Center for Mental Health Services Research Publications and Presentations Copyright (c) 2013 University of Massachusetts Medical School All rights reserved. http://escholarship.umassmed.edu/psych_cmhsr Recent documents in Center for Mental Health Services Research Publications and Presentations en-us Wed, 22 May 2013 13:42:11 PDT 3600 Assessing disulfiram compliance: validational study of an abbreviated breath test procedure http://escholarship.umassmed.edu/psych_cmhsr/595 http://escholarship.umassmed.edu/psych_cmhsr/595 Wed, 22 May 2013 13:38:06 PDT An abbreviated breath test for detecting the disulfiram metabolite carbon disulfide (CS2) was evaluated in an analogue investigation of the sensitivity of the test in identifying disulfiram and non-disulfiram intake in a group of 14 alcoholic inpatients.

Disulfiram (250 mg) was administered within an ABAB repeated measures design over a 12-day period with corresponding breath tests administered during morning and afternoon time periods. Dependent measures included spectrophotometric analysis of reacted test samples and visual ratings of sample color.

Results indicated that the test was highly sensitive in discriminating disulfiram administration for the group as a whole, as well as for individual subjects. Moreover, visual ratings were more accurate than spectrophotometric cut-off scores in identifying disulfiram administration.

The test shows considerable promise as a rapid means of assessing disulfiram compliance.

]]> Robert G. Rychtarik et al. Adult Alcoholism Breath Tests Carbon Disulfide Disulfiram Humans Male *Patient Compliance Spectrophotometry College women coping with depression http://escholarship.umassmed.edu/psych_cmhsr/594 http://escholarship.umassmed.edu/psych_cmhsr/594 Wed, 22 May 2013 13:38:04 PDT Depression is a common problem among college women, and many of them cope with it on their own (without professional help). Since these naturally occurring episodes of self-controlled behavior are frequent—and sometimes dramatically successful—they were investigated in this study. College women who had coped successfully and unsuccessfully with clinically-significant levels of depression were interviewed about their coping efforts. In contrast to previous research of this type, the present investigation did not identify any clear coping differences between successful and unsuccessful copers. Follow-up interviews indicated that many initially unsuccessful subjects eventually became much less depressed. The implications of these results are discussed, with suggestions for future research.

]]> Leonard A. Doerfler et al. *Adaptation, Psychological Adult Depressive Disorder Female Humans Psychological Tests Type III error in research on interpersonal models of depression http://escholarship.umassmed.edu/psych_cmhsr/593 http://escholarship.umassmed.edu/psych_cmhsr/593 Wed, 22 May 2013 13:38:03 PDT Reviews an interactional model of depression proposed by J. C. Coyne (see PA, Vols 56:2455 and 61:1146), empirical evaluations of this model, and related research. It is contended that laboratory studies designed to test these interactional models have examined stangers' reactions to depressives and therefore have little relevance to these models, which focus on the interactional processes between a depressed individual and his/her family and friends. It is argued that relevant empirical research is necessary before theoretical conjectures and treatment strategies based on an interactional model are accepted. (27 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)

]]> Leonard A. Doerfler et al. Depressive Disorder Humans *Interpersonal Relations *Models, Psychological Research Design Depression in children and adolescents: a comparative analysis of the utility and construct validity of two assessment measures http://escholarship.umassmed.edu/psych_cmhsr/592 http://escholarship.umassmed.edu/psych_cmhsr/592 Wed, 22 May 2013 13:38:02 PDT The utility and construct validity of the Children's Depression Inventory and the youth version of the Center for Epidemiological Studies Depression Scale were examined. No significant grade, sex or race effects were obtained for either measure. Examination of convergent and discriminate validity for these measures revealed high correspondence with self-report measures of related constructs. Children's self-reports corresponded poorly with ratings by teachers or parents. Finally, the utility of recommended cutoff scores for identifying extreme groups of depressed children and adolescents was evaluated. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

]]> Leonard A. Doerfler et al. Child Depressive Disorder Female Humans Male *Personality Inventory Psychometrics Reference Values A fine-grained analysis of the role of self-efficacy in self-initiated attempts to quit smoking http://escholarship.umassmed.edu/psych_cmhsr/591 http://escholarship.umassmed.edu/psych_cmhsr/591 Wed, 22 May 2013 13:38:00 PDT The relation between self-efficacy ratings and smoking behavior was explored among 36 people who were trying to quit smoking on their own. Self-efficacy was predictive of smoking outcome, but there was considerable intersubject variability in the strength of the relation between efficacy and smoking behavior. Both efficacy and previous smoking behavior predicted smoking outcome equally well, however.

