Biomedical subjects

Sherry H Stewart

Publications and source records attributed to Sherry H Stewart.

At least 19 recordsLinked to original sources

PubMed2007

Prevention and intervention strategies to alleviate preoperative anxiety in children: a critical review.

Preoperative anxiety (anxiety regarding impending surgical experience) in children is a common phenomenon that has been associated with a number of negative behaviors during the surgery experience (e.g., agitation, crying, spontaneous urination, and the need for physical restraint during anesthetic induction). Preoperative anxiety has also been associated with the display of a number of maladaptive behaviors postsurgery, including postoperative pain, sleeping disturbances, parent-child conflict, and separation anxiety. For these reasons, researchers have sought out interventions to treat or prevent childhood preoperative anxiety and possibly decrease the development of negative behaviors postsurgery. Such interventions include sedative premedication, parental presence during anesthetic induction, behavioral preparation programs, music therapy, and acupuncture. The present article reviews the existing research on the various modes of intervention for preoperative anxiety in children. Clinical implications and future directions are discussed.

Anti-Anxiety Agents↗

PubMed2006

Exploring differential patterns of situational risk for binge eating and heavy drinking.

This study was designed to compare risk situations for binge eating vs. heavy drinking among women who struggle with both problems. Participants were 41 women in treatment for an alcohol problem who also self-reported binge eating. Participants completed the Inventory of Binge Eating Situations (IBES; [Baker, J. M. (1998). Binge eating and binge drinking among university women. Unpublished master's thesis, Department of Psychology, Queen's University, Kingston, Ontario, Canada]) and the Inventory of Drinking Situations (IDS-42; [Annis, H. M., Graham, J. M., & Davis, C. S. (1987). Inventory of Drinking Situations (IDS) user's guide. Toronto, Canada: Addiction Research Foundation]) to measure frequency of binge eating and heavy drinking, respectively, in eight categories of situations. A 2 (substance) x8 (situation) repeated measures ANOVA revealed a significant substancexsituation interaction. Further exploration of this interaction indicated that heavy drinking is more likely than binge eating to occur in reward and interpersonal situations involving pleasant emotions, pleasant times with others, social pressure, and conflict with others. In contrast, binge eating and heavy drinking are equally likely to occur in relief situations involving unpleasant emotions, and physical discomfort, as well as in situations involving urges and temptations, and testing control. Implications of findings for the treatment of co-occurring binge eating and heavy drinking in women are discussed.

Adult↗

PubMed2006

Effects of midazolam on explicit vs implicit memory in a pediatric surgery setting.

RATIONALE: Placebo-controlled studies show that midazolam impairs explicit memory in children undergoing surgery (Buffett-Jerrott et al., Psychopharmacology 168:377-386, 2003; Kain et al., Anesthesiology 93:676-684, 2000). A recent within-subjects study showed that midazolam impaired explicit memory while leaving implicit memory intact in a sample of older children undergoing painful medical procedures (Pringle et al., Health Psychol 22:263-269, 2003). OBJECTIVES: We attempted to replicate and extend these findings in a randomized, placebo-controlled design with younger children undergoing surgery. MATERIALS AND METHODS: Children aged 3-6 years who were undergoing ear tube (myringotomy) surgery were randomly assigned to receive midazolam (n = 12) or placebo (n = 11). After surgery, they were tested on explicit (recognition) and implicit (priming) memory for pictures encoded before surgery. RESULTS: Relative to placebo, the midazolam-treated children showed poorer recognition memory on the explicit task but equivalent priming on the implicit task. CONCLUSIONS: Overall, it appears that midazolam induces a dissociation between explicit and implicit memory in young children in the pediatric surgery setting. Theoretical and clinical implications of the findings are discussed along with directions for future research.

Anti-Anxiety Agents↗

PubMed2006

High levels of impulsivity may contraindicate midazolam premedication in children.

