Exploring Demographic and Substance Use Correlates of Hookah Use in a Sample of Southern California Community College Students.

BACKGROUND AND PURPOSE: Hookah smoking is a growing young adult phenomenon, particularly among college students. Many users feel that it is safer than other tobacco products, although its health threats are well documented. Little is known about hookah use rates in community colleges that are attended by nearly half of all US college students. This study examined hookah use in a diverse convenience sample of students attending two southern California community colleges. METHODS: In fall 2011, a cross-sectional, in-classroom survey was administered to 1,207 students. A series of fully adjusted multivariate logistic regressions were conducted to explore demographic, other substance use, and attitudinal correlates of lifetime and current hookah use. RESULTS: Lifetime hookah use (56%) was higher than lifetime cigarette use (49%). Gender and personal socioeconomic status were not related to hookah use. Current use (10.8%) was associated with current use of alcohol, cigars, and cigarettes. Compared to African-Americans, Whites were 2.9 times more likely to be current users, and students who perceive hookah to be more socially acceptable were 21 times more likely to currently use. CONCLUSION: Since hookah use rates are high, colleges should offer health education programs to inform incoming students about the health risks of hookah and cessation programs.

Geriatric rigidity and its psychotherapeutic implications.

The elderly tend to be more rigid than younger adults in their attitudes and personalities, and such rigidity is correlated with poor adjustment. However, the rigidity is not the cause of the poor adjustment; rather, it is an attempted solution. One of the patterns of rigidity is an outgrowth of the lifestyle of pessimism, suspicion, self-reliance, self-discipline, determination, and endurance. Two case studies are presented illustrating how rigidity can channel thoughts and prevent the brooding which works itself into depression or anxiety, while simultaneously reinforcing self-help behavior. Geriatric psychotherapy should be problem-centered and should not launch a frontal assault on rigidity or attempt to reconstruct the patient's personality. Behavioral modification, authority, and motivation slogans can be used in conjunction with the rigidity to improve the patient's coping ability.

Brief psychotherapy: a case report illustrating its potential effectiveness.

The advance of industrialization in Mexico and elsewhere has brought about psychosocial problems of aging similar to those encountered in the United States. A case study is presented of a 64-year-old Mexican widow who had suicidal thoughts and feeling of uselessness. External constraints on the therapist dictated that psychotherapy be completed within 15 days. A strategy of brief psychotherapy was adopted. The focus was not on establishing transference, probing the unconscious or reconstructing the patient's personality, but on identifying problems and formulating practical solutions promptly. Four hour-long sessions were sufficient to gather information and to counsel the patient and her family. The diagnosis was depression. Treatment centered around increasing the quality of the patient's activity. The initial success of these measure made for a good prognosis. Both patient and family were advised of the availability of antidepressant drugs, and advised against relocating the patient.

Self-ratings of memory versus psychometric ratings of memory and hypochondriasis.

Self-ratings of memory were studied in 69 institutionalized women. The patients also were evaluated by means of three screening tests for organic brain syndrome (OBS) and a hypochondriasis scale. A negative correlation existed between self-rating of memory and actual memory as measured by the screening tests for OBS, but it was significant (p less than .05) for only one of the tests. There was also a negative correlation (p less than .01) between memory rating and scores on the hypochondriasis scale. Therefore, clinicians should not take patients' memory complaints as valid indicators of OBS, but as possible indicators of hypochondriasis.

Geriatric paranoia: case report illustrating behavioral management.

Paranoid thinking is a defense mechanism against feelings of inferiority and humiliation. Paranoid behavior serves as a means of getting attention, sympathy and help. A case study of an 81-year-old woman illustrates the nature of geriatric paranoia and the roles of interpersonal relationships, rigid personality, depression, and the impairment of sensory and memory functions. The problem proved to be the effects on the family and neighbors of the patient's verbally expressed paranoid delusions. Treatment consisted of reducing the frequency of these paranoid complaints by means of reality therapy and verbal non-reinforcement.

Geriatric hypochondriasis: situational factors.

The hypochondriacal attitudes of 53 aged community residents were studied. No significant correlations were found with situational stress, sex, or ethnicity (English-speaking vs Spanish-speaking). The levels of hypochondriasis appeared to be inversely related to self-evaluation of memory ability. There was no indication of an inherent iatrogenic effect. It was concluded that hypochondriacal behavior is chiefly a function of the underlying personality, which may influence the perception of events as stressful.

Senile confusion: limitations of assessment by the face-hand test, mental status questionnaire, and staff ratings.

Three of the most common and convenient measures of senile confusion are informal staff ratings, the Face-Hand Test (FHT) and the Mental Status Questionnaire (MSQ). A group of 112 geriatric patients in two extended care facilities, and a volunteer sample of 40 community aged were examined by means of the FHT and MSQ. These instruments proved valuable in differentiating patients rated as confused from those rated as lucid and alert, and from the community subjects. However, each of these measures, as well as the staff ratings, produced false negative findings. Staff ratings incorrectly identified a hypochondriacal and paranoid patient as confused. The FHT scores of lucid and alert patients with some brain damage were low. MSQ scores of some poorly educated immigrants were very low, even though these patients were rated as lucid and alert by the staff and passed the FHT. One normally lucid and alert patient with a fever and an irregular rapid pulse failed both the FHT and the MSQ. Guidelines for further use of these instruments are presented.

Senile confusion: assessment with a new stimulus recognition test.

