Female alcoholic subtypes : some clinical and social implications

Bibliography: leaf xiii-xiv.Classifying subtypes is widely accepted in alcoholics research on males. Female alcoholics are largely investigated as a homogenous group. Furthermore, the literature indicates that female alcoholics are more psychologically disturbed than male alcoholics. The present study was set up to investigate these issues. Twenty-nine white female alcoholic in-patients at a specialist hospital for alcoholics were tested on Cattell's 16 Personality Factor Questionnaire (16 PF), the Hostility Direction of Hostility Questionnaire (HDHQ) and the Semantic Differential (SD). Subjects were mostly from the lower-middle class with a mean age of 45,45. Subjects were assigned to one of three groups: Gamma, Delta and Intermediate as defined by Jellinek (1960) using Walton's criteria (1968) of Gamma/Delta alcoholism. It was hypothesized that there would be intergroup differences on all of the above measures. The Symptom Sign Inventory (SSI) was used to compare the degree of psychological disturbance on the above groups with an age-matched sample of male alcoholic in-patients on criteria of neuroticism, psychoticism and personal disturbance. The female gamma group had a higher Total Hostility (p < ,01) Extrapunitiveness (p < ,01) and Intrapunitiveness score (p < 05) than the female delta group. However, the three female subgroups did not differ from each other on the personality factors (16 PF), nor on measures of the perceptions of self (SD). In addition, no differences were found between the sexes in the manifestation of psychological disturbance; although a high proportion of subjects revealed psychological disturbance (SSI)

Marginalized Transition Models for Longitudinal Binary Data With Ignorable and Nonignorable Dropout

We extend the marginalized transition model of Heagerty (2002) to accommodate nonignorable monotone dropout. Using a selection model, weakly identified dropout parameters are held constant and their effects evaluated through sensitivity analysis. For data missing at random (MAR), efficiency of inverse probability of censoring weighted generalized estimating equations (IPCW-GEE) is as low as 40% compared to a likelihood-based marginalized transition model (MTM) with comparable modeling burden. MTM and IPCW-GEE regression parameters both display misspecification bias for MAR and nonignorable missing data, and both reduce bias noticeably by improving model fi

Virtual faces as a tool to study emotion recognition deficits in schizophrenia

Studies investigating emotion recognition in patients with schizophrenia predominantly presented photographs of facial expressions. Better control and higher flexibility of emotion displays could be afforded by virtual reality (VR). VR allows the manipulation of facial expression and can simulate social interactions in a controlled and yet more naturalistic environment. However, to our knowledge, there is no study that systematically investigated whether patients with schizophrenia show the same emotion recognition deficits when emotions are expressed by virtual as compared to natural faces. Twenty schizophrenia patients and 20 controls rated pictures of natural and virtual faces with respect to the basic emotion expressed (happiness, sadness, anger, fear, disgust, and neutrality). Consistent with our hypothesis, the results revealed that emotion recognition impairments also emerged for emotions expressed by virtual characters. As virtual in contrast to natural expressions only contain major emotional features, schizophrenia patients already seem to be impaired in the recognition of basic emotional features. This finding has practical implication as it supports the use of virtual emotional expressions for psychiatric research: the ease of changing facial features, animating avatar faces, and creating therapeutic simulations makes validated artificial expressions perfectly suited to study and treat emotion recognition deficits in schizophrenia

Redirecting research efforts on the diversification-performance linkage: The search for synergy

We review the literature on the diversification-performance (D-P) relationship to a) propose that the time is ripe for a renewed attack on understanding the relationship between diversification and firm performance, and b) outline a new approach to attacking the question. Our paper makes four main contributions. First, through a review of the literature we establish the inherent complexities in the D-P relationship and the methodological challenges confronted by the literature in reaching its current conclusion of a non-linear relationship between diversification and performance. Second, we argue that to better guide managers the literature needs to develop along a complementary path – whereas past research has often focused on answering the big question of does diversification affect firm performance, this second path would focus more on identifying the precise micro-mechanisms through which diversification adds or subtracts value. Third, we outline a new approach to the investigation of this topic, based on (a) identifying the precise underlying mechanisms through which diversification affects performance; (b) identifying performance outcomes that are “proximate” to the mechanism that the researcher is studying, and (c) identifying an appropriate research design that can enable a causal claim. Finally, we outline a set of directions for future research

Comparative quantification of health risks: Conceptual framework and methodological issues

Reliable and comparable analysis of risks to health is key for preventing disease and injury. Causal attribution of morbidity and mortality to risk factors has traditionally been conducted in the context of methodological traditions of individual risk factors, often in a limited number of settings, restricting comparability. In this paper, we discuss the conceptual and methodological issues for quantifying the population health effects of individual or groups of risk factors in various levels of causality using knowledge from different scientific disciplines. The issues include: comparing the burden of disease due to the observed exposure distribution in a population with the burden from a hypothetical distribution or series of distributions, rather than a single reference level such as non-exposed; considering the multiple stages in the causal network of interactions among risk factor(s) and disease outcome to allow making inferences about some combinations of risk factors for which epidemiological studies have not been conducted, including the joint effects of multiple risk factors; calculating the health loss due to risk factor(s) as a time-indexed "stream" of disease burden due to a time-indexed "stream" of exposure, including consideration of discounting; and the sources of uncertainty

Mammography stages of change in middle-aged women with schizophrenia: An exploratory analysis

BACKGROUND: Health care providers and educators who seek to create health promotion programs and individualized comprehensive care plans for women with schizophrenia are hindered by the lack of data to guide their efforts. PURPOSE: This study tested the hypothesis that women with schizophrenia adhere to mammography screening guidelines at the same rate as other same-age women. The study also investigated the validity of the Health Belief (HB) and Stages of Change (SOC) models for breast cancer screening among women with schizophrenia. METHODS: Socio-demographic and clinical variables, as well as knowledge, attitudes, and barriers were assessed as a function of stage of change related to breast cancer screening in 46 women with schizophrenia. RESULTS: Women with schizophrenia were statistically less likely to be adherent to the screening recommendations than those without schizophrenia. Some support was found for the validity of the HB and SOC models for breast cancer screening in women with schizophrenia. Women in the Precontemplation stage had significantly higher negative attitude scores compared to Contemplation and Action/Maintenance stages (59.7, 45.7, and 43.2, respectively), and there was a trend for more barriers in the Precontemplation group (4.6, 2.6, 2.7 respectively). CONCLUSION: Given the small sample size, further research on the rates of breast cancer screening in women with schizophrenia is warranted. Nonetheless, these data suggest that providers who care for women with schizophrenia may need to make take additional measures to ensure that this population receives appropriate screening so as to not put them at greater risk for a late-stage diagnosis of breast cancer. Furthermore, these pilot data suggest that HB and SOC theory-based interventions may be valid for increasing mammography rates in women with schizophrenia