The dependent personality: Developmental, social, and clinical perspectives.

Developmental, social, and clinical studies of dependency have produced remarkably consistent results. A review and integration of these findings allow strong conclusions to be drawn regarding the etiology and dynamics of dependency. The etiology of dependency appears to lie in overprotective, authoritarian parenting. In social settings, dependency is associated with suggestibility, conformity, compliance, interpersonal yielding, affiliative behavior, and sensitivity to interpersonal cues. Dependency predicts the onset of certain psychological disorders and follows the onset of others. It seems that the fundamental motivation of the dependent person, from which the behaviors that are exhibited in different situations are derived, is a strong desire to obtain and maintain nurturant supportive relationships. Implications of these findings for different theoretical models of dependency are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Etiology of alcoholism reconsidered: The case for a biopsychosocial process.

Argues that the etiology of alcoholism is best understood within the context of a longitudinal–developmental framework that includes physiological, behavioral, and sociocultural variables. It is further argued that G. E. Valliant and E. S. Milofsky's (see record 1982-30620-001) follow-up study on the etiology of alcoholism, although ostensibly set within such a framework, in fact understates the role of personality influences and dismisses childhood effects out of hand. Valliant and Milofsky's data are reviewed, and a different set of conclusions about the roles of childhood influences, personality, and cultural factors in the etiologic process is offered. An alternative integrative review of the existing longitudinal literature is presented that sets these findings in the context of a biopsychosocial process. (90 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical study on hepatocellular carcinoma with extrahepatic malignancies

In a consecutive series of 146 patients with hepatocellular carcinoma (HCC), 10 patients (6.8%) were found to have one or two extrahepatic malignancies (EHM). Of these, eight had double cancers and two, triple cancers. The associated malignancies included eight cases of gastric cancer and four cases of colon cancer. Among the 12 lesions, eight were in the early stage. All the 10 patients were hepatitis B surface antigen negative. The incidence of coexisting liver cirrhosis and the retention rate of indocyanin green in 15 minutes among HCCs with EHM were significantly lower than those among HCC alone. These results suggest that the etiology of HCC with EHM is different from the etiology of HCC alone in Japan.     

Lambda repressor N-terminal DNA-binding domain as an assay for protein transmembrane segment interactions in vivo

OBJECTIVE: To critically review the English-language literature and describe the current diagnosis, prevalence, etiology, and treatment of antisperm antibodies (ASA). DESIGN: A comprehensive literature search of the English-language literature published between 1966 and December 1997 was performed on MEDLINE. Articles were also located via bibliographies of published works. RESULT(S): Data were excerpted from articles identified by MEDLINE search. The diagnosis, prevalence, etiology, and treatment of ASA are described. CONCLUSION(S): There is sufficient evidence that ASA impair fertility in couples with unexplained infertility. A number of different methodologies are available, which may be used in their detection. However, in many cases, test interpretation is subjective. Although there is not enough evidence to support systemic treatment for ASA, application of a variety of assisted reproductive technologies improves outcome.     

Effects of perceived etiology attribution similarity on client ratings of counselor credibility.

An experimental design was used to test the hypothesis that clients who perceived their counselors as holding etiology attributions similar to their own would rate their counselors' credibility higher than clients who perceived their counselors as holding dissimilar attributions. 40 undergraduate volunteers participated as clients in counseling role-plays with 11 graduate student counselors. At the end of the 3-session counseling analogue experience, each client was exposed to a mock counselor questionnaire on which the counselor's etiology attributions were manipulated to either agree or disagree with the client's etiology attributions. Results indicated that clients in the similarity of etiology attribution condition rated their counselors to be more credible sources of help than did clients in the dissimilarity of etiology attribution condition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conflict and deficit: Two theories or one?

Comments on A. Sugarman's (see record 1995-33122-001) illumination of a major controversy in psychoanalysis: the conflict-versus-deficit models of the etiology of psychopathology and the resulting different views of the process of treatment. Sugarman's recommendation for a synthesis of these 2 models is supported. The basis for the author's rationale stems from Freud's own writing and early theory of psychopathology, which focused only on the nature of conflict. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Language production and thought disorder in schizophrenia.

