Biomedical subjects

Patrick E Shrout

Publications and source records attributed to Patrick E Shrout.

14 recordsLinked to original sources

PubMed2007

Longitudinal development of antisocial behaviors in young and early adolescent Puerto Rican children at two sites.

OBJECTIVE: This report provides descriptive longitudinal findings over three waves of a study designed to assess the development of antisocial behaviors in young and early adolescent Puerto Rican children at two sites. METHOD: Through the use of standard assessment measures, representative samples of Puerto Rican children of both genders 5 to 13 years of age and their adult caretakers were interviewed at two sites: the South Bronx in New York City (n = 1,138) and the Standard Metropolitan Areas in Puerto Rico (n = 1,353; N = 2,491). RESULTS: Although no differences in prevalence between the two sites were apparent at baseline, analyses of the longitudinal data show that site differences emerge over time, with a decrease in risk of antisocial behavior over time in the Standard Metropolitan Areas relative to the Bronx. CONCLUSIONS: The decreased risk of these disorders in the Standard Metropolitan Areas corroborates the low rates in Puerto Rico reported in previous research. Future analyses of these data are needed to identify the risk and protective factors associated with this difference.

Adolescent↗

PubMed2006

Predictors of psychosis remission in psychotic disorders that co-occur with substance use.

OBJECTIVE: To examine rates and predictors of psychosis remission at 1-year follow-up for emergency admissions diagnosed with primary psychotic disorders and substance-induced psychoses. METHOD: A total of 319 patients with comorbid psychosis and substance use, representing 83% of the original referred sample, were rediagnosed at 1 year postintake employing a research diagnostic assessment. Remission of psychosis was defined as the absence of positive and negative symptoms for at least 6 months. Likelihood ratio chi-square tests and multivariate logistic regression were the main means of analysis. RESULTS: Of those with a baseline diagnosis of primary psychotic disorder, 50% were in remission at 1 year postintake, while of those with a baseline diagnosis of substance-induced psychosis, 77% were in remission at this time point. Lower Positive and Negative Syndrome Scale (PANSS) symptom levels at baseline, better premorbid functioning, greater insight into psychosis, and a shorter duration of untreated psychosis predicted remission at 1 year in both diagnostic groups. No interaction effects of baseline predictors and diagnosis type were observed. A stepwise multivariate logistic regression holding baseline diagnosis constant revealed the duration of untreated psychosis (odds ratio [OR] = 0.97; 95% confidence interval [CI] = 0.95, 0.997), total PANSS score (OR = 0.98; 95% CI = 0.97, 0.987), Premorbid Adjustment Scale score (OR = 0.13; 95% CI = 0.02, 0.88), and Scale to Assess Unawareness of Mental Disorders unawareness score (OR = 0.84; 95% CI = 0.71, 0.993) as key predictors of psychosis remission. CONCLUSIONS: The association of better premorbid adjustment, a shorter duration of untreated psychosis, better insight into psychotic symptoms, and lower severity of psychotic symptoms with improved clinical outcome, reported previously in studies of schizophrenia, generalizes to psychosis remission in psychotic disorders that are substance induced.

Adolescent↗

PubMed2006

Paper or plastic? Data equivalence in paper and electronic diaries.

Concern has been raised about the lack of participant compliance in diary studies that use paper-and-pencil as opposed to electronic formats. Three studies explored the magnitude of compliance problems and their effects on data quality. Study 1 used random signals to elicit diary reports and found close matches to self-reported completion times, matches that could not plausibly have been fabricated. Studies 2 and 3 examined the psychometric and statistical equivalence of data obtained with paper versus electronic formats. With minor exceptions, both methods yielded data that were equivalent psychometrically and in patterns of findings. These results serve to at least partially mollify concern about the validity of paper diary methods.

Adolescent↗

PubMed2006

Why is enacted social support associated with increased distress? Using simulation to test two possible sources of spuriousness.

Although perceiving that social support is available is often associated with psychological benefits in times of stress, there is evidence that actually receiving support is associated with increased distress. To assess whether this latter association could be spurious, the authors conducted computer simulation studies to examine two theoretical models that could give rise to it. Study 1 examined a process whereby distress leads to provision of support rather than the reverse. Study 2 examined a process whereby an adverse event increases both support and distress. In both cases, substantial spurious associations were produced only when parameter values were markedly unrealistic. It was concluded that these possible sources of spuriousness are insufficient to explain the association between support and distress found in naturalistic studies.

