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Biomedical subjects

P Zelkowitz

Publications and source records attributed to P Zelkowitz.

13 recordsLinked to original sources
PubMed2001

Diatheses and stressors in borderline pathology of childhood: the role of neuropsychological risk and trauma.

OBJECTIVE: To determine the relative contributions of neuropsychological deficits and psychosocial stressors to the presence of borderline pathology in children. METHOD: The subjects were 86 school-age children (75 males, 11 females) referred for psychiatric day treatment. Thirty-five of the children met criteria for borderline pathology. Data on psychosocial risk factors were obtained for each child from a questionnaire completed by members of the child's clinical team and were based on interviews with parents and children, as well as reports from schools and social agencies. Neuropsychological measures included computerized versions of the Wisconsin Card Sorting Test and the Continuous Performance Test. RESULTS: Both deficits in executive function and psychological trauma made significant and independent contributions to the variance in borderline pathology. Inclusion of both sets of risk factors produced a model that explained 48% of the variance in borderline diagnosis. CONCLUSIONS: Both environmental risks and neurobiological vulnerability should be taken into account to understand the etiology of borderline pathology in children.

Borderline Personality Disorder↗
PubMed2001

The course of postpartum psychiatric disorders in women and their partners.

This study examined the course of postpartum psychiatric disorders in a community sample of mothers and their partners to determine whether sociodemographic variables, life stress, and psychiatric history were related to persistence of mental health problems. At 6 months postpartum, 48 index couples where the wife had a psychiatric disorder at 2 months postpartum and 50 control couples with no such diagnosis underwent diagnostic interviews and completed questionnaires on psychological symptoms, life stress, and treatment history. The results indicate that at follow-up, 54% of the index mothers still had a psychiatric diagnosis, as did 60% of their partners who had had a psychiatric diagnosis at 2 months postpartum. Socioeconomic status, country of origin, and life stress were related to persistence, as were diagnosis and timing of onset of the disorder. About a third of the parents were referred for treatment. It is concluded that for many families, postpartum psychiatric disorders are not a transient phenomenon.

Depression, Postpartum↗
PubMed1999

Psychological risk factors for borderline pathology in school-age children.

OBJECTIVE: To determine whether children with borderline pathology have a specific pattern of psychological risk factors. METHOD: The subjects were 94 school-age children in day treatment, divided into borderline (n = 41) and nonborderline (n = 53) groups using the child version of the Retrospective Diagnostic Interview for Borderlines. All children were assessed using the Child Behavior Checklist, the Schedule for Affective Disorders and Schizophrenia for School-Age Children, and the Psychosocial Questionnaire. Parental pathology was assessed by a computerized version of the Structured Clinical Interview for DSM-III-R. RESULTS: Children with borderline pathology had higher rates of physical abuse, sexual abuse, severe neglect, as well as family breakdown and parental criminality. In multivariate analyses, the discriminating factors were sexual abuse and parental criminality. Borderline pathology was highly comorbid with conduct disorder, but most of these results remained significant in reanalyses comparing children with and without conduct disorder. CONCLUSIONS: Borderline pathology in children has a unique pattern of risk factors not accounted for by conduct disorder alone.

Borderline Personality Disorder↗
PubMed1999

Neuropsychological factors associated with borderline pathology in children.

OBJECTIVE: To determine whether children with borderline pathology have a specific pattern of neuropsychological risk factors. METHOD: The subjects were 94 school-age children in day treatment, divided into borderline (n = 41) and nonborderline (n = 53) groups according to results of the Child version of the Diagnostic Interview for Borderlines. All children were assessed with the Child Behavior Checklist, the Schedule for Affective Disorders and Schizophrenia for School-Age Children, and a neuropsychological battery. RESULTS: Children with borderline pathology had abnormal scores on the Wisconsin Card Sorting Test and on the Continuous Performance Test, both of which suggested problems with executive function. Although borderline pathology was highly comorbid with conduct disorder, most results were independent of this comorbidity. CONCLUSIONS: Borderline pathology in children has a unique pattern of neuropsychological risk factors that may reflect a diathesis for this syndrome.

Analysis of Variance↗
PubMed1997

Outcome of small-for-gestational age and appropriate-for-gestational age infants born before 27 weeks of gestation.

OBJECTIVE: To evaluate the consequences of being small-for-gestational age at extremely low gestational age. METHODOLOGY: Comparison of two historical cohorts of small-for-gestational age (SGA) and appropriate-for-gestational age (AGA) infants born between 24 and 26 6/7 weeks of gestation (gestational age estimated by early ultrasound at 16 to 18 weeks). Data were collected retrospectively on 191 successive admissions to the neonatal intensive care unit between January 1, 1983, and December 31, 1992. These included: demographic and maternal information, delivery mode and condition at birth, mortality, neonatal intensive care unit morbidities (respiratory distress syndrome, intraventricular hemorrhage, patent ductus arteriosis [PDA], chronic lung disease [CLD], retinopathy of prematurity [ROP], necrotizing enterocolitis, infection), nutrition, and length of hospitalization. RESULTS: Forty-one (21%) of the 191 infants were classified as SGA. Those with congenital anomalies (10% in the SGA and 2% in the AGA group) were excluded from further analysis. Despite a similar rate of respiratory distress syndrome (50%), the SGA infants had a greater rate of failure of indomethacin treatment for PDA closure (54% vs 32% for AGA), a higher risk for CLD defined as a need for supplementary oxygen at 36 weeks (65% vs 32% for AGA), a more prolonged need for oxygen supplementation and ventilatory support (94 days vs 68 days for AGA and 58 days vs 40 days for AGA, respectively). SGA infants were also at greater risk for developing severe ROP (stage >/=III) (65% vs 12% for AGA). CONCLUSIONS: For infants born before 27 weeks, being small-for-gestational age confers additional risks for severe morbidity, ie, PDA ligation, CLD, and ROP.

