Accuracy of knowledge of family history of cardiovascular disorders.

Compared 292 undergraduates' reports of their parents' and grandparents' histories of 6 medical disorders (atherosclerosis, heart attack, hypertension, kidney disease, migraine headaches, and stroke) with the parents' reports. Ss also completed measures assessing frequency of contact with parents, comfort in discussing health matters with parents, and importance of health to Ss; Rotter's Internal–External Locus of Control Scale; and the Health Locus of Control Scale. Results show moderate agreement concerning the parents' health, especially when reports were negative, but substantial disagreement concerning the grandparents' health. Demographic and personality variables did not predict accuracy of Ss' reports of parental hypertension, the most frequently reported disorder. Among the disorders, differences in agreement of reporting arose; the most salient condition, heart attack, had the highest agreement for both parents and grandparents. Results suggest that caution is necessary in evaluating family health information from Ss in research and from target individuals in prevention programs. (45 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fears of medical events among school-age children with emotional disorders, parents, and health care providers

The purpose of this comparative study was to describe the reports of fears of medical events among school-age children with emotional disorders and compare their reports with those of parents and health care providers. A secondary purpose was to determine the reliability of the Child Medical Fear Scale (CMFS) with this population. Thirty children, parents, and health care providers (N = 90) completed the CMFS; the parents and health care providers also completed demographic instruments. The internal consistency reliability was acceptable (alpha = .75) for the CMFS with this population. Overall, the children reported lower fear scores of medical events than in previous research studies. Boys reported lower fear scores (p = .03) than girls. There was a statistical difference (p = .006) between the mean scores of the children and those of the parents and health care providers, with the children reporting less fear. The CMFS is useful among children with emotional disorders both in the clinical setting and in research.     

Changes in ocular dimensions and refraction with accommodation

We assessed the accuracy of the family history (FH-RDC) and family study (SADS-L) methods for obtaining information about the presence of psychopathology in 274 first-degree relatives of patients with psychotic disorders. The family history method had only modest sensitivity, 40.8% for affective disorders and 58.6% for psychotic disorders, but high specificity, 94.1% for affective disorders and 98.7% for psychotic disorders. For both disorders, sensitivity was higher for relatives who had had previous psychiatric admissions. However, with the family study method, we found that relatives with affective disorder were more likely to be interviewed than those relatives with other disorders. Hence, the family study method may be prone to selection bias that distorts morbid risk estimates. We conclude that the best way of collecting information regarding family psychopathology is to interview directly as many relatives as possible and to collect supplementary family history information on unavailable relatives.     

Expectant parents' representations of early attachment relationships: Associations with mental health and family history.

The association between adult representations of early attachment relationships and history of individual and family mental health was examined in a sample of 233 expectant mothers and fathers. As predicted, security of attachment was linked to mental health. Parents classified as Preoccupied were more likely than other parents to report suicidal ideation, whereas parents classified as Unresolved more- often reported suicidal ideation, emotional distress, and substance abuse. With respect to family history, Unresolved and Preoccupied attachment classifications were significantly related to child abuse involving a relative and parental separation or divorce. These findings support theoretical conceptualizations regarding the link between adult attachment and mental health in middle-class American adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of various phosphodiesterase-inhibitors, forskolin, and sodium nitroprusside on porcine detrusor smooth muscle tonic responses to muscarinergic stimulation and cyclic nucleotide levels in vitro

The Gail model is being used increasingly to determine individual breast cancer risk and to tailor preventive health recommendations accordingly. Although widely known to the medical and biostatistical communities, the risk factors included in the model may not be salient to the women to whom the model is being applied. This study explored the relationship of the individual Gail model risk factors to perceived risk of breast cancer and prior breast cancer screening among women with a family history of breast cancer. Data from baseline interviews with 969 women found a striking disparity between the objective risk factors included in the model and the accuracy of perceived risk and screening behaviors of this population, particularly among women over the age of 50 years. Risk perception accuracy was unrelated to all of the Gail model risk factors for all age groups. Reported mammography adherence was only associated with having had a breast biopsy in both age groups. Breast self examination (BSE) practice was independent of all measured factors for both age groups. These findings support the need for further research to identify additional determinants of risk perception and motivators of screening behavior.     

