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1.
J Neuroophthalmol ; 2024 May 08.
Artículo en Inglés | MEDLINE | ID: mdl-38715188

RESUMEN

BACKGROUND: Visual changes due to hyperglycemia in diabetes are not uncommon. While blurred vision is a well-established sequela of chronic hyperglycemia, homonymous hemianopia with or without electroclinical seizures is much rarer and can be mistaken for migraine, temporal arteritis, or ischemia of the central nervous system. METHODS: This article analyzed case studies for 3 patients (67M, 68M, 52F) presenting with complex visual phenomena, from 3 to 42 days duration, including pathogenesis, clinical findings, management, and follow-up. RESULTS: Examinations demonstrated dense left homonymous hemianopias in 2 patients and a left inferior homonymous quadrantanopia in one, with no other abnormalities. Patients described vivid, nonstereotyped intermittent hallucinations in the affected fields. Blood glucose levels ranged from 13.5 to 35.0 mmol/L (243-630 mg/dL) without ketosis and HbA1c from 14.6% to 16.8%. Computed tomography of the brain showed no acute intracranial pathology. MRI of the brain either detected no abnormalities or demonstrated changes consistent with seizure activity. Electroencephalogram (EEG) demonstrated seizures over the right occipital region in each patient. EEG seizures coincided with patients' hallucinations, while they remained otherwise conscious. Oral hypoglycemic and antiepileptic medications were commenced with rapid and complete reversal of the seizures and visual field deficits, confirmed by repeat Automated 30-2 and MRI. CONCLUSIONS: Hyperglycemia-induced occipital lobe seizures with visual hallucinations and interictal homonymous visual field defects represent a rare but clinically important diagnosis. This article highlights the importance of prompt recognition and treatment to facilitate recovery.

2.
Intern Med J ; 54(6): 916-924, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38204302

RESUMEN

BACKGROUND: Vestibular migraine (VM) is a common cause of recurrent vertigo. Migraine headache preventative therapies are currently prescribed to control vertigo symptoms in VM. Clinical trials of nutraceuticals for migraine headache prevention have shown positive outcomes, but, to date, there have been no studies to assess their effectiveness in the management of VM. AIMS: To report the effects of nonprescription therapy management on VM symptoms. METHODS: We undertook a prospective, questionnaire-based assessment of patients diagnosed with VM between November 2019 and August 2021 at two Sydney tertiary referral clinics. Patients were advised on optimising sleep, hydration, exercise and nutrition and instructed to use an over-the-counter combination product containing riboflavin 200 mg, magnesium 150 mg, coenzyme Q10 75 mg and feverfew 200 mcg. Symptom severity and frequency were assessed using the Dizziness Handicap Inventory (DHI), the Vertigo Symptom Score short-form (VSS-sf) and two visual analogue scales for severity (VAS-s) and frequency (VAS-f) before and 3 months after commencing treatment. RESULT: In 82 participants (78% female; mean age, 44 ± 14 years) we recorded a decrease in DHI (mean, 16.8 [95% confidence interval (CI), 12.8-20.9], VSS-sf (9.3, 7.1-11.5), VAS-s (3.0, 2.2-3.8) and VAS-f (2.8, 2.1-3.4), equating to an improvement of 44.1%, 44.9%, 44.1% and 38.9% for each measure respectively. On the DHI and VSS-sf, 41 (50%) and 44 (53.7%) patients showed improvement in their symptoms; 39 (47.6%) and 36 (43.9%) patients noted no change and two patients reported worsening. The supplement was well-tolerated. CONCLUSIONS: The results provide preliminary evidence that VM symptom frequency and severity can be reduced by using nonprescription therapies.


Asunto(s)
Trastornos Migrañosos , Vértigo , Humanos , Femenino , Masculino , Trastornos Migrañosos/tratamiento farmacológico , Trastornos Migrañosos/prevención & control , Adulto , Estudios Prospectivos , Persona de Mediana Edad , Encuestas y Cuestionarios , Vértigo/tratamiento farmacológico , Resultado del Tratamiento , Medicamentos sin Prescripción/uso terapéutico , Ubiquinona/análogos & derivados , Ubiquinona/uso terapéutico
4.
J Med Internet Res ; 25: e45135, 2023 06 12.
Artículo en Inglés | MEDLINE | ID: mdl-37307046

