Trajectories of marijuana use from adolescence to young adulthood: predictors and outcomes

Semiparametric group-based mixture modeling was used with data from an adolescent school sample (N = 1205) for three purposes. First, five trajectory groups were identified to characterize different patterns of change in the frequency of marijuana use across four waves of assessment during adolescence. These trajectory groups were labeled Abstainers, Experimental Users, Decreasers, Increasers, and High Chronics. Second, trajectory group comparisons were made across eight adolescent risk factors to determine distinctive predictors of the trajectory groups. Findings indicated, for example, that the High Chronic group, relative to the other trajectory groups, had higher levels of delinquency, lower academic performance, more drug using friends, and more stressful life events. Third, adolescent trajectory group comparisons were made across 10 risk behaviors in young adulthood (average subject age = 23.5 years) and the occurrence of psychiatric and substance abuse disorders. Findings indicated some consistency across adolescence to young adulthood with regard to risk factors, and specificity with regard to the prediction of disorders. Adolescent trajectory group membership was significantly associated in young adulthood with cannabis and alcohol disorders but not with major depressive disorders or anxiety disorders.     

Parameters related to fibrinolysis and their meanings

To accurately assess fibrinolytic activity in plasma, many different assay methods are employed. We divided these to three categories by their capabilities. The method to assay plasminogen activation potential is the first, which is essentially determined by the balance between tissue plasminogen activator (tPA) and plasminogen activator inhibitor type 1(PA-1), and could be evaluated by plasma levels of these molecules as well as euglobulin clot lysis time (ECLT). The method to assay plasmin-dependent fibrin degradation potential is the second, which is mainly influenced by thrombin activatable fibrinolysis inhibitor (TAFI) and alpha2-antiplasmin, and could be evaluated by plasma levels of these modifiers as well as tPA supplemented plasma clot lysis time. The method to estimate ongoing status of fibrinolytic reaction in-vivo is the last, which could be evaluated by plasma levels of FDP including D-dimer and alpha2-antiplasmin-plasmin complex. Employing the methods in the first two categories, we may estimate the risk for thrombosis. Employing the methods in the last two categories, we may estimate the effectiveness as well as the bleeding risk of thrombolytic therapy. These assay methods are described together with underlying molecular mechanisms at each step of fibrinolytic system.     

The outcome of childhood conduct disorder: implications for defining adult personality disorder and conduct disorder.

The effect of conduct disorder on adult social functioning in the areas of work, sexual/love relationships, social relationships and criminality was studied in a sample of young adults who spent much of their childhoods in group-cottage children's homes and an inner-city comparison group. Most subjects with conduct disorder had pervasive (but not necessarily severe) social difficulties compared to peers without conduct disorder. Less than half of this group met DSM-III adult criteria for antisocial personality disorder and just over half were given a diagnosis of personality disorder on interviewer clinical ratings. A latent class model that used both the retrospective and contemporaneous indicators of conduct disorder confirmed the very high continuity with adult social difficulties. Current diagnoses did not adequately describe this group and conduct disorder appeared to be an almost necessary condition for multiple social disability in adults in these samples.     

Bipolar I affective disorder: predictors of outcome after 15 years

Background: Robust predictors of long-term outcome in bipolar affective disorder would have substantial importance to both clinicians and researchers. Such predictors are not available, however, perhaps because of the limitations of previous efforts to find them. Methods: In this study, 113 patients with bipolar affective disorder were followed semiannually for 5 years and annually for a subsequent 15 years. Of these, 23 (20.4%) had a poor long-term outcome indicated by the presence of mania or major depressive disorder throughout the 15th year. Results: Among the baseline demographic and clinical variables tested, only active alcoholism and low levels of optimum functioning in the preceding 5 years characterized poor outcome patients. The persistence of depressive symptoms in the first 2 years of follow-up predicted depressive symptoms 15 years later but the early persistence of manic symptoms seemed to have no predictive value. A regression analysis eliminated alcoholism as an independent predictor. Thus, only poor optimal functioning in the 5 years before baseline assessment, and the persistence of depressive symptoms in the two subsequent years, were independently associated with poor, long-term prognosis. Limitations: Patients were recruited at tertiary care centers and sampling was therefore biased toward greater severity and chronicity. As is true of all naturalistic studies of course, treatment was not controlled. Conclusion: These findings suggest the existence of a poor outcome, depression-prone subtype of bipolar affective disorder.     

