RESUMEN
Ultrafast laser techniques have revealed extraordinary spin dynamics in magnetic materials that equilibrium descriptions of magnetism cannot explain. Particularly important for future applications is understanding non-equilibrium spin dynamics following laser excitation on the nanoscale, yet the limited spatial resolution of optical laser techniques has impeded such nanoscale studies. Here we present ultrafast diffraction experiments with an X-ray laser that probes the nanoscale spin dynamics following optical laser excitation in the ferrimagnetic alloy GdFeCo, which exhibits macroscopic all-optical switching. Our study reveals that GdFeCo displays nanoscale chemical and magnetic inhomogeneities that affect the spin dynamics. In particular, we observe Gd spin reversal in Gd-rich nanoregions within the first picosecond driven by the non-local transfer of angular momentum from larger adjacent Fe-rich nanoregions. These results suggest that a magnetic material's microstructure can be engineered to control transient laser-excited spins, potentially allowing faster (~ 1 ps) spin reversal than in present technologies.
RESUMEN
BACKGROUND: Data from a community-based longitudinal study were used to investigate whether childhood abuse and neglect increases risk for personality disorders (PDs) during early adulthood. METHODS: Psychosocial and psychiatric interviews were administered to a representative community sample of 639 youths and their mothers from 2 counties in the state of New York in 1975, 1983, 1985 to 1986, and 1991 to 1993. Evidence of childhood physical abuse, sexual abuse, and neglect was obtained from New York State records and from offspring self-reports in 1991 to 1993 when they were young adults. Offspring PDs were assessed in 1991 to 1993. RESULTS: Persons with documented childhood abuse or neglect were more than 4 times as likely as those who were not abused or neglected to be diagnosed with PDs during early adulthood after age, parental education, and parental psychiatric disorders were controlled statistically. Childhood physical abuse, sexual abuse, and neglect were each associated with elevated PD symptom levels during early adulthood after other types of childhood maltreatment were controlled statistically. Of the 12 categories of DSM-IV PD symptoms, 10 were associated with childhood abuse or neglect. Different types of childhood maltreatment were associated with symptoms of specific PDs during early adulthood. CONCLUSIONS: Persons in the community who have experienced childhood abuse or neglect are considerably more likely than those who were not abused or neglected to have PDs and elevated PD symptom levels during early adulthood. Childhood abuse and neglect may contribute to the onset of some PDs.
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Maltrato a los Niños/estadística & datos numéricos , Trastornos de la Personalidad/epidemiología , Adolescente , Adulto , Factores de Edad , Niño , Maltrato a los Niños/diagnóstico , Abuso Sexual Infantil/diagnóstico , Abuso Sexual Infantil/estadística & datos numéricos , Preescolar , Escolaridad , Femenino , Humanos , Lactante , Estudios Longitudinales , Masculino , Trastornos Mentales/epidemiología , New York/epidemiología , Padres/psicología , Trastornos de la Personalidad/diagnóstico , Estudios Retrospectivos , Factores de RiesgoRESUMEN
The study's goal was to determine if cardiac output (CO), obtained by impedance cardiography (ICG), would be improved by a new equation N, implementing a square root transformation for dZ/dtmax/Z0, and a variable magnitude, mass-based volume conductor Vc. Pulmonary artery catheterisation was performed on 106 cardiac surgery patients pre-operatively. Post-operatively, thermodilution cardiac output (TDCO) was simultaneously compared with ICG CO. dZ/dtmax/Z0 and Z0 were obtained from a proprietary bioimpedance device. The impedance variables, in addition to left ventricular ejection time TLVE and patient height and weight, were input using four stroke volume (SV) equations: Kubicek (K), Sramek (S), Sramek-Bernstein (SB), and a new equation N. CO was calculated as SV x heart rate. Data are presented as mean +/- SD. One way repeated measures of ANOVA followed by the Tukey test were used for inter-group comparisons. Bland-Altman methods were used to assess bias, precision and limits of agreement. P< 0.05 was considered statistically significant. CO implementing N (6.06 +/- 1.48 l min(-1)) was not different from TDCO (5.97 +/- 1.41 l min(-1)). By contrast, CO calculated using K (3.70 +/- 1.53 l min(-1)), S (4.16 +/- 1.83 l min(-1)) and SB (4.37 +/- 1.82 l min(-1)) was significantly less than TDCO. Bland-Altman analysis showed poor agreement between TDCO and K, S and SB, but not between TDCO and N. Compared with TDCO, equation N, using a square-root transformation for dZ/dtmax/Z0, and a mass-based Vc, was superior to existing transthoracic impedance techniques for SV and CO determination.
