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Biomedical subjects

Robert H Pietrzak

Publications and source records attributed to Robert H Pietrzak.

13 recordsLinked to original sources
PubMed2025

Developmental timing of index trauma exposure and accelerated epigenetic aging in United States military veterans.

Trauma exposure has been linked to accelerated GrimAge, an epigenetic biomarker of premature morbidity and mortality. Building on this evidence, the present study examined whether the type and timing of index trauma exposure are differentially associated with accelerated GrimAge. Participants were 873 European American male United States military Veterans from the National Health and Resilience in Veterans Study. We investigated associations between self-reported age at index trauma, index trauma type (interpersonal violence, non-interpersonal trauma, or loss/instability/other), and accelerated GrimAge, operationalized as GrimAge exceeding chronological age by five or more years. Results revealed that interpersonal violence was associated with three-fold greater odds of accelerated GrimAge compared to other trauma types. Age at index trauma was not independently associated with accelerated GrimAge. However, we observed a significant interaction between trauma type and its developmental timing, even after adjusting for index trauma recency, cumulative trauma burden, and other potential confounders. Specifically, Veterans who were older at the time of exposure to interpersonal violence or trauma involving loss or instability had higher odds of accelerated GrimAge. In contrast, exposure to non-interpersonal trauma was more strongly associated with accelerated GrimAge when it occurred at younger ages. These results indicate that trauma type and timing jointly influence epigenetic aging in Veterans, highlighting the need for tailored interventions that address specific trauma characteristics to reduce associated long-term health risks in this population.

Humans↗
PubMed2006

Gambling level and psychiatric and medical disorders in older adults: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

OBJECTIVE: This study examined the association between gambling level and psychiatric and medical disorders in a nationally representative sample of older adults. METHOD: Data on 10,563 U.S. older adults (age 60 or older) were analyzed from the National Epidemiologic Survey on Alcohol and Related Conditions. RESULTS: A total 28.74% of older adults were lifetime recreational gamblers and 0.85% were lifetime disordered gamblers. Compared with older adults without a history of regular gambling, recreational gamblers had significantly elevated rates of alcohol (30.1% versus 12.8%), nicotine (16.9% versus 8.0%), mood (12.6% versus 11.0%), anxiety (15.0% versus 11.6%), and personality disorders (11.3% versus 7.3%) and obesity (25.6% versus 20.8%), but were less likely to have past-year diagnoses of arteriosclerosis (4.7% versus 6.0%) or cirrhosis (0.2% versus 0.4%). Disordered gamblers were significantly more likely than older adults without a history of regular gambling to have alcohol (53.2% versus 12.8%), nicotine (43.2% versus 8.0%), drug (4.6% versus 0.7%), mood (39.5% versus 11.0%), anxiety (34.5% versus 11.6%), and personality (43.0% versus 7.3%) disorders, and to have past-year diagnoses of arthritis (60.2% versus 44.3%) or angina (22.7% versus 8.8%). These results remained significant even after controlling for demographic, psychiatric, and behavioral risk factors. CONCLUSIONS: Lifetime recreational gamblers were more likely than nonregular gamblers to have psychiatric disorders but were less likely to have some medical conditions. Lifetime disordered gamblers had a range of lifetime psychiatric disorders and were more likely than nonregular gamblers to have past-year diagnoses of angina and arthritis.

Adaptation, Psychological↗
PubMed2006

Pre/early adolescent onset of gambling and psychosocial problems in treatment-seeking pathological gamblers.

This study examined the association between pre- or early-adolescent onset of gambling and severity of gambling and psychosocial problems in treatment-seeking adult pathological gamblers. A total of 236 pathological gamblers entering outpatient treatment completed the South Oaks Gambling Screen (SOGS) and the Addiction Severity Index (ASI). Using a quartile split procedure, gamblers who began gambling during their pre- or early-adolescent years (mean age of 10.5 years; 1st quartile) were compared to gamblers who began gambling later in life (mean age of 23.0 years; 2nd to 4th quartiles). Compared to later onset gamblers, pre/early adolescent onset gamblers reported increased severity of psychiatric, family/social, and substance abuse problems on the ASI. They were more likely to report cognitive problems (trouble understanding, concentrating, or remembering), suicidal ideation, and a history of inpatient psychiatric treatment, and were less likely to be satisfied with their current living situation. Pre/early adolescent onset gamblers also reported earlier age of initiation of drinking, and were more likely to have received treatment for an alcohol use disorder, and to have used cannabis and cocaine in their lifetimes. Taken together, these data suggest that pre/early adolescent-onset of gambling may be a risk factor for later-life psychiatric, family/social, and substance abuse problems in treatment-seeking pathological gamblers.