Affective instability, family history of mood disorders, and neurodevelopmental disturbance.

The association between affective instability and both family history of mood disorders and signs of neurodevelopmental disturbance was examined in a sample of 303 adults. Affective instability was measured using the borderline personality disorder “affective instability due to a marked reactivity of mood” diagnostic criterion as assessed dimensionally using the Personality Disorder Interview—IV. Participants were interviewed concerning family history of mood disorders, with family history coded using the Family History Research Diagnostic Criteria. Minor physical anomalies, inconsistent hand use, and dermatoglyphic asymmetries were used to index neurodevelopmental disturbance. Affective instability was associated with elevated rates of family history of mood disorders, particularly among individuals who exhibited inconsistent hand use and greater minor physical anomalies. These associations could not be accounted for by shared variance with age, gender, negative affect, or personal history of mood disorders. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Information booklet for parents of children surviving cancer

With increasing survival rates in pediatric oncology, the medical and psychosocial costs of cure are becoming apparent for the child and his family. The focus of our concern is now how to prevent and to reduce these adverse late effects of cancer and its treatment. To reduce the late psychosocial consequences for the child and its family a booklet was written for parents. We decided to address parents because of the young age of many children when treatment is completed, the essential role of parents in alleviating late effects for the child and his siblings, and the possibility to discuss the whole range of psychosocial late effects: those for the patient, the siblings, and for the parents themselves. The booklet acknowledges the specific emotional problems in patients, parents, and siblings that results from surviving childhood cancer and provides information and support on how to deal with them. The booklet can enhance open communication with the health care team about late consequences. In this way the booklet supports the further integration of medical and psychosocial aftercare.     

The impact of PTSD, depression, and substance use disorders on disease burden and health care utilization among OEF/OIF veterans.

Growing evidence suggests that posttraumatic stress disorder (PTSD) is associated with poorer health status (e.g., more medical disease, physical symptoms, and sick visits to health care professionals) among veterans who served in Operation Enduring Freedom (OEF) in Afghanistan and Operation Iraqi Freedom (OIF) in Iraq. We investigated whether PTSD, depression, and substance use disorders independently predicted health status over time among OEF/OIF veterans. Information regarding psychiatric and medical conditions and health care utilization was culled for 4,463 OEF/OIF veterans enrolled in Veterans Administration primary care for a period of 6 years. Data were analyzed using multilevel modeling and generalized estimating equations. Results suggest that PTSD, depression, and substance use disorders are independently associated with increased medical disease burden and mental health care utilization but not increased medical health care utilization. The association between PTSD and medical disease burden strengthened over time. These data suggest that OEF/OIF veterans with PTSD may be at risk for increasingly poorer physical health in terms of medical disease burden over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support in families of children with chronic conditions: supportive and nonsupportive behaviors

We questioned parents of 182 young children with a variety of chronic health conditions concerning the amount of emotional, informational, and tangible social support they received from the family, community, and service providers. We also asked parents to describe nonsupportive or hurtful behaviors received from family or community members. Both mothers and fathers reported that family members provided the most emotional and tangible social support and service providers the most informational support. The amount of perceived support from all sources increased over time, but 78% of mothers and 60% of fathers reported at least one instance of nonsupport from these same sources, primarily from extended family members and health professionals. We encourage health professionals to show respect and to provide timely, accurate information in a sensitive manner to parents whose child has a chronic health condition and to assist parents in handling nonsupportive behaviors from family and friends.     

Type A behavior pattern, parental history of hypertension, and cardiovascular reactivity in college males.