Neuropsychology of obsessive-compulsive disorder: a review and treatment implications

The existing literature examining neuropsychological features of obsessive-compulsive disorder (OCD) is reviewed. The accumulated research points to a deficit in organizational strategies in general, suggesting problems in executive functioning. The available research is inconsistent in identifying memory deficits in OCD. However, memory problems are most evident when tests are used that require an implicit organizational strategy. While the majority of the research reviewed involves adult samples, there is emerging evidence that these deficits are present in children as well. It is suggested here that the interaction between organizational strategy deficits and the effort to recall unstructured information contributes to doubting, an important feature of OCD. Implications of this body of research for behavior therapy are considered.     

Trajectories and biopsychosocial predictors of daily acute pain in adolescents receiving treatment for pain: a daily diary study

Journal of Behavioral Medicine - Research regarding daily acute pain and its correlates has primarily been conducted with adolescents who have had major surgery or musculoskeletal pain, restraining...     

Predominant polarity in bipolar disorder: diagnostic implications

BACKGROUND: It has been reported that patients with bipolar disorder (BD) remain about 10 years symptomatic before the correct diagnosis is made. This fact is particularly important for patients with predominantly depressed polarity who tend to be diagnosed as suffering from unipolar major depressive disorder and treated with antidepressants. The present study was carried out to assess clinical differences between predominantly manic and depressed BD patients with a special focus on the time that patients remained undiagnosed. METHODS: Clinical and socio-demographic characteristics were obtained from a sample of 149 euthymic bipolar outpatients. Patients were divided into depressive or manic predominance of polarity. Clinical features, number of years undiagnosed (NYU) and occupational functioning were assessed in the two groups. RESULTS: Forty-five patients were classified as a "Depressive Polarity" whilst forty-seven were considered as "Manic Polarity". Depressive Polarity was associated with a longer delay to be diagnosed (F=14.43, df=89, p=0.001). The predominantly depressive patients tended to present a depressive onset of illness, earlier age of onset, longer duration of illness and higher number of suicide attempts than manic polarity patients. CONCLUSION: There was a marked clinical difference between predominantly manic and depressive bipolar patients. Predominantly depressive polarity is associated with a longer delay in receiving a correct diagnosis and effective treatment which has an important impact on the management of the illness.     

Trajectories of interpersonal problems in residential eating disorder treatment: Exploring the influence of primary diagnosis

Baseline interpersonal problems have been associated with treatment outcome in eating disorders (ED) and are important for understanding ED maintenance and aetiology. Despite this evidence, little is known about trajectories of change in interpersonal problems in the context of treatment, particularly in intensive ED treatment. This study examined the trajectory of total interpersonal problems in residential ED treatment, as well as two subdomains previously highlighted in ED research of being overly Cold (interpersonally distant) or overly Domineering (interpersonally controlling), as a function of different primary presenting ED diagnoses: anorexia nervosa restricting subtype (AN-R), binge-purge subtype (AN-BP), and bulimia nervosa or binge eating (BN/BED). Interpersonal problem data were collected at admission, discharge, and 6-month follow-up. Trajectories were analysed with multilevel models. Results showed small-to-medium statistically significant reductions in interpersonal problems across diagnostic groups from admission to discharge for total interpersonal scores, and gains appeared to be maintained at follow-up for both AN groups. Patients diagnosed with primary AN experienced steeper declines in total interpersonal problems from admission to follow-up compared with patients diagnosed with BN/BED, with AN-R experiencing the steepest trajectory. Planned contrasts indicated anyone with relevant binge eating behaviours had higher average levels of both Cold, as well as Domineering problems. Exploratory contrasts suggested that patients who had more Domineering problems also exhibited more binge symptoms and were typically slower to improve. Overall, results suggest interpersonal problems are generally malleable in residential ED treatment, yet change patterns differ by presenting ED symptoms and interpersonal problem subdomain.     

Posttraumatic stress disorder and pregnancy health: preliminary update and implications

Posttraumatic stress disorder (PTSD) is pervasive among women of childbearing age. The cascade of behavioral health and neuroendocrine changes commonly associated with PTSD may adversely affect perinatal health. The authors examined the relationship between PTSD and perinatal health in a sample of 101 women seeking prenatal care on the island of Oahu, Hawaii. Trauma, PTSD, and psychological and behavioral health were assessed during prenatal care. Pregnancy health, labor and delivery information, and birth outcomes were abstracted from medical records post-partum. Findings suggest that women with PTSD entering pregnancy are at increased risk for engaging in high-risk health behaviors, such as smoking, alcohol consumption, substance use, poor prenatal care, and excessive weight gain. Authors discuss clinical and research implications.     