There is a need for rapid and convenient assessment instruments to test the aged for senile confusion due to organic brain syndrome (OBS). The Mental Status Questionnaire (MSQ) and the Face-Hand Test (FHT) have certain limitations. A valid instrument must measure short-term memory loss and recognition. Sixty-two patients were examined in 17 different trials of the Stimulus Recognition Test (SRT), which involves 10 items. Each item classified the patients according to staff ratings (P less than .001), MSQ MSQ scores (P less than .005), and FHT scores (P less than .005). The composite MSQ score on a scale of 0--10 also served to separate the patients according to staff ratings (P less than .005). The SRT scores correlated .81 to .67 with the MSQ and FHT scores. The SRT does not show the same false positive patterns as the MSQ and FHT. For that reason, it constitutes a useful diagnostic supplement. Suggestions for further research are made.

Hypochondriasis in an institutional geriatric population: construction of a scale (HSIG).

The staffs at three extended care facilities identified a group of 10 hypochondriacal patients. The research team asked these 10 patients and 59 controls, 27 questions relating to health attitudes and behaviors. Six items were found to be fairly useful in distinguishing hypochondriacal from non-hypochondriacal subjects. These six items were taken as the Hypochondriasis Scale for Institutional Geriatric Patients (HSIG), and each patient scored on the basis of his responses to these six items. This test proved to be one way of distinguishing between hypochondriacal and non-hypochondriacal groups (P less than .005). However, because of the possibility of false positive results, the scale should be used only to confirm staff suspicions of hyponchondriasis and should not be used as part of the clinical intake procedure.

Development and validation of a geriatric depression screening scale: a preliminary report.

A new Geriatric Depression Scale (GDS) designed specifically for rating depression in the elderly was tested for reliability and validity and compared with the Hamilton Rating Scale for Depression (HRS-D) and the Zung Self-Rating Depression Scale (SDS). In constructing the GDS a 100-item questionnaire was administered to normal and severely depressed subjects. The 30 questions most highly correlated with the total scores were then selected and readministered to new groups of elderly subjects. These subjects were classified as normal, mildly depressed or severely depressed on the basis of Research Diagnostic Criteria (RDC) for depression. The GDS, HRS-D and SDS were all found to be internally consistent measures, and each of the scales was correlated with the subject's number of RDC symptoms. However, the GDS and the HRS-D were significantly better correlated with RDC symptoms than was the SDS. The authors suggest that the GDS represents a reliable and valid self-rating depression screening scale for elderly populations.

Depression in the aged: dynamics and treatment.

Depression is one of the common threats to the mental health of the aged. The chief cause is the interiorization of the personality and the growth of inferiority feelings due to poor adjustment to retirement, widowhood, and/or chronic physical conditions. Psychotherapy for geriatric depression can be done by a primary care physician. Specific guidelines are given for the use of psychotherapy, psychotropics, and electroconvulsive therapy (ECT) with aged patients suffering from depression in conjunction with various complications (suicidal risk, chronic brain syndrome, hypochondriasis, and paranoia).

Processing postmortem specimens with C18-carboxypropylbetaine and analysis by PCR to develop an antemortem test for Mycobacterium avium infections in ducks.

Mycobacterium avium is the causative agent of the avian mycobacteriosis commonly known as avian tuberculosis (ATB). This infection causes disseminated disease, is difficult to diagnose, and is of serious concern because it causes significant mortality in birds. A new method was developed for processing specimens for an antemortem screening test for ATB. This novel method uses the zwitterionic detergent C18-carboxypropylbetaine (CB-18). Blood, bone marrow, bursa, and fecal specimens from 28 ducks and swabs of 20 lesions were processed with CB-18 for analysis by smear, culture, and polymerase chain reaction (PCR). Postmortem examination confirmed nine of these birds as either positive or highly suspect for disseminated disease. The sensitivities of smear, culture, and PCR, relative to postmortem analysis and independent of specimen type, were 44.4%, 88.9%, and 100%, respectively, and the specificities were 84.2%, 57.9%, and 15.8%, respectively. Reductions in specificity were due primarily to results among fecal specimens. However, these results were clustered among a subset of birds, suggesting that these tests actually identified birds in early stages of the disease. Restriction fragment length polymorphism mapping identified one strain of M. avium (serotype 1) that was isolated from lesions, bursa, bone marrow, blood, and feces of all but three of the culture-positive birds. In birds with confirmed disease, blood had the lowest sensitivity and the highest specificity by all diagnostic methods. Swabs of lesions provided the highest sensitivity by smear and culture (33.3% and 77.8%, respectively), whereas fecal specimens had the highest sensitivity by PCR (77.8%). The results of this study indicate that processing fecal specimens with CB-18, followed by PCR analysis, may provide a valuable first step for monitoring the presence of ATB in birds.

Hypochondriasis, loneliness, and social functioning.

For 69 community college students, scores on the Hypochondriasis Scale correlated .44 with those on the UCLA Loneliness Scale, and .53 with problems in social functioning. These data are consistent with DSM-III--R listings of poor coping and social skills for hypochondriacal personality.

Assessment of depression in college students: Geriatric Depression Scale versus Center for Epidemiological Studies Depression Scale.

103 college students took the Geriatric Depression Scale and Center for Epidemiological Studies Depression Scale along with five measures of life satisfaction. The correlation between scores on the first scales was .66. Both depression scales had moderate negative correlations (-.34 to -.71) with each measure of life satisfaction. However, on every measure of life satisfaction, the correlation with scores on the Geriatric Depression Scale was higher than with those on the CES-Depression Scale.