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Biomedical subjects

N Horesh

Publications and source records attributed to N Horesh.

At least 19 recordsLinked to original sources

Self-report vs. computerized measures of impulsivity as a correlate of suicidal behavior.

OBJECTIVES: To compare the use of a self-report form of impulsivity versus a computerized test of impulsivity in the assessment of suicidal adolescent psychiatric inpatients. METHODS: Sixty consecutive admissions to an adolescent in patient unit were examined. The severity of suicidal behavior was measured with the Childhood Suicide Potential Scale (CSPS), and impulse control was measured with the self report Plutchik Impulse Control Scale (ICS) and with the Test of Variables of Attention (TOVA), a continuous performance test (CPT). The TOVA is used to diagnose adolescents with attention deficit disorder. RESULTS: There was a significant but low correlation between the two measures of impulsivity. Only the TOVA commission and omission errors differentiated between adolescent suicide attempters and nonattempters. CONCLUSIONS: Computerized measures of impulsivity may be a useful way to measure impulsivity in adolescent suicide attempters. Impulsivity appears to play a small role only in nondepressed suicidal adolescents, especially boys.

Adolescent↗

Internalized anger, self-control, and mastery experience in inpatient anorexic adolescents.

OBJECTIVES: To evaluate the implications of internalized anger, self-control and experience of mastery for adolescent girls with severe anorexia nervosa (AN). METHODS: Internalized and externalized anger, internal and external control, mastery, use of methods for self-control, and severity of anorexic symptoms were measured by self-report questionnaires in inpatient anorexic teenagers (N=26), inpatient female adolescent psychiatric patients (N=24), and a normal female comparison group (N=29). RESULTS: Internalized anger was significantly higher in both the anorexic and general psychiatric patients as compared to normal controls, but this difference was significant only for the anorexic patients. Anorexic and general psychiatric patients experienced significantly less mastery than normal controls, but again this difference was significant only in the anorexic group. Within the anorexic group, severity of symptoms correlated significantly with internalized anger, low mastery, and external locus of control, and negative significant correlations among control measures and anger were found. Total length of hospitalization correlated positively with internalized anger only for the anorexics. CONCLUSION: The findings support the notion that internalized anger and defective experience of self-control are important factors in the psychopathology of adolescent anorexic inpatient females The results may have implications for the clinical management of patients with severe AN.

Adolescent↗

Perception of ill spouse and dyadic relationship in couples with affective disorder and those without.

BACKGROUND: This study compares the perception of spouses and the quality of the dyadic relationship of patients with severe affective disorders in remission with healthy couples. METHOD: The sample included spouses of patients between the ages of 20 and 65 who had been hospitalized with severe affective illness and who were currently in remission (depressive, n=23; bipolar, n=11) and a control group matched by socioeconomic status. Both groups completed three instruments measuring the quality of the dyadic relationship, attributed characteristics of the spouse and non-formal social support. RESULTS: The spouses of patients, as compared to spouses of controls, scored lower on consensus, unity and expressions of affection in their marital relationship, ranked their ill spouses lower on the positive qualities and higher on the negative qualities and reported receiving less emotional and practical support. LIMITATIONS: The limitations of the study are the small sample size and cross sectional design. CONCLUSIONS: The results suggest that severe affective disorders are associated with marital dysfunction, even during periods of symptom remission.

Adult↗

Close relationships and social competence of hospitalized and nonhospitalized adolescents.

This study was designed to examine the social relationships of adolescents with severe disorders. The study sample consisted of 33 adolescent inpatients in a psychiatric unit, as well as 33 nonhospitalized adolescents. Participants completed the Network of Relationship Inventory for an assessment of the quality of their relationships with mother, father, close friend, and other significant adults. In addition, friendship intimacy was assessed. Results showed nonhospitalized adolescents describing a close relationship with their parents, as well as with their close friends. Their relationships with their friends were mature. Hospitalized adolescents described a less close relationship with their parents, whereas they were close to and valued their relationships with their friends and other significant adults. Though both groups described similar levels of emotional closeness, hospitalized adolescents tended more to exert control or to evince a penchant for similarity to the other in their friendships. Results are discussed within the framework of adolescent social tasks.

Adolescent↗

Impulsivity as a correlate of suicidal behavior in adolescent psychiatric inpatients.

One hundred and eighteen inpatient adolescents in a psychiatric hospital were evaluated to determine the relationship of aggression, self injury, and suicidal behavior to impulsivity. It was hypothesized that all these variables would be significantly and positively correlated with one another. This hypothesis was in part based on the results of psychobiological research that found serotonin dysfunction to be the common denominator of these psychopathological dimensions. As predicted, a significant correlation was found between the measures of suicidal behavior, aggressive behavior, and impulsivity. This correlation between suicidal behavior and impulsivity remained after partialing out the factor of aggression. Furthermore, the correlations between impulsivity and suicidality appeared greater in males than in females. Since male suicide attempters are more likely to eventually commit suicide than female suicide attempters, these findings may have a bearing on suicide prediction.