The authors examined the relationship between language production (LP) processes and thought disorder. Thirty-nine schizophrenic or schizoaffective participants completed tasks measuring discourse planning, monitoring, and grammatical–phonological encoding, as well as an interview used to rate thought disorder. The authors found that different LP processes were differentially related to different thought disorder subtypes. Incompetent references were strongly and selectively related to discourse planning performance. In addition, word approximations–neologisms were strongly and specifically associated with grammatical–phonological encoding performance. The article concludes with a discussion of the implications of these results for understanding the multifaceted nature and etiology of thought disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the etiology of neurosis.

Evaluated the concept of predisposition to neurosis within the context of 2 broad classes of interaction: (a) between organismic and socialization variables which produce relevant dispositions and (b) between these dispositions and current environmental conditions. It is suggested that treating abnormal behavior as a dependent rather than as an independent variable may be a useful approach in studying its etiology. Implications of this analysis for theoretical and methodological approaches to etiology of neurotic phenomena are discussed. (52 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of alcohol use with multidimensional concepts and measures.

Reviews the results of selected studies by the authors (1969, 1970, and 1973) on 5,000 patients undergoing treatment for alcoholism. Findings support a multidimensional perspective of alcoholism. Data on the covariations among self-reported symptoms and other drinking-related variables indicate 15 psychometrically independent 1st-order factors and 5 broad 2nd-order dimensions. These factors provide reliable operational definitions of alcoholism that correspond to different constructs and have different relations to variables reflecting etiology, personality, treatment outcome, and life-span development. These factors provide a basis for the diagnosis of a variety of alcohol-related problems and for the design of effective programs of therapy. It is concluded that future research on alcohol abuse should be based on multivariate measurement. (71 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Etiologic structure and clinical characteristics of acute viral infections of the central nervous system with hyperproteinorachia

Clinical syndrome of acute viral meningitis and meningoencephalitis may be induced by different viruses. Etiologic diagnosis may be set by the isolation of the virus from the liquor and by the detection of specific antibodies in the blood and liquor. Our aim was to determine viral etiology of AVI with special reference to hyperproteinorachia. The study was conducted in 55 patients treated at the Clinic of Infectious Diseases in Novi Sad, with clinical picture of acute meningitis or meningoencephalitis, with pleocytosis above 50 ml in the cerebrospinal fluid. Depending on the levels of proteinorachia the patients were divided into the group with proteinorachia levels below 1g/l (34 patients) and above 1 g/l (21 patients). In the first group the most common was herpes simplex- and adenoviral etiology while in the second group most frequently found were choriolymphocytic meningitis virus (LCM) and herpes simplex virus. The protein level was in correlation with the severity of the clinical features and the duration of the treatment.     

An unusual case of Creutzfeldt-Jakob disease

A patient with histopathologically verified sporadic Creutzfeldt-Jakob disease (CJD) presented initially with diplopia, sleep disturbances, and L-dopa-responsive parkinsonism. After more than a year of slow progression, he did not become demented, and failed to fulfill the clinical criteria for possible CJD. No clinical examinations currently proposed to detect CJD showed the disease. CJD should be in the differential diagnosis of "parkinson plus" syndromes until a different etiology has been found or a histopathologic examination performed.     

HLA class I and II alleles and susceptibility to generalized pustular psoriasis: significant associations with HLA-Cw1 and HLA-DQB1*0303

HLA alleles in generalized pustular psoriasis (GPP) were investigated to clarify the etiology and/or pathogenesis of this disease. Not only serological typing of HLA class I and II antigens but also genotyping of HLA class II alleles were carried out in twenty-six unrelated Japanese patients with GPP. These patients were classified according to their history of psoriasis vulgaris (PV). Serological typing revealed a significantly high incidence of HLA-Cw1 (Pc = 0.04) in the patients as compared with Japanese healthy controls. The frequency of HLA-B46 was particularly high in the patients with GPP and a previous history of PV. Genotyping of HLA class II alleles showed a highly significant increase in HLA-DQB1*0303 (Pc = 0.01) in the patients vs. the healthy controls. In particular, HLA-DQB1*0303 was significantly more frequent in the patients with no prior history of PV than in those with a history of PV. Analysis on linkage disequilibrium showed remarkably different patterns for HLA class II haplotypes between the patients and the healthy controls. Based on the comparative analysis among the amino acid sequences of the beta 1-domain of the HLA-DQB1*03 alleles, proline at residue 55 was suggested to be important as a common amino acid for determination of the susceptibility to GPP. These results revealed not only an association between the etiology and/or pathogenesis of GPP and HLA, but also different mechanisms of the immune response between the patients with GPP and PV.     

