Biomedical subjects
Publications and source records attributed to R A Sansone.
The case is reported of a 5 year old boy who was pressured to lose weight in order to wrestle at a lower weight class. Although a minority of athletes engage in unhealthy weight management practices, this is an unusual case because of the age of the athlete and the influential role of a parent.
OBJECTIVES: This study was designed to explore the prevalence and types of stipulations (such as clarifications or changes) required of investigators by the institutional review board (IRB) of one institution over a five year period. DESIGN: Stipulations to research proposals (n = 124) were documented from the minutes of the IRB meetings. SETTING: Community hospital. PARTICIPANTS: IRB submissions. MAIN MEASUREMENTS: Number and type of IRB stipulations. RESULTS: Nineteen research submissions (15.3%) were approved without any stipulations. For the remainder, the majority of stipulations related to consent forms (74.2%). CONCLUSIONS: Consent forms appear to be at highest risk for IRB stipulations. Being aware of high risk areas before submission of research proposals may reduce the frequency of stipulations required of investigators.
OBJECTIVE: The purpose of this study was to examine the relationships among body weight, borderline personality symptomatology, and several measures of body image among women presenting for psychiatric evaluation. METHOD: Forty-eight women in a university-based psychiatric outpatient clinic completed the borderline personality scale of the Personality Diagnostic Questionnaire-Revised (PDQ-R) and several measures of body image and indicated lifetime prevalence of depression histories. RESULTS: PDQ-R scores correlated (r = 0.44, p < 0.01) with body mass index (BMI). Also, there were significant relationships between PDQ-R scores and measures of body image even after controlling for BMI. DISCUSSION: In a psychiatric outpatient setting, borderline personality symptomatology is associated with higher body weight as well as body-image issues that are not necessarily due to larger body size.
In this study we explored among males a possible relationship between recollection of adult body weights and a history of sexual abuse prior to the age of 15. Using a survey format, 34 men hospitalized in an acute care psychiatric facility completed measures. Of the men who acknowledged sexual abuse (n=9), all reported their lowest, highest, and perceived ideal body weight, compared with non-sexually abused men of whom only 80%, 48%, and 52%, respectively, reported the requested weight information. It may be that sexual abuse among men during childhood results in heightened body awareness in adulthood.
This study explores the relationship between obesity and borderline personality symptomatology in two clinical settings: a psychiatric vs primary care setting. The body mass indices (BMI) of 48 women from a psychiatric outpatient setting and 83 women from a primary care setting were calculated. Each participant completed the borderline personality scale of the Personality Diagnostic Questionnaire-Revised (PDQ-R). While BMI and PDQ-R were moderately related in the psychiatric sample (r=0.43, P<0.01), there was a lack of association between these variables in the primary care sample (r=0.04, P>0.05). In conclusion, women's increasing body weight appears to have some degree of correlation to borderline personality symptomatology among psychiatric patients, whereas it apparently does not among primary care patients.
Support groups are reported as helpful for some individuals with eating disorders. Such groups enable information sharing as well as support with recovery. For clinicians with small numbers of eating disorder patients in their practices, support groups within the practice are not feasible. However, with the availability of the internet, clinicians may facilitate support between two or more similarly afflicted patients through an e-mail connection. The selection and matching of patients is described, as well as the potential benefits and risks of this type of adjunctive intervention. Overall, this type of support appears to be a positive experience for patients.
OBJECTIVE: To determine if demographic differences exist in patients with depressive symptoms as the principal reason for visits to primary care physicians (PCP) versus psychiatrists. To estimate the likelihood of these patients receiving a range of mental health services from each provider group. METHODS: Review and analysis of all outpatient visits made by patients with depressive symptoms using the National Ambulatory Medical Care Surveys (NAMCS) conducted in 1995 and 1996. RESULTS: A significantly greater proportion of visits by persons with depressive symptoms as the principal reason for visit were made to psychiatrists than to primary care physicians (T = -3.56, p = .000). However, men, African-Americans, other Non-White persons, and persons aged 65 to 74 and 75 years and over were proportionately more likely to visit a PCP than a psychiatrist. Women, whites, and persons aged 45 to 64 were proportionately more likely to make a visit to a psychiatrist than to a PCP. The overall intensity of care delivered by PCPs for patients with depressive symptoms was significantly lower than that provided by psychiatrists (t = -2.03, p = .02). Analysis of individual services also revealed significant differences in service provision. CONCLUSIONS: Demographic differences among the patient caseloads of these physician groups have implications for mental health service delivery because of known distinctions in prevalence rates, symptom presentation, and functionality among depressed patient subgroups.
