Rican popular category of distress using a representative, community-based sample. This paper addresses several key questions about ataques de nervios which come from previous psychiatric and anthropological literatures concerning the social correlates of who experiences an ataque de nervios and the relationship of ataques to social distress and psychiatric disorder. People who reported an ataque de nervios were more likely to be female, older, less educated, and formerly married. They were also more likely to meet criteria for anxiety and depressive disorders than those who had not experienced an ataque. The picture that emerges from our analyses is that those who suffer from a combination of social disadvantage, psychiatric disorder, and poor perceived health are more likely to experience an ataque de nervios.

Adolescent↗

PubMed1993

Drug abuse and illicit drug use in Puerto Rico.

OBJECTIVES: Based on an epidemiologic field survey of community households in Puerto Rico, this study estimates the frequency of illicit drug use and clinically defined drug abuse and/or dependence syndromes. Results are compared with those from surveys on the United States mainland. Suspected risk factors are studied as well, with a special focus on childhood misbehavior. METHODS: Trained lay interviewers administered a Spanish Diagnostic Interview Schedule to 912 respondents aged 17 to 68 years who were selected by multistage probability sampling of island households. RESULTS: An estimated 8.2% of the population had a history of illicit drug use and 1.2% qualified for a standardized lifetime diagnosis of drug abuse, dependence, or both. An estimated 18.4% of the male drug users and 7.7% of the female drug users met criteria for drug abuse and/or dependence. A history of drug use was related to the diagnoses of alcohol abuse and/or dependence and antisocial personality, but few persons who had used illicit drugs at least once in their lifetime reported a history of receiving treatment for alcohol, drug, or mental health problems. CONCLUSIONS: The data were consistent with a suspected association between level of childhood misbehavior and occurrence of illicit drug use, even after statistical control for potentially confounding variables.

Adolescent↗

PubMed1992

Functional somatic symptoms: a cross-ethnic comparison.

Type, distribution, and comorbidity of functional somatic symptoms were examined in four community samples, three Hispanic and one non-Hispanic white. Important intergroup and intragroup differences between Hispanic and non-Hispanic white groups were identified. Of the four groups, Puerto Rican respondents reported the highest level of somatic symptoms; this finding was apparently independent of sociodemographic factors.

Adolescent↗

PubMed1992

Are attentional-hyperactivity deficits unidimensional or multidimensional syndromes? Empirical findings from a community survey.

Factor analysis on teacher ratings of symptoms in a probability community sample of children aged 6 to 16 years (N = 614) yielded two factors: Inattention and Hyperactivity-Impulsivity. Subsequent cluster analyses on the scores of factorially derived scales for a subsample of 170 children with a diagnosis of attention deficit disorder with (ADDH) and without hyperactivity (ADDWO), or normals, resulted in five clusters that accounted for 88% of the variance. The existence of these clusters was confirmed using external validating criteria. The data support a bidimensional conceptualization of attention deficit disorder with hyperactivity, one dimension consisting of symptoms of inattention and another of symptoms of hyperactivity-impulsivity. The data also suggests that a condition very similar to the DSM-III-R description of undifferentiated attention-deficit disorder also exists as a distinct entity.

Adolescent↗

PubMed1992

Somatic symptoms after a natural disaster: a prospective study.

The authors prospectively examined the prevalence of somatization symptoms among community respondents after a natural disaster in Puerto Rico. Exposure to the disaster was related to a higher prevalence of medically unexplained physical symptoms, particularly gastrointestinal ones (abdominal pain, vomiting, nausea, excessive gas) and pseudoneurological ones (amnesia, paralysis, fainting, unusual spells/double vision).

Disasters↗

PubMed1992

Mental health status among Puerto Ricans, Mexican Americans, and non-Hispanic whites.

Compared mental health characteristics of island Puerto Ricans to three groups from the Los Angeles Epidemiologic Catchment Area Study: Mexican American immigrants, U.S.-born Mexican Americans, and Non-Hispanic whites. The Diagnostic Interview Schedule was used to obtain both diagnostic and symptom scale information about affective disorders, alcohol abuse/dependence, somatization, phobic disorder, and psychotic disorder. Mexican American immigrants had the fewest mental health problems of all groups. Puerto Ricans had more somatization disorder, but less affective and alcohol disorders than U.S.-born Mexican Americans or non-Hispanic whites. Results are considered in the light of selection factors, relative disadvantage of groups and methodological problems.

Adolescent↗

PubMed1991

A cross-cultural adaptation of a psychiatric epidemiologic instrument: the diagnostic interview schedule's adaptation in Puerto Rico.