Fetal Growth Retardation↗
PubMed1996

Postpartum psychiatric disorders: their relationship to psychological adjustment and marital satisfaction in the spouses.

The authors examined mental health and marital quality in an index group of spouses of women with postpartum psychiatric disorders and a control group of men whose wives had recently given birth but had no such disorders. At 6 to 9 weeks postpartum, couples underwent a psychiatric interview and completed self-report measures of psychological symptoms, marital satisfaction, and changes in couple and family functioning since the birth. Index spouses reported more symptoms and had lower Global Assessment of Functioning (R. L. Spitzer, J. B. W. Williams, M. Gibbon, & M. B. First, 1990) scores than controls. Index men reported greater marital dissatisfaction and more change in household routines, recreation, and intimacy with their partners than controls.

Adaptation, Psychological↗
PubMed1996

Risk factors for borderline pathology in children.

OBJECTIVE: To examine risk factors associated with borderline pathology in latency-age children. METHOD: The subjects were 98 children assessed for day treatment. Borderline subjects were identified in a chart review using the Child Diagnostic Interview for Borderlines, which divided the sample into borderline (n = 41) and nonborderline (n = 57) groups. Functional levels were assessed by Children's Global Assessment Scale scores. The risk factors were also rated by chart review; all subjects were given a cumulative abuse score and a cumulative parental dysfunction score. RESULTS: Both groups demonstrated severe functional impairment. The risk factors that differentiated the borderline group were sexual abuse, physical abuse, severe neglect, and parental substance abuse or criminality. Sexual abuse and severe neglect were significant in multivariate analysis. Cumulative abuse and cumulative parental dysfunction scores were both higher in the borderline group. CONCLUSIONS: The findings indicate that the risk factors in borderline children are similar to those found in adults.

Borderline Personality Disorder↗
PubMed1996

Psychopathology in offspring of mothers with borderline personality disorder: a pilot study.

OBJECTIVE: Children of mothers with borderline personality disorder (BPD) were hypothesized to be at greater risk for psychopathology, particularly impulse spectrum disorders, than children of mothers with other personality disorders. METHOD: Twenty-one index children were compared with 23 children of mothers with a nonborderline personality disorder. Diagnoses were obtained using the Kiddie Schedule for Affective Disorders and Schizophrenia-Episodic Version (KSADS-E) and the Child Diagnostic Interview for BPD (CDIB), and functioning was rated with the Child Global Assessment Schedule (CGAS). Physical, sexual, and verbal abuse, as well as family violence and placements, were also assessed. RESULTS: The children of the borderline mothers, as compared with controls, had more psychiatric diagnoses, more impulse control disorders, a higher frequency of child BPD, and lower CGAS scores. There were no differences between the groups for trauma. CONCLUSION: The offspring of borderline mothers are at high risk for psychopathology.

Adolescent↗
PubMed1996

Childrearing attitudes among parents of very low birth weight and normal birth weight children.

The childrearing attitudes of parents of school-age children born at weights under 1500 g (VLBW) were compared with those of parents of age- and gender-matched children born at full term (NBW) to determine whether there were systematic differences between the two groups and whether parental attitudes were associated with child outcomes. Parents completed a self-report measure of childrearing attitudes and provided information on the child's health since birth. The children were given measures of IQ and self-concept, and their teachers rated their social and academic competence. Neonatal morbidity and subsequent need for hospitalization were unrelated to parental attitudes. Parents of VLBW children reported less use of guilt as a control strategy. They were also less child-centered, particularly if their children had chronic respiratory or ear-nose-throat problems. Greater parental warmth, less control through guilt, and less parental detachment were associated with more socially competent behavior and more positive self-concept in 9-year-old VLBW children.

Adaptation, Psychological↗
PubMed1995

Screening for post-partum depression in a community sample.

OBJECTIVE: This study undertook to estimate the prevalence of post-partum depression in the community by means of telephone screening. Demographic correlates of post-partum depression were also investigated. METHOD: The sample was identified through two community health centres. Over a period of 17 months, 1559 childbearing women were screened at six weeks post-partum, using the ten-item Edinburgh Postnatal Depression Scale (EPDS). RESULTS: The prevalence of post-partum depression was estimated to be 6.2%, using a cut point of 10 on the EPDS, and 3.4% using the more stringent cut point of 12. Women who were not working or those with lower occupational status, were at greater risk for depression. Recent immigrants, particularly those who were not working or who had given birth to a second child, were also at higher risk. CONCLUSION: Telephone screening for post-partum depression is feasible, and can aid in the identification of women at risk.

Acculturation↗
PubMedDate not supplied

A comparison of the families of mothers with borderline and nonborderline personality disorders.

The purpose of this study was to evaluate the families of procreation of mothers with borderline personality disorder (BPD) on measures of family stability, family satisfaction, and family environment. Families of nine BPD mothers were compared with families of 14 mothers with other personality disorders using a semi-structured interview to evaluate family history, the Family Environment Scale (FES), and the Family Satisfaction Scale (FSS). Families of procreation of BPD mothers were more unstable than comparison group families. FES scores of BPD mothers were significantly lower than controls in cohesion and organization, but not in conflict. Instability and low family cohesion are common in families of BPD mothers, and may place their children at increased risk for development of psychopathology.

Adolescent↗