bluuebunny/crossref_metadata_2025_split huggingface dataset:
The dimensional structure of first episode psychosis: an exploratory
factor
analysis
Authors: McGORRY P. D. , BELL R. C. , DUDGEON P. L. , JACKSON H. J. 
Published: July 2002

Background. Recent research has focused upon the
subdiagnostic level in an effort to derive more
valid domains of psychotic disorder. This has led to the influential
positive–negative dichotomy in
schizophrenia being superseded by a three-syndrome model. The
strategy of looking for syndromes
within poorly validated diagnostic categories, such as schizophrenia,
has limitations, particularly
since it originated in, and has been largely restricted to, the more chronic
subsamples.Method. A representative sample of first episode psychosis

(N=509), which includes the full
spectrum of functional psychosis, was utilized to re-examine the
dimensional structure of functional
psychosis from first principles. Patients were assessed with the Royal
Park Multidiagnostic
Instrument for Psychosis (MIP), a comprehensive procedure that documents
the psychopathology
of the first episode in a clinically valid manner.Results. Principal axis factor analysis was carried
out on the tetrachoric correlation matrix of 92
core psychopathological items. A robust and clinically valid four-factor
solution was obtained,
comprising depression, mania and only two other factors. The first was
a Bleulerian blend of
negative symptoms, catatonic/motor symptoms and disorganization. The
second was
a combination of Schneiderian first rank symptoms, and other hallucinations

and delusions. The data thus failed
to support the three-syndrome model for non-affective symptoms in this
population. A six-factor
solution, although partially consistent with other studies, represented
a more complex and
confusing elaboration of the more clinically valid four-factor solution.Conclusions. The findings have implications for
the conceptualization of early psychosis, which
need to be explored further in validation studies.
The development of the Short Explanatory Model Interview (SEMI)
and its use among primary-care attenders with common mental disorders
Authors: LLOYD K. R. , JACOB K. S. , PATEL V. , St. LOUIS L. , BHUGRA D. , MANN A. H. 
Published: July 2002

Background. Recent anthropological studies have
documented the importance of understanding
the relation of culture to the experience of mental illness. The use of
interviews that elicit
explanatory models has facilitated such research, but currently
available interviews are lengthy and
impractical for epidemiological studies. This paper is a
preliminary report on the development of
a brief instrument to elicit explanatory models for use in field work.Method. The development of the SEMI, a short interview
to elicit explanatory models is described.
The interview explores the subject's cultural background, nature
of presenting problem, help-seeking behaviour, interaction with physician/healer and beliefs related
to mental illness.Results. The SEMI was employed to study the explanatory
models of subjects with common mental
disorders among Whites, African-Caribbean and Asians living in London and
was also used in
Harare, Zimbabwe. Data from its use in four different ethnic
groups is presented with the aim of
demonstrating its capacity to show up differences in these varied settings.Conclusions. The simplicity and brevity of the SEMI allow
for its use in field studies in different
cultures, data can be used to provide variables for use in quantitative
analysis and provide
qualitative descriptions.
A population-based twin study of self-esteem and gender
Authors: KENDLER K. S. , GARDNER C. O. , PRESCOTT C. A. 
Published: July 2002

Background. Self-esteem (SE), a widely used construct
in the social sciences, is usually conceptualized
as a reflection of socialization and interpersonal experiences that may
differ considerably between
the genders.Methods. The Rosenberg self-esteem scale was assessed at personal
interview in both members of
3793 unselected twin pairs (1517 male–male, 856 female–female
and 1420 male–female) from the
population-based Virginia Twin Registry. Gender effects on SE were assessed
by both analysis of
variance and biometrical twin modelling.Results. The mean SE score was slightly but significantly lower
in women v. men, and in women who
grew up with a male v. a female co-twin. Twin modelling suggested
that: (i) individual differences
in self-esteem in both men and women were best explained by genetic and
individual-specific
environment factors; (ii) heritability estimates were similar
in women (32%) and in men (29%); and
(iii) the same genetic factors that influenced SE in women also
influenced SE in men. Analyses
supported the validity of the equal environment assumption for SE. The
heritability of SE cannot
be explained by the moderate correlation between SE and symptoms of depression.Conclusions. These results are inconsistent with prominent
gender-related aetiological models for
SE, which postulate that individual differences arise from socialization
experiences both within and
outside the home of origin which differ widely for the two genders. Instead,
a significant proportion
of the population variance in SE is due to genetically-influenced temperamental
variables that are
the same in men and women.
Symptoms of depression and anxiety during adult
life: evidence for a decline in prevalence with age
Authors: HENDERSON A. S. , JORM A. F. , KORTEN A. E. , JACOMB P. , CHRISTENSEN H. , RODGERS B. 
Published: July 2002

