http://www.iowaaces360.org/uploads/1/0/9/2/10925571/relationship_of_childhood_abuse_and..._1998.pdf

Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study

Background: This study presents estimates of lifetime and 12-month prevalence of 14 DSM-III-R psychiatric disorders from the National Comorbidity Survey, the first survey to administer a structured psychiatric interview to a national probability sample in the United States. Methods: The DSM-III-R psychiatric disorders among persons aged 15 to 54 years in the noninstitutionalized civilian population of the United States were assessed with data collected by lay interviewers using a revised version of the Composite International Diagnostic Interview. Results: Nearly 50% of respondents reported at least one lifetime disorder, and close to 30% reported at least one 12-month disorder. The most common disorders were major depressive episode, alcohol dependence, social phobia, and simple phobia. More than half of all lifetime disorders occurred in the 14% of the population who had a history of three or more comorbid disorders. These highly comorbid people also included the vast majority of people with severe disorders. Less than 40% of those with a lifetime disorder had ever received professional treatment, and less than 20% of those with a recent disorder had been in treatment during the past 12 months. Consistent with previous risk factor research, it was found that women had elevated rates of affective disorders and anxiety disorders, that men had elevated rates of substance use disorders and antisocial personality disorder, and that most disorders declined with age and with higher socioeconomic status. Conclusions: The prevalence of psychiatric disorders is greater than previously thought to be the case. Furthermore, this morbidity is more highly concentrated than previously recognized in roughly one sixth of the population who have a history of three or more comorbid disorders. This suggests that the causes and consequences of high comorbidity should be the focus of research attention. The majority of people with psychiatric disorders fail to obtain professional treatment. Even among people with a lifetime history of three or more comorbid disorders, the proportion who ever obtain specialty sector mental health treatment is less than 50%. These results argue for the importance of more outreach and more research on barriers to professional help-seeking.

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Lifetime and 12-Month Prevalence of DSM-III-R Psychiatric Disorders in the United States: Results From the National Comorbidity Survey

Background Little is known about the general population prevalence or severity of DSM-IV mental disorders. Objective To estimate 12-month prevalence, severity, and comorbidity of DSM-IV anxiety, mood, impulse control, and substance disorders in the recently completed US National Comorbidity Survey Replication. Design and Setting Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using a fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview. Participants Nine thousand two hundred eighty-two English-speaking respondents 18 years and older. Main Outcome Measures Twelve-month DSM-IV disorders. Results Twelve-month prevalence estimates were anxiety, 18.1%; mood, 9.5%; impulse control, 8.9%; substance, 3.8%; and any disorder, 26.2%. Of 12-month cases, 22.3% were classified as serious; 37.3%, moderate; and 40.4%, mild. Fifty-five percent carried only a single diagnosis; 22%, 2 diagnoses; and 23%, 3 or more diagnoses. Latent class analysis detected 7 multivariate disorder classes, including 3 highly comorbid classes representing 7% of the population. Conclusion Although mental disorders are widespread, serious cases are concentrated among a relatively small proportion of cases with high comorbidity.

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Prevalence, Severity, and Comorbidity of 12-Month DSM-IV Disorders in the National Comorbidity Survey Replication

Background: Data were obtained on the general population epidemiology of DSM-III-R posttraumatic stress disorder (PTSD), including information on estimated lifetime prevalence, the kinds of traumas most often associated with PTSD, sociodemographic correlates, the comorbidity of PTSD with other lifetime psychiatric disorders, and the duration of an index episode. Methods: Modified versions of the DSM-III-R PTSD module from the Diagnostic Interview Schedule and of the Composite International Diagnostic Interview were administered to a representative national sample of 5877 persons aged 15 to 54 years in the part II subsample of the National Comorbidity Survey. Results: The estimated lifetime prevalence of PTSD is 7.8%. Prevalence is elevated among women and the previously married. The traumas most commonly associated with PTSD are combat exposure and witnessing among men and rape and sexual molestation among women. Posttraumatic stress disorder is strongly comorbid with other lifetime DSM-III-R disorders. Survival analysis shows that more than one third of people with an index episode of PTSD fail to recover even after many years. Conclusions: Posttraumatic stress disorder is more prevalent than previously believed, and is often persistent. Progress in estimating age-at-onset distributions, cohort effects, and the conditional probabilities of PTSD from different types of trauma will require future epidemiologic studies to assess PTSD for all lifetime traumas rather than for only a small number of retrospectively reported "most serious" traumas. (Arch Gen Psychiatry. 1995;52:1048-1060)

Posttraumatic stress disorder in the National Comorbidity Survey.

Background. A 10-question screening scale of psychological distress and a six-question short-form scale embedded within the 10-question scale were developed for the redesigned US National Health Interview Survey (NHIS). Methods. Initial pilot questions were administered in a US national mail survey (N fl 1401). A reduced set of questions was subsequently administered in a US national telephone survey (N fl 1574). The 10-question and six-question scales, which we refer to as the K10 and K6, were constructed from the reduced set of questions based on Item Response Theory models. The scales were subsequently validated in a two-stage clinical reappraisal survey (N fl 1000 telephone screening interviews in the first stage followed by N fl 153 face-to-face clinical interviews in the second stage that oversampled first-stage respondents who screened positive for emotional problems) in a local convenience sample. The second-stage sample was administered the screening scales along with the Structured Clinical Interview for DSM-IV (SCID). The K6 was subsequently included in the 1997 (N fl 36116) and 1998 (N fl 32440) US National Health Interview Survey, while the K10 was included in the 1997 (N fl 10641) Australian National Survey of Mental Health and Well-Being. Results. Both the K10 and K6 have good precision in the 90th‐99th percentile range of the population distribution (standard errors of standardized scores in the range 0‐20‐0‐25) as well as consistent psychometric properties across major sociodemographic subsamples. The scales strongly discriminate between community cases and non-cases of DSM-IV}SCID disorders, with areas under the Receiver Operating Characteristic (ROC) curve of 0‐87‐0‐88 for disorders having Global Assessment of Functioning (GAF) scores of 0‐70 and 0‐95‐0‐96 for disorders having GAF scores of 0‐50. Conclusions. The brevity, strong psychometric properties, and ability to discriminate DSM-IV cases from non-cases make the K10 and K6 attractive for use in general-purpose health surveys. The scales are already being used in annual government health surveys in the US and Canada as well as in the WHO World Mental Health Surveys. Routine inclusion of either the K10 or K6 in clinical studies would create an important, and heretofore missing, crosswalk between community and clinical epidemiology.