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Cardiografía de Impedancia/métodos , Modelos Cardiovasculares , Volumen Sistólico , Adulto , Anciano , Anciano de 80 o más Años , Procedimientos Quirúrgicos Cardíacos , Femenino , Hemodinámica , Humanos , Masculino , Persona de Mediana Edad , Cuidados Posoperatorios/métodos , Procesamiento de Señales Asistido por ComputadorRESUMEN
OBJECTIVE: The purpose of this study was to estimate the prevalence, concurrent validity, and stability of DSM-III-R personality disorders in a large community-based sample of adolescents. METHOD: A randomly selected community sample of 733 youths ranging in age from 9 to 19 years was followed over a 2-year period. The protocol consisted of structured interviews with the adolescents and their mothers and self-report questionnaires. Algorithms for 10 DSM-III-R axis II disorders were developed to produce diagnoses at two levels of severity; these were validated against multiple indicators of distress and functional impairment. RESULTS: The overall prevalence of personality disorders peaked at age 12 in boys and at age 13 in girls and declined thereafter. Obsessive-compulsive personality disorder was the most prevalent moderate axis II disorder, narcissistic personality disorder the most prevalent severe disorder, and schizotypal personality disorder the least prevalent axis II disorder, based on both moderate and severe diagnostic thresholds. All moderate axis II disorders were associated with significantly greater odds for at least five of 12 diagnostic validators. Longitudinal follow-up revealed that although most axis II disorders did not persist over a 2-year period, subjects with disorders identified earlier remained at elevated risk for receiving a diagnosis again at follow-up. CONCLUSIONS: These findings suggest that a substantial minority of adolescents who are not in treatment qualify for DSM-III-R personality disorder diagnoses and that these diagnoses are associated with increased risk of psychological distress and functional impairment.
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Trastornos de la Personalidad/epidemiología , Adolescente , Adulto , Factores de Edad , Niño , Estudios Transversales , Recolección de Datos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Narcisismo , Oportunidad Relativa , Trastornos de la Personalidad/diagnóstico , Inventario de Personalidad , Prevalencia , Escalas de Valoración Psiquiátrica , Psicología del Adolescente , Factores de Riesgo , Trastorno de la Personalidad Esquizotípica/diagnóstico , Trastorno de la Personalidad Esquizotípica/epidemiología , Índice de Severidad de la Enfermedad , Factores SexualesRESUMEN
OBJECTIVE: The purpose of this study was to investigate the childhood antecedents of personality disorders that are diagnosed in adolescence. METHOD: A randomly selected community sample of 641 youths was assessed initially in childhood and followed longitudinally over 10 years. Childhood behavior ratings were based on maternal report; diagnoses of adolescent personality disorders were based on data obtained from both maternal and youth informants. Four composite measures of childhood behavior problems were used: conduct problems, depressive symptoms, anxiety/fear, and immaturity. Adolescent personality disorders were considered present only if the disorders persisted over a 2-year period. For all analyses, personality disorders were grouped into the three clusters (A, B, and C) of DSM-III-R. RESULTS: Logistic regression analyses indicated that all four of the putative childhood antecedents were associated with greater odds of an adolescent personality disorder 10 years later. Childhood conduct problems remained an independent predictor of personality disorders in all three clusters, even when other childhood problems were included in the same regression model. Additionally, depressive symptoms emerged as an independent predictor of cluster A personality disorders in boys, while immaturity was an independent predictor of cluster B personality disorders in girls. No moderating effects of age at time of childhood assessment were found. CONCLUSIONS: These results support the view that personality disorders can be traced to childhood emotional and behavioral disturbances and suggest that these problems have both general and specific relationships to adolescent personality functioning.
