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Biomedical subjects

S M Manson

Publications and source records attributed to S M Manson.

At least 19 recordsLinked to original sources
PubMed1996

Predictive and concurrent validity of the Suicidal Ideation Questionnaire among American Indian adolescents.

Suicide is currently the second leading cause of death for ages 15-24 years; reports indicate that 6-8% of American teens have attempted suicide. Rates of suicide and suicide attempts are at least as high, if not higher, for American Indian adolescents and young adults. The Suicidal Ideation Questionnaire (Junior High School Version) (SIQ-JR) could be used to identify young people who may be at risk for attempting suicide, since this questionnaire focuses on suicidal ideation, a major risk factor for suicide attempt. However, little is known about the predictive validity of the SIQ-JR, particularly in American Indian adolescent populations. A suicide attempt cluster at an American Indian boarding school provided the unique opportunity to examine the performance of the SIQ-JR in a group of American Indian high school students who had taken the SIQ-JR approximately 2 months prior to the outbreak of attempts. The SIQ-JR proved to be an excellent predictor of future suicide attempts when compared to other measures of distress: anxiety, depression, and alcohol use. The SIQ-JR is an effective screener for suicide risk in this American Indian adolescent population.

Adolescent↗
PubMed1996

Research in American Indian and Alaska Native communities: navigating the cultural universe of values and process.

The National Institutes of Health's guidelines for recruiting ethnic minorities and women into clinical research have raised numerous questions among investigators. Highlighted in this article are a number of important issues for those researchers seeking to include American Indians and Alaska Natives in their studies; that is, defining the population of American Indians and Alaska Natives for inclusion in a study, participation of the tribes in research and approval by the Institutional Review Board, issues of confidentiality and anonymity of individuals and tribes, identifying potential benefits to American Indian and Alaska Native communities, and the importance of evaluating the scientific merit of a proposed study. Awareness and a commitment to ongoing education regarding these issues will enhance the quality and benefits of research among American Indian and Alaska Native people.

Alaska↗
PubMed1996

Factors associated with the receipt of alcohol treatment services among American Indian adolescents.

OBJECTIVE: This study examines factors potentially associated with the receipt of alcohol treatment services among a large sample of American Indian adolescents. METHOD: Data for this study were drawn from the Voices of Indian Teens project, a 5-year, longitudinal project involving school-based survey data collection at 10 primarily American Indian schools. In November 1992 a total of 2,077 American Indian youths in grades 9 through 12 completed self-report surveys. Of these, 1,681 had a complete set of data for these analyses. Three logistic regression models were developed to predict the probability of (1) receipt of treatment, (2) treatment recommendation, and (3) receipt of treatment among those teenagers who received a treatment recommendation. RESULTS: The probability of an individual receiving treatment was 15 times greater if treatment was recommended. Treatment recommendation mediated the relationship of several measures of psychological distress and alcohol use, abuse, and dependence with actual treatment. CONCLUSIONS: Recommendation for treatment is strongly associated with receiving treatment. Community education about the risks, signs, symptoms, need, and mechanisms for obtaining treatment of alcohol abuse among youths might help alcohol-abusing individuals receive the help they need.

Adolescent↗
PubMed1996

Substance abuse treatment of American Indian adolescents: comorbid symptomatology, gender differences, and treatment patterns.

OBJECTIVE: To describe the patient population and use of mental health treatment at a residential substance abuse treatment program for American Indian and Alaska Native adolescents. Specifically, this article (1) reports the level of psychiatric symptomatology among the patient population; (2) compares male and female patients in terms of demographics, symptomatology, and receipt of mental health treatment; and (3) examines the degree of association between patient psychiatric symptomatology and the receipt of mental health treatment. METHOD: Medical records were reviewed for all 64 patients admitted over a 1-year period. Data included patient characteristics such as substance use and psychiatric symptomatology as well as the receipt of mental health treatment. RESULTS: Sixty-eight percent of patients screened positive for at least one psychiatric symptom type. Females reported greater substance use and were more likely to report that they were victims of abuse. Females also were more likely than males to receive mental health treatment even though males had at least equal need. Finally, there was no significant relationship between measures of psychopathology and subsequent receipt of mental health treatment. CONCLUSIONS: Reassessment of the methods for identifying and treating patients with comorbid psychopathology within programs of this nature is indicated.