RESUMEN

BACKGROUND: Digital mental health (DMH) interventions incorporating elements that adapt to the evolving needs of consumers have the potential to further our understanding of the optimal intensity of therapist assistance and inform stepped-care models. OBJECTIVE: The primary objective was to compare the efficacy of a transdiagnostic biopsychosocial DMH program, with or without therapist assistance for adults with subthreshold symptoms or a diagnosis of anxiety or depression. METHODS: In a randomized adaptive clinical trial design, all participants had access to the DMH program, with eligibility to have their program augmented with therapist assistance determined by program engagement or symptom severity. Participants who met stepped-care criteria were randomized to have their treatment program augmented with either low-intensity (10 min/week of video chat support for 7 weeks) or high-intensity (50 min/week of video chat support for 7 weeks) therapist assistance. A total of 103 participants (mean age 34.17, SD 10.50 years) were assessed before (week 0), during (weeks 3 and 6), and after the intervention (week 9) and at the 3-month follow-up (week 21). The effects of 3 treatment conditions (DMH program only, DMH program+low-intensity therapist assistance, and DMH program+high-intensity therapist assistance) on changes in the 2 primary outcomes of anxiety (7-item Generalized Anxiety Disorder Scale [GAD-7]) and depression (9-item Patient Health Questionnaire [PHQ-9]) were assessed using the Cohen d, reliable change index, and mixed-effects linear regression analyses. RESULTS: There were no substantial differences in the outcome measures among intervention conditions. However, there were significant time effect changes in most outcomes over time. All 3 intervention conditions demonstrated strong and significant treatment effect changes in GAD-7 and PHQ-9 scores, with absolute Cohen d values ranging from 0.82 to 1.79 (all P<.05). The mixed-effects models revealed that, in the Life Flex program-only condition at week 3, mean GAD-7 and PHQ-9 scores significantly decreased from baseline by 3.54 and 4.38 (all P<.001), respectively. At weeks 6, 9, and 21, GAD-7 and PHQ-9 scores significantly decreased from baseline by at least 6 and 7 points (all P<.001), respectively. Nonresponders at week 3 who were stepped up to therapist assistance increased program engagement and treatment response. At the postintervention time point and 3-month follow-up, 67% (44/65) and 69% (34/49) of the participants, respectively, no longer met diagnostic criteria for anxiety or depression. CONCLUSIONS: The findings highlight that early detection of low engagement and non-treatment response presents an opportunity to effectively intervene by incorporating an adaptive design. Although the study findings indicate that therapist assistance was no more effective than the DMH intervention program alone for reducing symptoms of anxiety or depression, the data highlight the potential influence of participant selection bias and participant preferences within stepped-care treatment models. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12620000422921; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378317&isReview=true. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/45040.


Asunto(s)
Depresión , Salud Mental , Humanos , Adulto , Australia , Ansiedad , Trastornos de Ansiedad
5.
JMIR Res Protoc ; 12: e45040, 2023 Apr 28.
Artículo en Inglés | MEDLINE | ID: mdl-37115623

RESUMEN

BACKGROUND: Anxiety and depression are leading causes of disease worldwide, requiring timely access to evidence-based treatment. Digital mental health (dMH) interventions increase accessibility to evidence-based psychological services delivered in a variety of web-based formats (eg, self-help and therapist-assisted interventions). Robust and rigorous studies of adaptive web-based intervention designs are scarce. No identified randomized clinical trial has investigated the efficacy of a 2-stage adaptive design, whereby the program-only condition or no support dMH treatment program is augmented by either low or high therapist assistance, if a participant does not improve or engage in the program-only condition. OBJECTIVE: The primary objective is to assess whether low or high therapist-assisted support delivered via video chat is more effective in reducing anxiety and depressive symptoms compared with a dMH program-only condition. The secondary objective is to evaluate the role of motivation; self-efficacy; and preferences in participant engagement, adherence, and clinical outcomes (anxiety and depression symptoms) among the 3 treatment conditions (program only, low-intensity therapist assistance, and high-intensity therapist assistance). A mixed methods analysis of factors affecting participant attrition, participant reasons for nonengagement and withdrawal, and therapist training and implementation of dMH interventions will be completed. Qualitative data regarding participant and therapist experiences and satisfaction with video chat assessment and treatment will also be analyzed. METHODS: Australian adults (N=137) with symptoms or a diagnosis of anxiety or depression will be screened for eligibility and given access to the 8-module Life Flex dMH treatment program. On day 15, participants who meet the augmentation criteria will be stepped up via block randomization to receive therapist assistance delivered via video chat for either 10 minutes (low intensity) or 50 minutes (high intensity) per week. This adaptive trial will implement a mixed methods design, with outcomes assessed before the intervention (week 0), during the intervention (weeks 3 and 6), after the intervention (week 9), and at the 3-month follow-up (week 21). RESULTS: The primary outcome measures are for anxiety (Generalized Anxiety Disorder-7) and depression severity (Patient Health Questionnaire-9). Measures of working alliance, health status, health resources, preferences, self-efficacy, and motivation will be used for secondary outcomes. Qualitative methods will be used to explore participant and therapist experiences of video chat assessment and treatment, participant reasons for withdrawal and nonengagement, and therapist training and implementation experiences. Data collection commenced in November 2020 and was completed at the end of March 2022. CONCLUSIONS: This is the first mixed methods adaptive trial to explore the comparative efficacy of different intensity levels of self-help and a therapist-assisted dMH intervention program delivered via video chat for adults with anxiety or depression. Anticipated results may have implications for the implementation of dMH interventions. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry 12620000422921; https://tinyurl.com/t9cyu372. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/45040.