Adolescent↗
PubMed2006

Cognitive effects of immediate-release methylphenidate in children with attention-deficit/hyperactivity disorder.

A growing body of literature has examined the cognitive effects of immediate-release methylphenidate in children with attention-deficit/hyperactivity disorder (ADHD). However, a clear understanding of the types and magnitude of such effects are difficult to discern from such a large and varied collection of published reports. This review evaluated a total of 40 relevant placebo-controlled studies published since Rapport and Kelly's [1993. Psychostimulant effects on learning and cognitive function. In: Matson, J.L. (Ed.), Handbook of Hyperactivity in Children. Allyn & Bacon, Boston, pp. 97-136] original review of cognitive effects of methylphenidate in children with ADHD. Of these published studies, 63.5% identified some improvement in cognitive function following methylphenidate treatment. Methylphenidate improved performance on saccadic eye movement, planning/cognitive flexibility, attention/vigilance, and inhibitory control tasks in 83.3%, 71.4%, 70.6%, and 69.7% of studies, respectively. A total 58.3% and 50% of studies that evaluated the effect of methylphenidate on tasks of memory and working memory/divided attention, respectively, noted improvement. Variability of findings across studies may be explained by differential effects of methylphenidate on brain function, intra- and inter-individual variability in medication response, methodological limitations, and problems associated with repeated neuropsychological assessment and metric properties of commonly utilised neuropsychological instruments.

Attention Deficit Disorder with Hyperactivity↗
PubMed2006

Severity of gambling problems and psychosocial functioning in older adults.

This study examined the relationship between severity of gambling problems and psychosocial functioning in older adults. Twenty-one current pathological gamblers and 10 current problem gamblers over 60 years of age completed the Addiction Severity Index (ASI), Geriatric Depression Scale (GDS), Brief Symptom Inventory (BSI), UCLA Loneliness Scale (UCLA-LS), and Social Provisions Scale (SPS). Compared with problem gamblers, pathological gamblers reported increased severity of gambling and family/social problems on the ASI; scored higher on the GDS, BSI, and UCLA-LS; and scored lower on the SPS. Although they were not seeking treatment at the time of the interview, three fourths of pathological gamblers and 30% of problem gamblers were interested in gambling treatment. These results suggest that severity of gambling problems is associated with increased psychosocial distress in older adults and that a significant proportion of older adults with a gambling disorder may be cognizant of their gambling problem and interested in treatment.

Aged↗
PubMed2005

Problem and pathological gambling are associated with poorer mental and physical health in older adults.

OBJECTIVE: To evaluate the prevalence and correlates of problem and pathological gambling in older adults. METHODS: Adults (n = 343) aged 60 years and older attending senior centers, bingo sites and other community activities completed a screening form containing the South Oaks Gambling Screen and the Short Form-12 Health Survey, to evaluate physical and mental health. RESULTS: Overall, 6.4% of the respondents were classified as problem gamblers and an additional 3.8% as pathological gamblers. Problem and pathological gamblers evidenced significantly greater physical and mental health problems than non-problem gamblers. CONCLUSIONS: These data suggest that about 10 percent of active older adults experience gambling problems, which are associated with poor physical and mental health.

Aged↗
PubMed2005

Antisocial personality disorder is associated with increased severity of gambling, medical, drug and psychiatric problems among treatment-seeking pathological gamblers.

