Biomedical subjects

R J McNally

Publications and source records attributed to R J McNally.

At least 19 recordsLinked to original sources

PubMed2001

Temporal increases in the incidence of childhood solid tumors seen in Northwest England (1954-1998) are likely to be real.

BACKGROUND: There has been speculation that increasing trends in incidence of childhood central nervous system tumors and infant neuroblastoma in the United States have been due to diagnostic improvements or reporting changes. To investigate whether or not such trends could be explained in this way in the U.K., the authors used population-based data from Northwest England to analyze incidence trends in childhood solid tumors. METHODS: Cases were diagnosed during 1954-1998 and were grouped according to a morphology-based classification scheme. More than 95% of diagnoses were based on special histopathologic review. Tissue sections were retained, and diagnoses were rereviewed to ensure consistency in classification throughout the time period. Age-, gender- and period-specific incidence rates were calculated. Analyses were performed with chi-square tests and Poisson regression. RESULTS: There was an overall increase in the incidence of all childhood solid tumors of 0.9% each year. A temporal increase was found in childhood brain tumors characterized by, in particular, annual increases of 1% in pilocytic astrocytoma, 1% in primitive neuroectodermal tumors, and 2.3% in miscellaneous gliomas. The incidence of germ cell tumors increased at a rate of 2.6% each year. CONCLUSIONS: These increases could not be attributed to changes in diagnostic practice, and it is unlikely that the increases were due to changes in reporting practice. Further, the restriction of the increases to certain groups, with stable rates in others, argued against the changes being artifactual. The authors concluded that the increases in incidence were likely to be real.

Central Nervous System Neoplasms↗

PubMed2001

Relative frequency and morphology of cancers in carriers of germline TP53 mutations.

The spectrum and frequency of cancers associated with germline TP53 mutations are uncertain. To address this issue a cohort of individuals from 28 families with Li-Fraumeni syndrome, segregating germline TP53 mutations was established. Predicted cancers were estimated by applying age, morphology, site and sex-specific UK cancer statistics to person-years at risk. Observed and predicted cancers were compared and two-sided P-values calculated. Cancer types occurring to excess and showing P-values <0.02, were designated strongly associated with germline TP53 mutations. These were removed from the data and a second round of analyses performed. Cancer types with P-values <0.02 and 0.02-0.05 in the second round analyses were considered moderately and weakly associated respectively. Strongly associated cancers were: breast carcinoma, soft tissue sarcomas, osteosarcoma, brain tumours, adrenocortical carcinoma, Wilms' tumour and phyllodes tumour. Carcinoma of pancreas was moderately associated. Leukaemia and neuroblastoma were weakly associated. Other common carcinomas including lung, colon, bladder, prostate, cervix and ovary did not occur to excess. Although breast carcinoma and sarcomas were numerically most frequent, the greatest increases relative to general population rates were in adrenocortical carcinoma and phyllodes tumour. We conclude that germline TP53 mutations do not simply increase general cancer risk. There are tissue-specific effects.

Adolescent↗

PubMed2001

Tertullian's motto and Callahan's method.

The purposes of this commentary are to provide a critique of Callahan's (this issue) article on Thought Field Therapy (TFT) and to discuss when our commitment to intellectual open-mindedness requires that we attend to nontraditional treatment interventions in clinical psychology.

Heart Rate↗

PubMed2001

Anxiety sensitivity index: normative data and its differentiation from trait anxiety.

In the present study we report: (1) normative data on the Spanish version of the Anxiety Sensitivity Index (ASI); and (2) empirical evidence related to differentiation between the constructs of anxiety sensitivity and trait anxiety. A sample of 390 university students (ranging in age from 18 to 34 years) completed the ASI and Spielberger's Trait Anxiety Scale (STAI-T). The means and standard deviations for the Spanish version of the ASI are similar to the ones reported by Peterson and Reiss (Anxiety Sensitivity Index Manual, 2nd edition. Worthington, OH: International Diagnostic Systems, 1992) for the English version. Factor analysis of the joint ASI and STAI-T items yielded two different factors; the STAI-T items load onto one factor (i.e., the trait anxiety factor) and the ASI items load onto the other factor (i.e., the anxiety sensitivity factor). Findings provide empirical support for validation of the Spanish ASI and are consistent with a construct distinction between anxiety sensitivity and trait anxiety.