Indications for surgery to determine the etiology of subcortical hemorrhage

We studied the etiology of subcortical hemorrhage in 55 patients (30 males, 25 females), aged 19-83 years (mean 60 years). CT scan was made in all patients on admission, with the use of intravenous infusion of contrast agent in 35 patients. Cerebral angiography was performed in 37 patients and MRI was performed in 22 patients. Forty-one patients underwent surgery and the other fourteen patients were treated conservatively. The cause of bleeding had been discovered before surgery in 12 cases; 10 arteriovenous malformations and 2 brain tumors. They were discovered by meticulous neuroradiological investigations including cerebral angiography, MRI, dynamic MRI, MRA and enhancing CT. The cause of bleeding was newly discovered after surgery in 7 cases; all of amyloid angiopathy. It remained unknown in the other 22 surgical cases although hypertensive angiopathy was suspected in eleven of them. Among the 14 patients who received conservative therapy, hemorrhagic diathesis including the use of Warfarin and DIC was the cause of bleeding in four cases and the etiology remained unknown in other ten, although hypertensive angiopathy was suspected in eight of them. The 32 patients in whom the etiology remained unknown had been observed as long as 12-120 months (mean, 40 months) and although bleeding has occurred at different locations in two of these patients, there has been no recurrence of bleeding at the same location in any of them. In conclusion, surgery is not indicated to determine the etiology of subcortical hemorrhage when meticulous neuroradiological investigations fail to disclose any vascular or tumorous lesions.     

Treatment of congestive heart failure with beta-methyldigoxin (lanitop)

Methylated Digoxin preparation--beta-Methyldigoxin (Lanitop) was used in 50 patients with congestive heart failure of different etiology (tablets of 0.3--0.6 mG per day). Its employment proved very effective in the treatment of congestive heart failure. It is not contraindicated to patients with chronic coronary insufficiency with underlying athrosclerotic cardiosclerosis with signs of congestive circulatory insufficiency. Side-effects of beta-Methyldigoxin are mild and noted rather seldom.     

Increased cutaneous toxicity to ionizing radiation in HIV-positive patients. Military Medical Consortium for the Advancement of Retroviral Research (MMCARR)

Little is known about the etiology of esophageal and gastric cardia adenocarcinoma (EGA), a cancer with one of the fastest-rising incidences in the developed world. To explore the etiology of this cancer, we conducted a retrospective cohort analysis using data from the Surveillance, Epidemiology and End Results Program of the United States National Cancer Institute to study EGA and esophageal squamous cell carcinoma (ESC), in association with cancers of other sites. Standardized incidence ratios, adjusted for age, sex, and time period, were calculated as a measure of the relative risk (RR) of developing a second primary cancer (EGA or ESC) following a given first primary site. We found a moderately elevated risk of EGA following cancers of the lung (RR = 1.9 in men and RR = 2.0 in women) and of the head and neck (RR = 2.1 in men and RR = 6.3 in women) and a strongly elevated risk of ESC following cancers of the lung (RR = 2.8 in men and RR = 5.1 in women) and of the head and neck (RR = 9.6 in men and RR = 38.8 in women). A significantly elevated risk following breast cancer in women was observed for both EGA (RR = 2.6; 95% confidence interval, 1.8-3.7) and ESC (RR = 1.4; 95% confidence interval, 1.1-1.9). We also found a significantly elevated risk of EGA following bladder (RR = 2.0), colorectal (RR = 1.7), and prostate (RR = 1.4) cancer in men and of ESC following colorectal cancer (RR = 1.7) in women in this study. The strong association with tobacco-related malignancies in this study reinforces the role of tobacco in the etiology of esophageal cancers, which appears stronger for squamous cell carcinoma than for adenocarcinoma and stronger in women than in men. The study also suggests a possible shared etiology between esophageal adenocarcinoma and colorectal cancer in men and provides new evidence about the association of both adenocarcinoma and squamous cell carcinoma of the esophagus with breast cancer in women. Findings of this study provide clues to the etiology of EGA and ESC.     

