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S Wolk

Publications and source records attributed to S Wolk.

At least 19 recordsLinked to original sources
PubMed2001

The association between childhood depression and adulthood body mass index.

OBJECTIVE: Stress in childhood relates to both childhood depression and elevated adult body mass index (BMI), a measure of relative overweight. However, there are limited data on the association between major depression in childhood and BMI in adulthood. The current study examines this association. METHOD: Children 6 to 17 years old with major depression (n = 90) or no psychiatric disorder (n = 87) were identified at Columbia Presbyterian Medical Center and followed up 10 to 15 years later. Psychiatric status at intake and follow-up was assessed via standardized psychiatric interviews. BMI during adulthood was recorded so that the association between depression and BMI could be considered over time. RESULTS: Participants with childhood major depression had a BMI of 26.1 +/- 5.2 as adults, compared with a BMI of 24.2 +/- 4.1 in healthy comparisons (t(175) = 2.7). This association could not be explained by a number of potentially confounding factors, including age, gender, cigarette or alcohol use, social class, and pregnancy or medication history. Although poverty during adulthood also predicted adult BMI, both the association between poverty and adult BMI (t(152) = 2.9), as well as between childhood depression and adult BMI (t(152) = 2.2) were significant in a multivariate model. Finally, duration of depression between childhood and adulthood also emerged as a predictor of adult BMI. CONCLUSIONS: Depression during childhood is positively associated with BMI during adulthood. This association cannot be explained by various potential confounding variables and may develop over time as children pass into their adult years.body mass index, depression, children, adolescents.

Adolescent↗
PubMed2000

Brief screening for family psychiatric history: the family history screen.

BACKGROUND: Brief screens to collect lifetime family psychiatric history are useful in clinical practice and for identifying potential families for genetic studies. METHODS: The Family History Screen (FHS) collects information on 15 psychiatric disorders and suicidal behavior in informants and their first-degree relatives. Since each question is posed only once about all family members as a group, the administrative time is 5 to 20 minutes, depending on family size and illness. Data on the validity against best-estimate (BE) diagnosis based on independent and blind direct interviews on 289 probands and 305 relatives and test-retest reliability across 15 months in 417 subjects are presented. RESULTS: Agreement between FHS and BE diagnosis for proband and relative self-report had median sensitivity (SEN) of 67.6 and 71.1 respectively; median specificity (SPC) was 87.6 and 89.4, respectively. Marked decrease in SEN occurred when a single informant (the proband) reported on a relative (median, 37.5); however, median SPC was 95.8. Use of more than 1 informant substantially improved SEN (median, 68.2), with a modest reduction in SPC (median, 86.8). Test-retest reliability across 15 months resulted in a median kappa of 0.56. CONCLUSIONS: The FHS is a promising brief screen for collecting lifetime psychiatric history on an informant and/or first-degree relatives. Its validity is best demonstrated for major depression, anxiety disorders, substance dependence (alcohol and drug dependence), and suicide attempts. It is not a substitute for more lengthy family history if more detail on diagnosis is required.

Adolescent↗
PubMed1999

Depressed adolescents grown up.

