Re: "Is an educated wife hazardous to your health"?
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Coronary Disease↗
Biomedical subjects
S W Vernon
Publications and source records attributed to S W Vernon.
Community exposure to hazardous waste disposal sites: assessing reporting bias.
A household health survey of residents living near two hazardous waste disposal sites in Calcasieu Parish, Louisiana was conducted in 1981-1982 as part of a comprehensive study of the effects of those sites on the environment and on the health of nearby residents. An unexposed community was included in the health survey for comparison. Due to media coverage and public concern about the sites, two potential indices of reporting bias, hypochondriasis and respondent's opinion about the environmental effects of waste sites, were included in the survey. Because air and water quality data showed little evidence that hazardous concentrations of chemicals were being released from the sites, questions were raised about the interpretation of the health survey data. The data were analyzed, therefore, for the association between symptom reports and the potential indices of reporting bias. Hypochondriasis scores were associated with symptom reports regardless of location of residence while an individual's opinion showed a different pattern by area of residence. Respondents living near one of the waste disposal sites who answered "yes" to the opinion question were 2-3 times more likely to report some types of symptoms than residents of the comparison community. In contrast, there was little difference in symptom reports between the exposed and comparison communities for those answering "no" to the opinion question. The usefulness of self-reported symptom data in studies of communities near hazardous waste disposal sites is discussed, and attention is called to the need to develop measures sensitive to reporting bias in epidemiologic studies.
Adolescent↗
Aging, sex-role orientation, and adjustment: a three-generations study of Mexican Americans.
The effect of sex-role orientation on psychological well-being was investigated with data from a three-generations study of Mexican Americans. More specifically, we examined the hypothesis that less traditional sex-role orientation is positively related to psychological well-being (other things equal) and that this relationship is stronger among the older than among younger generations. Traditional sex-role orientation was positively related to depression among older women, lending partial support to the hypothesis. Among men, however, traditional sex-role orientation was not related to well-being in the older generation but was related to both depression and life satisfaction in the younger generation. The interactive effects of marital status and retirement status with sex-role orientation were also examined but were not found to be significant.
Aging↗
Ethnic status and participation in longitudinal health surveys.
Ethnic differences in survey participation and their effects on self-reported physical and psychiatric health status measures were examined in a longitudinal health study in Alameda County, California, in 1978 following two time intervals. Blacks and Mexican-Americans were more likely than whites to refuse to participate in follow-up surveys and were more difficult to trace when the time interval between interviews was long. With the exception of age, demographic characteristics were not consistently associated with participation status either across ethnic groups or across time periods. Self-reported psychiatric and physical health status were not statistically associated with participation status in any ethnic group for either time period, despite differential participation by ethnicity.
Adult↗
The Center for Epidemiologic Studies Depression Scale: its use in a community sample.
The authors gave the Center for Epidemiologic Studies Depression (CES-D) Scale, a self-report depression symptom scale, to 528 subjects drawn from a larger longitudinal community survey. Interviewers also assessed respondents using the Schedule for Affective Disorders and Schizophrenia (SADS), a structured clinical interview; on the basis of the SADS the subjects were then given diagnoses according to the Research Diagnostic Criteria. The results corroborated earlier findings of a modest relationship between self-reported symptoms of depression and the diagnosis of depression. The authors conclude that the CES-D Scale may be useful as an initial or first-stage screening test.
California↗
Use of the SADS-RDC in a tri-ethnic community survey.
The Schedule for Affective Disorders and Schizophrenia and the Research Diagnostic Criteria were used to ascertain community-based rates of affective and nonaffective psychiatric disorders. Both current-point and lifetime prevalence rates were reported for a sample of whites, blacks and Mexican-Americans. Rates for whites were compared with those reported for another community sample in which the same diagnostic criteria were applied. Comparison of lifetime rates from the two studies showed good concurrence for most of the affective disorders, particularly depression. This study also examined differences in rates by ethnic status.
Adult↗
Depression in the community: prevalence and treatment.
Research Diagnostic Criteria were used to make psychiatric diagnoses in a study of the prevalence of depression and its treatment in Alameda County, California, in 1978. As in findings from a study in New Haven, Conn, the number of people with clinical depression (as well as those with other psychiatric disorders) who sought help from a mental health professional or from any other source was quite low (only one in five had seen a mental health professional). Men in particular were less likely to report having received treatment for their emotional problems. However, contrary to the New Haven study, in Alameda County those with depression diagnosed were not more likely than those with other psychiatric diagnoses to seek care for emotional problems from nonpsychiatric physicians or from other sources of care.
Adult↗
Prevalence of treated and untreated psychiatric disorders in three ethnic groups.