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Síntomas Afectivos/diagnóstico , Trastornos de la Conducta Infantil/diagnóstico , Trastornos de la Personalidad/diagnóstico , Adolescente , Síntomas Afectivos/epidemiología , Ansiedad/diagnóstico , Ansiedad/epidemiología , Niño , Trastornos de la Conducta Infantil/epidemiología , Comorbilidad , Depresión/diagnóstico , Depresión/epidemiología , Miedo , Femenino , Estudios de Seguimiento , Humanos , Modelos Logísticos , Estudios Longitudinales , Masculino , Oportunidad Relativa , Trastornos de la Personalidad/epidemiología , Distribución Aleatoria , Factores de Riesgo , Muestreo , Factores SexualesRESUMEN
OBJECTIVE: This report presents initial findings on the reliability and validity of a new retrospective measure of child abuse and neglect, the Childhood Trauma Questionnaire. METHOD: Two hundred eighty-six drug- or alcohol-dependent patients were given the Childhood Trauma Questionnaire as part of a larger test battery, and 40 of these patients were given the questionnaire again after an interval of 2 to 6 months. Sixty-eight of the patients were also given a structured interview for child abuse and neglect, the Childhood Trauma Interview, that was developed by the authors. RESULTS: Principal-components analysis of responses on the Childhood Trauma Questionnaire yielded four rotated orthogonal factors: physical and emotional abuse, emotional neglect, sexual abuse, and physical neglect. Cronbach's alpha for the factors ranged from 0.79 to 0.94, indicating high internal consistency. The Childhood Trauma Questionnaire also demonstrated good test-retest reliability over a 2- to 6-month interval (intraclass correlation = 0.88), as well as convergence with the Childhood Trauma Interview, indicating that patients' reports of child abuse and neglect based on the Childhood Trauma Questionnaire were highly stable, both over time and across type of instruments. CONCLUSIONS: These findings provide strong initial support for the reliability and validity of the Childhood Trauma Questionnaire.
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Maltrato a los Niños/diagnóstico , Inventario de Personalidad/normas , Adulto , Anciano , Alcoholismo/diagnóstico , Alcoholismo/psicología , Atención Ambulatoria , Niño , Abuso Sexual Infantil/diagnóstico , Análisis Factorial , Familia/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Inventario de Personalidad/estadística & datos numéricos , Escalas de Valoración Psiquiátrica/normas , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Psicometría , Reproducibilidad de los Resultados , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Factores Sexuales , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/psicología , Encuestas y Cuestionarios/normasRESUMEN
Eye tracking accuracy, which has been found to be impaired in schizophrenic patients and their relatives, was assessed in 26 patients with schizotypal personality disorder, 17 control subjects with other non-schizophrenia-related personality disorders, 29 normal control subjects, and 44 schizophrenic patients. Both schizotypal and schizophrenic patients, but not control subjects with other personality disorders, demonstrated significantly more impaired tracking than the normal control subjects. These results suggest that patients with clinically defined schizotypal personality disorder may be biologically related to schizophrenic patients as part of a spectrum of schizophrenia-related disorders.
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Movimientos Oculares , Trastorno de la Personalidad Esquizotípica/fisiopatología , Adulto , Diagnóstico Diferencial , Humanos , Trastornos de la Personalidad/diagnóstico , Trastornos de la Personalidad/fisiopatología , Escalas de Valoración Psiquiátrica , Esquizofrenia/diagnóstico , Esquizofrenia/fisiopatología , Trastorno de la Personalidad Esquizotípica/diagnósticoRESUMEN
OBJECTIVE: To present initial findings on the validity of a recently developed maltreatment inventory, the Childhood Trauma Questionnaire (CTQ), in a sample of adolescent psychiatric patients. METHOD: Three hundred ninety-eight male and female adolescents (aged 12 to 17 years) admitted to the inpatient service of a private psychiatric hospital were given the CTQ as part of a larger test battery. Structured interviews were also conducted with the primary therapists of 190 of the patients to obtain ratings of abuse and neglect based on all available data, including clinical interviews with patients and their relatives and information from referring clinicians and agencies. RESULTS: Principal-components analysis of the CTQ items yielded five rotated factors-emotional abuse, emotional neglect, sexual abuse, physical abuse, and physical neglect-closely replicating the factor structure in an earlier study of adult patients. The internal consistency of the CTQ factors was extremely high both in the entire sample and in every subgroup examined. When CTQ factor scores were compared with therapists' ratings in a series of logistic regression analyses, relationships between the two sets of variables were highly specific, supporting the convergent and discriminant validity of the CTQ. Finally, when therapists' ratings were used as the validity criterion, the CTQ exhibited good sensitivity for all forms of maltreatment, and satisfactory or better levels of specificity. CONCLUSIONS: These initial findings suggest that the CTQ is a sensitive and valid screening questionnaire for childhood trauma in an adolescent psychiatric inpatient setting.