Background. To test the hypothesis that the prevalence,
in the general population, of symptoms of
depression and anxiety declines with age.Methods. A general population sample of 2725 persons aged 18
to 79 years was administered two
inventories for current symptoms of depression and anxiety, together with
measures of neuroticism
and of exposures that may confer increased risk of such symptoms.Results. Symptoms of depression showed a decline with age in
both men and women. For anxiety,
the decline was statistically significant for women but not consistently
so for men. For the risk
factors examined, there was a decline with age in the neuroticism score,
the frequency of adverse
life events, being seriously short of money and having had parents who
separated or divorced.
Further analysis showed that the association between age and a declining
symptom score cannot be
entirely attributed to these risk factors, with the single exception of
neuroticism. The latter is itself
likely to be contaminated by current symptoms.Conclusion. Unless these findings are due to bias in the sample
of those who agreed to participate,
they add to the evidence that symptoms of depression and to a lesser extent
of anxiety decline in
prevalence with age. Some risk factors also decline with age. It now has
to be determined if these
cross-sectional observations are also to be found in longitudinal data;
and what process may
underlie this striking change in mental health during adulthood.
Symptoms of depression among community-dwelling
elderly African-American and White older adults
Authors: BLAZER D. G. , LANDERMAN L. R. , HAYS J. C. , SIMONSICK E. M. , SAUNDERS W. B. 
Published: July 2002

Background. Few studies have explored the variance in
individual symptoms by race in older
adults.Methods. Data were analysed from the Duke site of the Established
Populations for Epidemiologic
Studies of the Elderly (EPESE), a community sample of persons 65 years-of-age
and older, 54% of
whom were African-Americans. Of the 3401 subjects with adequate data on
depressive
symptomatology, confirmatory factor analysis and LISREL were first used
to confirm the presence
of the factor structure previously reported for the CES-D. Next, bivariate
analysis was performed
to determine the prevalence of individual symptoms by race. Finally, LISREL
analysis was
performed to control for potential confounding variables.Results. When bivariate comparisons of specific symptoms by
race were explored, African-Americans
were more likely to report less hope about the future, poor appetite, difficulty

concentrating, requiring more effort for usual activities, less talking,
feeling people were unfriendly,
feeling disliked by others and being more ‘bothered’ than usual.
When LISREL analyses were
applied to these data (controlling for education, income, cognitive impairment,
chronic health
problems and disability and other factors) racial differences in somatic
complaints and life
satisfaction disappeared, yet differences in interpersonal relations persisted.Conclusions. This study confirms earlier findings of minimal
overall differences in symptom
frequency between African-American and non-African-American community-dwelling
older adults
in controlled studies.
Childhood attention deficit/hyperactivity disorder in
adults with anxiety disorders
Authors: MANCINI C. , VAN AMERINGEN M. , OAKMAN J. M. , FIGUEIREDO D. 
Published: July 2002

Background. Previous research has reported co-morbidity between attention deficit hyperactivity
disorder (ADHD) and anxiety disorders. Interpretation of these findings is complicated by
symptom overlap in the clinical presentation of the disorders. We estimate the prevalence of ADHD
in both the current and childhood histories of adults with anxiety disorders, while taking symptom
overlap into account. We also evaluate the utility of the Wender Utah Rating Scale (WURS) for
retrospective reporting of ADHD.Methods. Consecutive admissions (N=149) to an anxiety disorders clinic were given a diagnostic
and psychometric assessment. The WURS was administered to obtain a retrospective diagnosis of
childhood ADHD. Twenty-nine of the 35 people surpassing the cut-off score on the WURS were
given a structured interview of adult ADHD symptoms.Results. The WURS contains many ‘internalizing’ items that may inflate retrospective accounts of
ADHD. After taking this into account, there is still a significantly higher prevalence of ADHD in
the retrospective reports of adults with anxiety disorders (15%) than would be expected by chance
(4%). Furthermore, of those who meet retrospective criteria for ADHD, 45% (13 of 29) continue
to meet diagnostic criteria for ADHD as adults.Conclusions. The WURS may require considerable revision for use with clinical populations. In
spite of these difficulties with retrospective assessment, available evidence indicates that ADHD is
more prevalent in the histories of anxiety disordered patients than would be expected from base
rates.
Conditions not attributable to a mental disorder in
Dutch psychiatric out-patients
Authors: SPINHOVEN P. , VAN DER DOES A. J. W. 
Published: July 2002