CONTEXT: Major depressive disorder (MDD) that arises in adolescence impairs functioning and is associated with suicide risk, but little is known about its continuity into adulthood. OBJECTIVE: To describe the clinical course of adolescent-onset MDD into adulthood. DESIGN AND PARTICIPANTS: Prospective case-control study. Seventy-three subjects had onset of MDD based on systematic clinical assessment during adolescence (Tanner stage III-V) and 37 controls had no evidence of past or current psychiatric disorders, and also were assessed in adolescence (assessment years: 1977-1985). Follow-up was conducted 10 to 15 years after the initial assessment by an independent team without knowledge of initial diagnosis (follow-up years: 1992-1996). SETTING: Cases were identified at Columbia Presbyterian Hospital, New York City, NY; controls were recruited from the community. MAIN OUTCOME MEASURES: Suicide and suicide attempts, psychiatric diagnoses, treatment utilization, and social functioning. RESULTS: Clinical outcomes of adolescent-onset MDD into adulthood compared with control subjects without psychiatric illness include a high rate of suicide (7.7%); a 5-fold increased risk for first suicide attempt; a 2-fold increased risk of MDD, but not other psychiatric disorders; an increased occurrence of psychiatric and medical hospitalization; and impaired functioning in work, social, and family life. Thirty-seven percent of those with adolescent MDD survived without an episode of MDD in adulthood vs 69% of the control participants (relative risk, 2.2 [95% confidence interval, 1.0-4.7; P<.05]). CONCLUSION: There is substantial continuity, specificity, morbidity, and potential mortality from suicide into adulthood in adolescent-onset MDD patients. Now that empirically based guides to their treatment are becoming available, early identification and treatment seems warranted.

Adolescent↗
PubMed1999

Children with prepubertal-onset major depressive disorder and anxiety grown up.

BACKGROUND: The continuity in adulthood of major depressive disorder (MDD) first arising before puberty is largely unknown. This information could guide early treatment and clarify the appropriateness of including children with MDD in genetic studies. METHODS: Eighty-three subjects with onset of MDD, 44 subjects with anxiety disorder and no MDD, and 91 subjects with no evidence of past or current psychiatric disorders were assessed by two psychiatrists before puberty (Tanner stage < III) and were evaluated 10 to 15 years later as adults by an independent team without knowledge of the initial diagnosis. RESULTS: The clinical outcome of children with prepubertal-onset MDD in adulthood includes a high risk of suicide attempts (nearly 3-fold compared with normal controls and 2-fold compared with children with anxiety) and bipolar disorder. Compared with controls, both the children with MDD and those with anxiety went on to have increased risk of substance abuse and conduct disorder but not other disorders, increased use of longterm psychiatric and medical services, and overall impaired functioning. Children with prepubertal-onset MDD with a recurrence of MDD during follow-up had higher rates of MDD in their first-degree relatives. CONCLUSIONS: There is high morbidity in clinically referred children with prepubertal-onset MDD and anxiety, but continuity and specificity of MDD or anxiety disorder in adulthood is less clear. Caution is warranted in selecting clinically referred children with prepubertal-onset MDD for inclusion in genetic studies unless they have a family history of MDD and recurrence of MDD over time.

Adolescent↗
PubMed1999

Effects of desipramine on autonomic input to the heart.

OBJECTIVE: To examine the impact of age on the effects of desipramine (DMI) on autonomic input to the heart. METHOD: Twenty-four-hour electrocardiograms were obtained from 42 subjects, aged 7 to 66 years, while off and on DMI. To obtain measures of autonomic input to the heart, heart rate variability was assessed via spectral analysis of RR interval variability. RESULTS: DMI treatment was associated with a significant increase in 24-hour mean heart rate and significant decreases in RR interval variability in all spectral bands, including in the high-frequency band, which provides a measure of parasympathetic input to the heart. RR interval variability was greater in younger individuals both off and on DMI. CONCLUSIONS: DMI treatment was associated with a marked decline in RR interval variability, indicating that DMI affects autonomic input to the heart. Specifically, DMI reduced parasympathetic input, which, in theory, may increase vulnerability to arrhythmias. However, the magnitude of DMI's impact on RR interval variability did not vary with age.

Adolescent↗
PubMed1996

Computer simulation of cerebrovascular circulation: assessment of intracranial hemodynamics during induction of anesthesia.

