PubMed Health⌕ Search

Biomedical subjects

R Longabaugh

Publications and source records attributed to R Longabaugh.

17 recordsLinked to original sources
PubMed1992

The relationship of pretreatment family functioning to drinking behavior during follow-up by alcoholic patients.

The relationship of alcoholics' perceptions of the pretreatment functioning of their families to drinking outcomes during an 18-month follow-up was examined. Family functioning was hypothesized to be predictive of drinking behavior, particularly in subjects with low assertion of autonomy scores. These individuals report greater dependency and attachment, and therefore might be more affected by the state of important relationships. The results indicated that with low autonomy male alcoholics, greater family dysfunction predicted significantly fewer days abstinent during Months 1-6 and 13-18 and more severe drinking episodes during the first year of the follow-up. In the high autonomy males, family dysfunction was unrelated to subsequent drinking behavior. In women, on the other hand, greater family dysfunction predicted more days abstinent in those high in autonomy and was unrelated to the drinking behavior of those low in autonomy. Implications for patient-treatment matching, differences between male and female alcoholics, and the need for additional studies of family functioning and drinking behavior in women are discussed.

Adult↗
PubMed1991

Liver function tests and neuropsychologic impairment in substance abusers.

The relationship between residual neuropsychologic dysfunction in alcoholics and subtle changes in liver function during acute phases of treatment was examined. Noncirrhotic alcoholics who exhibited extreme elevations in the liver enzyme gamma-glutamyl transferase (GGT) were found to have greater impairments in tasks of visuoperceptual and conceptual abilities when compared to alcoholics with normal or only mild elevations in GGT. The relationship between acute liver dysfunction and residual neuropsychologic impairment appeared to be independent of age and patterns of drinking. The implications of these findings in relation to treatment planning and prognosis of alcoholics are discussed.

Adult↗
PubMed1991

The cost effectiveness of treatment for alcoholism: a first approximation.

This study undertakes an analysis of cost effectiveness of alcoholism treatment modalities based upon (1) findings from clinical trials, (2) costs for treatment in settings and/or by providers and (3) recommendations from treatment experts about appropriate settings, providers and treatment events. This analysis, which assumes a prototypic patient, suggests that modalities with the most evidence of effectiveness (based on three or more clinical trials) are not the most expensive. Within this study, total cost of care was negatively related to effectiveness. Modalities categorized as having insufficient evidence of effectiveness (i.e., lacking three or more clinical trials) are in the higher cost categories. The results of this first effort to establish initial cost/effectiveness considerations are intended to stimulate researchers to conduct the types of clinical studies where both cost and effectiveness are carefully measured to increase the scientific basis for future cost/effect policy considerations. The authors expect future clinical studies will revise the results of this initial effort.

Alcoholism↗
PubMed1990

Determinants of neuropsychological impairment in antisocial substance abusers.

Persons displaying Antisocial Personality Disorder (ASP) may be at risk for neuropsychological impairment due to a number of developmental and later life experiences to which they are prone. Thirty substance abusers meeting research criteria for ASP were compared to a demographically matched non-ASP cohort on neuropsychological test performance. The ASP subjects were found to have a higher prevalence of neuropsychological deficit. The groups were then compared on factors which might lead to brain impairment. Presence of ASP was associated with earlier and heavier past drinking patterns, more negative health and behavioral effects of alcohol abuse, and greater abuse of other drugs in addition to alcohol. The ASP alcoholics also reported a high prevalence of serious head injury (58%), although they did not differ from non-ASP alcoholics in this regard. Implications for the neuropsychology of alcoholism and for treatment are discussed.

Adult↗
PubMed1989

Risk factors for neuropsychological impairment in alcoholics: antisocial personality, age, years of drinking and gender.

One hundred eighty-two alcoholics were studied using subtests from the Halstead-Reitan Neuropsychological Battery, Wechsler Adult Intelligence Scale and the Wechsler Memory Scale. Alcoholics who displayed antisocial personality disorder (ASPD) were more impaired on the Brain Age Quotient, a summary measure of neuropsychological impairment. Multivariate analyses indicated that presence of ASPD contributed significantly to this impairment, independent of age, length of drinking history or gender. Discriminant analysis using these variables as predictors allowed for clinically useful levels of prediction of neuropsychological impairment in individual subjects.

Adult↗
PubMed1988

An outcome monitoring system for psychiatric inpatient care.

As the national impetus for examining treatment outcomes increases, the demand for cost-effective systems for psychiatric outcome monitoring grows. This article describes one local effort to develop a monitoring system at Butler Hospital in Providence, Rhode Island. The system uses a combination of face-to-face and computer interviews of a random sample of recently admitted inpatients, with follow-up interviews one month postdischarge and one year following admission. The patient self-report data and interviewer assessment data generated by these interviews are used to quantify patient symptoms and social functioning. With a large enough sample, these findings can be used to identify areas where patient care may be improved. The article also discusses the process and problems involved in implementing the monitoring system and presents illustrative preliminary findings.

Hospital Bed Capacity, 100 to 299↗
PubMed1978

The paradoxical underutilization of partial hospitalization.

Partial hospitalization continues to be underutilized even though its clinical effectiveness for a variety of psychiatric patients has been demonstrated. The authors investigated the potential economic advantage of partial hospitalization by comparing matched groups of day hospital patients and inpatients who had comparable symptoms and prognoses on admission. They present one-year follow-up data documenting the comparability of the study groups on clinical outcome measures and the cost advantages favorable the partial hospitalization group. They discuss possible causes of the paradoxical underutilization of the clinically effective and lower-cost partial hospitalization, which include institutional factors, patients' clinical characteristics, family resistance, and clinician bias.

Adolescent↗
PubMed1975

The problem-oriented record. Problem definition.

A problem is defined when the clinician judges a dysfunction is apparent or highly probable for the patient in one or more of three areas: physiological, psychological, or social functioning. In defining specific problems, data assessments are often confounded with the data themselves. To "lump" or "split" problems in psychiatry should be by theoretical and practical considerations. Problem indicators should be "split" when the clinician believes they are not different indicators of the same problem or treatments for the problem indicators will be different. They can be "lumped" when the clinician believes they are different indicators of the same problem, or when the treatment will be the same. Criteria supporting the belief of a single problem construct are met when indicators co-vary, are functionally equivalent, or respond similarly to the same treatment variable.

Communication↗