Adolescent↗
PubMed1995

Screening for depression among newly arrived Vietnamese refugees in primary care settings.

A brief, culture-specific, self-report screening measure for depression, the Vietnamese Depression Scale, was used to determine the prevalence of depressive symptoms among 1,998 consecutive adult Vietnamese refugees who presented at 10 public health clinics within 2 months of their arrival in the United States. Of these patients, 6% met the criterion for a probable case of depression ("positive"). Being divorced, separated, or widowed and poorly educated were strongly associated with a greater likelihood of screening positive. Somatic complaints were common and induced considerable anxiety about physical health status. Nearly a third of the patients reported sadness and dysphoria; culture-specific symptoms of depression also were prevalent. Our findings document the feasibility of screening for depression using the Vietnamese Depression Scale among Vietnamese refugees, particularly in primary care settings where they are first likely to be seen by health professionals after arrival in their host country.

Adult↗
PubMed1995

Culture and major depression. Current challenges in the diagnosis of mood disorders.

Although the religious and spiritual dimensions of life are among the most important cultural factors structuring human experience, behavior, and illness patterns, mainstream psychiatry has tended either to ignore or pathologize the religious and spiritual issues that clients bring into treatment. To redress this lack of sensitivity, the authors of this article propose a new diagnostic category to the DSM-IV Task Force entitled "Religious or Spiritual Problem" (V62.61). It is hoped that the acceptance of this category will increase the accuracy of diagnostic assessments, reduce iatrogenic harm from misdiagnosis, and increase mental health professionals' respect for individual beliefs and values.

Adult↗
PubMed1993

Prevalence of depressive symptoms among established Vietnamese refugees in the United States: detection in a primary care setting.

OBJECTIVE: To determine the prevalence of depressive symptoms among Vietnamese refugees who have lived in the United States for at least two months. DESIGN: A prospective and descriptive study using the Vietnamese Depression Scale (VDS). Scores of > or = 13 on the VDS were considered indicative of depression. SETTING: Ten public health clinics in four states. PATIENTS/PARTICIPANTS: Four hundred seventy-six consecutive adult Vietnamese refugees presenting for primary care. INTERVENTIONS: The VDS, an 18-item culture-specific self-report measure, was used to screen for depressive symptoms. MEASUREMENTS AND MAIN RESULTS: Twenty percent of these patients had scores of 13 or above. Although being female; being older; being divorced, separated, or widowed; and being poorly educated were significant univariate risk factors for screening positive, only the latter two were significant in a multivariate model. Physical complaints were common and induced considerable anxiety about health status, but psychological and emotional symptoms were even more prevalent. Patients scoring 13 or higher had a higher rate of endorsement for every item in the scale than did those scoring lower than 13. CONCLUSIONS: This study substantiates the feasibility and importance of screening for depressive symptoms among Vietnamese refugees, particularly in primary care settings where they are most likely to seek care for both medical and psychological problems.

Adolescent↗
PubMed1993

Criterion validity of the Center for Epidemiologic Studies Depression Scale in a population sample from an American Indian village.

The criterion validity of the Center for Epidemiologic Studies Depression Scale (CES-D) is examined in 120 adult Northwest Coast American Indians. The criterion was a DSM-III-R diagnosis derived from the Lifetime version of the Schedule for Affective Disorders and Schizophrenia. Sensitivity for major depression was 100% (95% confidence limits 36%, 100%); specificity was 82.1% (75.1%; 89%). For a broad category of depressive disorders (n = 9), sensitivity was 77.8% and specificity was 84.7%. Cut points based on receiver operating characteristic analyses did not greatly improve the performance of the CES-D. The use of factor scores instead of total scores made little difference.

Adolescent↗
PubMed1993

Psychiatric disorders among recently-arrived Eastern Europeans seen through a US refugee counseling service.