OBJECTIVE: The purpose of this project was to develop a computer model of cerebrovascular hemodynamics interacting with a pharmacokinetic drug model to examine the effects of various stimuli on cerebral blood flow and intracranial pressure during anesthesia. METHODS: The mathematical model of intracranial hemodynamics is a seven-compartment, constant-volume system. A series of resistance relate blood and cerebrospinal fluid fluxes to pressure gradients between compartments. Arterial, venous, and tissue compliance are also included. Autoregulation is modeled by transmural pressure-dependent, arterial-arteriolar resistance. The effect of a drug (thiopental) on cerebrovascular circulation was simulated by a variable arteriolar-capillary resistance. Thiopental concentration was predicted by a three-compartment, pharmacokinetic model. The effect site compartment was included to account for a disequilibrium between drug plasma and biophase concentrations. The model was validated by comparing simulation results with available experimental observations. The simulation program is written in VisSim dynamic simulation language for an IBM-compatible PC. RESULTS: The model developed was used to calculate the cerebral blood flow and intracranial pressure changes that occur during the induction phase of general anesthesia. Responses to laryngoscopy and intubation were predicted for simulated patients with elevated intracranial pressure and non-autoregulated cerebral circulation. Simulation shows that the induction dose of thiopental reduces intracranial pressure up to 15%. The duration of this effect is limited to less than 3 minutes by rapid redistribution of thiopental and cerebral autoregulation. Subsequent laryngoscopy causes acute intracranial hypertension, exceeding the initial intracranial pressure. Further simulation predicts that this untoward effect can be minimized by an additional dose of thiopental administered immediately prior to intubation. CONCLUSION: The presented simulation allows comparison of various drug administration schedules to control intracranial pressure and preserve cerebral blood flow during induction of anesthesia. The model developed can be extended to analyze more complex intraoperative events by adding new submodels.

Anesthesia, General↗
PubMed1992

Factors affecting parents' perceptions of temperament in early infancy.

Parents' perceptions of temperament in their three-month-old infants were examined in relation to prenatally measured parental characteristics and to objective indices of infant behavior at three months. Infant behavior and parental characteristics appear to make independent contributions to parents' perceptions in early infancy.

Attitude↗
PubMed1989

Conformational analysis of d(C3G3), a B-family duplex in solution.

NMR and circular dichroism studies of the duplex formed by the self-complementary DNA hexanucleotide d(C3G3) indicate that it is a B-type structure but differs from standard B-form. An analysis of NMR coupling constants within the deoxyribose moieties yields a 70% or greater contribution from pseudorotation phase angles corresponding to the C3'-exo conformation, a conformation similar to the C2'-endo conformation associated with B-form DNA. Intranucleotide interproton distances are consistent with a B-form structure, but some internucleotide distances are intermediate between A- and B-form structures. Circular dichroism spectra have B-form characteristics but also include an unusual negative band at 282 nm. The solution spectroscopic results are in contrast with X-ray crystallographic studies which find A-form structures for similar sequences.

Circular Dichroism↗
PubMed1987

Structure, dynamics, and thermodynamics of mismatched DNA oligonucleotide duplexes d(CCCAGGG)2 and d(CCCTGGG)2.

The structures and hydrogen exchange properties of the mismatched DNA oligonucleotide duplexes d(CCCAGGG)2 and d(CCCTGGG)2 have been studied by high-resolution nuclear magnetic resonance. Both the adenine-adenine and thymine-thymine mismatches are intercalated in the duplexes. The structures of these self-complementary duplexes are symmetric, with the two strands in equivalent positions. The evidence indicates that these mismatches are not stably hydrogen bonded. The mismatched bases in both duplexes are in the anti conformation. The mismatched thymine nucleotide in d(CCCTGGG)2 is intercalated in the duplex with very little distortion of the bases or sugar-phosphate backbone. In contrast, the bases of the adenine-adenine mismatch in d(CCCAGGG)2 must tilt and push apart to reduce the overlap of the amino groups. The thermodynamic data show that the T-T mismatch is less destabilizing than the A-A mismatch when flanked by C-G base pairs in this sequence, in contrast to their approximately equal stabilities when flanked by A-T base pairs in the sequence d(CAAAXAAAG.CTTTYTTTG) where X and Y = A, C, G, and T [Aboul-ela, F., Koh, D., & Tinoco, I., Jr. (1985) Nucleic Acids Res. 13, 4811]. Although the mechanism cannot be determined conclusively from the limited data obtained, exchange of the imino protons with solvent in these destabilized heteroduplexes appears to occur by a cooperative mechanism in which half the helix dissociates.

