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Biomedical subjects

Sheri L Johnson

Publications and source records attributed to Sheri L Johnson.

14 recordsLinked to original sources
PubMed2006

Role of treatment alliance in the clinical management of bipolar disorder: stronger alliances prospectively predict fewer manic symptoms.

The strength of the treatment alliance between patients and their clinicians may play a unique role in the management of bipolar disorder. However, few empirical studies have examined the alliance in bipolar disorder or its effects on patient outcomes. This study investigates variables associated with a strong treatment alliance in bipolar disorder, and the prospective effects of treatment alliance on patients' mood symptoms and treatment attitudes. Participants were 58 longitudinally followed individuals with Bipolar I disorder. We found that alliance ratings covaried with depressive symptoms, such that alliance strength increased as depressive symptoms decreased, and stronger alliances were associated with more social support. Tests of temporal association indicated that stronger alliances predicted fewer manic symptoms 6 months later. Stronger alliances also predicted less negative attitudes about medication and less of a sense of stigma about bipolar disorder. Thus, a strong treatment alliance may help to reduce manic symptoms over time. It may be that a strong treatment alliance encourages patients' greater acceptance of bipolar disorder and psychopharmacological interventions, and thus contributes to improved medication adherence and clinical outcomes. Considered in sum, these findings suggest that the treatment alliance is an integral component of the long-term management of bipolar disorder.

Attitude to Health↗
PubMed2006

Life events and juvenile bipolar disorder: conceptual issues and early findings.

There is increasing interest in the psychosocial variables that might predict the course of child and adolescent bipolar disorder. In the literature on adult bipolar disorder, life events have been shown to be a major predictor of symptoms. In this review, we focus on studies of how life events influence the course of child and adolescent bipolar disorder. To begin, we review methodological considerations in life events research, and briefly summarize the findings regarding life events in adult bipolar disorder. Then, we discuss available studies on life events as a predictor of the course of juvenile bipolar disorder. We conclude with suggested directions for future research.

Adolescent↗
PubMed2006

Reactivity to a laboratory stressor among individuals with bipolar I disorder in full or partial remission.

Strong links have been documented between life events and the course of bipolar disorder. Laboratory studies of stress provide an opportunity to understand the mechanisms involved in reactivity to stressors, but few such studies have been done in the bipolar field. In the current study, 28 people with bipolar I disorder in full or partial remission and 40 people with no history of a mood disorder were randomly assigned to 1 of 3 conditions involving different levels of failure feedback on a concept formation task. Confidence, affective reactions, and performance on a subsequent anagram task were assessed. Results provide tentative support for reactivity to the stressor among the bipolar group, although reactivity was limited to impaired anagram performance.

Adult↗
PubMed2006

Early alliance, alliance ruptures, and symptom change in a nonrandomized trial of cognitive therapy for avoidant and obsessive-compulsive personality disorders.

Participants were 30 adult outpatients diagnosed with avoidant personality disorder or obsessive-compulsive personality disorder who enrolled in an open trial of cognitive therapy for personality disorders. Treatment consisted of up to 52 weekly sessions. Symptom evaluations were conducted at intake, at Sessions 17 and 34, and at the last session. Alliance variables were patients' first alliance rating and "rupture-repair" episodes, which are disruptions in the therapeutic relationship that can provide corrective experiences and facilitate change. Stronger early alliances and rupture-repair episodes predicted more improvement in symptoms of personality disorder and depression. This work points to potentially important areas to target in treatment development for these personality disorders.

Adult↗
PubMed2006

The prospective impact of sleep duration on depression and mania.

OBJECTIVE: Many patients report sleeping less than 6 h per night during episodes of depression and mania. This type of sleep deficit may also be a risk factor for subsequent mood episodes; however, the long-term impact of sleep deficit remains unclear. The current study is among few longitudinal studies to assess the prospective effect of sleep deficit on depression and mania. METHODS: A subsample of 54 individuals from a longitudinal study of bipolar I disorder was selected. Participants entered the study during a mood episode. Baseline symptom data were collected at month 4 to allow for recovery from the initial episode, sleep was assessed at month 6, and follow-up symptom data were obtained during months 7-12. RESULTS: Sleep deficit predicted depressive symptoms across the 6-month follow-up but not mania. CONCLUSIONS: It is likely that the impact of sleep deficit on mania was probably missed because assessments covered a full month. Monitoring sleep duration may help predict depression in bipolar disorder and provide an opportunity for targeting intervention.

Adult↗
PubMed2006

Diagnostic inconsistency: a marker of service utilization in bipolar disorder.

Community outcomes for the treatment of bipolar disorder remain poor, including frequent hospitalization. Recent small-scale studies suggest that hospitalization may be tied to poor recognition and medication management. This paper examines the health care charges associated with poor recognition of mania. Service utilization was analyzed for 3,856 individuals with bipolar disorder in a managed care plan. Only 8.2% of patients were diagnosed with bipolar disorder, however they accounted for 45% of inpatient charges. Among patients with bipolar disorder, cases where diagnoses were changed to unipolar depression were hospitalized more quickly. Interventions are suggested to increase consistent recognition of manic history.

Adolescent↗
PubMed2005

Life events in bipolar disorder: towards more specific models.