Adolescent↗

Adult attachment style and the perception of others: the role of projective mechanisms.

In 3 reported studies the authors examined attachment-style differences in the perception of others and the hypothesis that projective mechanisms underlie these differences. In these studies, participants reported on their attachment style and generated actual-self-traits and unwanted-self-traits. Then, a 2nd session was conducted, in which impression formation about new persons (Study 1), the ease of retrieval of memories about known persons (Study 2), or memory inferences about learned features of fictional persons (Study 3) were assessed. Findings indicate that whereas anxious-ambivalent persons' impression formation, memory retrieval, and inferences about others reflected the projection of their actual-self-traits, avoidant persons' responses reflected the projection of their unwanted-self-traits. Findings are discussed in terms of the regulatory goals and strategies that characterize the mental representations of each attachment style.

Adult↗

The contribution of adult attachment style to the adjustment to infertility.

This study examines the contribution of adult attachment style to the adjustment to infertility. Both husbands and wives of 80 infertile couples undergoing medical treatment completed the Attachment Style Scale, the Mental Health Inventory and the Dyadic Adjustment Scale. One year later, data were collected on whether women became pregnant. Diagnosis of male infertility was significantly more distressing than diagnosis of female infertility. Significant differences were found among attachment groups: secure persons, either men or women, reported more well-being, less distress and more dyadic adjustment than avoidant and anxious-ambivalent persons. Partners of secure persons also reported significantly higher levels of well-being and dyadic adjustment and significantly lower levels of distress than partners of anxious-ambivalent persons. However, these effects of attachment style were significant mainly when male infertility was diagnosed. Husbands' secure attachment made a significant positive contribution to pregnancy likelihood and this effect was mediated by adjustment measures. Results are discussed in terms of attachment theory.

Adaptation, Psychological↗

Personality differences between obsessive-compulsive disorder subtypes: washers versus checkers.

Personality differences between 'washer' and 'checker' subtypes of obsessive-compulsive disorder (OCD) were explored. Fifty-one OCD patients were recruited from several outpatient clinics in Central Israel. OCD was diagnosed according to DSM-III-R using the Structured Clinical Interview for DSM-III-R, and personality disorders were diagnosed using the Structured Clinical Interview for DSM-III-R Personality Disorders. Washers were much more likely to have personality disorders than checkers. Personality disorders were diagnosed in 12 of 13 washers vs. three of 11 checkers (chi 2 = 10.75, Fisher's exact test, P < 0.001, d.f. = 1, odds ratio = 32, CI = 2.8-365) and 21 of 27 patients with mixed OCD symptoms. The results support the validity of the washer-checker subdivision and might explain the relative refractoriness of washers to conventional intervention.

Adult↗

Life events in childhood, adolescence and adulthood and the relationship to panic disorder.

The aim of this study was to explore the association between stressful life events (SLE) and the development of panic disorder (PD) in an Israeli sample. A total of 44 PD patients and a matched control group were studied with regard to SLE over the life cycle (in childhood, adolescence, adulthood and the year preceding the outbreak of the disorder). The major findings were as follows. (i) With regard to the total number of life events experienced in childhood and adolescence, the PD group had experienced significantly more life events than the control group. (ii) No differences were detected in the total amount of SLE between the PD group and the control group with regard to adulthood and the year preceding the outbreak of the disorder, although the PD group had more life events relating to loss in adulthood, whereas in the year before the outbreak of PD life events relating to 'love and family', negative and loss events were more prevalent. These results expand previous findings by demonstrating that SLE in childhood and adolescence may contribute to the development of PD in adulthood.

Adolescent↗

Anger, impulsivity and suicide risk.

BACKGROUND: To examine the relationship between anger, impulsivity and suicidality. METHODS: Thirty psychiatric inpatients admitted for suicidal behavior were compared with 30 nonsuicidal psychiatric inpatients and 32 healthy controls on measures of anger, impulsivity and suicide risk. RESULTS: The three groups were similar on demographic variables, but the suicidal group scored higher on the suicide risk scale, impulsivity scale and anger scale. Anger and impulsivity correlated significantly with suicide risk. High anger and impulsivity contributed synergistically to the suicide risk. Whereas anger was specific to both psychiatric groups, suicidals and nonsuicidals, only impulsivity was specific to the suicidal group. CONCLUSIONS: These findings may have important implications for therapists and primary prevention workers, and may pave the way for the recognition of risk factors and for effective intervention in patients with a high suicide risk.

Adult↗

Abnormal psychosocial situations and eating disorders in adolescence.

OBJECTIVE: To assess the relationship between abnormal psychosocial situations and eating disorders in adolescents. METHOD: Twenty girls with eating disorders, 20 girls with major psychiatric conditions, and 20 healthy controls took part in the study. They were interviewed using a semistructured interview designed by the World Health Organization to diagnose the psychosocial situations included in the International Classification of Disease Axis 5 classification for child and adolescent psychiatry. All subjects were also given the Eating Attitudes Test. RESULTS: Many life events and psychosocial adversities differentiated significantly between the patients and controls. Inappropriate parental pressure was specific only for the subjects with eating disorders compared with the other psychiatric patients. In addition, Eating Attitudes Test scores correlated significantly with hostility toward child, sibling disability, parental overprotection, inappropriate parental pressures, and negative changes in family relationships. CONCLUSION: These results support the growing literature on the interrelationship between disordered family relationships and eating disorders. They point the way for developing treatment programs dealing with these issues.