]]> Manual E. Garcia et al. Adaptation, Psychological Adolescent Adult Female Humans Internal-External Control Male *Motivation *Self Concept Smoking Evaluating mental health outcomes in an inpatient setting: convergent and divergent validity of the OQ-45 and BASIS-32 http://escholarship.umassmed.edu/psych_cmhsr/590 http://escholarship.umassmed.edu/psych_cmhsr/590 Wed, 22 May 2013 13:37:59 PDT The evolution of managed behavioral health care has led to an increased emphasis on reliable and valid assessment of outcomes in clinical practice. The present study evaluated the convergent, divergent, and concurrent validity and sensitivity to change of two widely used measures: Behavior and Symptom Identification Scale (BASIS-32) and Outcome Questionnaire (OQ-45). Comparisons of the two measures revealed that both were sensitive to change over a relatively short inpatient stay. Both measures also showed evidence of convergent and divergent validity of specific subscales, although the total scores of each measure also were highly correlated. Evidence of concurrent validity was suggested by differences between diagnostic groups on specific subscale scores. Together with previous research, these results suggest that the BASIS-32 and OQ-45 can be useful measures for tracking patient functioning over a range of treatment contexts.

]]> Leonard A. Doerfler et al. Adult Behavioral Medicine Diagnosis-Related Groups Female Hospitals, Teaching Humans Male Massachusetts Mental Disorders Mental Health Services Outcome Assessment (Health Care) Psychiatric Department, Hospital Psychiatric Status Rating Scales *Questionnaires Anxiety, posttraumatic stress disorder, and depression in patients with coronary heart disease: a practical review for cardiac rehabilitation professionals http://escholarship.umassmed.edu/psych_cmhsr/589 http://escholarship.umassmed.edu/psych_cmhsr/589 Wed, 22 May 2013 13:37:58 PDT Leonard A. Doerfler et al. Anxiety Comorbidity Coronary Disease Depression Health Status Indicators Humans Stress Disorders, Post-Traumatic Panic disorder in clinically referred children and adolescents http://escholarship.umassmed.edu/psych_cmhsr/587 http://escholarship.umassmed.edu/psych_cmhsr/587 Wed, 22 May 2013 13:37:56 PDT The present study examined the frequency and characteristics of panic disorder in children and adolescents who had been referred to a pediatric psychopharmacology clinic. Of the 280 children and adolescents evaluated in this clinic, 35 were diagnosed with panic disorder using a semi-structured clinical interview (K-SADS) and other objective measures. Approximately half of the youngsters with panic disorder also met criteria for the diagnosis of agoraphobia. There was extensive comorbidity between panic disorder and other internalizing and externalizing disorders. Parents reported clinically significant levels of child symptomatology on the CBCL. Teacher-and child-reported symptomatology on the CBCL was within the normal range. At the same time, it was notable that no child had been referred specifically for evaluation or treatment of panic disorder or agoraphobia. Implications for clinical assessment/identification and treatment are discussed.

]]> Leonard A. Doerfler et al. Adolescent Agoraphobia Child Comorbidity Female Humans Male Panic Disorder Prevalence Referral and Consultation Severity of Illness Index Conduct disorder subtype and comorbidity http://escholarship.umassmed.edu/psych_cmhsr/586 http://escholarship.umassmed.edu/psych_cmhsr/586 Wed, 22 May 2013 13:37:55 PDT BACKGROUND: Conduct disorder is considered difficult to treat, but comorbid psychiatric disorders may be a basis for treating some youths with conduct disorder. We sought to identify patterns of comorbid psychiatric diagnoses and psychopathology associated with conduct disorder by reported age-of-onset.

METHODS: Referred children and adolescents, aged 4-17 years old, were clinically evaluated. Ages of onset of CD symptoms (N=53) were ascertained and divided according to DSM-IV criteria as childhood onset (old) or adolescent onset (>or=10 years old).

RESULTS: Childhood-onset conduct disorder was associated with higher rates of ADHD and anxiety disorders, male gender, and perceived and total hostility scores than adolescent-onset conduct disorder. Adolescent-onset was associated with higher rates of PTSD, alcohol and substance use disorders, complex comorbidity (i.e., 6+ diagnoses lifetime), and female gender.

CONCLUSIONS: Understanding age-of-onset-related patterns of comorbidity may facilitate psychiatric treatment planning in children and adolescents with conduct disorder.