Examined 2 risk factors for cardiovascular disorders—parental history of hypertension and the Type A (coronary prone) behavior pattern—with respect to cardiovascular reactivity to challenging situations. 64 college males completed a structured interview (SI), Jenkins Activity Survey (JAS), and family health questionnaire. Ss were monitored for blood pressure (BP), heart rate (HR), and pulse transit time response to 4 tasks. Type As based on SI classification had significantly higher HR levels across all tasks than did Type Bs (noncoronary prone), as well as higher diastolic BP levels in the cold pressor task. No main effects for Type A-B using JAS classification were found. Type A and parental history did interact in a limited way on some tasks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Inaccuracy of family health information: Implications for prevention.

Highlights the relevance of family health history information for secondary and possibly primary prevention and discusses the complications of interaction of multiple risk factors, such as the lack of knowledge of family health history for adoptees and inaccurate knowledge of family health history for nonadoptees. Conflicts between the rest of the family's right to medical confidentiality and the individual's need to know about health risks for which he or she may show increased susceptibility are noted. Implications of inaccurate information for self-directed and public health prevention are discussed, and confidentiality and other reasons for maintaining nondisclosure are considered. It is contended that research and progress in prevention will likely accelerate, continuing to alter the traditional view from one of the individual with a personal health history to one in which individuals share a familial (genetic?+?shared environment?+?similar behavior patterns) risk with others, who may also benefit from preventive programs. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Occupational status, family environments, and adolescents' aspirations: The Laosa model.

L. M. Laosa (see record 1983-11265-001) suggested a theoretical model in which parent–child interactions are a mediating variable between social-status indicators and children's attributes. The present study examined relationships between family learning environments and the aspirations of 512 Australian adolescents from 3 occupational status groups. Family environments were assessed initially when the adolescents were 11 yrs old, and measures were obtained from parents of their aspirations for their children and their instrumental and affective orientations toward learning. When the adolescents were 16 yrs old, their perceptions of the support for learning provided by their parents were measured. Regression surfaces were constructed from models that included terms to account for possible linear, interaction, and curvilinear associations among the variables. Adolescents' aspirations generally had moderate associations with parents' aspirations but only modest or negligible relations to parents' instrumental and affective orientations. Although occupational status had only modest or negligible associations with the environment and aspiration scores, results indicate that within the different occupational groups the environmental variables combined to have variable patterns of linear, interaction, and curvilinear relationships with adolescents' aspirations. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Metabolic characteristics of hypertension: importance of positive family history

This study was performed to compare metabolic and endocrine characteristics of untreated hypertensive patients and normal controls. Measurements were made in age-matched, body mass index (BMI) matched, normotensive patients with (n = 40; age = 53; BMI = 28) and without (n = 39; age = 54; BMI = 27) a family history of hypertension and hypertensive patients with (n = 38; age = 53; BMI = 28) and without (n = 25; age = 54; BMI = 29) a family history of hypertension. Norepinephrine, renin activity, and total cholesterol blood concentrations were similar in normotensive patients with a positive family history of hypertension and in hypertensive patients with or without a family history. Similarly, there were no differences in plasma insulin concentrations or insulin/glucose ratios between the normotensive patients with a family history of hypertension and hypertensive patients with or without a family history. But in all three groups the values were significantly greater (at least p < 0.05 for each) than in the normotensive patients without a family history. Increases in systolic blood pressure during treadmill testing were 51 +/- 4 mm Hg in the normotensive patients with a family history, 50 +/- 3 mm Hg in hypertensives with a family history, and 45 +/- 5 mm Hg in hypertensives without a family history; these changes were all less (p < 0.05 for each) than in normotensives without a family history (65 +/- 3 mm Hg).(ABSTRACT TRUNCATED AT 250 WORDS)     

Subgrouping children with familial phonologic disorders

Familial aggregation of speech and language disorders was examined as a basis of subgrouping children with phonologic disorders. Fifty-nine children with phonologic disorders were subgrouped according to whether or not other nuclear family members reported a history of speech/language disorders. Thirty-four subjects (58%) reported at least one other nuclear family member affected and 25 subjects (42%) reported no other nuclear family members affected. Groups were compared on measures of articulation, phonology, language, and oral motor skills to determine if the familial phonologic subgroup presented a unique profile of speech and language deficits. Significant group differences were not observed. However, children with positive nuclear family histories tended to perform more poorly than children without histories on all tasks, although not reaching significance. Although all parents were considered to have achieved normal adult articulation, parents of children with positive family histories also tended to perform more poorly than parents of children with negative histories. Results suggested that poorer oral motor coordination and productive phonology may distinguish individuals with familial phonologic disorders from individuals with phonologic disorders of unknown origin.     