6.
J Relig Health ; 62(3): 2112-2130, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35930213

RESUMEN

The 20-item Gomez and Fisher (Personal Individ Differ 35:1975-1991, 2003) Spiritual Well-Being Questionnaire (SWBQ) is a widely used measure of spiritual well-being. Its theoretical model is a higher-order model with primary factors for personal, communal, environmental, and transcendental well-being, and a secondary global spiritual well-being factor. The current study, conducted in Australia, reevaluated the factor structure of the SWBQ. Unlike previous studies, the current study also used exploratory structural equation modeling (ESEM) to examine the factor structure of the SWBQ and selected the preferred model using not only global model fit values, but also the clarity, reliabilities, and validities of the factors in the models. A total of 227 adults (males = 63; females = 164; M age = 26.1 years; SD = 5.2 years) completed the SWBQ. Based on the model selection criteria applied in the study, the ESEM model with four group factors was selected as the preferred model. However, there was also adequate support for the proposed theoretical higher-order model and the first-order oblique model with the four well-being factors. Concerning our preferred model, its factors showed reasonable clarity for factor loadings and (omega) reliabilities. However, only the communal domain scale was supported empirically for external validity. The implications of the findings for the theoretical model, the use of the SWBQ, and future studies are discussed. In this respect, there are three potential models (theorized higher-order model, 4-factor first-order oblique model, and the ESEM model proposed in this study) that warrant further detailed investigation with a larger, more representative population and additional validation measures.


Asunto(s)
Modelos Teóricos , Adulto , Masculino , Femenino , Humanos , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Análisis de Clases Latentes , Australia , Psicometría , Análisis Factorial
7.
Personal Disord ; 14(3): 334-338, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-35404647

RESUMEN

The study examined the measurement invariance (configural, metric, scalar, and residual) of the Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Brief Form (PID-5-BF; Krueger et al., 2013) across gender for the theorized Five-Factor oblique model. A large group of adults (N = 502), with ages ranging from 18 to 67 years, from the Australian general community completed the PID-5-BF. When the Δχ² test was applied, multiple-group confirmatory factor analysis supported configural invariance and full metric and residual invariance. For scalar invariance, at least seven items (constituting 13 thresholds) across the different dimensions lacked invariance for one or more of its thresholds. In addition, controlling all these noninvariance thresholds, women had higher latent mean scores for Negative Affect, and men had higher scores for Antagonism and Disinhibition. When the Δcomparative fit index (ΔCFI) test was applied, the findings also supported the configural invariance model and the full metric and residual invariance models. With the exception of one threshold, all the other thresholds were also invariant. The psychometric and practical implications of the findings are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Asunto(s)
Problema de Conducta , Adulto , Masculino , Humanos , Femenino , Adolescente , Adulto Joven , Persona de Mediana Edad , Anciano , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Reproducibilidad de los Resultados , Australia , Inventario de Personalidad , Psicometría , Personalidad
9.
Heliyon ; 8(10): e10712, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-36247147