]]> Daniel F. Connor et al. Adolescent Age of Onset Alcoholism Attention Deficit Disorder with Hyperactivity Bipolar Disorder Child Comorbidity Conduct Disorder Depressive Disorder Female Humans Income Male Parent-Child Relations Parents Severity of Illness Index Substance-Related Disorders Separation anxiety and panic disorder in clinically referred youth http://escholarship.umassmed.edu/psych_cmhsr/585 http://escholarship.umassmed.edu/psych_cmhsr/585 Wed, 22 May 2013 13:37:54 PDT This study examined whether youngsters with separation anxiety disorder (SAD) and panic disorder (PD) had experienced more separation-related events than youngsters with SAD (without comorbid PD). We also examined whether age of onset of SAD and comorbidity with other psychological disorders was related to the occurrence of PD. We compared youngsters who were diagnosed with SAD and PD (N=31) with youngsters who were diagnosed with SAD without comorbid PD (N=63) for the number of separation-related events, severity of psychopathology, and parent and child CBCL ratings, age of onset of SAD, and the number of comorbid diagnoses. The findings indicate that youngsters with SAD and PD had a later age of onset of SAD and more extensive psychopathology and functional impairment than youngsters with SAD (without comorbid PD). Contrary to hypothesis, there were no differences between the groups in the occurrence or number of separation-related events.

]]> Leonard A. Doerfler et al. Anxiety, Separation Child Child Behavior Disorders Comorbidity Female Humans Life Change Events Male Panic Disorder Personality Assessment ADHD with comorbid oppositional defiant disorder or conduct disorder: discrete or nondistinct disruptive behavior disorders http://escholarship.umassmed.edu/psych_cmhsr/584 http://escholarship.umassmed.edu/psych_cmhsr/584 Wed, 22 May 2013 13:37:52 PDT OBJECTIVE: In children with ADHD who have comorbid disruptive behavior diagnoses distinctions between oppositional defiant disorder (ODD) and conduct disorder (CD) remain unclear. The authors investigate differences between ODD and CD in a large clinical sample of children with ADHD.

METHOD: Consecutively referred and systematically assessed male children and adolescents with either ADHD (n = 65), ADHD with ODD (n = 85), or ADHD with CD (n = 50) were compared using structured diagnostic interviews and parent, teacher, and clinician rating scales.

RESULTS: In children with ADHD, significant differences emerged between ODD and CD in the domains of delinquency, overt aggression, and ADHD symptom severity; ADHD with CD was most severe, followed by ADHD with ODD, and ADHD had the least severe symptoms. Distinctions between ADHD with CD and the other two groups were found for parenting, treatment history, and school variables.

CONCLUSION: Within the limits of a cross-sectional methodology, results support clinically meaningful distinctions between ODD and CD in children with ADHD.

]]> Daniel F. Connor et al. Adolescent Aggression Anxiety Disorders Attention Deficit Disorder with Hyperactivity Attention Deficit and Disruptive Behavior Disorders Bipolar Disorder Child Comorbidity Conduct Disorder Depressive Disorder Diagnosis, Differential Diagnostic and Statistical Manual of Mental Disorders Female Humans Juvenile Delinquency Male Aggression, ADHD symptoms, and dysphoria in children and adolescents diagnosed with bipolar disorder and ADHD http://escholarship.umassmed.edu/psych_cmhsr/583 http://escholarship.umassmed.edu/psych_cmhsr/583 Wed, 22 May 2013 13:37:51 PDT BACKGROUND: This study had two objectives: (1) examine characteristics of aggression in children and adolescents diagnosed with bipolar disorder and (2) determine whether the CBCL pediatric bipolar disorder profile differentiated youngsters with bipolar disorder from youngsters with ADHD.

METHOD: Children and adolescents referred to a pediatric psychopharmacology clinic were systematically evaluated for psychopathology using a psychiatrist-administered diagnostic interview, parent- and teacher-report rating scales assessing the child's behavior, and child-completed self-report scales. In this sample, 27 children and adolescents were diagnosed with bipolar disorder and 249 youngsters were diagnosed with ADHD without co-occurring bipolar disorder. These two groups were compared to determine whether there were significant differences on various measures of psychopathology.

RESULTS: Youngsters diagnosed with bipolar disorder were more verbally aggressive and exhibited higher levels of reactive aggression than youngsters with ADHD without co-occurring bipolar disorder. Youngsters with bipolar disorder also reported higher levels of depressive symptoms than youngsters with ADHD without bipolar disorder. The CBCL pediatric bipolar disorder profile did not accurately identify youngsters diagnosed with bipolar disorder.

CONCLUSIONS: The present findings present a picture of manic youngsters as verbally aggressive and argumentative, who respond with anger when frustrated. Youngsters diagnosed with bipolar disorder and ADHD exhibited significant levels of impulsive behavior and attention problems, but youngsters with bipolar disorder also exhibited significant levels of aggressive behavior and dysphoric mood. Finally, the CBCL pediatric bipolar disorder profile did not accurately identify youngsters who were diagnosed with bipolar disorder.

]]> Leonard A. Doerfler et al. Adolescent *Affect Aggression Attention Deficit Disorder with Hyperactivity Bipolar Disorder Child Depression Female Hostility Humans Interview, Psychological Male Psychiatric Status Rating Scales