Effects of alcohol abuse and familial alcoholism on physical health in men and women.

Administered a structured interview measuring 5 categories of physical health (medical history, alcohol-related disorders, trauma history, drug use history, and female-related disorders) to 76 male and 72 female detoxified alcoholics and 50 male and 51 female nonalcoholic controls. Ss were aged 21–62 yrs, and approximately half the Ss had a positive family history (FH) of alcoholism (AC). Results indicate that (1) alcoholics suffer pervasive physical health difficulties, (2) an FH of AC is predictive of health problems in both alcoholics and controls, (3) the effects of alcohol abuse and FH of AC on health are independent and additive, and (4) women may exhibit increased vulnerability to the adverse effects of AC. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping and parenting: Mediators of 12-month outcomes of a family group cognitive–behavioral preventive intervention with families of depressed parents.

Objective: In a randomized clinical trial with 111 families of parents with a history of major depressive disorder (86% mothers, 14% fathers; 86% Caucasian, 5% African-American, 3% Hispanic, 1% American Indian or Alaska Native, 4% mixed ethnicity), changes in adolescents' (mean age = 11 years; 42% female, 58% male) coping and parents' parenting skills were examined as mediators of the effects of a family group cognitive–behavioral preventive intervention on adolescents' internalizing and externalizing symptoms. Method: Changes in hypothesized mediators were assessed at 6 months, and changes in adolescents' symptoms were measured at a 12-month follow-up. Results: Significant differences favoring the family intervention compared with a written information comparison condition were found for changes in composite measures of parent–adolescent reports of adolescents' use of secondary control coping skills and direct observations of parents' positive parenting skills. Changes in adolescents' secondary control coping and positive parenting mediated the effects of the intervention on depressive, internalizing, and externalizing symptoms, accounting for approximately half of the effect of the intervention on the outcomes. Further, reciprocal relations between children's internalizing symptoms and parenting were found from baseline to 6-month follow-up. Conclusion: The present study provides the first evidence for specific mediators of a family group cognitive–behavioral preventive intervention for families of parents with a history of major depressive disorder. The identification of both coping and parenting as mediators of children's mental health outcomes suggests that these variables are important active ingredients in the prevention of mental health problems in children of depressed parents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Study of the Health of Seafaring Workers of Valencia, Spain

Under the auspices of the Service of Maritime Health of the Marine Social Institute of Valencia, Spain, the health status of seafaring workers from Valencia was evaluated. An epidemiologic study was carried out based on 707 pre-embarkation health examinations, collecting information about the health problems of these workers and their associated risk factors. The data were analyzed to estimate population frequencies and the corresponding 95% confidence intervals. Significance among groups was calculated by the chi-square test (p < 0.05). Relative risks were calculated in comparisons of the seafaring workers with the general population of Valencia. High incidences of ophthalmologic disorders were found in workers over 50 years of age (15.9%) and in alcohol consumers (29.3%). Digestive problems were observed among alcohol-consuming (21.7%) workers 31-40 years old (8.5%). Risk factors for circulatory disorders increased steadily among those over age 50 (9.0%), non-smokers (10.3%), and those weighing more than 75 kg (8.2%). Finally, respiratory diseases were more frequent among individuals whose work involved fishing (12.7%). Risks increased with alcohol and tobacco consumption (16.6% and 17.5%, respectively). The risks of developing circulatory and ophthalmologic disorders were 10.5 and 10.3 times greater, respectively, among the seafaring workers than in the general population, while the risks of infections and genitourinary disorders were 10.2 and 9.7 times greater. Workers at high risk for health problems were typically more than 51 years old, with body weights of more than 75 kg, family histories of health problems, and heavy use of tobacco and alcohol. Compared with the general population of Valencia and the national population of Spain, the prevalences of ophthalmologic, digestive, respiratory, and circulatory disorders were higher in the seafaring workers.     