Adaptation, Psychological↗

PubMed2006

A procedure for evaluating sensitivity to within-person change: can mood measures in diary studies detect change reliably?

The recent growth in diary and experience sampling research has increased research attention on how people change over time in natural settings. Often however, the measures in these studies were originally developed for studying between-person differences, and their sensitivity to within-person changes is usually unknown. Using a Generalizability Theory framework, the authors illustrate a procedure for developing reliable measures of change using a version of the Profile of Mood States (POMS; McNair, Lorr, & Droppleman, 1992) shortened for diary studies. Analyzing two data sets, one composed of 35 daily reports from 68 persons experiencing a stressful examination and another composed of daily reports from 164 persons over a typical 28-day period, we demonstrate that three-item measures of anxious mood, depressed mood, anger, fatigue, and vigor have appropriate reliability to detect within-person change processes.

Adult↗

PubMed2005

Risk factors for long-term homelessness: findings from a longitudinal study of first-time homeless single adults.

OBJECTIVES: We examined risk factors for long-term homelessness among newly homeless men and women who were admitted to New York City shelters in 2001 and 2002. METHODS: Interviews were conducted with 377 study participants upon entry into the shelter and at 6-month intervals for 18 months. Standardized assessments of psychiatric diagnosis, symptoms, and coping skills; social and family history; and service use were analyzed. Kaplan-Meier survival analysis and Cox regression were used to examine the association between baseline assessments and duration of homelessness. RESULTS: Eighty-one percent of participants returned to community housing during the follow-up period; the median duration of homelessness was 190 days. Kaplan-Meier survival analysis showed that a shorter duration of homelessness was associated with younger age, current or recent employment, earned income, good coping skills, adequate family support, absence of a substance abuse treatment history, and absence of an arrest history. Cox regression showed that older age group P<.05) and arrest history (P<.01) were the strongest predictors of a longer duration of homelessness. CONCLUSIONS: Identification of risk factors for long-term homelessness can guide efforts to reduce lengths of stay in homeless shelters and to develop new preventive interventions.

Adaptation, Psychological↗

PubMed2005

Differences between early-phase primary psychotic disorders with concurrent substance use and substance-induced psychoses.

CONTEXT: The distinction between a substance-induced psychosis and a primary psychotic disorder that co-occurs with the use of alcohol or other drugs is critical for understanding illness course and planning appropriate treatment, yet there has been little study and evaluation of the differences between these 2 diagnostic groups. OBJECTIVE: To identify key demographic, family, and clinical differences in substance-induced psychosis and primary psychotic disorders diagnosed according to DSM-IV criteria using a research diagnostic instrument for psychiatric and substance use comorbidity. DESIGN: Data on demographic, family, and clinical factors were gathered at baseline as part of a 3-year longitudinal study of early-phase psychosis and substance use comorbidity in New York, NY. SETTING: Psychiatric emergency department admissions. PARTICIPANTS: The study is based on a referred sample of 400 subjects interviewed at baseline. Participants had at least 1 psychotic symptom assessed during administration of the research protocol, had used alcohol and/or other drugs within the past 30 days, and had no psychiatric inpatient history before the past 6 months. Subject race included 43.5% black, 42.0% Hispanic, and 14.5% white or other. MAIN OUTCOME MEASURE: Psychotic disorders defined by the DSM-IV. RESULTS: Overall, 169 (44%) were diagnosed as having substance-induced psychosis and 217 (56%), as having primary psychosis. Significant differences were observed in all 3 domains. Multivariate analysis using logistic regression identified the following 3 key predictors as being greater in the substance-induced group: parental substance abuse (odds ratio [OR], 1.69; 95% confidence interval [CI], 1.00-2.85), a diagnosis of dependence on any drug (OR, 9.41; 95% CI, 5.26-16.85), and visual hallucinations (OR, 2.13; 95% CI, 1.10-4.13). The key predictor of total positive and negative symptom score was greater in the primary psychosis group (OR, 0.96; 95% CI, 0.94-0.97). CONCLUSIONS: Differences in demographic, family, and clinical domains confirm substance-induced and primary psychotic disorders as distinct entities. Key predictors could help emergency clinicians to correctly classify early-phase psychotic disorders that co-occur with substance use.