Adolescent↗

PubMed2001

On Wakefield's harmful dysfunction analysis of mental disorder.

Wakefield's harmful dysfunction analysis of mental disorder is among the most rigorous and thoughtful attempts to address serious conceptual problems that beset the foundations of abnormal psychology. According to Wakefield, disorder is a hybrid concept comprising a factual component specifying derangement in a naturally-selected function, and a value component specifying the resultant harm. It is unclear, however, whether an evolutionary interpretation of dysfunction is either feasible or necessary; a nonhistorical causal role analysis of psychological function may enable ascription of disorder (assuming resultant harm). Moreover, the dysfunction component itself appears hybrid, comprising both a factual assertion about the state of a mechanism and a normative assertion implying that the mechanism is not functioning as it ought be.

Adaptation, Psychological↗

PubMed2001

On the scientific status of cognitive appraisal models of anxiety disorder.

The cognitive paradigm for understanding and treating anxiety disorders comprises two distinct and potentially incompatible approaches: appraisal and information-processing. Advocates of the latter approach have sharply criticized the scientific adequacy of the appraisal models popularized by cognitive therapists. The purpose of this essay is to provide a reappraisal of these critiques of appraisal, and to defend an argument for methodological pluralism.

Anxiety Disorders↗

PubMed2001

The voice of emotional memory: content-filtered speech in panic disorder, social phobia, and major depressive disorder.

We asked patients with either panic disorder, social phobia, or major depressive disorder and healthy control participants to describe their most frightening experience and to describe an emotionally neutral experience. Both fear and neutral autobiographical memories were audiotaped and processed through a low-pass filter that eliminated frequencies above 400 Hz, thereby abolishing semantic content but leaving paralinguistic aspects like rate, pitch, and loudness intact, and these convey emotional cues. Raters blind to content and diagnosis rated the content-filtered speech clips on emotional dimensions. The results revealed that content-filtered fear memories received significantly higher ratings on anxious, aroused, and dominant (but not sad or negative) scales than did content-filtered neutral memories, irrespective of the diagnostic status of the speaker. Content-filtered speech appears promising as an on-line probe of emotional processing during accessing of autobiographical memories.

Adult↗

PubMed2001

Emotion- and intrusion-based reasoning in Vietnam veterans with and without chronic posttraumatic stress disorder.

Patients suffering from anxiety disorders other than posttraumatic stress disorder (PTSD) interpret anxiety responses themselves as evidence that threat is impending: "if anxiety, then threat" (Arntz, Rauner, & van den Hout, 1995, Behaviour Research and Therapy, 33, 917-925). This "emotion-based reasoning" (ER) may render a disorder self-perpetuating. Analogous to ER, danger might also be inferred from the presence of intrusions: "intrusion-based reasoning" (IR). The aims of this study were to test whether ER and IR are involved in chronic PTSD. Vietnam combat veterans with or without PTSD or other anxiety disorders rated perceived danger of brief scenarios in which information about objective danger (danger vs safety) and response (anxiety/intrusions vs non-distressing emotion) was systematically varied. Two series were administered: ER-scenarios were non-specific for PTSD and IR-scenarios were specific for PTSD. Relative to control participants, PTSD patients engaged in both ER and IR: whereas veterans without PTSD inferred the danger of scenarios from objective stimulus information, veterans with PTSD also inferred danger from the presence of anxiety or intrusions. Further analyses showed that these effects were largely mediated by perceived uncontrollability.

Anxiety↗

PubMed2001

Missing the forest for the trees? Deficient memory for linguistic gist in obsessive-compulsive disorder.