Background. According to DSM-III-R V-code conditions refer
to marital relationships, family
circumstances, interpersonal relationships, or stressful life events that
are not attributable to a
mental disorder but that are the focus of treatment. The purpose of the
present study was to assess
the prevalence and patient and treatment characteristics of adult psychiatric
out-patients diagnosed
with V-code conditions.Methods. The records of all 5660 consecutive admissions to
a psychiatric out-patient clinic over a
12-year period were studied retrospectively. On the basis of both primary
and secondary
DSM-III-R diagnoses on Axis I, two subgroups of patients were compared:
(1) patients with V-code
conditions; and (2) patients with mental disorders.Results. Fourteen per cent of the patients had a V-code condition
and no mental disorder, while the
remaining patients were diagnosed with mental disorder (with or without
an additional V-code
condition). Comparisons of sociodemographic and clinical severity characteristics
of the two groups
indicated that patients with V-code conditions tended to have a higher
socio-economic status and
to present with less severe problems as assessed both by the primary therapist
and the
Symptom-Checklist-90. With respect to service use and treatment outcome
variables, it appeared that V-code
patients tended to be more frequently treated by couple/family therapy
and to receive a slightly
lower number of treatment sessions.Conclusions. The pattern of results in The Netherlands seems
comparable to results of previous
North American studies. Implications of these findings for future studies
and for use of mental
health services are discussed.
Social and personal resources and the prevalence of
phobic disorder in a community population
Authors: HYBELS C. F. , BLAZER D. G. , KAPLAN B. H. 
Published: July 2002

Background. Phobic disorder is one of the most prevalent psychiatric disorders in community
populations and much attention has focused on the association of sociodemographic factors and
social resources with the disorder. There has been little investigation of the more personal resources
such as self-confidence, religiosity, social support and self-perceived health that may increase
vulnerability.Methods. We used a sample of 2914 community residents aged 18 or older who participated in the
Duke University Epidemiologic Catchment Area Study to explore the relationship between both
social and personal resources and the prevalence of DIS/DSM-III phobic disorder.Results. The 1-month prevalence of any phobic disorder was 7·6%. In bivariate analyses, we found
both race/ethnicity and gender differences in prevalence, with a higher prevalence of phobic
disorder in African-Americans and females. Lower socio-economic status, rural residence and
unmarried status were also associated with current prevalence. No association was found for social
network and social interaction. Impaired subjective social support, low self-confidence, perceived
poorer physical health and co-morbid psychiatric disorder were significantly associated with
current prevalence in uncontrolled analyses, while associations between lack of a confidant as well
as religiosity and phobic disorder were not. Female gender (OR = 1·7), perceived low self-
confidence (OR = 2·0), and two interaction terms, age × co-morbid psychiatric disorder and
race/ethnicity × perceived physical health were associated with phobic disorder in controlled
analyses using logistic regression.Conclusions. We conclude that both social and personal resources, particularly self-confidence, co-morbidity and perceived physical health are important correlates of phobic disorder.
Age is no kinder to the better educated:
absence of an association investigated using latent
growth techniques in a community sample
Authors: CHRISTENSEN H. , HOFER S. M. , MACKINNON A. J. , KORTEN A. E. , JORM A. F. , HENDERSON A. S. 
Published: July 2002

Background. Higher education has been posited to protect against cognitive decline, either because
the rate of decline is slower in the more highly educated or the start of decline is delayed. Latent
growth models provide improved methodology to examine this issue.Methods. The sample consisted of 887 participants aged 70–93 years in 1991 and followed up in
1994 and 1998. Latent growth models and standard regression techniques were used to examine the
rate of cognitive decline in four cognitive measures while controlling for health status and sex. A
delayed start model was examined by incorporating interaction effects in a regression model.Results. Neither the latent growth models nor the regression techniques revealed a slower rate of
decline for the more highly educated. The proportion of the highly educated showing no change was
no larger than the proportion of the less well educated. There were no significant age by education
interaction effects, no chronologically later accelerations in the rate of change as a function of
education, and no differences in rate of decline between the first measurement interval and the
second.Conclusions. Education may not protect against cognitive decline although it is associated with
long-term individual differences in level of functioning. The discrepancy between our study and
others may be attributable to attrition effects, follow-up length, sample age, scaling artefacts and
negative publication bias. Most importantly, practice effects may favour the better educated and
hence account for the supposed protective effect in many longitudinal studies of cognitive change.
The natural history of somatization in primary care
Authors: GUREJE OYE , SIMON GREGORY E. 
Published: July 2002