Genetic predisposition to hypertension facilitates blood pressure elevation in hemodialysis patients treated with erythropoietin

PURPOSE: This study investigated the hypothesis that a genetic predisposition to hypertension is involved in the etiology of the elevation in blood pressure induced by human recombinant erythropoietin (rHuEPO). PATIENTS AND METHODS: Blood pressure changes after 10 weeks of treatment with rHuEPO were compared between 26 patients with a positive family history of hypertension and 27 with a negative family history. RESULTS: Mean blood pressure was significantly increased in patients with a positive family history of hypertension (+8.8 mm Hg, p < 0.001). In contrast, the change was not significant in those whose family history was negative (+1.8 mm Hg, not significant). The mean blood pressure of 14 of 26 patients with a positive family history of hypertension increased by more than 10%, whereas such an increase occurred in only 2 of 27 patients with a negative family history (p < 0.001). The two groups were similar in terms of the total dose of rHuEPO given, the degree to which their anemia improved, and their basal blood pressures. CONCLUSION: It appears that hemodialysis patients with a positive family history of hypertension are susceptible to developing hypertension during treatment with rHuEPO.     

Parenting and psychological adjustment of adolescent immigrants in Israel.

Parental and familial factors and their association with adolescents’ mental health were examined among former Soviet Union (FSU) immigrants and nonimmigrants in Israel. Questionnaires regarding parental control, inconsistency, and rejection, in addition to adolescent–family connectedness and psychological disorders, were administered to 83 FSU immigrants and 106 nonimmigrant adolescents. According to the results, FSU adolescents are less connected to their families, experience their parents as less warm and more inconsistent in their childrearing behavior, report that their mothers subject them to a higher level of control, and the psychological disorders among them are more widespread than among nonimmigrant adolescents. Maternal control, maternal temporal inconsistency, and maternal and paternal rejection were associated with psychological disorders only among nonimmigrant adolescents. No such association was found among FSU adolescents, suggesting that FSU mental health problems are associated with immigration and cultural and social factors, rather than parental and familial factors. A comprehensive intervention program is required to provide support and assistance to help immigrants overcome their psychological distresses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence of comorbid anxiety disorders in primary care outpatients

OBJECTIVE: To estimate the extent to which anxiety disorders (eg, panic disorder, phobia, and generalized anxiety disorder [GAD]) co-occur in patients with major medical and psychiatric conditions. DESIGN: Observational study. SETTING: Offices of primary care providers in three US cities, with mental health specialty providers included for comparative purposes. PATIENTS: Adult patients (N = 2494) with hypertension, diabetes, heart disease (congestive heart failure or myocardial infarction), current depressive disorder, or subthreshold depression. MEASURES: Current (past 12 months) and lifetime panic disorder, phobia, GAD, perceived need for help for emotional or family problems, and unmet need (ie, failure to get help that was needed). METHODS: Comparisons of the prevalence of anxiety comorbidity in medically ill nondepressed patients of primary care providers and in depressed patients of both primary care and mental health specialty providers. RESULTS: Among primary care patients, those with chronic medical illnesses or subthreshold depression had low rates of lifetime (1.5% to 3.5%) and current (1.0% to 1.7%) panic disorder, but those with current depressive disorder had much higher rates (10.9% lifetime and 9.4% current panic disorder). Concurrent phobia and GAD were more common (10.4% to 12.4% current GAD), especially among depressed patients (25% to 54% current GAD). Depending on the type of medical illness or depression, 14% to 66% of primary care patients had at least one concurrent anxiety disorder. Patient-perceived unmet need for care for personal or emotional problems was high among all primary care patients (54.6% to 72.9%). CONCLUSION: Primary care clinicians should be aware of the possible coexistence of anxiety disorders (especially GAD) among their patients with chronic medical conditions, but especially among those with current depressive disorder.