BACKGROUND: Patients with obsessive-compulsive disorder (OCD) exhibit recall deficits on word learning tasks, mediated by their failure to detect semantic connections among the words. METHODS: In the present experiment, using methods devised by Bransford & Franks (1971), we tested whether this encoding problem impairs their extraction of gist from complex linguistic material. RESULTS: Consistent with our hypothesis, OCD patients extracted less gist from related sentences than did healthy participants. The groups did not differ in recognition memory for individual sentences or in criterion for affirming previously encountered sentences as 'old', as evinced by signal detection indices of memory sensitivity (d') and response bias (beta), or in recognition memory confidence. CONCLUSIONS: These data provide further evidence that OCD patients exhibit less reliance on organizational strategies than do healthy control participants. These data are consistent with neuropsychological research suggestive of prefrontal executive problems in OCD.

Adult↗

PubMed2001

Directed forgetting of trauma cues in adults reporting repressed or recovered memories of childhood sexual abuse.

An item-cuing directed forgetting task was used to investigate whether women reporting repressed (n = 13) or recovered (n = 13) memories of childhood sexual abuse (CSA) exhibit an avoidant encoding style (and resultant impaired memory) for trauma cues relative to women reporting no CSA experience (n = 15). All participants viewed intermixed trauma (e.g., molested), positive (e.g., confident), and categorized neutral (e.g., mailbox) words on a computer screen and were instructed either to remember or to forget each word. The results provided no support for the hypothesis that people reporting either repressed or recovered memories of CSA are especially adept at forgetting words related to trauma. These groups recalled words they were instructed to remember more often than words they were instructed to forget regardless of whether they were trauma related.

Adult↗

PubMed2001

Examination of temporal trends in the incidence of childhood leukaemias and lymphomas provides aetiological clues.

The age-sex distributions and temporal trends in incidence of leukaemia and lymphoma from the Manchester Children's Tumour Registry (MCTR), 1954-1998, are reported. This 45-year study includes 1795 children, all of whom had a histologically and/or cytologically verified leukaemia or lymphoma. At the time of their diagnoses all the children were under 15 years of age and were resident in a geographically defined area of northwest England covered by the MCTR. Log-linear modelling identified significant linear increases in acute lymphoblastic leukaemia (ALL) (average annual increase 0.7%; P= 0.005) and in Hodgkin's disease (HD) (1.2%, P=0.04), but not in acute myeloid leukaemia (AML), nor in non-Hodgkin's lymphoma (NHL). The increase in ALL was most pronounced amongst males, aged 1-4 years, and is likely to be due to precursor B-cell leukaemias. The increases in ALL and HD are discussed in relation to current hypotheses suggesting a role for infection. Additionally, a non-linear cohort effect was identified for NHL (P= 0.008), which may indicate the involvement of environmental factors other than infection.

Acute Disease↗

PubMed2001

The anxiety sensitivity index: item analysis and suggestions for refinement.

Anxiety sensitivity is the fear of anxiety-related sensations, and is measured by the 16-item Anxiety Sensitivity Index (ASI). Despite the popularity and utility of the ASI in research, a number of studies have provided evidence for the inadequacy of several items, and item-to-scale correlations for the ASI have not been published. In this study, a converging set of analyses to evaluate the item adequacy and factor structure of the ASI was used. The results of these multiple analyses converged nicely suggesting that Items 1, 5, 7, 8, and 13 should be considered for removal from the instrument. The impact of removing these problematic items from the scale was explored through the reanalysis of data from 3 previously published studies that compared the original ASI with the new 11-item version (the ASI minus the 5 problematic items). The results of these analyses suggest that the 2 scales function comparably in many respects but that the new version may be a more precise measure of anxiety sensitivity. The 11-item ASI appears to tap 2 primary aspects of anxiety sensitivity: fears of somatic sensations of anxiety and fears of loss of mental control. Suggestions for further development of the ASI are offered.

Adult↗

PubMed2000

Incidence of childhood precursor B-cell acute lymphoblastic leukaemia in north-west England.

A temporal increase in the incidence of childhood acute lymphoblastic leukaemia (ALL) in the UK has been noted. We present data from the Manchester Children's Tumour Registry which provide strong evidence that the increase is a result of an increase in the precursor B-cell subtype. In the childhood peak (age 1-4 years), the annual increase in precursor B-cell ALL between 1980 and 1998 was 3.0% (p=0.024). Recent findings are consistent with the causal involvement of infections in precursor B-cell ALL.