AIMS: To evaluate systematically whether pathological gamblers with antisocial personality disorder (ASPD) experience increased severity of gambling, medical, psychiatric, substance use and psychosocial problems compared to pathological gamblers without ASPD. PARTICIPANTS, DESIGN AND MEASUREMENTS: Pathological gamblers (n = 237) entering an out-patient treatment study for pathological gambling completed the ASPD section of the Structured Clinical Interview for Diagnostic and Statistical Manual version IV (DSM-IV) Personality Disorders, California Psychological Inventory-Socialization Scale, Addiction Severity Index (ASI), Brief Symptom Inventory (BSI) and gambling questionnaires. SETTING: Pathological gambling research clinic. FINDINGS: Thirty-nine (16.5%) pathological gamblers met DSM-IV diagnostic criteria for ASPD. Compared to pathological gamblers without ASPD, pathological gamblers with ASPD were younger, more likely to be male and divorced/separated, and had fewer years of education. They also began gambling earlier in life, reported increased severity of gambling, medical and drug problems, and scored higher on the paranoid ideation, somatization and phobic anxiety subscales of the BSI. Further, logistic regression identified male gender, history of illicit drug use and severity of gambling and medical problems as independent predictors of ASPD. CONCLUSIONS: These results underscore the importance of assessing a wide range of behaviors and personality indices, including ASPD, among treatment-seeking pathological gamblers.

Adult↗
PubMed2005

Health and psychosocial correlates of disordered gambling in older adults.

OBJECTIVE: A number of regional prevalence studies suggest that disordered gambling is a clinically significant problem among older adults. However, little research has evaluated whether older adults with a gambling disorder experience increased health, psychiatric, substance use, and social problems as compared with older adults without a gambling disorder. METHODS: A group of 48 older-adult disordered gamblers and 48 older adult non/infrequent gamblers, matched by age, sex, race, and recruitment site, completed the Addiction Severity Index (ASI), Brief Symptom Inventory (BSI), and Short Form-36 Health Survey (SF-36). Multivariate general-linear models evaluated between-group differences on these indices. RESULTS: Compared with non/infrequent gamblers, disordered gamblers reported increased severity of medical, family/social, psychiatric, and alcohol problems on the ASI. They also scored higher on depression, anxiety, paranoid ideation, and psychoticism subscales of the BSI, and lower on vitality, physical functioning, role-physical, general health, and social functioning subscales of the SF-36. CONCLUSIONS: These results suggest that older adults with a gambling disorder experience increased severity of health and psychosocial problems, compared with older adult non/infrequent gamblers matched by age, sex, race, and recruitment site.

Aged↗
PubMed2004

Age of gambling initiation and severity of gambling and health problems among older adult problem gamblers.

This study examined the relationship between age at first gambling experience and severity of gambling and related problems among older adult problem gamblers. Fifty-two problem gamblers over the age of 65 years completed self-report instruments that assessed gambling problems as well as the Short Form 36 health survey. The median age at first gambling experience was 21 years. Compared with gamblers who had a late onset of gambling, those with an early onset wagered more frequently and had more severe medical and psychiatric problems. These data suggest that gambling that begins in adolescence may be associated with an elevated severity of problems throughout the life span among older adult problem gamblers.

Adult↗
PubMed2003

Disordered gambling in adolescents : epidemiology, diagnosis, and treatment.