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OBJECTIVE: This study was designed to explore the relationship between three types of abuse in childhood and their relationship to somatic preoccupation, in general and by body area, in adulthood. METHOD: Eighty-five women in an internal medicine clinic completed self-report measures of childhood sexual, physical, and emotional abuse as well as the Bradford Somatic Inventory. RESULTS: Using simple correlations, all three types of abuse were positively related to current somatic preoccupation. Using multiple regression analysis that included demographic variables (education and age) and the three forms of childhood abuse, only the demographic variables and sexual abuse were uniquely predictive of somatic preoccupation. To determine the relationship between childhood abuse and somatic symptoms based on body area (head, chest, stomach, throat) and fatigue, a series of multiple regression analyses were performed. The chest and throat areas were significant, but no abuse variable was uniquely predictive. CONCLUSIONS: Among females in adulthood, all studied forms of abuse in childhood appear to contribute to general somatic preoccupation, as well as specific somatic symptoms in the chest and throat areas. Sexual abuse, specifically, is a unique predictor for general somatic preoccupation, but not necessarily specific body areas.
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Somatic preoccupation has been associated with a variety of comorbid psychiatric conditions including childhood trauma, personality disorder, and depression. The current study was undertaken to simultaneously explore the inter-relationship of these psychiatric variables as conceptualized in a path model. Participants (N = 120), both men and women, seen for nonemergent health care in a resident-staffed internal medicine clinic, were given questionnaires exploring the presence of childhood trauma, borderline personality symptomatology, current depression, worry, and somatic preoccupation. With one exception, all simple correlation coefficients among study variables were relatively substantial. By sequencing variables into an a priori model and using a path analytic approach, several indirect and direct relationships among variables were evident. Most important, childhood trauma exhibited a direct effect on somatic preoccupation as well as indirect effects through borderline personality disturbance and current depression. These data suggest that childhood trauma may be a precursor for somatic preoccupation during adulthood.
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OBJECTIVES: This study was designed to examine the potential relationship of family factors to somatic preoccupation. METHOD: A total of 116 internal medicine patients completed research booklets exploring perceptions of parents' health, childhood trauma, borderline personality symptomatology [Personality Diagnostic Questionnaire-Revised (PDQ-R)], and somatic preoccupation (Bradford Somatic Inventory). RESULTS: Simple correlations revealed that most of the relationships between somatic preoccupation and remaining study variables were statistically significant (e.g., poor parental health status correlated to somatic preoccupation). Using path analysis, poor perception of mother's health demonstrated an indirect effect on somatic preoccupation via borderline personality symptomatology, whereas, poor perception of father's health demonstrated an indirect effect on somatic preoccupation via childhood trauma. Neither parents' health status demonstrated direct effects on somatic preoccupation. CONCLUSIONS: There appear to be parent gender differences in the mediation of the relationship between poor parental health status and somatic preoccupation in the offspring. The implications of these findings are discussed.
Through a MEDLINE and PsycLIT database search, all US studies relating to the prevalence of borderline personality disorder (BPD) among obese individuals were reviewed. The highest rates of BPD among these individuals were found in samples recruited from psychologically oriented settings (i.e., eating disorders program, mental health setting). Lowest rates were found among those seeking weight loss in non-psychological programs or those in primary care settings. Among those studies examining individuals with binge-eating disorder (BED), all indicated a higher-than-community prevalence of BPD. These data suggest that the prevalence of BPD appears increased among those obese individuals seeking psychological care or who have BED.
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In an attempt to explore the possibly adaptive function obesity may serve for some women with histories of sexual trauma, we examined relationships among sexual abuse history, body dissatisfaction, and maximum weight fluctuation among obese (n = 38; Body Mass Index > or = 27.3) and nonobese (n = 112; Body Mass Index < 27.3) women sampled from a primary care medical setting. History of sexual abuse was unrelated to current body weight within the entire sample, as well as the nonobese and the obese subsamples. However, the interaction between obesity and sexual abuse was statistically significant in the prediction of both current/ideal body-weight discrepancy (i.e., body dissatisfaction) and maximum weight fluctuation during adulthood. Among nonobese women, history of sexual abuse was unrelated to current body dissatisfaction but was related to greater maximal weight fluctuation during adulthood. Among obese women, those with a history of sexual abuse reported relatively less current body dissatisfaction and less weight fluctuation during adulthood compared to nonsexually-abused obese women. Results are discussed with regard to the potential adaptive function obesity may play for some sexually abused women and the need for additional research using larger, more diverse samples and more elaborate measures.