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In this article two conceptual frameworks for understanding the effects of childhood sexual exploitation are presented: the traumagenic dynamics model and the model of information processing. Various research studies of the long-term effects of this problem are reviewed and summarized. Results of these studies show that survivors of childhood sexual exploitation experience a variety of long-term effects, including low self-esteem, posttraumatic stress disorder, depression, suicidal attempts, and drug and alcohol abuse. Implications for nursing practice and research are suggested.
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PMID:Long-term effects of childhood sexual exploitation. 267 6

Social phobia is a distinct clinical entity that accounts for significant morbidity. It is often linked to depression and other anxiety disorders and may be a risk factor for alcohol abuse. Primary care physicians can more easily recognize the disorder if they carefully question patients about anxiety in social situations. Effective behavioral and pharmacologic therapies for social phobia are available. However, primary care physicians may prefer to refer patients to a specialist because of inherent difficulties in treatment that may require the experience of a clinician more familiar with the disorder.
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PMID:Social phobia. Recognizing the distress signals. 268 82

The relationship of parental closeness to current behavior and related psychopathological indices is studied among alcoholics. Seventy alcoholics from an inpatient treatment unit and thirty medical inpatients were given a battery of alcohol related measures. These measures included a scale assessing the psychological distance from mother and father, a social closeness measure, an index of anger, a locus of control measure, along with basic alcohol-related information. In addition, the alcoholic sample was given psychometric measures of depression and cognition. Results show that perceived distance from parents is greater among alcoholics than medical patients. Comparison analyses of mother and father distance scores on the study variables of alcohol-related and psychometric measures yielded only a few differences. Correlational analyses showed, however, that distance from mother and father is related to parental alcohol abuse and parents not being at home but not to current behavior (except anger).
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PMID:Distance from mother and father among alcoholics. 271 16

Using structured interviews and the SCL-90R, study was made of the behaviors of 29 applicants to a residential treatment program for cocaine abuse who had been placed on the program's waiting list for periods ranging from 1 to 6 months. It was hypothesized that applicants waiting treatment for 3 months or less (N = 16) would be more likely to view themselves as treatment candidates and would show behaviors different from those waiting 4-6 months (N = 13). Being on the waiting list a longer period was associated with greater evidence of criminal justice involvement, but with few other differences. Nearly half the total sample (48.3%) reported having significantly reduced drug use in association with their applying for treatment, but most applicants (58.6%) were pessimistic about their long-term capacity to remain free of drug-related difficulty. The pattern of SCL-90R scores for all subjects suggested significant psychiatric symptoms, including depression. Nonetheless, a majority of all applicants (51.7%) reported themselves as having become less interested in entering treatment. Nearly all applicants reported high levels of encouragement for their decision to enter treatment from persons with whom they were living and about half reported encouragement from friends. Of the 23 applicants who were IV drug users, 10 (41.7%) reported knowing someone who had contracted AIDS, 87.0% reported having changed behaviors--chiefly needle sharing--to reduce the risk of infection, and 69.6% reported having obtained HIV testing. The difficulty encountered in locating a random sample of applicants suggests the problem of maintaining a useful waiting list for treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
Am J Drug Alcohol Abuse 1989
PMID:The functioning of individuals on a drug abuse treatment waiting list. 276 83

Symptoms of antisocial personality disorder (ASPD) and of psychiatric conditions reported to be related to ASPD were subjected to grade of membership analysis, a relatively new procedure for medical classification, to identify the pure types that would empirically emerge in the absence of prior assumptions about the clustering of those symptoms. The sample consists of 914 respondents who participated in the NIMH Epidemiologic Catchment Area Program at the North Carolina site. Symptom and diagnostic data were obtained using the Diagnostic Interview Schedule. Seven pure types emerged from the grade of membership analysis. Two pure types closely resemble the DSM-III portrait of ASPD. Two other pure types consisted of alcohol abuse/dependence symptoms and indicators of illicit drug use for recreational purposes. Only two of the symptomatic pure types were common among women. The first of these was characterized by marital instability, other domestic problems, and employment difficulties; as such this type resembles the DSM-III description of borderline and/or histrionic personality disorder. The other female pure type was characterized by multiple symptoms of depression and selected symptoms of other axis I disorders. The final pure type was characterized by an absence of psychiatric symptoms and served as a comparison group against which the symptomatic pure types were compared.
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PMID:Antisocial and related disorders in a southern community. An application of grade of membership analysis. 276 46