Adolescent↗

PubMed2000

Film-induced sadness as a trigger for disinhibited eating.

OBJECTIVE: We tested whether film-induced sadness enhances food intake in restrained eaters. METHOD: Female participants scoring either high or low on a measure of dietary restraint viewed two film segments in counterbalanced order on successive days: an emotionally neutral travelogue and a sad film depicting the death of the young female protagonist. RESULTS: Contrast analyses revealed that film-induced sadness significantly reduced food intake in low-restraint individuals, but only nonsignificantly increased it in high-restraint individuals. DISCUSSION: When sadness is induced without an apparent ego threat, high-restraint participants may not exhibit as much disinhibited eating as when they are exposed to mood inductions that threaten their self-esteem.

Adult↗

PubMed2000

Personality profiles, dissociation, and absorption in women reporting repressed, recovered, or continuous memories of childhood sexual abuse.

Women reporting either repressed, recovered, or continuous memories of childhood sexual abuse or no abuse history completed questionnaires tapping personality traits, absorption (fantasy proneness), dissociation, depression, and posttraumatic stress. Planned contrasts indicated that recovered memory participants scored higher on absorption and dissociation than did those reporting either continuous memories or no abuse history; repressed memory participants scored nonsignificantly higher than did recovered memory participants. On measures of distress, continuous memory participants were indistinguishable from nonabused participants, repressed memory participants scored highest, and recovered memory participants scored midway between continuous and repressed memory participants.

Adolescent↗

PubMed2000

Space-time clustering patterns in childhood leukaemia support a role for infection.

Previous studies of space-time clustering in childhood leukaemia have produced equivocal and inconsistent results. To address this issue we have used Manchester Children's Tumour Registry leukaemia data in space-time clustering analyses. Knox tests for space-time interactions between cases were applied with fixed thresholds of close in space, <5 km and close in time <1 year apart. Addresses at birth as well as diagnosis were utilized. Tests were repeated replacing geographical distance with distance to the Nth nearest neighbour. N was chosen such that the mean distance was 5 km. Data were also examined by a second order procedure based on K-functions. All methods showed highly significant evidence of space-time clustering based on place of birth and time of diagnosis, particularly for all leukaemias aged 0-14 and 0-4 years, and acute lymphoblastic leukaemia (ALL) 0-4 years. Some results based on location at diagnosis were significant but mainly gave larger P-values. The results are consistent with an infectious hypothesis. Furthermore, we found an excess of male cases over females involved in space-time pairs. We suggest this may be related to genetic differences in susceptibility to infection between males and females. These findings provide the basis for future studies to identify possible infectious agents.

Adolescent↗

PubMed2000

False recognition in women reporting recovered memories of sexual abuse.

False recognition--the mistaken belief that one has previously encountered a novel item--was examined in four groups of subjects: women reporting recovered memories of childhood sexual abuse, women who believe that they were sexually abused as children but who cannot recall this abuse (the "repressed" group), women who were sexually abused as children and always remembered the abuse, and women with no history of childhood sexual abuse. Subjects were administered a Deese/Roediger-McDermott paradigm. The results suggest that the recovered-memory group was more prone to false recognition than the other groups. In addition, women reporting recovered and repressed memories showed greater reduction in false recognition across study trials than did other subjects, perhaps reflecting strategic changes in performance.

Adult↗

PubMed2000

Cognitive processing of trauma cues in adults reporting repressed, recovered, or continuous memories of childhood sexual abuse.

Psychologically traumatized people exhibit delayed color naming of trauma words in the emotional Stroop task. Four groups of participants were asked to color name positive words, neutral words, and trauma words; these groups included 15 women who believed that they harbored repressed memories of childhood sexual abuse (CSA), 13 women who reported recovered memories of CSA, 15 women who had never forgotten their CSA, and 12 women who had never been abused. Repressed-memory participants exhibited patterns of interference indistinguishable from those of the nonabused control group participants. Irrespective of group membership, the severity of self-reported posttraumatic stress disorder symptoms was the only significant predictor of trauma-related interference, r(48) = .30, p < .05.

Adult↗