The pattern and overlap of treated and untreated rates of psychiatric symptoms and disorders were examined in a sample of whites, blacks, and Mexican-Americans. In addition, we compared treatment sources for family or personal problems for the three groups. The results suggest caution in substituting treated for untreated rates and also in interchanging rates based on symptom scales with rates from clinical diagnostic instruments. Underutilization was assessed by linking psychiatric status with reports of help-seeking behavior. Comparisons indicated that all groups underuse services relative to need, but underutilization is greater for blacks and Mexican-Americans. With the exception of nonpsychiatric physicians, use of treatment sources was similar for all groups. Whites were much more likely than blacks or Mexican-Americans to use this source of care. Possible reasons for this difference are discussed in the context of the methodology employed in the study.
Black or African American↗
Response tendencies, ethnicity, and depression scores.
The Center for Epidemiologic Studies Depression scale was given to a sample of whites, blacks, and Mexican-Americans residing in Alameda County, California, in 1978. Scores on the scale were analyzed to see whether or not a potentially important source of bias called response tendencies affected prevalence estimates and associations between symptom scores and demographic variables. Response tendencies were found to be differentially correlated with symptom scores by ethnic status; however, their effects were not of sufficient magnitude to alter most associations observed between symptom scores and demographic variables. The need for further methodological studies to clarify the definitions of concepts such as "depression" is discussed.
Adult↗
Measuring nonspecific psychological distress and other dimensions of psychopathology. Further observations on the problem.
The reliability and validity of the Psychiatric Epidemiology Research Interview (PERI) are examined using data from a triethnic (white, black, and Mexican -American) sample of community respondents. The PERI scales attempt to measure both nonspecific psychological distress and different dimensions of psychopathology. Internal consistency reliability is assessed using Cronbach's coefficient alpha. Concurrent and discriminant validity are evaluated by comparing the PERI scales with the Center for Epidemiologic Studies Depression Scale and the Bradburn Negative Affect Scale. These scales show high internal consistency reliability in all three ethnic groups. The Demoralization Scale measures a separate dimension from the other psychopathology scales, and the latter scales are distinct from one another. While the criterion validity of the PERI in population samples remains unknown, it is possible to measure important dimensions of psychopathology in the general population. The PERI may constitute one such measure.
Adult↗
Usefulness of the PERI demoralization scale screen for psychiatric disorder in a community sample.
The authors gave the PERI Demoralization Scale (PERI-D), a measure of nonspecific psychological distress, to 528 subjects drawn from a larger longitudinal community survey. Respondents also were interviewed using the Schedule for Affective Disorders and Schizophrenia (SADS), a structured clinical interview. Based on the SADS, subjects were given diagnoses based on Research Diagnostic Criteria (RDC). The results corroborate earlier findings of a modest relationship between self-reported symptoms of distress and the diagnosis of clinical psychiatric disorder. There was somewhat better fit between RDC diagnoses of depression, particularly major depression, and PERI-D symptom scores, suggesting the PERI-D items may be slightly more useful for detecting cases of depression in the community than for the broader range of psychiatric disorders. In general, the authors concur with earlier writers who suggest that brief psychiatric symptom scales may be useful as screening tests in community surveys, but such instruments do not in themselves provide good-estimates of the prevalence of clinical psychiatric disorders in the community.
Affective Symptoms↗
Worksite cancer screening and nutrition intervention for high-risk auto workers: design and baseline findings of the Next Step Trial.
BACKGROUND: This article describes the design and baseline findings of The Next Step Trial, a health promotion intervention targeting automobile industry employees at increased colorectal cancer risk. The intervention encouraged colorectal cancer screening participation and adoption of low-fat, high-fiber diets. METHODS: Twenty-eight worksites (n = 5,042) were randomized to control (a company-sponsored screening program) or intervention (an enhanced screening program including a personalized educational booklet and motivational telephone call and diet-change program including nutrition classes, self-help materials, and computer-generated personalized feedback). Outcomes included screening compliance and fat and fiber intake. RESULTS: Pretrial data indicated targeted employees were predominantly older, well educated, married, Caucasian men. Sixty-one percent (SE = 2) participated in the screening program in the preceding 2 years, and 24% (SE = 1) reported a history of colorectal polyps or cancer. Fifty-eight percent of the cohort responded to the baseline questionnaire; respondents were older and more educated; more were married, retired, and Caucasian than nonrespondents. Mean dietary intakes were 36.9% energy from fat (SE = 0.21), 8.8 g fiber/1000 kcal (SE = 0.07), and 3.4 servings of fruits and vegetables per day (SE = 0.04). CONCLUSIONS: Baseline data show moderate screening participation and dietary intakes that did not meet guidelines; hence intervention efforts were warranted. Data from this trial will support a rigorous test of whether this high-risk employee population is responsive to targeted health promotion, early cancer detection, and prevention interventions.