PURPOSE: To investigate the effects of midazolam on emotional reactivity during induction of anesthesia in a pediatric day surgery setting. A secondary purpose was to determine if these effects were influenced by child temperament factors. METHODS: Forty children (age four to six years) scheduled for myringotomy were randomly assigned, in a double blind fashion, to receive either oral midazolam 0.5 mg.kg-1 mixed with acetaminophen suspension or acetaminophen alone. The Emotionality, Activity, Sociability, and Impulsivity (EASI) scale was used as a measure of child temperament. The modified Yale Preoperative Anxiety Scale (m-YPAS), an observer-rated measure of state anxiety, was employed to assess anxiety pre- and post-drug, and also at induction of anesthesia. RESULTS: Children who received midazolam reacted significantly less to induction of anesthesia than did children in the placebo control group, F (1, 38) = 7.46, P = 0.01. A significant positive association was observed between baseline levels of anxiety and observer-rated anxiety at anesthetic induction, but only in the placebo group, r = 0.58, P < 0.01. A significant positive association was observed between levels of impulsivity at baseline and observer-rated anxiety at anesthetic induction, but only in the midazolam group, r = 0.42, P < 0.05. CONCLUSIONS: Midazolam dampened adverse reactivity during anesthetic induction, particularly among children with high baseline levels of anxiety. Baseline level of impulsivity was positively associated with adverse reactions to anesthesia induction in the drug group, but not in the placebo group, suggesting that high levels of trait impulsivity may contraindicate the use of midazolam as a preoperative medication.

Acetaminophen↗

PubMed2006

Taxonicity of anxiety sensitivity: a multi-national analysis.

Taxometric coherent cut kinetic analyses were used to test the latent structure of anxiety sensitivity in samples from North America (Canada and United States of America), France, Mexico, Spain, and The Netherlands (total n = 2741). Anxiety sensitivity was indexed by the 36-item Anxiety Sensitivity Index--Revised (ASI-R; [J. Anxiety Disord. 12(5) (1998) 463]). Four manifest indicators of anxiety sensitivity were constructed using the ASI-R: fear of cardiovascular symptoms, fear of respiratory symptoms, fear of publicly observable anxiety reactions, and fear of mental incapacitation. Results from MAXCOV-HITMAX, internal consistency tests, analyses of simulated Monte Carlo data, and a MAMBAC external consistency test indicated that the latent structure of anxiety sensitivity was taxonic in each of the samples. The estimated base rate of the anxiety sensitivity taxon differed slightly between nations, ranging from 11.5 to 21.5%. In general, the four ASI-R based manifest indicators showed high levels of validity. Results are discussed in relation to the conceptual understanding of anxiety sensitivity, with specific emphasis on theoretical refinement of the construct.

Adolescent↗

PubMed2006

Heart rate increase to alcohol administration and video lottery terminal play among probable pathological gamblers and nonpathological gamblers.

The authors examined heart-rate responses to alcohol consumption and video lottery terminal (VLT) play. Regular VLT players (30 probable pathological gamblers [PPGs]; 30 nonpathological gamblers [NPGs]) were randomized to an alcohol (mean postdrinking blood alcohol concentration = 0.056%) or placebo condition. Heart rate was recorded at pre- and postdrinking baselines and during VLT play. Consistent with an earlier study, alcohol-condition participants displayed elevated heart rates relative to placebo-condition participants only at postdrinking and VLT play. Moreover, alcohol-condition participants showed a greater heart rate increase to VLT play than did placebo-condition participants. However, PPGs were not more susceptible to alcohol- and/or VLT play-induced heart rate accelerations than were NPGs. Implications for gambling/alcohol-disorder comorbidity are discussed.

Adult↗

PubMed2006

Tendency to catastrophize somatic sensations: pain catastrophizing and anxiety sensitivity in predicting headache.

