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Biomedical subjects

N C Beck

Publications and source records attributed to N C Beck.

At least 37 records · Page 2Linked to original sources

Patients with rheumatoid arthritis at high risk for noncompliance with salicylate treatment regimens.

Recent studies indicate the adherence of many patients with rheumatoid arthritis (RA) to their treatment regimens is poor. Management of this problem depends on identification of noncompliant patients, followed by interventions to increase their level of adherence. In this study, 63 patients with RA receiving salicylate drugs completed a questionnaire during an outpatient visit. The questionnaire contained items believed to be predictive of future compliance, including patient self-predictions regarding future compliance, ratings of behavior in similar situations and barriers to compliance, such as ease of transportation to the clinic. Compliance was estimated via a salicylate assay that was taken during a subsequent outpatient appointment. Multivariate analyses of our data revealed that significant predictions could be made regarding future compliance, with 75% of the noncompliant patients correctly identified. Variables contributing significantly included behavioral self-predictions and a measure of current behavior in similar situations, as assessed by a salicylate assay that was collected during the 1st outpatient visit.

Arthritis, Rheumatoid↗

Antidepressant analgesia in rheumatoid arthritis.

Forty-seven patients with definite rheumatoid arthritis (RA) were treated in a 32 week, double blind, crossover trial of amitriptyline, desipramine, trazodone, and placebo. All drug regimens produced significant changes on pain measures relative to baseline, but only amitriptyline exceeded placebo. Amitriptyline was associated with a significant reduction in the number of painful/tender joints. Our study supports the efficacy of a moderate dose of amitriptyline as an adjunct drug for the treatment of pain in both depressed and nondepressed patients with RA.

Aged↗

Depression in rheumatoid arthritis.

Operationalized diagnostic criteria for depression were used to assess 137 (76% male, 24% female) patients with rheumatoid arthritis (RA). Forty-two percent met criteria for some form of depression. Discriminant function analysis revealed a significant relationship between the presence or history of depression and higher levels of pain, but not between current depression and common indicators of RA activity or severity. These results suggest that depression is a frequent disorder among persons with RA. The importance of patient appraisal of disease and assessment of repeated depressive episodes is discussed. Attention to specific interventions for depression in conjunction with the treatment of the RA is suggested.

Arthritis, Rheumatoid↗

Situational factors and behavioral self-predictions in the identification of clients at high risk to drop out of psychotherapy.

Two hundred and eight adults who requested outpatient treatment at a community mental health center were asked to complete brief questionnaires immediately prior to and after their first therapy session. Questionnaires contained items that pertained to self-predicted length of stay in psychotherapy, situational barriers to regular attendance, and past behavior in similar situations (e.g., appointment-keeping with other health care professionals). Therapists also were asked to make predictions with regard to client length of stay. Questionnaire data were analyzed via a series of double cross-validated multiple regression and discriminant function equations, and results indicated that client and therapist predictions of length of stay in therapy were the most stable and consistent correlates of attendance behavior.

Adult↗

Psychiatric disorders in a community sample of adolescents.

The prevalence of psychiatric disorders diagnosed according to DSM-III in adolescents in the general population is not known. The authors address this issue in a community sample of 150 adolescents 14-16 years of age. Structured interviews as well as other instruments were used to collect data. Twenty-eight (18.7%) of the 150 adolescents were identified as having a psychiatric disorder. These 28 adolescents viewed their parents as less caring, had lower self-esteem, and resolved their conflicts through verbal aggression and physical violence more often than did the adolescents who did not have a psychiatric disorder. The authors make recommendations regarding the use of structured interviews in future research.

Adolescent↗

Depression, depressive symptoms, and depressed mood among a community sample of adolescents.

Using a structured interview, the authors found that the prevalence of major depression and dysthymic disorder was 4.7% and 3.3%, respectively, in a community sample of 150 adolescents. All of the adolescents who met the criteria for major depression and dysthymic disorder had other psychiatric disorders as well; anxiety was the most frequent accompanying DSM-III diagnosis.

Adolescent↗

Predictors of psychopathology in children of patients with major affective disorders.