Rapid expansion of legalized gambling has been associated with increased rates of gambling disorders among adults and adolescents worldwide. Epidemiologic studies suggest that, in North America, up to 6% of adults and 20% of adolescents have a gambling problem. Despite increasing prevalence rates of gambling disorders, little research is available on how to treat such disorders in adolescents. Much of what is known about how to treat adolescent problem and pathological gambling comes from research on psychosocial and psychopharmacologic treatments for adult pathological gambling. Risk factors for adolescent gambling disorders include male gender, alcohol and drug use, deviant peers, family history of gambling, and impulsive behavior. While several risk factors characterize disordered gambling among adolescents, the extent to which these characteristics are related remains to be determined. In terms of screening for adolescent problem and pathological gambling, several instruments designed to reflect the Diagnostic and Statistical Manual of Mental Disorders diagnostic criteria for pathological gambling are available. Psychosocial approaches used to treat adult pathological gambling include Gamblers Anonymous, cognitive-behavioral therapy (CBT), and motivational enhancement therapy (MET). Among adolescents, CBT as well as an eclectic therapy have been helpful in reducing problematic gambling behavior. In terms of pharmacotherapy, three classes of psychotropic drugs have been used to treat adult pathological gambling - serotonin reuptake inhibitors, opioid antagonists, and mood stabilizers. While some of these pharmacotherapies have been efficacious in treating adult pathological gambling, additional double-blind, placebo-controlled studies are needed to determine the long-term effectiveness of these treatments. No known study has evaluated the use of psychopharmacologic agents in treating adolescent pathological gambling. Possible reasons for the lack of research on treatment for adolescent gambling disorders include lack of motivation to pursue treatment, feelings of self-control, and negative perception of therapy. Referrals from parents, teachers, and peers of adolescents, as well as community outreach programs, may be useful in successfully deriving a treatment population. Clinicians are advised to be sensitive to behavioral risk factors and to screen for disordered gambling in high risk adolescents. A combination of CBT and MET, as well as medication for any comorbid psychiatric condition, is recommended.

Adolescent↗
PubMedDate not supplied

Reasons for seeking genetic susceptibility testing among first-degree relatives of people with Alzheimer disease.

Advances in genetic research have provided a basis for susceptibility testing for Alzheimer disease (AD). Prior surveys have examined attitudes toward genetic testing for AD in hypothetical scenarios, but it is unclear what reasons would motivate people to seek testing in real-life situations. This study presents data from the first randomized trial to evaluate genetic susceptibility testing for asymptomatic adult children of people with AD. We examined (1) reasons endorsed as motivations for seeking testing, (2) demographic characteristics associated with these reasons, and (3) how these reasons related to the eventual decision to pursue testing. Eligible participants were 206 adult children of people with AD (mean age 53 years; 72% female; 93% white), 77.7% of whom (n = 160) went on to seek testing. Participants endorsed numerous reasons for seeking susceptibility testing (mean 7.2), encompassing a range of motivations. The most commonly endorsed reasons were as follows: (1) to contribute to research (93.9%), (2) to arrange personal affairs (87.4%), and (3) the hope that effective treatment will be developed (86.8%). Women strongly endorsed more reasons for seeking testing than men (p < 0.05). The best predictor of actual pursuit of testing was strong endorsement of the need to prepare family members for AD (odds ratio = 3.3, p < 0.01). Findings suggest that genetic susceptibility testing is of interest to individuals at risk for AD for a variety of reasons, even in the relative absence of available treatments.

Alzheimer Disease↗
PubMedDate not supplied

Health problems and medical utilization associated with gambling disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

OBJECTIVE: Pathologic gambling is believed to be associated with adverse health consequences, but no prior studies have rigorously evaluated these relationships. We sought to examine medical disorders and health service utilization associated with problem and pathologic gambling. METHOD: A total of 43,093 adults aged 18 years and older were evaluated in the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions. Self-reported medical diagnoses and past-year medical services used were assessed. RESULTS: Pathologic gamblers were more likely than low-risk individuals to have been diagnosed with tachycardia (odds ratio [OR] = 1.77; 95% confidence interval [CI] = 1.05-2.97), angina (OR = 2.35; 95% CI = 1.33-4.15), cirrhosis (OR = 3.90; 95% CI = 1.11-13.72), and other liver disease (OR = 2.98; 95% CI = 1.07-8.26). Gambling severity was also associated with higher rates of medical utilization with pathologic gamblers more likely than low-risk individuals to have been treated in the emergency room in the year before the survey (OR = 1.98; 95% CI = 1.27-3.09). Significant effects of gambling severity remained even after controlling for demographic characteristics (age, gender, ethnicity, marital status, education, income, and region of the country) and behavioral risk factors such as body mass index, alcohol abuse and dependence, nicotine dependence, and mood and anxiety disorders. CONCLUSIONS: A lifetime diagnosis of pathologic gambling is associated with several medical disorders and increased medical utilization, perhaps leading to a burden on healthcare costs in the United States.

Adolescent↗