The advent of the use of structured interview schedules that generate psychiatric diagnoses in epidemiologic studies has promoted an intense interest in its cross-cultural use. However, the valid use of these instruments across cultures requires a careful adaptation process which goes beyond mere language translation. In this article the authors illustrate the application of a comprehensive cross-cultural adaptation model to both the translation into Spanish and the adaptation to the population of Puerto Rico of a widely used psychiatric epidemiologic research instrument: the Diagnostic Interview Schedule (DIS). The process aimed to ensure the development of a research instrument that is not only in correct Spanish and comprehensible for most Spanish-speaking people, but also culturally adapted to Puerto Rico's population. Various steps were taken (including bilingual committee, back-translation, instrument testing and diagnostic comparisons) to address cross-cultural validity in five important dimensions (i.e., semantic, technical, content, criterion and conceptual equivalence). The result is an interview schedule that is not only linguistically and culturally adequate for the targeted population but also includes elements which can contribute to the development of the instrument both in its original English language and in its translated versions.

Cross-Cultural Comparison↗

PubMed1991

Screening for childhood psychopathology in the community using the Child Behavior Checklist.

One of the uses of the Child Behavior Checklist is as a screening instrument for childhood psychopathology in two-phase designs. The present report involves a two-phase epidemiological survey conducted in Puerto Rico in which the CBCL was used as a screening instrument during the first stage, and children were evaluated clinically during the second stage. The data indicate that in using the CBCL for screening for psychopathology in children, parent information is most informative, particularly for children in the adolescent age group. Nevertheless, the data also reinforce the need to obtain teacher information with the Teacher Report Form to enhance screening sensitivity. In this population, the data obtained with the Youth Self-Report were found to be of limited usefulness for screening purposes.

Adolescent↗

PubMed1991

Children of alcoholic parents in the community.

The relationship between parental alcoholism and risk for maladjustment in the offspring was investigated in a community sample. Children of parents who met criteria for DIS/DSM-III alcohol abuse or dependence and children of parents who met criteria for ten other diagnoses were compared to children of "normal" parents. The data were obtained from the merging of the data banks of two major psychiatric epidemiology studies of the adult (17-64) and child (4-16) population of Puerto Rico. Results indicated that parental alcoholism in addition to creating an adverse family environment had an effect on the relative risk for maladjustment in the offspring (as measured by scores on the Child Behavior Checklist). Although previous studies have reported higher levels of externalizing behaviors in children of alcoholics, an increased risk for internalizing symptoms was observed in the children studied. Similar findings were obtained for the children of parents with other psychiatric disorders suggesting that the effects of parental alcoholism in children ages 4 to 16 may not be different from the consequences of parental mental illness per se.

Adolescent↗

PubMed1991

[Importance of the family as a resource in social support in Puerto Rico].

In this article we examine the role of the family in the provision of social support by studying the identity of persons which the participants consider available for providing support. We define social support as that human relationship in which socio-emotional (closeness, intimacy counseling), instrumental (goods and services) and recreational (companionship for recreation) resources are interchanged. Based on a probabilistic sample of the adult (17-68 yrs.) population, 912 persons were successfully interviewed (response rate = 90.4%) using a structured interview schedule. Results indicate that close relatives (parents, brothers/sisters, sons/daughters) are the main resource of all types of support, not only of the general population but also of specific demographic groups defined by their gender, age (17-39, 40-68) and schooling (0-11, 12 + yrs). The marital partner was also identified as an important support resource, especially emotional and recreational; more distant relatives were also important for providing instrumental support. Although the compared groups showed many similarities, they also differed in various aspects both when individually and jointly analyzed. It is concluded that the family is very important in the provision of social support in Puerto Rico (PR).

Adolescent↗

PubMed1991

[Use of health services in Puerto Rico by persons with mental disorders].

As part of a major study on the prevalence of mental disorders in Puerto Rico, this paper describes the mental health care utilization patterns of persons with a DIS/DSM-III disorder within the last year. The main findings of this analysis show that (a) There is a high rate of health service utilization, (b) The public sector is the main provider of services, (c) People with a DIS disorder tend to resort to the non-psychiatric physician, (d) People with alcohol abuse and/or dependence tend to use the services of general practitioners while schizophrenics, somatizers, and people with cognitive impairment tend to apply for the services of mental health specialists. Seeking help from other sources such as clergymen or spiritualists does not substitute the use of health services.

Adolescent↗

PubMed1991

[The Composite International Diagnostic Interview (CIDI): an epidemiologic instrument suitable for using in conjunction with different diagnostic systems in different cultures].