In this study, 40 older female and 40 older male community volunteers (age range = 60-78 years) read fictional case descriptions of a healthy person and of individuals with one of five types of psychopathology (paranoia, depression, dementia, hypochondriasis, and alcohol abuse). In each group, 1/2 of the volunteers read descriptions of an older woman and 1/2 read analogous descriptions of an older man. Participants rated the psychological disturbance of the stimulus individuals. The hypothesis that older women would rate symptoms of psychopathology of elderly people as more severe than would older men was not supported. Normal stimulus individuals were typically perceived to be extremely healthy, thus, strongly accounting for a main effect of pathology type. The five psychopathology conditions also were viewed differentially in terms of severity. These results suggest that older women are no more perceptive of psychopathology than are older men.
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PMID:Older adults' perceptions of psychopathology. 280 32

Alcohol dependence and abuse have been commonly found to coexist with other psychiatric disorders. In order to further investigate this relationship two populations with combined dysfunctional alcohol use and psychiatric illness were studied, one at an alcohol treatment centre and one at a general hospital psychiatric service. Sixty of the 63 people screened at the alcohol treatment centre and 41 of the 43 people with an alcohol problem at the psychiatric unit, met the combined criteria, thus confirming that a very high proportion of people with alcohol problems, and who present for treatment, also have additional psychiatric disorders. The two sample populations were similar on sociodemographic variables. There were differences in the types of psychiatric disorders occurring at the two treatment centres with depression predominating at the psychiatric unit and anxiety disorders occurring more frequently at the alcohol treatment facility. Both samples showed a high rate of schizophrenia. The sample at the alcohol treatment centre showed higher levels of alcohol consumption and had higher rates of problems associated with alcohol. Service delivery issues are discussed in relation to these results. The importance of psychiatric symptoms in both the genesis of dysfunctional drinking and in service utilisation are highlighted.
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PMID:Alcoholism and psychiatric disorder in patients who present to different services in Wellington. 281 92

The Vietnam Experience Study was a multidimensional assessment of the health of Vietnam veterans. From a random sample of enlisted men who entered the US Army from 1965 to 1971, 7924 Vietnam and 7364 non-Vietnam veterans participated in a telephone interview; a random subsample of 2490 Vietnam and 1972 non-Vietnam veterans also underwent a comprehensive health examination, including a psychological evaluation. At the time of the study, the two groups of veterans were similar in terms of level of education, employment, income, marital status, and satisfaction with personal relationships. Certain psychological problems, however, were significantly more prevalent among Vietnam veterans than among non-Vietnam veterans. These included depression (4.5% of Vietnam veterans vs 2.3% of non-Vietnam veterans), anxiety (4.9% vs 3.2%), and alcohol abuse or dependence (13.7% vs 9.2%). About 15% of Vietnam veterans experienced combat-related posttraumatic stress disorder at some time during or after military service, and 2.2% had the disorder during the month before the examination.
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PMID:Health status of Vietnam veterans. I. Psychosocial characteristics. The Centers for Disease Control Vietnam Experience Study. 283 30

The purpose of this paper is to describe the authors' ongoing investigation of alcoholism and family interaction--a large-scale observation study involving intact families assessed under a broad range of conditions. The methodology is characterized by the inclusion of two control groups, laboratory observations involving experimental drinking procedures, and naturalistic home observations focused on dinnertime interactions. Key issues addressed involve the impact of alcoholism on the process and structure of family life, the degree to which varying patterns of family interaction serve to potentiate or inhibit the development of alcoholism in children of alcoholics, and the degree to which observed patterns vary in relation to nature of dysfunction (alcoholism versus depression). The current status and initial outcomes of the project are described in detail.
Am J Drug Alcohol Abuse 1989
PMID:Alcoholism and family interaction: an experimental paradigm. 292 13

In this study we conducted a resurvey at 33 months of elderly general medical clinic outpatients previously classified as depressed or not using the Zung Self-Rating Depression Scale. Resurvey results and review of medical records permitted characterization of the point prevalences of depression at the time of the initial and follow-up surveys, and identification of physical illness factors associated with depression. The point prevalences of depression were approximately equal (20%), although only about 10% were depressed at both occasions. Among the initially nondepressed, the number of new physical diagnoses during follow-up was the best predictor of depression at retest. Other factors associated with depression at one or both occasions were: alcohol abuse, obstructive pulmonary disease, and a relatively greater number of medical diagnoses. Thus, among elderly outpatients, depression appears common with roughly equal rates of remission and incidence; also, new medical illness may precipitate depression.
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PMID:Depression and physical illness among elderly general medical clinic patients. 294 71


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