General catastrophic thinking styles about uncomfortable bodily sensations may predispose the development of common health pathologies, such as persistent headache. The purpose of this research was to explore the relationships between the Pain Catastrophizing (PC) Scale and Anxiety Sensitivity (AS) Index, which measure tendencies to catastrophize pain- and anxiety-related somatic sensations, respectively. A non-clinical sample completed the PC Scale, AS Index, and health outcome questionnaires regarding headache (n = 1018). Results revealed that: (i) AS and PC are empirically separate constructs; (ii) the overlap between PC and AS lies within the domain of fearing physical catastrophe; (iii) AS independently predicts weekly headache, headache pain intensity, and the number of a wide range of physical symptoms associated with headache; and (iv) PC independently predicts the presence of weekly headache. Limitations and implications of this research, as well as recommendations for future research directions are discussed.

Adolescent↗

PubMed2006

Differences in high and low anxiety sensitive women's responses to a laboratory-based cold pressor task.

Anxiety sensitivity (AS) has been linked to a variety of disabling chronic health conditions, including pain-related conditions. A recent study has found that healthy women with high AS reported significantly higher levels of sensory and affective pain on an experimental cold pressor task compared to women with low AS. However, this study found no differences between AS groups for pain tolerance or pain threshold. In the present study, which was designed to replicate and extend these findings, 90 undergraduate university women were selected for inclusion in 1 of 2 AS groups (high or low) based on their screening scores on a 16-item measure of AS. Participants were tested individually on a lab-based cold pressor task using a variety of self-report and observer-measured variables. Data analyses revealed that, as expected, the high AS participants reported significantly more fear in response to the cold pressor on a relevant item of the McGill Pain Questionnaire-Short Form (SF-MPQ) than did the low AS participants. Also as expected, the high AS participants reported more pain in response to the cold pressor on the Present Pain Index (PPI) of the SF-MPQ than did the low AS participants. High AS participants did not differ from low AS participants on other aspects of the cold pressor response (e.g. pain threshold, pain tolerance, pain recovery). These results support the role of pain-related fear as a mediating variable between AS and increased perceived pain intensity.

Adolescent↗

PubMed2006

A brief cognitive-behavioral approach to reducing anxiety sensitivity decreases pain-related anxiety.

Anxiety sensitivity (AS; fear of anxiety-related sensations) is a known risk factor for anxiety disorders and recently has been linked to pain disorders. The present study was guided by the hypothesis that a program designed to reduce AS levels might also result in a decrease in anxiety related to pain sensations. Female undergraduates, selected as either high or low in AS according to screening scores on the Anxiety Sensitivity Index (ASI), were randomly assigned to participate in 3 1-hour, small group sessions of either cognitive behavioral therapy (CBT; psycho-education, cognitive restructuring, and interoceptive exposure) or a non-specific treatment (NST). Immediately prior to and following the intervention, participants completed the 20-item Pain Anxiety Symptoms Scale (PASS-20). Consistent with hypothesis, results revealed a 3-way interaction between AS group, intervention condition, and time on PASS-20 total scores. Only participants with high pre-morbid levels of AS assigned to the CBT condition showed a significant reduction in scores on the PASS-20 from pre- to post-treatment. Implications for improving CBT approaches for pain disorders are discussed.

Adolescent↗

PubMed2006

Anxiety sensitivity and its impact on pain experiences and conditions: a state of the art.

This paper serves as an introduction to the special issue of Cognitive Behaviour Therapy devoted to the topic of anxiety sensitivity (AS) and its impact on pain experiences and conditions. We provide a historical overview of relevant cognitive behavioural models of chronic pain, summarize recent models incorporating the AS construct, and introduce the papers in the special issue. These papers are organized into two sets--basic laboratory-based investigations and relatively more applied studies. We attempt to highlight some of the most important findings from each of these investigations and studies, in turn. Then, we consider several important conclusions derived from the set of special issue papers and the implications of these for the practice of cognitive-behavioural interventions with pain populations. Finally, we make several suggestions for directions for future investigations in this burgeoning area of cognitive behavioural research and practice.

Anxiety↗

PubMed2006

Why do women with alcohol problems binge eat? Exploring connections between binge eating and heavy drinking in women receiving treatment for alcohol problems.