Adult↗

PubMed2005

Psychometric properties of the Spanish version of two mental health outcome measures: World Health Organization Disability Assessment Schedule II and Lehman's Quality Of Life Interview.

This study presents data on the cultural adaptation to Latino populations of two outcome measures that respond to the need for developing comprehensive instruments for outcome assessments in minority populations. We examined the psychometric properties of outcome measures designed to assess impairment in functioning, and quality of life. Impairment in functioning was measured with the Disability Assessment Schedule II (WHO-DASII) developed by the World Health Organization (1997) and quality of life was measured with A. F. Lehman's (A. F. Lehman, 1983; A. F. Lehman, 1988) shortened Quality of Life Interview (QOLI). Spanish speaking consumers (N = 198) from Fresno (CA), San Antonio (TX) and San Juan (PR) participated in this study. They were recruited from both mental health outpatient clinics and primary care rural clinics. The WHO-DASII showed good to excellent internal consistency in all sites (alpha = .72 to .97) except for one subscale (Self-Care alpha = .47). Test-retest reliability estimates were mostly moderate to substantial (.57 to .83), again with one exception, the Self-Care subscale (.46). For the QOLI internal consistency ranged from .34 to .98 and test-retest reliability ranged from .40 to .86 across all sites. An initial validation strategy using both known-groups and concurrent validity produced promising evidence of the construct validity of both measures. The Spanish versions of the WHO-DASII and the QOLI lend support to the translation and adaptation process to which these instruments were subjected.

Adolescent↗

PubMed2004

The DSM-IV rates of child and adolescent disorders in Puerto Rico: prevalence, correlates, service use, and the effects of impairment.

BACKGROUND: Few prevalence studies in which DSM-IV criteria were used in children in representative community samples have been reported. We present prevalence data for the child and adolescent population of Puerto Rico and examine the relation of DSM-IV diagnoses to global impairment, demographic correlates, and service use in an island-wide representative sample. METHODS: We sampled 1886 child-caretaker dyads in Puerto Rico by using a multistage sampling design. Children were aged 4 to 17 years. Response rate was 90.1%. Face-to-face interviews of children and their primary caretakers were performed by trained laypersons who administered the Diagnostic Interview Schedule for Children, version IV (DISC-IV) in Spanish. Global impairment was measured by using the Children's Global Assessment Scale scored by the interviewer of the parent. Reports of service use were obtained by using the Service Assessment for Children and Adolescents. RESULTS: Although 19.8% of the sample met DSM-IV criteria without considering impairment, 16.4% of the population had 1 or more of the DSM-IV disorders when a measure of impairment specific to each diagnosis was considered. The overall prevalence was further reduced to 6.9% when a measure of global impairment was added to that definition. The most prevalent disorders were attention-deficit/hyperactivity disorder (8.0%) and oppositional defiant disorder (5.5%). Children in urban settings had higher rates than those in rural regions. Older age was related to higher rates of major depression and social phobia, and younger age was related to higher rates of attention-deficit/hyperactivity disorder. Both overall rates and rates of specific DSM-IV/DISC-IV disorders were related to service use. Children with impairment without diagnosis were more likely to use school services, whereas children with impairment with diagnosis were more likely to use the specialty mental health sector. Of those with both a diagnosis and global impairment, only half received services from any source. CONCLUSIONS: Because we used the DISC-IV to apply DSM-IV criteria, the study yielded prevalence rates that are generally comparable with those found in previous surveys. The inclusion of diagnosis-specific impairment criteria reduced rates slightly. When global impairment criteria were imposed, the rates were reduced by approximately half.

Adolescent↗

PubMed2004

Understanding caregivers' help-seeking for Latino children's mental health care use.