Base Sequence↗
PubMed1986

The relative effects of three expressive methods upon the speech intelligibility of profoundly deaf speakers.

Two studies, conducted over a nine month interval, were designed to evaluate the relative effects of three expressive methods (speech alone, speech and signs, and speech with cues) upon speech intelligibility. Five profoundly deaf adults, who were receiving continuous speech training, were recorded reading lists of individual words under all three expressive modes. Listeners were required to identify through a multiple choice format the target stimuli from auditory presentations only. Study I results indicated that speech with cues produced the highest level of intelligibility, while speech and signs produced the lowest level. Study II, with an expanded set of word stimuli, found that speech alone produced a 65% rate of correct identification by listeners; speech and signs again produced the lowest rate of correct identifications. Implications for the assessment and understanding of speech intelligibility are considered.

Adult↗
PubMed1978

The interactive effects of locus of control and situational stress upon performance accuracy and time.

The present paper sought to clarify the conceptual relationship between expectancy for personal control, stress, and behavioral reactions to stress. Expectancy for control was assessed as a personality characteristic of internal control; stress was experienced as strong environmental interruptions, disturbances and unpredictable obstacles encountered during the performance of assigned tasks. Subjects were junior high school aged students who attempted to complete three academic type tasks during one of two levels of stress or a base line, no stress, condition. Analyses of the data included: (a) internal subjects were capable of sustaining task performance under high stress, but external students experienced performance decrements as stress increased; (b) time to complete the mathematics task reflected a facilitating effect of stress for internals but a debilitating effect for externals; (c) performance differences between internal and external students, in the absence of differences in reported anxiety, could be attributed to the stronger reward expectancies possessed by the internal individual. Interpretation of the data suggested an interactive relationship between type of stress (threat to ego vs. threat to instrumental performance) and expectancy for control in the influencing of behavior reactions to stress.

Achievement↗
PubMed1977

Runaway adolescents' perceptions of parents and self.

The purpose of the study was to investigate the relationship between runaway behavior in adolescence and an adolescent's self-concept and antecedent parental treatment. The Cornell Parent Behavior Questionnaire and the Adjective Check List were used to assess 47 runaways and a matched group of non-runaways. Analyses of the data indicated: (a) runaway adolescents report more punishment and less support from their parents; (b) runaway girls report the most and runaway boys the least degrees of parental control; (c) runaways hold a less favorable self-concept, specifically on the dimensions of anxiety, self-doubt, poor interpersonal relationships, and defensiveness; (d) runaways also manifest, as an aspect of the self, a readiness for counseling.

Adolescent↗
PubMed1976

Psychological and social correlates of life satisfaction as a function of residential constraint.

Two questions were addressed in the present study: Do residential setting of varying levels of constraint influence life satisfaction? Do such settings involve different correlates of life satisfaction? A total of 129 male and female ambulatory residents were surveyed in settings of high and low constraint on the following measures: life, satisfaction, developmental task resolution, self-acceptance, perceived autonomy, activity level, health and educational level. Stepwise regression, covariance, and t-test analyses indicated: (1) life satisfaction and developmental task accomplishment were greater in the lower constraining setting; (2) the selected correlates resulted in multiple correlations of .675 and .590 with satisfaction; (3) differing sets of correlates significantly predicted satisfaction in each setting; health the most important in the high constraining setting and perceived autonomy and self-concept important to the low constraining setting; (4) developmental task success significantly predicted satisfaction in both settings.

Activities of Daily Living↗