OBJECTIVE: To describe the types and extent of psychiatric disorders found in a group of recently-arrived Eastern Europeans being treated by native-speaking mental health providers. PATIENTS: Forty seven Hungarians, Romanians, Czechoslovakians, Poles and Gypsies referred by voluntary or government agencies, other organizations or community members to a refugee counseling service in Seattle, Washington. Over 90% were refugees and 68% maintained this status at the intake evaluation. METHOD: Clinical, descriptive study of data collected retrospectively by chart review. RESULTS: The majority of clients had poor or fair English skills and less than half were employed. Twelve (26%) had a prior mental health problem and five (11%) a psychiatric hospitalization. The most common diagnoses were adjustment reaction in 21 (45%), marital/family problems in five (11%), and paranoid schizophrenia in five (11%). CONCLUSIONS: Psychiatric disorders were frequent in this clinical population of Eastern Europeans presenting for outpatient mental health care and may be associated with previous mental health problems. Our findings emphasize the need for sensitivity to the special risks of emigration.

Adjustment Disorders↗
PubMed1993

Alcohol use among male and female Native American adolescents: patterns and correlates of student drinking in a boarding school.

This study examined the patterns and correlates of alcohol use in a Native American boarding school. Specifically, stressful life events, social support and emotional distress were associated with quantity as well as frequency of alcohol use in this population. A sample of 188 students (52% female) in grades 9-12 attending a boarding school in the midwest were administered self-report measures of these above constructs as part of a larger battery. Family support, and to some degree stressful life events and emotional distress, correlated significantly with alcohol use. The implications of these findings for Native American adolescents in general, and in a boarding school population specifically, are discussed. The need for longitudinal research to explore further the temporal sequence of depression, stressful life events and social support in relation to alcohol use is addressed.

Adaptation, Psychological↗
PubMed1990

Properties of the Inventory to Diagnose Depression in American Indian adolescents.

The Inventory to Diagnose Depression (IDD) was administered to 177 American Indian adolescents attending a tribally administered boarding school. The psychometric properties in this population were studied and compared to those obtained when the Center for Epidemiologic Studies-Depression Scale (CES-D) was administered to a similar population. Analyses were performed on the scale items individually as well as on the continuous summary score and the dichotomous diagnosis. The internal consistency was very good (0.94 to 0.96). There were relatively few gender effects at the item level and none with respect to the diagnosis. IDD prevalence estimates of depression were much closer to the expected rates suggested by epidemiological studies than those generated by other self-report measures like the CES-D. These findings recommend the IDD for additional investigation in terms of its use with adolescent populations.

Adolescent↗
PubMed1989

Long-term care in American Indian communities: issues for planning and research.

Planning and research related to long-term care for the American Indian elderly population lag far behind the state-of-the-art. The Indian Health Service, the major health care provider for this special population, has actively resisted developing services specific to older tribal members. Yet, despite this lack of leadership, many innovative efforts have emerged at the local level. These efforts, the issues that face subsequent program advancement, and critical questions for future study are discussed.

Aged↗
PubMed1989

Provider assumptions about long-term care in American Indian communities.

A brief survey of 208 Indian Health Service (IHS) providers and allied personnel revealed the extent to which they subscribed to a number of myths about long-term care. With some exceptions, long-term care is equated with the nursing home, perceived as involving essentially health care professionals, and service objectives are assumed to be primarily rehabilitative and protective in nature. Underscored is the importance of past recommendations of geriatric training for IHS and tribal human service providers.

Aged↗
PubMed1989

Abuse and neglect of American Indian children: findings from a survey of federal providers.

Child abuse and neglect is of growing concern in many American Indian and Alaska Native communities. The present paper represents one attempt to add to the existing, albeit sparse, knowledge base concerning the abuse and neglect of American Indian children. It reports the results of a survey of federal human service providers in which the subject of child abuse and neglect in Indian communities figured prominently. The study took place at several locations in Arizona and New Mexico. Data were obtained using the key-informant method from 55 federal service providers who identified 1,155 children, from birth to 21 years for inclusion in the survey. Children were included if they were currently in mental health treatment, if they were in need of mental health treatment, or if they were known to have been abused or neglected. Particular emphasis was given in the data collection to abuse- and neglect-related factors such as living arrangements, familial disruption, psychiatric symptoms, substance abuse, and school adjustment. The patterns evident in this sample closely resemble those trends identified among abused and/or neglected children in the general population. Sixty-seven percent of the sample was described as neglected or abused. The presence of abuse and/or neglect was strongly related to severe levels of chaos in the family. Children who were described as both abused and neglected had more psychiatric symptoms, greater frequency of having run away or been expelled, and greater frequency of drug use.

Adolescent↗