BACKGROUND: Latino children have persistent low rates of mental health service use. Understanding the factors that influence caregivers' decisions about whether to use mental health care for their children can help explain why. OBJECTIVE: The objective of this study was to investigate the factors reported by the primary caregiver that could help classify Puerto Rican children into users versus nonusers of mental health services and mental health versus school sector care, among users. SUBJECTS: Data were collected from a random Puerto Rican community sample of caregiver-child dyads. MEASURES: Version-IV of the Computerized Diagnostic Interview for Children (DISC) was used to assess psychiatric disorders in children. The Service Assessment for Children and Adolescents (SACA) was used to examine the types of services used for mental health problems. STATISTICAL METHODS: The Classification and Regression Tree (CART) approach was used to develop a simple model simulating caregivers' decision-making around taking children for mental health care and the setting for care. RESULTS: The classification model of use versus no use of mental health service suggested 3 significant predictors: child's level of impairment, parental concern, and child's difficulty in performing schoolwork. The classification model of sector of care, mental health versus school setting, identified 1 significant predictor, any disruptive disorder diagnosis. CONCLUSION: : Assisting caregivers in linking a child's impairment with need for mental health care might be a mechanism to reduce children's unmet need. Approaches such as CART, used to identify factors predicting consumer choices in marketing, might be useful to select strategies for social campaigns targeted toward decreasing unmet need.

Adolescent↗

PubMed2003

Daily supportive equity in close relationships.

Receiving support in committed relationships has frequently been associated with negative psychological outcomes in the recipient, such as increased distress. The authors hypothesized that these negative effects could be offset by support recipients' reciprocation of support, that is, by creating a sense of supportive equity. To investigate this hypothesis, the authors obtained daily reports of mood and of received and given emotional support from both partners in 85 couples throughout a 4-week period. Reciprocity in support transactions was associated with higher levels of positive mood and lower levels of negative mood. In line with previous research, receiving support without reciprocation was associated with increases in negative mood. Giving support, regardless of receipt, was associated with a decrease in negative mood.

Adult↗

PubMed2002

Witnessing interparental psychological aggression in childhood: implications for daily conflict in adult intimate relationships.

We examined the consequences of witnessing interparental psychological aggression in childhood for daily conflict processes in adult intimate relationships. Both partners in 73 heterosexual couples provided daily diary reports of relationship conflict over a 28-day period. Partners' reports of witnessing mother-to-father and father-to-mother psychological aggression were used to predict exposure to daily relationship conflicts and reactivity to those conflicts (as reflected in end-of-day anger). Results showed no evidence of exposure effects: Witnessing interparental psychological aggression was unrelated to the number of conflict days reported by either partner. Reactivity effects emerged for males only, with father's aggression predicting increased reactivity and mother's aggression predicting the opposite. However, we found evidence of direct or unmediated effects of interparental conflict on daily anger for both males and females. Mirroring the reactivity pattern, the same-sex parent's psychological aggression predicted greater daily anger, whereas the opposite-sex parent's aggression predicted less daily anger. These effects emerged independently of Big Five measures of personality; moreover, Big Five measures did not predict outcomes independently of interparental aggression.

Adult↗

PubMed2002

Mediation in experimental and nonexperimental studies: new procedures and recommendations.

Mediation is said to occur when a causal effect of some variable X on an outcome Y is explained by some intervening variable M. The authors recommend that with small to moderate samples, bootstrap methods (B. Efron & R. Tibshirani, 1993) be used to assess mediation. Bootstrap tests are powerful because they detect that the sampling distribution of the mediated effect is skewed away from 0. They argue that R. M. Baron and D. A. Kenny's (1986) recommendation of first testing the X --> Y association for statistical significance should not be a requirement when there is a priori belief that the effect size is small or suppression is a possibility. Empirical examples and computer setups for bootstrap analyses are provided.

Guidelines as Topic↗

PubMedDate not supplied

What changes in infant walking and why.

This study compared the relative contributions of growing body dimensions, age, and walking experience in the development of walking skill in 9- to 17-month-old infants (N = 210), 5-6-year old kindergartners (N = 15), and college students (N = 13). Kinematic measures derived from participants' footprints showed characteristic improvements in walking skill. As children became bigger, older, and more experienced, their steps became longer, narrower, straighter, and more consistent. Improvements reflected a narrowing base of support and increasing control over the path of progression. Although both infants' age and the duration of their walking experience contributed to improvements in walking skill, experience was the stronger predictor. This finding suggests that practice is the more important developmental factor for helping infants to conquer their weak muscles and precarious balance.

Child↗