RESUMEN

Background: The trait-impulsivity hypothesis posits impulsivity as the underlying substrate of Attention-deficit/hyperactivity disorder (ADHD) and Oppositional defiant disorder (ODD) symptom expressions. The current study applied network analysis to evaluate the inter-relationships of dimensions within ADHD (inattention and hyperactivity/impulsivity) and ODD (anger/irritable, vindictiveness, and argumentative/defiant behavior) with components of impulsivity as captured by the UPPS-P model (negative urgency, lack of premeditation, lack of perseverance, sensation seeking, and positive urgency). Method: A total of 324 emerging adults (women = 246) from the general community completed questionnaires covering these dimensions. Results: Our findings showed that the ADHD and ODD dimensions were associated differentially with different types of impulsivity, in their unique patterns of network connectivities, a possibility that has had little attention in the trait-impulsivity hypothesis literature. Conclusions: This study is the first to tease out the unique associations of the ADHD and ODD dimensions with different types of impulsivity, and in that way provide new contributions to our understanding of the existing trait impulsivity theory. Our findings would be especially relevant to those interested in understanding how different dimensions of trait impulsivity underly the ADHD and ODD dimensions.

10.
BMC Psychiatry ; 22(1): 263, 2022 04 13.
Artículo en Inglés | MEDLINE | ID: mdl-35418047

RESUMEN

Based on parent and teacher ratings of their children, this study used regularized partial correlation network analysis (EBIC glasso) to examine the structure of DSM-5 Oppositional Defiant Disorder (ODD) symptoms. Parent and teachers (N = 934) from the general community in Malaysia completed questionnaires covering DSM-5 ODD symptoms. The most central ODD symptom for parent ratings was anger, followed by argue. For teacher ratings, it was anger, followed by defy. For both parent and teacher ratings, the networks revealed at least medium effect size connections for temper and argue, defy, and argue, blames others, and annoy, and spiteful and angry. Overall, the findings were highly comparable across parent and teacher ratings, and they showed a novel understanding of the structure of the ODD symptoms. The clinical implications of the findings for assessment and treatment of ODD are discussed.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Déficit de la Atención y Trastornos de Conducta Disruptiva , Déficit de la Atención y Trastornos de Conducta Disruptiva/diagnóstico , Niño , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Humanos , Malasia , Padres , Encuestas y Cuestionarios
11.
PLoS One ; 17(2): e0261914, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35130284

RESUMEN

The Questionnaire of Cognitive and Affective Empathy (QCAE) is a multiple dimensional measure of cognitive empathy [comprising primary factors for perspective taking (PT), online simulation (OS)], and affective empathy [comprising primary factors for emotion contagion (EC), proximal responsivity (PRO), and peripheral responsivity (PER)]. This study used independent clusters confirmatory factor analysis (ICM-CFA) and exploratory structural equation modeling (ESEM) to examine the scale's factor structure. A general community sample of 203 (men = 43, women = 160) between 17 and 63 years completed the QCAE. Although both the five-factor oblique and second order factor models showed good model fit, and clarity in the pattern of factor loadings, in the second-order factor model, none of the primary factors loaded significantly on their respective secondary factors, thereby favoring the five-factor oblique model. The factors in this model were supported in terms of external validity. Despite this, the factor for PRO in this model showed low reliability for meaning interpretation. A revised four-factor oblique model without the PRO factor showed good fit, clarity in the pattern of factor loadings, and reliability and validity for the factors in this model, thereby suggesting this to be the best model to represent ratings on the QCAE.


Asunto(s)
Empatía
12.
Otol Neurotol ; 43(4): e489-e496, 2022 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-35085109