The Composite International Diagnostic Interview (CIDI), written at the request of the World Health Organization/US Alcohol, Drug Abuse, and Mental Health Administration Task Force on Psychiatric Assessment Instruments, combines questions from the Diagnostic Interview Schedule with questions designed to elicit Present State Examination items. It is fully structured to allow administration by lay interviewers and scoring of diagnoses by computer. A special Substance Abuse Module covers tobacco, alcohol, and other drug abuse in considerable detail, allowing the assessment of the quality and severity of dependence and its course. This article describes the design and development of the CIDI and the current field testing of a slightly reduced "core" version in Puerto Rico. The field test was being conducted in 19 centers around the world to assess the interviews' reliability and its acceptability to clinicians and general people in different cultures and providing data on which to base revisions that may be found necessary. In addition, questions to assess International Classification of Diseases, ninth revision, and the revised DSM-III diagnoses are being written. If all goes well, the CIDI will reliably allow investigators to assess mental disorders according to the most widely accepted nomenclatures in many different populations and cultures.

Cross-Cultural Comparison↗

PubMed1991

[Utilization of health services in Puerto Rico of persons with mental disorders].

As part of a major study on the prevalence of mental disorders in Puerto Rico, this paper describes the mental health care utilization patterns of persons with a Diagnostic Interview Schedule (DIS) disorder within the last year. The main findings of this analysis show that a) there is a high rate of health service utilization, b) the public sector is the main provider of services c) persons with a DIS disorder use more the non psychiatric physician d) those with alcohol abuse and/or dependence tend to use more the services of general practitioners while schizophrenics, somatizers and those with cognitive impairment use more the services of mental health specialists. The use of other resources such as clergy or spiritualists do not substitute the use of health services.

Adolescent↗

PubMed1990

The internal consistency and concurrent validity of a Spanish translation of the Child Behavior Checklist.

The Child Behavior Checklist's applicability to a Hispanic sample was assessed by an examination of the instrument's internal consistency and concurrent validity. The CBCL and TRF were administered to a community sample representative of children of Puerto Rico aged 4 to 16. Cronbach's alpha was used to assess the internal consistency of empirically derived scales. The relation of CBCL and TRF scores to clinical diagnosis, adaptive functioning, and need for services served as indicators of the concurrent validity of the instrument's Spanish version. The results indicate that the total behavior problem scores on the instruments are good continuous measures of maladjustment for children in Puerto Rico. A child with high values on the scales has a high probability of being classified as a case by a psychiatrist. High levels of internal consistency were found in most subscales. Only scales comprising low prevalence problems showed poor internal consistency.

Adolescent↗

PubMed1990

The psychological sequelae of disaster stress prospectively and retrospectively evaluated.

Aimed to document the psychological sequelae of a disaster in the adult (17-68 years) population of the Caribbean island of Puerto Rico, by surveying 912 persons (including 375 previously interviewed) with a Spanish version of the Diagnostic Interview Schedule. A rigorous methodology, which included both retrospective and prospective designs, was used, enabled by the occurrence of a catastrophic disaster only a year after a comprehensive survey was completed. Framed in a stress theoretical perspective, disaster effects for new depressive, somatic, and posttraumatic stress symptoms were identified, even after adjusting for demographic and methodologic factors. All the effects, however, were relatively small, suggesting that most disaster victims were rather resilient to the development of new psychological symptoms. Comparison of results with previous findings and its implications for both disaster and stress research are discussed, as well as the role of community psychologists in disaster action.

Adaptation, Psychological↗

PubMed1990

Epidemiological comparisons of Puerto Rican and U.S. mainland children: parent, teacher, and self-reports.

U.S. mainland and Puerto Rican nonreferred samples were compared via the Child Behavior Checklist (ages 4 to 16), Teacher's Report Form (ages 6 to 16), and Youth Self-Report (ages 12 to 16). Problem scores were significantly higher in parent and teacher ratings of Puerto Rican than mainland subjects, but were significantly lower in self-ratings by Puerto Rican adolescents. Adolescents in both cultures reported significantly more problems than their parents or teachers did. Most of the significant cross-cultural differences in parent, teacher, and self-ratings of competencies showed more favorable scores for the mainland subjects. High referral rates, a high prevalence of DSM diagnoses, and low scores on the Children's Global Assessment Scale are consistent with the high problem rates reported by Puerto Rican parents and teachers but not with the lower rates reported by adolescents. Different clinical cutoffs may be needed for all assessments in the mainland versus Puerto Rico.

Adolescent↗