Questionnaires assessing heavy drinking and binge eating were administered to 58 women with alcohol problems. A sub-sample of the binge-eaters then participated in qualitative interviews about their perceptions of the connections between their two problems. Seventy-one percent self-identified as binge-eaters with most reporting 'severe' binge eating. Binge-eaters were younger, more frequent drinkers and drank more often for emotional relief than non-binge-eaters. Binge eating and heavy drinking appeared to serve similar functions in a given client (i.e. emotional relief or reward functions). We discuss implications of the findings for the development of better treatments for women struggling with both health issues.

Adult↗

PubMed2006

Efficacy of cognitive-behavioral interventions targeting personality risk factors for youth alcohol misuse.

Sensation seeking, anxiety sensitivity, and hopelessness are personality risk factors for alcohol use disorders, each associated with specific risky drinking motives in adolescents. We developed a set of interventions and manuals that were designed to intervene at the level of personality risk and associated maladaptive coping strategies, including alcohol misuse. Manuals contained psychoeducational information on the target personality risk factor and how it is associated with maladaptive coping, as well as exercises targeting maladaptive cognitions and behaviors specific to each personality type. We tested the efficacy of these novel interventions on reducing drinking behavior by randomly assigning 297 Canadian high school students (56% girls, mean age 16, mean grade 11) to personality-targeted interventions (group format; 2 sessions) or to a no-treatment control group. Intent-to-treat analyses indicated beneficial effects of the intervention and Intervention x Personality interactions on drinking rates, drinking quantity, binge drinking, and problem drinking symptoms at 4-month follow-up.

Adaptation, Psychological↗

PubMed2005

Is beer the drink of choice for women with alcohol use problems? --Positive alcohol outcome expectancies as a function of beverage type.

The primary goal of this study was to evaluate whether women with alcohol problems report differences in their strength of endorsement of specific positive outcome expectancies as a function of alcoholic beverage type. Fifty-four participants completed the Beverage Expectancy Questionnaire (BEQ) that assessed five specific positive outcome expectancies across three different beverage types (i.e., wine, beer, hard liquor). Participants endorsed the strongest expectancies of Social/Sexual Enhancement, Global Positive Affect and Relaxation in the beer-specific context as compared to the wine-specific context. Levels of consumption were significantly higher overall for hard liquor than for wine in the sample as a whole. Quantity of wine drinking was predicted by wine-specific Arousal and Personality Transformation expectancies; quantity of beer drinking was predicted by beer-specific Arousal expectancies; quantity of hard liquor consumption was predicted by hard liquor-specific Personality Transformation, Relaxation, and Arousal expectancies. Clinical implications of the findings and future research directions are discussed.

Adult↗

PubMed2005

Anxiety sensitivity taxonicity across gender among youth.

The present investigation comparatively evaluated the latent class structure and parameters of anxiety sensitivity (AS) among female and male youth using the Childhood Anxiety Sensitivity Index. Participants were 4462 adolescents (2189 females) in grades 7-12 (M(age)=15.6 years). Consistent with prediction, taxometric analyses indicated the latent structure of AS was taxonic in both males and females, demonstrating the taxonic latent structure of AS is similarly observed across gender. Also consistent with prediction, the base rate of the AS taxon differed between genders -- higher for females (12%) compared to males (7%). These findings are discussed in terms of their implications for the study of AS and panic vulnerability among youth.

Adolescent↗

PubMed2005

Introduction to the special issue on ''relations between gambling and alcohol use''.

It has long been recognized that gambling is an activity that is often combined with alcohol intake. Not only do the behaviors of drinking and gambling frequently co-occur, alcohol use disorders and pathological gambling are also commonly co-morbid conditions in both clinical and non-clinical samples. This article introduces a special issue of the Journal of Gambling Studies focusing on cutting edge findings on the relations between gambling and alcohol use behaviors and their associated disorders. We set the stage for the following series of six novel empirical papers and integrative commentary by reviewing the theoretical pathways through which alcohol use and gambling disorders may be linked. We conclude by describing some of the novel contributions of each of the empirical studies from within the context of these theoretical models.