Adolescent↗

Coping styles and suicide risk.

A total of 30 psychiatric in-patients admitted because of suicidal behaviour were compared with 30 non-suicidal psychiatric in-patients and 32 healthy controls on measures of suicide risk and coping styles. The three groups were similar with regard to demographic variables, but the suicidal group scored higher on the suicide risk scale. Suicidal patients were significantly less likely to use the coping styles of minimization and mapping. They were unable to de-emphasize the importance of a perceived problem or source of stress. They also lacked the ability to obtain new information required to resolve stressful life events. Four coping styles correlated negatively with the suicide risk (minimization, replacement, mapping and reversal), while another three (suppression, blame and substitution) correlated positively. These findings may have important implications for therapists and primary prevention workers, and might pave the way towards recognition of the role played by coping styles in predicting suicide and its use for cognitive intervention in these high-risk patients.

Adaptation, Psychological↗

Life events and severe anorexia nervosa in adolescence.

The purpose of the study was to study the influence of life events on adolescent patients suffering from anorexia nervosa. Twenty one hospitalized adolescent inpatients with severe anorexia nervosa were compared with 79 adolescent nonanorectic psychiatric inpatients and 40 healthy adolescents for stressful life events throughout their lives. The nonanorectic patients suffered from schizophrenia, affective disorders, anxiety disorders, borderline personality disorder or conduct disorder. The assessment of the contribution of life events to the development of anorexia and the control mental disorders was based on semistructured interviewing of the patients, their parents and the patients' therapists. The instrument used was that developed by Pfeffer. The anorectic patients showed significantly higher negative life event scores than healthy controls in all the areas of life events examined. In addition, they showed significantly more negative life events concerning parents than patients in the other psychiatric diagnostic categories. These findings have relevance for the growing literature on the association between eating disorders and certain forms of child abuse.

Adolescent↗

Life satisfaction and adjustment in lithium-treated affective patients in remission.

The aim of this study was to assess life satisfaction and adjustment of lithium-treated affective patients in remission. Scores of life satisfaction and adjustment in four areas were obtained for two experimental groups of 50 unipolars and 50 bipolars and for two control groups of 50 healthy individuals and 50 patients with personality disorders. Subjects' self-assessments and psychiatrists' evaluation were rated using a modification of Cantril's ladder device. No significant differences were found between affective patients and healthy controls regarding life satisfaction and adjustment, whereas psychiatric controls scored significantly less on most indices. Moreover, the treating psychiatrists rated affective patients significantly higher than psychiatric controls and perceived them as actualizing their potential to a greater degree. Thus, it is concluded that neither the affective illness nor lithium as a prophylactic agent interfered with the patients' feelings of satisfaction or with manifest functioning while in remission.

Adaptation, Psychological↗

Bilateral electrodermal activity in depressive patients.

Integrated bilateral skin conductance response and reactive lateral eye movements were studied in 19 depressive patients and 14 normal subjects during visual and verbal tasks and tone habituation sequence. Distinct right-left differences between depressed and normal subjects in reactive lateral eye movements were revealed. Both endogenous and reactive depression patients were classified as 'left-movers'. Marked bilateral differences were observed in electrodermal activity (EDA) in patients during verbal and visual tasks. In endogenous depression EDA was higher on the left hand compared with the right under all the conditions studied (visual and verbal, and tone habituation sequence). In reactive depression EDA was higher on the left side during the verbal task and tone habituation sequence and on the right side in the visual task. Neither result in reactive depression group attained significance. The results are interpreted as a reflection of a different pathophysiology underlying reactive and endogenous depression.

Adjustment Disorders↗

Relationship between self-disclosure and serious suicidal behavior.

The ability to predict which suicidal patient is at high risk for a serious attempt is an important clinical problem. On the basis of our clinical research, we hypothesized that self-disclosure may be an important personality variable differentiating suicide attempters and completers. We assessed 80 patients with depressive disorder, divided into four groups of 20 each: suicidal ideation only, nonserious suicide attempts, severe suicide attempts, and no suicidal behavior. Comparisons were also made with 20 healthy controls. All subjects completed Jourad's Self-Disclosure Questionnaire (JSDQ), as well as scales measuring depression/anxiety and hopelessness. The lack of willingness for self-disclosure significantly differentiated the serious attempters from the suicide ideators and mild attempters. The relationship of self-disclosure and more lethal suicide attempts did not appear to be mediated by depression, anxiety, or hopelessness. This preliminary study indicates that self-disclosure may be a promising field for assessment, therapy, and prevention in suicidal patients. Further studies are needed to investigate related variables, wider patients groups, and the use of different instruments.

Adult↗