Automobiles↗
Intention to screen for colorectal cancer among white male employees.
BACKGROUND: This study identifies factors associated with employee intention to participate in a company-sponsored program of continuous screening for colorectal cancer. Automobile industry pattern and model makers who had been offered screening for over a decade were included in the study. METHODS: Data were collected at the outset of a randomized trial of screening and nutrition interventions. A baseline survey was mailed to 4,490 white men without a history of colorectal cancer. This mailing generated complete responses from 2,693 (60%) individuals. Survey data obtained for these men, including measures of cognitive and psychological representations related to colorectal screening, social influence, and intention to screen, were supplemented by background information gathered from employment records of these men. Workplace screening services were documented via a survey of plant health care professionals. RESULTS: Fifty-eight percent of respondents reported a high level of intention to screen. Multivariate analyses showed that intention to screen was positively associated with employee past participation in screening, belief in the salience and coherence of screening, belief in screening efficacy, perceived self-efficacy, belief that polyp removal prevents colorectal cancer, perceived personal susceptibility to colorectal cancer or polyps, receptivity to family member support for screening, and workplace scheduling of screening examinations. CONCLUSIONS: Factors associated with intention to screen may contribute to participation in continuous screening programs. Research is needed to assess the impact of interventions that facilitate appointment scheduling, provide tailored education about screening, and encourage lay support.
Adult↗
The effect of physician recommendation on enrollment in the Breast Cancer Chemoprevention Trial.
BACKGROUND: The purpose of this study was to evaluate the effect of physician recommendation on whether to enroll in a randomized controlled chemoprevention trial for breast cancer. METHODS: We surveyed 360 women who were at increased risk for breast cancer regarding social and behavioral factors that could influence their decision to enroll or not to enroll in the Breast Cancer Prevention Trial (BCPT). Respondents completed a questionnaire following attendance at an informational session about the trial. The analysis was restricted to 175 women who discussed the possibility of their participation in the trial with their primary care physician (PCP) and who reported what their physician advised them to do regarding participation. RESULTS: Logistic regression modeling showed that among women who discussed the trial with their physician, physician recommendation was the most important factor that influenced the respondent's decision to enroll in the BCPT. Women who reported that their physician advised them to enroll in the trial were 13 times more likely to participate than were women who reported that their physicians advised them not to participate. CONCLUSIONS: The results of our study show that PCPs play an important role in influencing preventive health behavior, specifically, regarding enrollment in a randomized breast cancer chemoprevention trial. Efforts to increase recruitment to a trial should include enlisting the support of PCPs.
Adult↗
Personality and coronary heart disease.
Three MMPI variables--HsK + Hy, neuroticism, and somatic complaints--were positively associated with incidence of uncomplicated angina pectoris and not significantly associated with incidence of myocardial infarction and coronary death in a 10-year cohort study of 2003 employed middle-aged men. All three were negatively associated with risk of coronary death after the diagnosis of uncomplicated angina had been established. These results support the hypothesis that tendencies to report somatic complaints or to experience negative, distressing emotions chronically are not related to incidence of coronary heart disease but are associated with incidence of a relative benign, nonatherosclerotic condition that is similar clinically to angina pectoris. Also, HsK + Hy and somatic complaints were positively associated with risk of coronary death in men who had survived an initial myocardial infarction. This result does not indicate an association with coronary hearth disease itself because all of these men already had coronary heart disease. This result may indicate that the tendency to report somatic complaints is related to increased susceptibility to acute emotional stressors that can trigger arrhythmias in an ischemic myocardium.
Adult↗
Patterns of preventive dental behavior.
Preventive dental behavior was examined using data from the National Health and Nutrition Examination Survey of 1971-75 conducted by the National Center for Health Statistics. Most research to date has dealt with the use of all types of dental services, with relatively few studies focusing on utilization of dental services for preventive purposes or on preventive dental behavior. Economic theory on the demand for health services and the Andersen model of health services utilization were applied to examine predisposing, enabling, and need characteristics which may influence use of preventive dental health services and preventive dental behavior. The associations between each of three measures of preventive dental behavior and the three sets of characteristics from Andersen's model were analyzed using multiple regression analysis. The enabling factors (income and a regular source of care) were the most important determinants of use of preventive dental services. Need characteristics, measured by self-evaluated condition of teeth, were also significant determinants of use, while the predisposing variables were the least important of the three types. In contrast, for the home care measure, frequency of brushing, the predisposing variables were the most important, with gender and education ranking highest. Consideration of these results may be useful to health educators and to those who formulate policies affecting the distribution of preventive dental services and dental insurance coverage.
Adult↗