RESUMEN

OBJECTIVE: Menière's disease (MD) is characterized by recurrent vertigo and fluctuating aural symptoms. Diagnosis is straightforward in typical presentations, but a proportion of patients present with atypical symptoms. Our aim is to profile the array of symptoms patients may initially present with and to analyze the vestibular and audiological test results of patients with a diagnosis of MD. DESIGN: A retrospective study of patient files. SETTING: A tertiary, neuro-otology clinic Royal Prince Alfred Hospital, Sydney, Australia. METHOD: We identified 375 patients. Their history, examination, vestibular-evoked myogenic potentials (VEMP), video head-impulse test, canal-paresis on caloric testing, subjective visual horizontal (SVH), electrocochleography, ictal nystagmus, and audiometry were assessed. RESULTS: Atypical presenting symptoms were disequilibrium (n = 49), imbalance (n = 13), drop-attacks (n = 12), rocking vertigo (n = 2), and unexplained vomiting (n = 3), nonspontaneous vestibular symptoms in 21.6%, fluctuation of aural symptoms only (46%), and headaches (31.2%). Low velocity, interictal spontaneous-nystagmus in 13.3% and persistent positional-nystagmus in 12.5%. Nystagmus recorded ictally in 90 patients was mostly horizontal (93%) and of high velocity (48 ±â€Š34°/s). Testing yielded abnormal caloric responses in 69.6% and abnormal video head impulse test 12.7%. Air-conducted cervical VEMPs were abnormal in 32.2% (mean asymmetry ratio [AR] 30.2 ±â€Š46.5%) and bone-conducted ocular VEMPs abnormal in 8.8% (AR 11.2 ±â€Š26.8%). Abnormal interictal SVH was in 30.6%, (ipsiversive n = 46 and contraversive n = 19). Mean pure-tone averages 50 dB ±â€Š23.5 and 20 dB ±â€Š13 for affected and unaffected ears. CONCLUSION: Menière's disease has a distinctive history, but atypical presentations with normal vestibular function and hearing are a diagnostic challenge delaying treatment initiation.


Asunto(s)
Enfermedad de Meniere , Nistagmo Patológico , Potenciales Vestibulares Miogénicos Evocados , Pruebas Calóricas , Audición , Humanos , Enfermedad de Meniere/diagnóstico , Nistagmo Patológico/diagnóstico , Estudios Retrospectivos , Vértigo/diagnóstico
13.
J Neurol ; 269(1): 294-306, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34398269

RESUMEN

OBJECTIVE: Many patients attending the emergency room (ER) with vertigo, leave without a diagnosis. We assessed whether the three tools could improve ER diagnosis of vertigo. METHODS: A prospective observational study was undertaken on 539 patients presenting to ER with vertigo. We used three tools: a structured-history and examination, nystagmus video-oculography (VOG) in all patients, additional video head-impulse testing (vHIT) for acute-vestibular-syndrome (AVS). RESULTS: In the intervention-group (n = 424), case-history classified AVS in 34.9%, episodic spontaneous-vertigo (ESV 32.1%), and episodic positional-vertigo (EPV 22.6%). In AVS, we employed "Quantitative-HINTS plus" (Head-Impulse, Nystagmus and Test-of-Skew quantified by vHIT and VOG, audiometry) to identify vestibular-neuritis (VN) and stroke (41.2 and 31.1%). vHIT gain ≤ 0.72, catch-up saccade amplitude > 1.4○, saccade-frequency > 154%, and unidirectional horizontal-nystagmus, separated stroke from VN with 93.1% sensitivity and 88.5% specificity. In ESV, 66.2 and 14% were diagnosed with vestibular migraine and Meniere's Disease by using history and audiometry. Horizontal-nystagmus velocity was lower in migraine 0.4 ± 1.6○/s than Meniere's 5.7 ± 5.5○/s (p < 0.01). In EPV, benign positional vertigo (BPV) was identified in 82.3% using VOG. Paroxysmal positional-nystagmus lasting < 60 s separated BPV from non-BPV with 90% sensitivity and 100% specificity. In the control group of ER patients undergoing management-as-usual (n = 115), diagnoses included BPV (38.3%) and non-specific vertigo (41.7%). Unblinded assessors reached a final diagnosis in 90.6 and 30.4% of the intervention and control groups. Blinded assessors provided with the data gathered from each group reached a diagnosis in 86.3 and 41.1%. CONCLUSION: Three tools: a structured-assessment, vHIT and VOG doubled the rate of diagnosis in the ER.