The present study reports on variables associated with psychopathology in children of patients hospitalized with major affective disorders. The primary instrument used in this investigation was a structured diagnostic interview that was completed by a child psychiatrist. Univariate and multivariate statistical analyses of these data suggest that severity of parental psychopathology (as measured by a higher score on the SCL-90 and a longer stay in the hospital) and the report of child abuse were associated with general childhood psychopathology. The significance of these and other findings are discussed.

Adolescent↗

Characteristics of well adjusted adolescents.

In a community sample of 150 adolescents 14-16 years old, 25 (16.7%) were found to be well adjusted on the basis of structured interviews with the youths and their parents. The personalities of these subjects were found to be different and their self-concepts better than those of the remaining sample. The well adjusted adolescents described their parents as more caring and reported a larger number of social support systems than did the controls. The direct significance of these findings, as well as more subtle ramifications for the mental health professional, is discussed.

Adolescent↗

Self-report and psychophysiological effects of Lamaze preparation: an analogue of labor pain.

Eighty nulliparous college female undergraduates were cast randomly into a series of eight treatment conditions representing all possible combinations of the three major components of the Lamaze method of childbirth preparation (relaxation training, informative lectures, and breathing exercises). Assessments of the efficacy of these pain coping strategies were subsequently made in the context of a 1-hour session involving twenty 80-second exposures to a laboratory pain stimulus, patterned so as to resemble labor contractions. Dependent variables included self-reported pain, systolic and diastolic blood pressure, frontalis EMG, and heart rate. Results of the study indicated that relaxation training comprises the most therapeutically active component of the Lamaze treatment regimen, with significant effects (treatments X trials) on self-reported pain, frontalis EMG, and heart rate. The implications of these findings are discussed from the perspective of designing new, and hopefully more efficacious, methods of preparing women for labor and delivery.

Blood Pressure↗

Predicting rehospitalization at a community mental health center: a "double-crossed" validation.

Used a multiple regression equation that contained a variety of demographic and diagnostic measures as predictor variables to predict 5-year recidivism in a group of 100 psychiatric inpatients hospitalized at a community mental health center. This equation then was cross-validated via the prediction of recidivism in a second group of 100 inpatients. A predictive equation derived from an analysis of this second group of patients then was used in a "double-crossed' validation back to the first group. Diagnoses that involved schizophrenia and drug abuse, major psychotropic drug regimens, and a failure to appear for follow-up therapy as an outpatient emerged consistently as predictor variables.

Aftercare↗

Patient diagnostic, behavioral and demographic variables associated with changes in civil commitment procedures.

Examined diagnostic and demographic characteristics of six groups of voluntary and committed patients (N = 300) over a 3-year period in order to assess the impact of a change in civil commitment procedures in the state of Missouri. Committed and voluntary patients differed on the basis of several demographic and behavioral variables, including diagnosis, employment status, and instances of serious physical harm recorded on admission. No differences were found between patients committed under the old law (which stipulated that the presence of "mental illness" was a sufficient criterion) and patients committed under the new law (which requires the presence of serious physical harm as an essential criterion). These findings were interpreted to suggest that, in at least some settings, clinicians were restricting commitment to cases that gave evidence of physical harm prior to the enactment of new legislation.

Adult↗

Facilitating psychiatric patient follow-up: a study of transfer attrition.

Tested the hypothesis that two brief pre-discharge interventions would improve transfer success for psychiatric inpatients discharged to an outpatient community aftercare program. Seventy-four inpatients viewed one of three videotapes designed to: (1) provide programmatic information about follow-up clinics; (2) shape accurate expectations for outpatient therapy; or (3) provide non-specific emphasis to the importance of aftercare. A baseline group also was employed. As hypothesized, posttest questionnaires showed that experimental Ss had significantly more knowledge of the follow-up program and greater congruence of therapy expectations. A generalized behavioral effect also occurred; the two experimental groups had a higher rate of transfer success (82%) than the controls (59%). No differences in therapy persistence were observed. These findings suggest that mental health centers might improve transfer success by providing inpatients with detailed information about community aftercare programs.

Adult↗

Prediction of discharges against medical advice from an alcohol and drug misuse treatment program.

A discriminant function method of data analysis revealed that statistically significant predictions could be made regarding AMA discharge, and that certain variables emerge consistently as predictors: a diagnosis involving personality disorder, admission after regular hours, age 20-29, intoxicated on admission, and less likely to have been referred by relatives or legal authorities.

Alcoholic Intoxication↗