Alcohol-Related Disorders↗

PubMed2005

Alcohol's effects on video lottery terminal (VLT) play among probable pathological and non-pathological gamblers.

This study tested whether alcohol increases behaviors associated with video lottery terminal (VLT) play, particularly among probable pathological gamblers. Forty-four regular VLT players were designated either probable pathological gamblers or non-pathological gamblers on the basis of scores on the South Oaks Gambling Screen (SOGS); [Lesieur & Blume (1997). American Journal of Psychiatry, 144, 1184-1188] Gamblers from each SOGS category were randomly assigned to either a moderately intoxicating alcohol dose or a control beverage condition (n = 11 per cell in the 2 x 2 between-subjects design). Following beverage consumption and absorption, participants played a video poker VLT game for up to 30 minutes. Four behaviors were measured: "power-bets" (doubling bet after viewing only two cards of the five-card poker hand); total money spent; mean bet magnitude; and number of minutes played. Alcohol increased time spent playing and rate of power-bets, particular among the probable pathological gamblers. Post hoc analyses revealed that alcohol also influenced the proportion of losing hands played--increasing them among the probable pathological gamblers while decreasing them among the non-pathological gamblers. Clinical and policy implications of the findings are discussed.

Adult↗

PubMed2005

Contingent gambling-drinking patterns and problem drinking severity moderate implicit gambling-alcohol associations in problem gamblers.

Although problem gambling and problem drinking often co-occur, the processes underlying this association are not well understood. This study investigated the effects of contingent gambling-drinking patterns and problem drinking severity on implicit gambling-alcohol associations. Participants were 144 (34 female) problem gamblers. The South Oaks Gambling Screen (SOGS) measured severity of problem gambling. The Brief Michigan Alcohol Screening Test (BMAST) measured severity of problem drinking. The Implicit Association Test (Greenwald, McGhee, & Schwartz, 1998, Journal of Personality and Social Psychology, 74, 1464-1480) measured gambling-alcohol associations. Participants who reported drinking when they won displayed faster response time (i.e., priming) on trials where alcohol words were paired with gambling win (e.g., jackpot) vs. gambling loss (e.g., forfeit) words. The tendency to drink in response to losses did not influence the priming effect of win cues or moderate the effects of Win-Drinking Pattern on priming. Severity of problem drinking on the BMAST also correlated positively the priming effects of win cues. These findings indicate that a tendency to drink in response to gambling wins and more severe alcohol problems each coincide with stronger associations between gambling win and alcohol concepts in memory. Such associations can promote drinking and its attendant effects (e.g., poor decision-making) in problem gamblers, and thus, may contribute to co-morbid gambling and alcohol use disorders.

Adult↗

PubMed2005

The relationship between social anxiety disorder and alcohol use disorders: a critical review.

Epidemiological studies have demonstrated a significant co-morbidity between social anxiety disorder (SAD) and alcohol use disorders (AUDs). Despite the fact that many studies have demonstrated strong relationships between SAD and AUD diagnoses, there has been much inconsistency in demonstrating causality or even directionality of the relationship between social anxiety and alcohol-related variables. For example, some studies have showed a positive relationship between social anxiety and alcohol-related variables, while others have shown a negative relationship or no relationship whatsoever. In an attempt to better understand the relationship between social anxiety and alcohol, some researchers have explored potential moderating variables such as gender or alcohol expectancies. The present review reports on what has been found with regard to explaining the high co-morbidity between social anxiety and alcohol problems, in both clinical and non-clinical socially anxious individuals. With a better understanding of this complex relationship, treatment programs will be able to better target specific individuals for treatment and potentially improve the efficacy of the treatments currently available for individuals with co-morbid SAD and AUD.

Adaptation, Psychological↗