Asunto(s)
Enfermedad de Meniere , Nistagmo Patológico , Neuronitis Vestibular , Vértigo Posicional Paroxístico Benigno/diagnóstico , Servicio de Urgencia en Hospital , Prueba de Impulso Cefálico , Humanos , Enfermedad de Meniere/diagnóstico , Nistagmo Patológico/diagnóstico
14.
HIV Med ; 23(6): 639-649, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-34964226

RESUMEN

OBJECTIVES: HIV outcomes centre primarily around clinical markers with limited focus on patient-reported outcomes. With a global trend towards capturing the outcomes that matter most to patients, there is agreement that standardizing the definition of value in HIV care is key to their incorporation. This study aims to address the lack of routine, standardized data in HIV care. METHODS: An international working group (WG) of 37 experts and patients, and a steering group (SG) of 18 experts were convened from 14 countries. The project team (PT) identified outcomes by conducting a literature review, screening 1979 articles and reviewing the full texts of 547 of these articles. Semi-structured interviews and advisory groups were performed with the WG, SG and people living with HIV to add to the list of potentially relevant outcomes. The WG voted via a modified Delphi process - informed by six Zoom calls - to establish a core set of outcomes for use in clinical practice. RESULTS: From 156 identified outcomes, consensus was reached to include three patient-reported outcomes, four clinician-reported measures and one administratively reported outcome; standardized measures were included. The WG also reached agreement to measure 22 risk-adjustment variables. This outcome set can be applied to any person living with HIV aged > 18 years. CONCLUSIONS: Adoption of the HIV360 outcome set will enable healthcare providers to record, compare and integrate standardized metrics across treatment sites to drive quality improvement in HIV care.


Asunto(s)
Infecciones por VIH , Adulto , Consenso , Infecciones por VIH/terapia , Personal de Salud , Humanos , Evaluación de Resultado en la Atención de Salud , Medición de Resultados Informados por el Paciente , Resultado del Tratamiento
16.
Assessment ; 28(1): 73-85, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-31535569

RESUMEN

Receiver operating characteristic curve analysis was used to examine and compare the diagnostic accuracy of the Conners 3-Parent Short Form (C 3-P(S)), and the Conners 3-Teacher Short Form (C 3-T(S)) inattention and hyperactivity/impulsivity scales, and the Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF) attention problems scales, to distinguish those with and without attention deficit/hyperactivity disorder (ADHD). It also examined and compared the diagnostic accuracy of the C 3-P(S) and C 3-T(S) Aggression (AG) scales, and the CBCL and TRF Aggressive Behavior (AB) scales, to distinguish those with and without oppositional defiant disorder (ODD). The study used archival data (N = 150-261) involving a large group of clinic-referred children aged between 6 and 11 years who had been interviewed for clinical diagnosis of ADHD and ODD using the Anxiety Disorders Interview Schedule for Children (ADISC-IV) as the reference standard, and then administered one or more of the screening measures. The findings provided empirical support for the use of the C 3-P(S) and CBCL for identifying ADHD and ODD, with the CBCL aggressive behavior scale having better ability to detect ODD. The implications of the findings for using the screening scales for diagnoses of ADHD and ODD are discussed.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Déficit de la Atención y Trastornos de Conducta Disruptiva/diagnóstico , Lista de Verificación , Niño , Humanos , Escalas de Valoración Psiquiátrica , Curva ROC
17.
J Neurol ; 268(2): 431-439, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31222419

RESUMEN

A retrospective analysis of the horizontal video head impulse test (vHIT) results and caloric testing results was undertaken on 644 patients who attended a neuro-otology outpatient facility. Presenting symptoms included spontaneous vertigo, positional vertigo, imbalance or chronic subjective dizziness. For 570 patients, the results of vHIT and caloric testing were concordant. Both tests were normal in 500 subjects with an average vHIT gain = 0.92 ± 0.09 (L); 0.98 ± 0.10 (R) and canal paresis (CP) = 7.88 ± 6.12; (range 0-28%). 54 had concordant asymmetries, average ipsilesional vHIT gain = 0.56 ± 0.15, average contralesional vHIT gain = 0.88 ± 0.12. CP = 68.02 ± 24.38 (range 31-100%). 16 subjects had bilateral vestibular hypofunction with average vHIT gains of 0.42 ± 0.20 (L); 0.41 ± 0.19 (R), peak slow phase velocity (SPV) on warm caloric testing = 2.68 ± 2.08, range 0-6°/s (L) and 3.75 ± 3.43 range, 0-10°/s (R). 36 patients showed a dissociation of results between the two tests. In these subjects, the vHIT gain was normal (0.93 ± 0.06 left and 0.98 ± 0.07 right) and the caloric test showed a CP > 30% (48 ± 13.8%). Their final diagnoses included clinically definite Meniere's disease (MD) (n = 27), vestibular schwannoma (VS) (n = 2) vestibular migraine (VM) (n = 1), vestibular neuritis (VN) (n = 5) and unknown (n = 1). No patient with abnormal HSCC gain on vHIT had a normal caloric result. The caloric test complements the vHIT in the assessment of vestibular disorders and is most useful in suspected endolymphatic hydrops. Asymmetric caloric function in the presence of normal horizontal head impulse tests is most commonly associated with Meniere's disease and may function as a diagnostic marker.