Attachment in middle childhood: predictors,correlates, and implications for adaptation

Middle childhood is a relative lacuna in behavioral attachment research. We examined antecedents, correlates, and implications of parent–child attachment at age 10 in a longitudinal study of community families from a Midwestern US state (N = 102, mothers, fathers, and children). Dimensions of security, avoidance, ambivalence, and disorganization of children’s attachment to each parent were observed in lengthy naturalistic interactions and assessed using Iowa Attachment Behavioral Coding (IABC). IABC scores were meaningfully associated with history of parental responsiveness (7–80 months) and with earlier and concurrent attachment security, assessed with other established instruments (parent- and observer-rated Attachment Q-Set at 25 months, children’s reports at age 8 and 10). Structural equation modeling analyses revealed that the overall history of responsive care was meaningfully associated with Security, Avoidance, and Disorganization at age 10, in both mother–child and father–child relationships, and that most recent care uniquely predicted Security. IABC scores were also meaningfully related to a broad range of measures of child adaptation at ages 10–12. Cumulative history of children’s security from infancy to middle childhood, integrating measures across relationships and methodologies, also predicted child adaptation at ages 10–12.     

Examination of predictors and moderators for self-help treatments of binge-eating disorder

Predictors and moderators of outcomes were examined in 75 overweight patients with binge-eating disorder (BED) who participated in a randomized clinical trial of guided self-help treatments. Age variables, psychiatric and personality disorder comorbidity, and clinical characteristics were tested as predictors and moderators of treatment outcomes. Current age and age of BED onset did not predict outcomes. Key dimensional outcomes (binge frequency, eating psychopathology, and negative affect) were predominately predicted, but not moderated, by their respective pretreatment levels. Presence of personality disorders, particularly Cluster C, predicted both posttreatment negative affect and eating disorder psychopathology. Negative affect, but not major depressive disorder, predicted attrition, posttreatment negative affect, and eating disorder psychopathology. Despite the prognostic significance of these findings for dimensional outcomes, none of the variables tested were predictive of binge remission (i.e., a categorical outcome). No moderator effects were found. The present study found poorer prognosis for patients with negative affect and personality disorders, suggesting that treatment outcomes may be enhanced by attending to the cognitive and personality styles of these patients.     

Rat model of acute tetracycline hepatosis and its dynamic predictors

It is demonstrated that intraperitoneal administration of tetracycline hydrochloride in a dose of 125 mg/kg leads to the development of acute fatty hepatosis in rats within a 24-h period, by which time the maximum accumulation of lipids and triacylglycerides is observed in the liver. In addition, a direct dependence is established between the severity of fatty hepatosis and a decrease in the cytochrome P-450 content. The cytochrome P-450 content is a dynamic predictor of tetracycline fatty hepatosis. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 118, N ^o 12, pp. 603–605, December, 1994     

Personality and symptom sensitivity predictors of alprazolam withdrawal in panic disorder

BACKGROUND: Discontinuation of benzodiazepine (BZ) treatment results in a well-characterized withdrawal syndrome in 40-50% of anxious patients. While numerous studies have established the role of BZ dose, treatment duration, half-life, potency, rate of withdrawal and severity of underling anxiety disorder in predicting severity of withdrawal symptoms, fewer studies have examined the role of psychological and personality factors. METHOD: In 123 panic disorder patients undergoing gradual tapered discontinuation of alprazolam in conjunction with pre-treatment with carbamazepine or placebo, the relationship between measures of 'symptom sensitivity' and 'harm avoidance', and severity of withdrawal symptoms measured as peak severity of symptoms, time before taper needed to be slowed due to symptoms, and ability to complete taper, was examined. RESULTS: After controlling for the less substantial effects of dose, treatment duration, pre-taper anxiety and panic attack frequency, measures of symptom sensitivity and harm avoidance accounted for an additional 3-6% of withdrawal variance. CONCLUSIONS: These results show an effect of symptom sensitivity and harm avoidance on BZ withdrawal symptoms, comparable to prior findings linking dependent personality characteristics to withdrawal severity. Failure to show the expected effect on ability to complete taper may be due to either the more symptomatic nature of the patients in this study.     

Metacognitive,cognitive and developmental predictors of generalised anxiety disorder symptoms

Generalised anxiety disorder (GAD) is the most significant and common of the anxiety disorders. Intolerance of uncertainty (IU) and negative metacognitive beliefs are two prominent cognitive factors in models of GAD, however only one study to date has examined the relative contribution of these factors. Therefore, this study aimed to investigate and compare these cognitive factors in their prediction of GAD symptoms, and also to examine possible developmental influences on GAD by examining the link between symptoms and the parentification style of childrearing. In this analogue study, 119 non‐clinical participants (M age 22.90 years; 95 females, 24 males) completed measures of these constructs. Results indicated that both IU and negative beliefs about worry significantly related to GAD symptoms, however, the degree to which they predicted GAD symptoms did not significantly differ. Although a weak but significant relationship was found between parentification and GAD, this relationship did not remain significant after controlling for depression. Implications and limitations are discussed.