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Maltrato a los Niños/diagnóstico , Maltrato a los Niños/psicología , Trastornos Mentales/psicología , Encuestas y Cuestionarios/normas , Adolescente , Niño , Abuso Sexual Infantil/diagnóstico , Abuso Sexual Infantil/psicología , Femenino , Humanos , Modelos Logísticos , Masculino , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
Seventy-six patients with closed head injuries alone were studied to define the relation between the severity of the head injury and secondary alterations of general metabolism. The effect of metabolic changes on neurological outcome and the importance of nutritional support on nutritional status and neurological outcome were also evaluated. Using a powerful statistical tool, convergence analysis, it was possible to take into consideration the effects of a number of confounding factors that obviously affected general metabolism. Most of the patients were hypermetabolic for prolonged periods. In addition, many did not receive even basal requirements of calories or protein for many days. Despite this, their outcomes were determined by their initial neurological status and the amounts that they were fed, admittedly relatively modest, did not influence their courses. Despite such feedings, their visceral protein levels, which often dropped initially, rose toward normal levels, indicating effective adaptation. Indeed, it could not be shown that these patients developed complications of malnutrition such as infections. However, it will require a sophisticated randomized clinical trial of vigorous intravenous hyperalimentation to determine whether this complex, dangerous, and expensive therapy is helpful for severely head-injured patients.
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Traumatismos Craneocerebrales/metabolismo , Traumatismos Craneocerebrales/sangre , Traumatismos Craneocerebrales/fisiopatología , Ingestión de Energía , Humanos , Sistema Nervioso/fisiopatología , Estado Nutricional , Albúmina Sérica/análisis , Transferrina/sangreRESUMEN
To try to define the significance of disseminated intravascular coagulation (DIC) in head-injured patients, we correlated clinical, laboratory, and pathological findings in 16 patients with head injury as their main problem who had DIC, who died within 4 days of injury, and who were examined postmortem. Patients were ranked according to the number of abnormal laboratory screening tests for DIC and the severity of these abnormalities. The most frequently abnormal laboratory tests were the fibrinogen degradation products and fibrinogen, followed in order by the activated partial thromboplastin time, prothrombin time, and thrombin time. The platelet count was the least abnormal value. The patients with the fewest abnormalities had the least abnormal computed tomographic scans. Autopsy reports revealed necrosis and bleeding in the brain and in a number of other organs, particularly the lungs. Microthrombi were not reported in the original autopsy reports. However, when these cases were reevaluated and their slides were stained with an immunoperoxidase technique using rabbit anti-human fibrinogen antiserum, microthrombi were seen frequently. Large microthrombi were more common in patients who had died within less than 24 hours, suggesting a relationship to death or to less time for lysis. In order of frequency, the brain/spinal cord, liver, lungs, kidneys, and pancreas were most commonly affected, and the liver, pituitary gland, pancreas, thymus, brain/spinal cord, large intestine, kidneys, and lungs had the greatest density of microthrombi. Pulmonary dysfunction had been a frequent problem in these patients, which may have been related to the high incidence of microthrombi and bleeding found in the lungs.(ABSTRACT TRUNCATED AT 250 WORDS)
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Lesiones Encefálicas/complicaciones , Encéfalo/patología , Coagulación Intravascular Diseminada/complicaciones , Pruebas de Coagulación Sanguínea , Lesiones Encefálicas/sangre , Lesiones Encefálicas/patología , Coagulación Intravascular Diseminada/sangre , Coagulación Intravascular Diseminada/patología , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Fibrinógeno/sangre , HumanosRESUMEN
The prolactin (PRL) response to the administration of serotonin (5HT) agonists is an index of central nervous system 5HT activity. This index is blunted in association with hostile aggression in personality and depressive disorder patients without substance abuse. We tested whether the PRL response to the oral administration of the partial 5HT agonist meta-chlorophenylpiperazine (MCPP), 0.35 mg/kg, was associated with a measure of trait hostility, the Buss Durkee Hostility Inventory (BDHI), in cocaine addicts who were completing a 3-week detoxification and rehabilitation program. We also tested whether the cocaine addicts differed from healthy volunteers on their PRL, cortisol (CORT) or temperature responses to MCPP. The PRL response to MCPP was positively associated with the total score on the BDHI. There were, however, no differences in the neuroendocrine or temperature responses to MCPP between the cocaine-dependent group and the healthy volunteers once age effects were controlled for.