Protein kinase C in platelets of depressed patients

Though described in 1769, the etiology of Zenker's diverticulum remains unclear. Various primary esophageal motor disorders have been proposed, but no consistent manometric pattern or anatomic etiology has been uniformly recognized. An association with clinical neurologic disease at our institution prompted a review of 12 cases of Zenker's diverticulum in patients over 60 years of age, treated in the last 8 years. Nine patients (75%) underwent cricopharyngeus myotomy and diverticulectomy, with uniformly good results. Ten patients (83%) had an associated neurologic disorder, substantiated by cranial CT or MRI, in most cases. A wide range of neurologic problems were identified, but a strong trend toward brainstem or basilar lesions was present. As expected, the etiology of the neurologic abnormality in most patients in this group was cerebrovascular disease, but two patients had peripheral neuropathies. We suggest that the etiology of Zenker's diverticulum in the elderly may be neurologic in origin. Esophageal motor disorders, including incomplete upper esophageal sphincter opening and increased hypopharyngeal pressures, which may result in Zenker's diverticulum, may be a manifestation of central or peripheral neurologic disease in the elderly.     

Exploring the genetic etiology of low general cognitive ability from 14 to 36 months

The genetic and environmental etiology of low general cognitive ability (g) during infancy and early childhood has not previously been investigated. The current study examined the genetic etiology of low cognitive ability at 14, 20, 24, and 36 months with twins from the MacArthur Longitudinal Twin Study. Low g groups were formed from the lowest 10th percentile at each age. Univariate probandwise concordance rates and DeFries-Fulker (J. C. DeFries & D. W. Fulker, 1985, 1988) multiple regression techniques suggest genetic etiology in low general cognitive ability groups. The stability of low general cognitive ability over time also appears to be primarily due to genetic factors. Although replication is necessary, these results suggest that the genetic etiology of low g during infancy and early childhood is at least as great as the heritability of g in the unselected population.     

Odontogenic (concomitant) etiology of headache

A systematic follow-up showed that out of 785 headache patients 1/4 had odontogenic pathogenic factors with possible connections to the headache syndrome and were indicated to be operated. 158 could be systematically examined and (surprisingly enough) improvement of headache syndromes ranking at 2/3 was about equally frequent within the group of those who had undergone dental operation and those that had not wanted to do so. In sub-groups different responses to operation were observed: cephalaea (permanent headache), better than migraine (attack figured headache); etiology of wisdom-tooth better than other tooth-pathology; upper jaw better than lower jaw. Our results once more underlined the multifactorial etiology of headache, that is opposed to a monocausal oriented headache diagnosis (as the IHS-nomenclature tries to impose). Still it has considered to be relevant that a good diagnostic examination in the field of tooth-, jaw- and mouth medicine should be conducted in every headache patient, even in "typical" migraine patients. When indicated, operations should be done; however the patient properly informed that improvement is not obligatory. Same time all the other possible etiologies for headaches shall be regarded and if positive treated.     

Acute pancreatitis of unknown etiology in the elderly

OBJECTIVE: The incidence of acute pancreatitis in the elderly patient is increasing, and a significant number of such patients have no clearly defined etiology of their pancreatitis. To delineate the role of early organ failure versus progressive pancreatic disease in the morbidity and mortality, the authors' experience with patients older than 60 years with acute pancreatitis was reviewed. SUMMARY BACKGROUND DATA: As many as 30%-40% of elderly patients with acute pancreatitis have an unclear etiology and such patients have high rates of early organ failure and death. While some authorities have shown that pre-existing disease in these elderly patients did not contribute to subsequent morbidity, others have demonstrated that poor outcome was related to co-existing medical illness. METHODS: Their review of acute pancreatitis in the elderly was grouped into known and unknown etiology patients. Various parameters such as morbidity, mortality and length of stay were then compared between the two groups. Severity of organ failure and acute pancreatitis on admission were both graded and attempts made to correlate this severity with subsequent outcome. RESULTS: Unknown etiology patients had a greater number of Ranson's criteria (3.5 +/- .44 vs. 2.4 +/- .18) (p < 0.02), higher morbidity (48% vs. 22%) (p < 0.05), higher mortality (24% vs. 8.3%), and more SICU days (4.4 +/- 1.3 vs. 1.6 +/- .44) (p < 0.05) when compared with the known etiology group. Duration of symptoms, admission hypotension, and Ranson's criteria were unsuccessful in predicting mortality. Functional status of the various organ systems on admission did predict subsequent mortality. CONCLUSIONS: Elderly patients with acute pancreatitis of unknown etiology present with a more severe disease, have higher morbidity and longer SICU stays, and appear to have greater compromise of organ function. Organ function compromise correlates with mortality and appears more significant than severity of pancreatic disease. Aggressive support of such organ systems may be beneficial in the management of these patients.