Background. Somatization is often regarded as a chronic disorder. However, empirical studies to
support this view and to determine its natural history in primary care are lacking. This paper
provides data on the incidence and persistence of current somatization syndrome in a large cross-national sample drawn from 15 sites in 14 countries.Methods. After screening with the General Health Questionnaire, a stratified sample of 5438
primary care patients was interviewed with the Composite International Diagnostic Interview and
evaluated for physical health status, self-rated overall health and for occupational disability. Twelve
months later, 3204 of the patients completed follow-up interviews.Results. Over a 12-month period, an abridged form of somatization defined as four current
symptoms in males and six in females was persistent in 45·9% of the patients. Persistence of
syndrome was related to age and to subjective indices of psychological distress at baseline.
Persistence was unrelated to depression. The 12-month incidence of the abridged somatization
syndrome was 7·1% (95% CI, 6·1–8·3%). Individuals with depression at baseline and those with
poor view of their health were more likely to develop new episodes of somatization 12-months later.Conclusion. Somatization syndrome showed considerable change over time. Persistence and onset
of somatization were related to both level of psychopathology and health beliefs.
Stimulation of the noradrenergic system enhances
and blockade reduces memory for emotional material in man
Authors: O'CARROLL R. E. , DRYSDALE E. , CAHILL L. , SHAJAHAN P. , EBMEIER K. P. 
Published: July 2002

Background. It is clearly established that emotional events tend to be remembered particularly
vividly. The neurobiological substrates of this phenomenon are poorly understood. Recently, the
noradrenergic system has been implicated in that beta blockade has been shown to reduce
significantly the delayed recall of emotional material with matched neutral material being
unaffected.Methods. In the present study, 36 healthy young adults were randomly allocated to receive either
yohimbine, which stimulates central noradrenergic activity, metoprolol which blocks noradrenergic
activity, or matched placebo. The three groups were well matched. All capsules were taken orally,
prior to viewing a narrated 11 slide show described a boy being involved in an accident.Results. Yohimbine significantly elevated, and metoprolol reduced mean heart rate during the slide
show relative to placebo, thus confirming the efficacy of the pharmacological manipulation. One
week later, in a ‘surprise’ test, memory for the slide show was tested. As predicted, yohimbine-treated subjects recalled significantly more and metoprolol subjects fewer slides relative to placebo.
This result was confirmed via analysis of multiple-choice recognition memory scores.Conclusions. We conclude that stimulation of the noradrenergic system results in the enhancement
and blockade in a reduction of recall and recognition of emotional material in man.
A difference that matters: comparisons of structured and
semi-structured psychiatric diagnostic interviews in the
general population
Authors: BRUGHA T. S. , BEBBINGTON P. E. , JENKINS R. 
Published: July 2002

Psychiatric case-identification in general populations allows us to study both individuals with
functional psychiatric disorders and the populations from which they come. The individual level of
analysis permits disorders to be related to factors of potential aetiological significance and the study
of attributes of the disorders that need to be assessed in non-referred populations (an initially
scientific endeavour). At the population level valid case identification can be used to evaluate needs
for treatment and the utilization of service resources (a public health project). Thus, prevalence is
of interest both to scientists and to those responsible for commissioning and planning services
(Brugha et al. 1997; Regier et al. 1998). The quality of case identification techniques and of
estimates of prevalence is thus of general concern (Bartlett & Coles, 1998).Structured diagnostic interviews were introduced into general population surveys in the 1970s as
a method ‘to enable interviewers to obtain psychiatric diagnoses comparable to those a psychiatrist
would obtain’ (Robins et al. 1981). The need to develop reliable standardized measures was partly
driven by an earlier generation of prevalence surveys showing rates ranging widely from 10·9%
(Pasamanick et al. 1956) to 55% (Leighton et al. 1963) in urban and rural North American
communities respectively. If the success of large scale psychiatric epidemiological enquiries using
structured diagnostic interviews and standardized classifications is measured in terms of citation
rates it would seem difficult to question. But the development of standardized interviews of
functional psychiatric disorders has not solved this problem of variability: the current generation
of large scale surveys, using structured diagnostic interviews and serving strictly defined classification
rules, have generated, for example, 12-month prevalence rates of major depression in the US of
4·2% (Robins & Regier, 1991) and 10·1% (Kessler et al. 1994). This calls into question the validity
of the assessments, such that we must reopen the question of what they should be measuring and
how they should do it.