This article reviews the evidence concerning life events as a predictor of symptoms within bipolar disorder. First, key methodological issues in this area are described, and criteria used for including studies in this review are defined. Then findings that negative life events predict worse outcomes within bipolar disorder are reviewed. Beyond general studies on relapse, it is important to differentiate predictors of depression from predictors of mania. When severe negative life events occur, they appear to trigger increases in bipolar depression. Nonetheless, many depressions are unrelated to negative life events and appear to be triggered by other variables. The strongest evidence suggests that negative life events do not trigger mania, except perhaps in certain contexts. Retrospective findings for schedule-disrupting life events as a trigger for manic symptoms await further assessment within a longitudinal study. Life events involving goal attainment do appear to trigger manic symptoms. Overall, it is time to differentiate among specific types of life events, as these different forms of events point towards mechanisms linking stressors with symptom expression. These mechanisms provide clues into ways to integrate the social environment with biological vulnerability (see [Monroe, S.M., & Johnson, S.L. (1990)). the dimensions of life stress and the specificity of disorder. Journal of Applied Social Psychology, 20, 167-1694; Harris, T.O. (1991). Life stress and illness: the question of specificity. Annals of Behavioral Medicine, 13, 211-219]).

Bipolar Disorder↗
PubMed2005

Distinctions between bipolar and unipolar depression.

This is a review of the studies comparing unipolar and bipolar depression, with focus on the course, symptomatology, neurobiology, and psychosocial literatures. These are reviewed with one question in mind: does the evidence support diagnosing bipolar and unipolar depressions as the same disorder or different? The current nomenclature of bipolar and unipolar disorders has resulted in research that compares these disorders as a whole, without considering depression separately from mania within bipolar disorder. Future research should investigate two broad categories of depression and mania as separate disease processes that are highly comorbid.

Bipolar Disorder↗
PubMed2005

Suicidality in bipolar I disorder.

People with bipolar disorder are at high suicide risk. The literature suggests that suicidality is predicted by higher symptom severity and less use of pharmacological agents, but few studies have examined the joint contributions of these variables. The present study examines the conjoint contribution of symptom severity and pharmacological treatment to suicidal ideation and behavior among participants with bipolar disorder. The model was able to account for 53% of the variance in suicidality scores. Depression, mixed state, and hopelessness were significantly associated with suicidality. All other variables were nonsignificant once symptom severity had been controlled. Implications for future research are described.

Adolescent↗
PubMed2004

Mania and dysregulation in goal pursuit: a review.

This paper reviews evidence for deficits in goal regulation in bipolar disorder. A series of authors have described mania as related to higher accomplishment, elevated achievement motivation, and ambitious goal setting. These characteristics appear to be evident outside of episodes, and to some extent, among family members of people with a history of mania. In addition, people with a history of mania demonstrate intense mood reactivity, particularly in response to success and reward. During positive moods, they appear to experience robust increases in confidence. These increases in confidence, coupled with a background of ambitious goals, are believed to promote excessive pursuit of goals. This excessive goal engagement is hypothesized to contribute to manic symptoms after an initial life success.

Achievement↗
PubMed2004

Coherence and specificity of information-processing biases in depression and social phobia.

Research has not resolved whether depression is associated with a distinct information-processing bias, whether the content of the information-processing bias in depression is specific to themes of loss and sadness, or whether biases are consistent across the tasks most commonly used to assess attention and memory processing. In the present study, participants diagnosed with major depression, social phobia, or no Axis I disorder, completed several information-processing tasks assessing attention and memory for sad, socially threatening, physically threatening, and positive stimuli. As predicted, depressed participants exhibited specific biases for stimuli connoting sadness; social phobic participants did not evidence such specificity for threat stimuli. It is important to note that the different measures of bias in memory and attention were not systematically intercorrelated. Implications for the study of cognitive bias in depression, and for cognitive theory more broadly, are discussed.

Adolescent↗
PubMed2004

Spanish-language measures of mania and depression.

Efforts to better understand bipolar spectrum disorders across ethnic groups are often hampered by the lack of commonly used self-report instruments to assess mania and depression in individuals who speak languages other than English. This article describes the translation into Spanish of 2 self-report measures of manic symptoms (i.e., the Internal State Scale and the Hypomanic Personality Scale) and 2 self-report measures of depression (i.e., the Inventory to Diagnose Depression and the Inventory to Diagnose Depression, Lifetime version). The authors translated these measures into Spanish and assessed their psychometric properties among bilingual college students (N = 88). Results suggest that the Spanish versions have psychometric properties comparable to the English versions of the instruments.

Adolescent↗
PubMed2004

Remarkable longevity of dilute sperm in a free-spawning colonial ascidian.

Many benthic marine invertebrates reproduce by releasing sperm into the sea (free-spawning), but the amount of time that sperm are viable after spawning may have different consequences for fertilization, depending on the type of free-spawner. In egg-broadcasting marine organisms, gamete age is usually assumed to be irrelevant because of the low probability of contact between dilute sperm and egg. However, direct dilution effects might be reduced in egg-brooding free-spawners that filter dilute sperm out of the water column, and sperm longevity may play a role in facilitating fertilization in these taxa. We investigated the effects of time, temperature, and mixing on the viability of naturally released sperm of the colonial ascidian Botryllus schlosseri. Our data indicate that B. schlosseri sperm have a functional life span that is considerably longer than those of the sperm of many other marine invertebrate taxa (half-life of approximately 16 to 26 h), are able to fertilize eggs at extremely low external sperm concentrations (ca. 10(1) sperm ml(-1)), and have a longevity that varies with temperature. It is possible that such prolonged sperm longevity may be achieved by reductions in motility, reactivation of quiescent sperm by chemical cues, or intermittent swimming.

Analysis of Variance↗