Sleep-related breathing disorders encompass a range of disorders in which abnormal ventilation occurs during sleep as a result of partial or complete obstruction of the upper airway, altered respiratory drive, abnormal chest wall... more
Sleep-related breathing disorders encompass a range of disorders in which abnormal ventilation occurs during sleep as a result of partial or complete obstruction of the upper airway, altered respiratory drive, abnormal chest wall movement, or respiratory muscle function. The most common of these is obstructive sleep apnea (OSA), occurring in both adults and children, and causing significant cognitive and daytime dysfunction and reduced quality of life. OSA patients experience repetitive brief cessation of breathing throughout the night, which causes intermittent hypoxemia (reductions in hemoglobin oxygen levels) and fragmented sleep patterns. These nocturnal events result in excessive daytime sleepiness, and changes in mood and cognition. Chronic excessive sleepiness during the day is a common symptom of sleep-related breathing disorders, which is assessed in sleep clinics both subjectively (questionnaire) and objectively (sleep latency tests). Mood changes are often reported by pat...
Since fetal alcohol syndrome was first described over 35 years ago, considerable progress has been made in the delineation of the neurocognitive profile in children with prenatal alcohol exposure. Preclinical investigators have made... more
Since fetal alcohol syndrome was first described over 35 years ago, considerable progress has been made in the delineation of the neurocognitive profile in children with prenatal alcohol exposure. Preclinical investigators have made impressive strides in elucidating the mechanisms of alcohol teratogenesis and in testing the effectiveness of pharmacological agents and dietary supplementation in the amelioration of alcohol-induced deficits. Despite these
Certain symptoms of grief have been shown (a) to be distinct from bereavement-related depression and anxiety, and (b) to predict long-term functional impairments. We termed these symptoms of "complicated grief" and developed the... more
Certain symptoms of grief have been shown (a) to be distinct from bereavement-related depression and anxiety, and (b) to predict long-term functional impairments. We termed these symptoms of "complicated grief" and developed the Inventory of Complicated Grief (ICG) to assess them. Data were derived from 97 conjugally bereaved elders who completed the ICG, along with other self-report scales measuring grief, depression, and background characteristics. Exploratory factor analyses indicated that the ICG measured a single underlying construct of complicated grief. High internal consistency and test-retest reliabilities were evidence of the ICG's reliability. The ICG total score's association with severity of depressive symptoms and a general measure of grief suggested a valid, yet distinct, assessment of emotional distress. Respondents with ICG scores > 25 were significantly more impaired in social, general, mental, and physical health functioning and in bodily pain...
The aim of this population-based study was to (1) describe living conditions and actual health care utilization among 85 year olds; (2) determine factors that affect hospital admissions in this age. The study was conducted on 85-year-old... more
The aim of this population-based study was to (1) describe living conditions and actual health care utilization among 85 year olds; (2) determine factors that affect hospital admissions in this age. The study was conducted on 85-year-old residents in Linköping municipality, Sweden. The data collected included medical records, health care utilization during the preceding 12 months and a postal questionnaire on assistance, assistive technology, functional impairment, feelings of loneliness, worries and health-related quality of life measured by the EQ-5D. Out of 650 eligible individuals, 496 (78% of those alive) participated. Despite the prevalence of multi-morbidity (68%) and mental discomfort, the majority managed self-care (85%), usual activities (74%) and had high (>60/100) self-rated health evaluated by a visual analog scale (VAS). The non-hospitalized group reported a better health status than the hospitalized group in terms of medical aspects, living conditions and subjectiv...
The aim of this paper is to provide the prevalence rates of mild, moderate and severe symptoms of social anxiety in a sample of high school students and to analyze gender differences and associated impairment levels within these three... more
The aim of this paper is to provide the prevalence rates of mild, moderate and severe symptoms of social anxiety in a sample of high school students and to analyze gender differences and associated impairment levels within these three levels of severity. Five hundred and twenty students were assessed with the Social Anxiety Spectrum Self-Report (SHY-SR), a questionnaire that explores social anxiety spectrum. By applying two cut-off scores determined on a separate sample by using ROC analysis, the large majority (73.3 %) of subjects were classified as low scorers, 9% as medium scorers and 17.7% as high scorers. Fears related to social situations were reported both by high and medium scorers. Functional impairment defined by avoidance and school difficulties was more common among high scorers, but it was also reported to a significant extent by medium scorers. Compared to low and medium scorers, high scorers showed a higher F/M ratio (about 4:1) and a more homogeneous symptomatologica...
We report a case of recurrent psychosis, spanning decades, with full inter-episode recovery and minimal functional impairment. While it is difficult to classify this disorder using DSM IV-TR criteria, Leonhard and others have described a... more
We report a case of recurrent psychosis, spanning decades, with full inter-episode recovery and minimal functional impairment. While it is difficult to classify this disorder using DSM IV-TR criteria, Leonhard and others have described a 'cycloid psychosis' that correlates well with the phenomenology and course of this case. We believe this may represent a subset within the ICD-10 category of 'acute and transient psychotic disorders'. While this disorder, of unknown incidence, is not well reported in the U.S., it is worthy of further investigation and clinical attention given its generally favorable prognosis and potentially distinct pathophysiology and treatment.