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Trastornos Relacionados con Cocaína/fisiopatología , Hostilidad , Piperazinas/farmacología , Prolactina/sangre , Antagonistas de la Serotonina/farmacología , Adulto , Temperatura Corporal/efectos de los fármacos , Humanos , Hidrocortisona/sangre , MasculinoRESUMEN
Data from a community-based longitudinal study were used to investigate the association between childhood neglect and personality disorder (PD) symptom levels during adolescence and early adulthood. Psychosocial and psychiatric interviews were administered to a representative sample of 738 youths and their mothers from upstate New York in 1975, 1983, 1985-1986, and 1991-1993. Evidence of childhood cognitive, emotional, physical, and supervision neglect was obtained from the maternal interviews that were conducted in 1975, 1983, and 1985-1986, and from New York State records. PDs were assessed among the youths in 1985-1986, when they were adolescents, and in 1991-1993, when they were young adults. Findings indicated that childhood emotional, physical, and supervision neglect were associated with increased risk for PDs and with elevated PD symptom levels during adolescence and early adulthood, after age, sex, childhood physical or sexual abuse, other types of childhood neglect, and cooccurring PD symptoms were controlled statistically. Childhood emotional neglect was associated with increased risk for avoidant PD and with paranoid and Cluster A PD symptom levels during adolescence and early adulthood. Childhood physical neglect was associated with increased risk for schizotypal PD and with Cluster A PD symptom levels during adolescence and early adulthood. Childhood supervision neglect was associated with increased risk for passive-aggressive and Cluster B PDs and with borderline, paranoid, and passive-aggressive PD symptom levels during adolescence and early adulthood. The present findings suggest that childhood emotional, physical, and supervision neglect may play a role in the etiology of some PDs.
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Maltrato a los Niños/estadística & datos numéricos , Trastornos de la Personalidad/epidemiología , Adolescente , Adulto , Niño , Maltrato a los Niños/diagnóstico , Maltrato a los Niños/psicología , Preescolar , Comorbilidad , Femenino , Humanos , Lactante , Estudios Longitudinales , Masculino , New York , Determinación de la Personalidad , Trastornos de la Personalidad/diagnóstico , Trastornos de la Personalidad/psicología , Escalas de Valoración Psiquiátrica , Factores de RiesgoRESUMEN
Although much of personality disorder research depends on diagnostic data obtained directly from patients, this approach has rarely been compared to interviews with knowledgeable informants. The purpose of this study was to determine the diagnostic agreement between these two assessment methods, as well as their relative contribution to the formulation of consensus diagnoses. Sixty-two psychiatric patients were assessed directly with the Structured Interview for DSM-III Personality Disorders (SIDP), and were asked to nominate an informant--either a family member or friend--to provide information about the patient in an interview with the same instrument. Informant interviews were conducted blind to patient-based information whenever feasible, and diagnostic consensus was achieved by an independent review of all available data by a senior clinician. Diagnostic agreement between patient-based and informant-based personality disorder interview was poor, confirming the findings of two previous studies. Information obtained from patients tended to be given greater weight in formulating consensus diagnoses than information provided by informants. However, about one quarter of diagnostic disagreements were resolved in favor of informant-based information. In contrast to a previous study, the inclusion of informant information did not appear to reveal greater psychopathology in patients. We conclude that supplementing direct patient interview with data provided by a knowledgeable informant appears to enhance the resolution of some personality disorder diagnoses. The utility of informant interviews may depend on an analysis of the costs and benefits of this additional degree of descriptive refinement.