Asunto(s)
Enfermedad de Meniere , Neuronitis Vestibular , Pruebas Calóricas , Prueba de Impulso Cefálico , Humanos , Enfermedad de Meniere/diagnóstico , Estudios Retrospectivos
18.
J Pers Assess ; 103(4): 523-534, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32496822

RESUMEN

Revised reinforcement sensitivity theory (r-RST) of personality is a major neuropsychological theory of motivation, emotion and personality. This paper presents the results of a study examining: (1) the factor structure of the Reinforcement Sensitivity Theory of Personality Questionnaire (RST-PQ) using confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM); and (2) the relationships of the r-RST constructs in the RST-PQ with attention deficit hyperactivity disorder (ADHD) symptom groups of inattention (IA) and hyperactivity/impulsivity (HI). A total of 572 (Sample 1) and 309 (Sample 2) adults completed the RST-PQ. Participants in Sample 2 also completed a questionnaire measuring ADHD symptoms. Results revealed more support for the ESEM model with six factors than the CFA model. For both the ESEM and CFA models, both IA and HI symptom groups were associated positively with the RST-PQ constructs of behavioral inhibition system (BIS) and behavioral approach system (BAS) Impulsivity, with IA also associated negatively with the BAS-Goal-Drive Persistence. The theoretical implications of these findings for understanding the factor structure of the RST-PQ, and for ADHD (IA and HI) in terms of r-RST, are discussed.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/psicología , Inhibición Psicológica , Personalidad , Refuerzo en Psicología , Adulto , Emociones , Análisis Factorial , Femenino , Humanos , Conducta Impulsiva , Masculino , Motivación , Trastornos de la Personalidad/psicología , Encuestas y Cuestionarios
19.
Personal Disord ; 11(1): 69-77, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31670543

RESUMEN

The Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Brief Form (PID-5-BF), is a 25-item self-report questionnaire that measures the severity of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-proposed personality pathology constructs of negative affectivity, detachment, antagonism, disinhibition, and psychoticism. The current study used exploratory factor analysis, exploratory structural equation modeling, and confirmatory factor analysis to examine the support for the theoretically proposed 5-factor model. In total, 502 adults (male = 182, female = 320, age = 18-67 years [M = 28.93, SD = 10.95]) provided ratings for the PID-5-BF. For the theorized 5-factor model, there was support for its factor structure, internal consistency reliabilities (Cronbach's, ordinal alpha, and omega) of the factors, and coefficient of congruence of the factors considering a previous Danish study. The findings also supported a strong general factor for a bifactor model involving a general factor alongside the 5 group factors. Together, the findings support the use of the 5 personality pathology constructs and the total PID-5-BF scores in clinical and research settings. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Trastornos de la Personalidad/diagnóstico , Inventario de Personalidad/normas , Escalas de Valoración Psiquiátrica/normas , Adolescente , Adulto , Anciano , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Psicológicos , Reproducibilidad de los Resultados , Adulto Joven
20.
Food Res Int ; 126: 108661, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31732080

RESUMEN

This review critically evaluates the literature concerning the impact of visual appearance cues (including colour, foam, and cloudiness) on people's perception in the beer category. The authors assess both the sensory expectations that are elicited by the visual appearance of beer, and the extent to which those expectations carry-over to influence the actual tasting experience. Beer is a particularly intriguing category to study since the differing production rules in different countries mean that there is not always the same scope to modify the colour in order to meet perceived consumer demands. What is more, there is currently disagreement in the literature concerning the impact of beer colour and foam on people's expectations of beer prior to tasting, and their multisensory flavour perception on tasting. Given how much beer is consumed annually, it is surprising that more research has not been published that assesses the undoubtedly important role of visual appearance in this beverage category. Part of the reason for this may simply be that it is difficult to create consistent experimental stimuli given the rapid transition of the head of the beer post-serving.


Asunto(s)
Cerveza , Color , Percepción Visual , Comportamiento del Consumidor , Humanos , Sensación , Gusto
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