The purpose of this study was to evaluate the psychometric properties of a measure, the Alexian Brothers Urge to Self-Injure Scale (ABUSI). The ABUSI was designed to assess the severity of the urge to engage in non-suicidal self-injury.... more
The purpose of this study was to evaluate the psychometric properties of a measure, the Alexian Brothers Urge to Self-Injure Scale (ABUSI). The ABUSI was designed to assess the severity of the urge to engage in non-suicidal self-injury. Non-suicidal self-injury is the deliberate damage of body tissue that is not sanctioned by society and is devoid of an active intent to die. Participants included 386 adolescent and adult patients (90.7% female, 86.3% non-Hispanic white) admitted to a psychiatric facility for the treatment of non-suicidal self-injury. Patients were administered the ABUSI as well as measures of the frequency of self-injury, quality of life and satisfaction, functional impairment, and suicidal ideation at admission and discharge as part of routine clinical assessment. Results provide preliminary support for the reliability and validity of the ABUSI as a measure of the intensity of the urge to self-injure. Specifically, the ABUSI demonstrated adequate internal consistency, test-retest reliability, sensitivity to change, and convergent, predictive, and incremental validity. Findings suggest the ABUSI is a promising tool for both clinical assessment and research.
This paper reviews the current status of research on the phenomenology, etiology, maintenance, assessment, and treatment of childhood and adolescent social anxiety disorder (SAD). Despite being one of the most prevalent disorders of... more
This paper reviews the current status of research on the phenomenology, etiology, maintenance, assessment, and treatment of childhood and adolescent social anxiety disorder (SAD). Despite being one of the most prevalent disorders of childhood and adolescence, SAD paradoxically stands as one of the least recognized, researched, and treated pediatric disorders. The small treatment outcome literature provides preliminary support to the
Certain symptoms of grief have been shown (a) to be distinct from bereavement-related depression and anxiety, and (b) to predict long-term functional impairments. We termed these symptoms of "complicated grief" and developed the... more
Certain symptoms of grief have been shown (a) to be distinct from bereavement-related depression and anxiety, and (b) to predict long-term functional impairments. We termed these symptoms of "complicated grief" and developed the Inventory of Complicated Grief (ICG) to assess them. Data were derived from 97 conjugally bereaved elders who completed the ICG, along with other self-report scales measuring grief, depression, and background characteristics. Exploratory factor analyses indicated that the ICG measured a single underlying construct of complicated grief. High internal consistency and test-retest reliabilities were evidence of the ICG's reliability. The ICG total score's association with severity of depressive symptoms and a general measure of grief suggested a valid, yet distinct, assessment of emotional distress. Respondents with ICG scores > 25 were significantly more impaired in social, general, mental, and physical health functioning and in bodily pain...
Osteoporosis (OP) is a well documented complication of some rheumatic diseases. Rheumatoid arthritis (RA) represents the paradigm of bone loss which occurs both locally (iuxta-articular OP and bone erosions) and systemically (generalized... more
Osteoporosis (OP) is a well documented complication of some rheumatic diseases. Rheumatoid arthritis (RA) represents the paradigm of bone loss which occurs both locally (iuxta-articular OP and bone erosions) and systemically (generalized osteoporosis and fractures). Both local and systemic bone loss in RA are mainly due to an imbalance in the RANKL/OPG ratio produced by pro-inflammatory cytokines. There is sub- stantial evidence that bone loss does occur also in systemic lupus erythematosus, ankylosing spondylitis and scleroderma. The pathogenesis of bone loss is multifactorial, with disease-dependent and disease-independent factors. Glucocorticoids represent the single most important risk factor for OP, even at low dose, and are associated with a significant increase in fracture risk. Functional impairment, hypovitaminosis D due to lack of sun exposure, disease activity and drugs, such as immunosuppressant and anticoagulants, also play a role.
Public health recommendations encourage the selection of a balanced diet and increasing physical activity to foster health and well-being. Whereas the adverse effects of restricted intakes of protein, fat, and carbohydrate on physical... more
Public health recommendations encourage the selection of a balanced diet and increasing physical activity to foster health and well-being. Whereas the adverse effects of restricted intakes of protein, fat, and carbohydrate on physical performance are well known, there is limited information about the impact of low intakes of vitamins and minerals on the exercise capacity and performance of humans. Physically active people generally consume amounts of vitamins and minerals consistent with the recommendations for the general public. However, when intakes are less than recommendations, some noticeable functional impairments occur. Acute or short-term marginal deficiencies, identified by blood biochemical measures of vitamin B status, had no impacts on performance measures. Severe deprivation of folate and vitamin B12 result in anemia and reduce endurance work performance. Evidence of vitamin A and E deficiencies in athletic individuals is lacking apparently because body storage is appr...
Objective: The objective of this study was to test the factor structure of the parent version of the Columbia Impairment Scale (CIS) in a sample of mothers who brought their children for community mental health (CMH) services (n = 280).... more
Objective: The objective of this study was to test the factor structure of the parent version of the Columbia Impairment Scale (CIS) in a sample of mothers who brought their children for community mental health (CMH) services (n = 280). Method: Confirmatory factor analysis (CFA) was used to test the fit of the hypothesized four-factor structure and the empirically validated one-factor structure. Exploratory factor analysis (EFA) was used to identify what factor structure best fit our sample of distressed mothers. Results: Neither the one- nor the four-factor model fit our sample. The EFA suggested that the CIS was best understood as a 12-item, three-factor model that identified functional impairment: (a) at school/work; (b) in socializing; and (c) at home/family. Conclusion: These findings call into question the construct validity of the parent version of the CIS in a CMH sample of mothers and provide support for multidimensional measures of functional impairment.