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Determinación de la Personalidad/estadística & datos numéricos , Trastornos de la Personalidad/diagnóstico , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Trastornos de la Personalidad/clasificación , Trastornos de la Personalidad/psicología , Psicometría , Reproducibilidad de los ResultadosRESUMEN
We present a series of measurements examining the penetration force required to push a flat plate vertically through a dense granular medium, focusing in particular on the effects of the bottom boundary of the vessel containing the medium. Our data demonstrate that the penetration force near the bottom is strongly affected by the surface properties of the bottom boundary, even many grain diameters above the bottom. Furthermore, the data indicate an intrinsic length scale for the interaction of the penetrating plate with the vessel bottom via the medium. This length scale, which corresponds to the extent of local jamming induced by the penetrating plate, has a square root dependence both upon the plate radius and the ambient granular stress near the bottom boundary, but it is independent of penetration velocity and grain diameter.
RESUMEN
OBJECTIVE: The purpose of this study was to contrast men and women in prospective relationships among family-oriented and alcohol-related variables obtained during adolescence, childhood physical, emotional and sexual abuse collected retrospectively, and later adult problem alcohol use. METHOD: In structural equation models, early family processes (support/bonding, parent drug-use problems, parental divorce and childhood maltreatment) and prior alcohol use simultaneously predicted adult problem alcohol use at two later time points in a longitudinal community sample of 426 (305 female) adults. RESULTS: Significant relationships were found among family processes, childhood maltreatment, and problem alcohol use within time and longitudinally for both men and women. Greater family support/bonding during adolescence predicted less problem alcohol use in adulthood. Men and women who experienced sexual abuse as a child reported more problem alcohol use in adulthood. Problem alcohol use was stable across time. Men reported more problem alcohol use in adolescence and adulthood, and women reported more early sexual abuse. These results contradict those that find no significant relationships between childhood abuse and subsequent alcohol-related problems. Parental drug use problems during the participant's adolescence did not directly predict problem alcohol use in adulthood. The relationship was more indirect in that parental drug use was associated with family-related concomitants that in turn were significant predictors of more problem alcohol use in adulthood. CONCLUSIONS: The strong stability for problem alcohol use across the three time periods is a signal that alcohol use in adolescence should not be ignored; furthermore, family dynamics need attention in addressing problem alcohol use.
Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Familia/psicología , Adolescente , Adulto , Factores de Edad , Maltrato a los Niños/estadística & datos numéricos , Femenino , Predicción , Humanos , Masculino , Padres/psicología , Estudios Retrospectivos , Distribución por Sexo , Encuestas y Cuestionarios , Factores de TiempoRESUMEN
The purpose of this study was to examine predictive relationships between types of childhood maltreatment and personality disorders in a substance-abusing population. Three hundred thirty-nine drug- or alcohol-dependent patients completed a reliable and valid retrospective measure of childhood trauma, the CTQ, and a self-report inventory that assesses the entire range of DSM-III-R personality disorders, the PDQ-R. As a preliminary step, factor analyses were used to group personality disorders into the three DSM-III-R Axis II clusters (Clusters A, B, and C), although some diagnostic subclusters were also found. Structural equation modeling analyses revealed several significant paths between types of maltreatment and personality disorder clusters (and subclusters). Physical abuse and physical neglect were related to a subcluster of "psychopathic" personality disorders consisting of childhood and adult antisocial personality traits and sadistic traits. Emotional abuse emerged as a broad risk factor for personality disorders in Clusters A, B, and C. Emotional neglect was related to the traits of schizoid personality disorder, which formed its own subcluster. Finally, sexual abuse, which had been expected to predict borderline personality disorder traits, was unrelated to any personality disorder cluster. These findings support the view that child maltreatment contributes to the high prevalence of co-morbid personality disorders in addicted populations.
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Maltrato a los Niños , Trastornos de la Personalidad , Trastornos Relacionados con Sustancias , Adulto , Trastorno de Personalidad Antisocial/complicaciones , Trastorno de Personalidad Antisocial/epidemiología , Ansiedad/complicaciones , Ansiedad/epidemiología , Trastorno de Personalidad Limítrofe/complicaciones , Trastorno de Personalidad Limítrofe/epidemiología , Niño , Maltrato a los Niños/clasificación , Maltrato a los Niños/estadística & datos numéricos , Diagnóstico Dual (Psiquiatría) , Femenino , Humanos , Masculino , Ciudad de Nueva York/epidemiología , Trastornos de la Personalidad/clasificación , Trastornos de la Personalidad/complicaciones , Trastornos de la Personalidad/epidemiología , Prevalencia , Estudios Retrospectivos , Trastorno de Personalidad Esquizoide/complicaciones , Trastorno de Personalidad Esquizoide/epidemiología , Estadística como Asunto , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/epidemiología , Veteranos/estadística & datos numéricosRESUMEN
The emotional disturbance of substance abusers is often described as an inability to identify and express feelings coupled with an excess vulnerability to experience negative affect. However, there is only limited empirical support for this perspective. To validate this description, we first defined components of alexithymia, hostility, and posttraumatic stress disorder (PTSD) derived from established measures of each by conducting confirmatory factor analyses based on a self-report data set from a clinical sample of 253 alcoholics and drug addicts. We then fashioned and tested overarching latent variables representing the three aspects of emotional dysfunction (i.e., alexithymia, hostility, and PTSD) and finally tested the correlations among these overarching variables. We found a strong association between a factor labeled Bottled-Up Emotions and another labeled Neurotic Hostility (r = .62) as well as an association between PTSD and Bottled-Up Emotions (r = .66). The structure, magnitude, and intercorrelation of the latent variables did not depend on the type of psychoactive substance abused. These results support the view that features of alexithymia and hostility coexist in substance abusers and that this joint deficit is part of a broad disturbance across multiple psychological domains including pathological response to traumatic stress.
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Síntomas Afectivos/complicaciones , Síntomas Afectivos/diagnóstico , Hostilidad , Trastornos por Estrés Postraumático/complicaciones , Trastornos Relacionados con Sustancias/complicaciones , Adulto , Síntomas Afectivos/psicología , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos de la Personalidad/complicaciones , Trastornos de la Personalidad/diagnóstico , Trastornos de la Personalidad/psicología , Índice de Severidad de la Enfermedad , Trastornos por Estrés Postraumático/psicologíaRESUMEN
PURPOSE: To assess the effectiveness of the Pritikin diet and exercise program on cardiovascular hemodynamics using the noninvasive technique of Thoracic Electrical Bioimpedance (TEB). MATERIAL AND METHODS: Twenty subjects divided in two groups, according to their body habitus and hemodynamic disturbances. These data were compared to a group of 10 healthy individuals not involved in the program. Hemodynamic parameters were collected at admission and at the end of the intensive 26-day program of exercise and nutrition. RESULTS: In obese and hypertensive subjects not on medication we observed that cardiac index increased from 3.27 +/- 0.4 to 3.58 + 0.5 L/min/m2; mean arterial pressure decreased from 100 +/- 8.5 to 94.8 +/- 7.9 mmHg while systemic vascular resistance index decreased from 2362 +/- 391 to 1934 +/- 357 dynes. sec. cm-5/m2; p less than 0.05 (Data obtained in supine position). Also documented was a improvement in ventricular performance after postural changes from upright to supine based on indices of left ventricular performance, uniquely obtained by the TEB technique. From admission to discharge, changes were: Ejection fraction 48% to 53%; Peak flow index 295 to 316 ml/s/m2 and Index of contractility 40 to 47 s-1, explained by a shift on the ascending limb of the Starling curve. CONCLUSION: In a selected population, this rehabilitation program is effective for hemodynamic improvement that can be partially explained by metabolic and biochemical changes already reported from this Center.
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Dieta , Terapia por Ejercicio , Hemodinámica , Hipertensión/fisiopatología , Obesidad/fisiopatología , Adulto , Anciano , Anciano de 80 o más Años , Gasto Cardíaco , Cardiografía de Impedancia , Femenino , Humanos , Hipertensión/rehabilitación , Masculino , Persona de Mediana Edad , Contracción Miocárdica , Obesidad/rehabilitación , Volumen SistólicoRESUMEN
Thoracic electrical bioimpedance (TEB) is a noninvasive method for the estimation of left ventricular stroke volume (SV). Objections to TEB in the past have included systematic overestimation of SV and cardiac output in normals, poor correlation in absolute terms with standard cardiac output reference techniques, motion and ventilation artifacts which distorted recorded waveforms except when patients remained in apnea during measurements, and lack of a computer to yield rapid heat-to-beat quantitation of SV and cardiac output. The present study entails real-time, beat-to-beat cardiac output determinations using TEB and assessing its agreement via a digital computer against a reference standard, thermodilution. A correlation coefficient of 0.88 is reported with 85% of data points falling within 20% confidence limits on either side of the line of identity.