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/F141675CCD0E08C0FB98E01C006B4E0D/S0033291702006074a.pdf/div-class-title-short-screening-scales-to-monitor-population-prevalences-and-trends-in-non-specific-psychological-distress-div.pdf

Short screening scales to monitor population prevalences and trends in non-specific psychological distress.

Background: The relationship between stress and alcohol consumption has been shown in recent research to be more complex than originally thought. Cross-sectional and short-term longitudinal studies may not provide adequate data to address subtle but important relationships that impact consumption frequency and/or quantity.



Methods: Participants were 33 males recruited from local bars who reported their alcohol consumption, stress, and other related variables every day for 2 years. Reports were provided by automated telephone to a computer-based interactive voice response (IVR) system. By closely monitoring call completion, we were able to collect over 95% of the daily calls.



Results: Using hierarchical linear modeling, daily stress was found to be associated with daily alcohol consumption, but in the opposite direction than would be predicted by a “drinking to cope” hypothesis. That is, same-day stress was found to be inversely related to consumption levels. Prior day's stress was not significantly associated with subsequent day's consumption; however, prior day's consumption was predictive of subsequent stress for up to 2 days. Similar analyses using week, rather than day, as the unit of measure paralleled these findings.



Conclusions: This study highlights the utility of using long-term daily process data to address important research and clinical questions in the alcohol field.

Stress and alcohol consumption in heavily drinking men: 2 years of daily data using interactive voice response.

• To test the contribution of the criterion of six months of illness to the predictive usefulness of theDSM-IIIdiagnosis of schizophrenia, we compared, from a sample of 121 patients with functional psychosis, those who had been ill for six months or more at index but did not meet the nontemporalDSM-IIIcriteria and those who met the full criteria. We found that while the six-month criterion is an important component, it is not the sole reason for the predictive power of these criteria. Many who met only this criterion had relatively good outcomes, and, as a group, their outcomes were only slightly worse than for the entire series of psychotic patients. Those who met the full criteria had a significantly poorer outcome in terms of both continued psychopathology and social functioning.

Contribution of the six-month criterion to the predictive validity of the DSM-III definition of schizophrenia.

BACKGROUND
Alcohol screening and brief intervention (BI) is an effective primary care preventive service, but implementation rates are low. Automating BI using interactive voice response (IVR) may be an efficient way to expand patient access to needed information and advice.

/pdf/interactive-voice-response-technology-can-deliver-alcohol-4y3aejojga.pdf

Interactive voice response technology can deliver alcohol screening and brief intervention in primary care.

The efficacy of individual and group cognitive-behavioral therapy (CBT) for alcohol use disorders (AUDs) has been demonstrated multiple randomized clinical trials (Morgenstern & Longabaugh, 2000). CBT is grounded in Social Cognitive Theory (Bandura, 1977, 1986), which posits that maladaptive alcohol in use (or other behavioral health problems) is a result of personal skills deficits. In CBT, therapists instruct and support their clients in the use of a variety of inter- and intrapersonal coping skills and encourage their application in real-life situations.

A number of studies have demonstrated that CBT for alcohol use disorders increases the development of coping skills (Chaney, O’Leary, & Marlatt, 1978; Monti et al., 1993; Oei & Jackson, 1980, 1982). Furthermore, skills use among clients in treatment for alcohol use disorders has a demonstrated impact on treatment outcome (Chung, Langenbucher, Labouvie, Pandina, & Moos, 2001; Connors, Maisto, & Zywiak, 1996; Litt, Kadden, Cooney, & Kabela, 2003; Miller, Westerberg, Harris, & Tonigan, 1996; Moser & Annis, 1996). Because relapse to drinking in the months following treatment is high (up to 80% at 12 months; Connors et al., 1996; Feeney, Young, Connor, Tucker, & McPherson, 2002; Hunt, Barnett, Branch, 1971; Litman, 1986; Lowman, Allen, Stout, & The Relapse Research Group, 1996; Miller et al., 1996; Moser & Annis, 1996), effort to support patients’ retention and use coping skills in the posttreatment period seems justified as a potential relapse prevention tool Extended treatment or aftercare often is available or affordable; thus, an accessible low-cost technology such as Interactive Voice Response (IVR) has promise as a means for maintaining patients’ connections to their therapeutic experience after discharge.

IVR has been used to monitor alcohol use and related symptoms among individuals receiving alcohol brief intervention, with demonstrated therapeutic benefit when participant feedback was included (Aharonovich et al., 2006; Helzer et al., 2008). Feasibility studies of IVR symptom monitoring with untreated alcoholics and their spouses (Cranford, Tennen, & Zucker, 2010) and among individuals recently completing specialty treatment for alcohol use disorders (Mundt, Moore, & Bean, 2006; Simpson, Kivlahan, Bush, & McFall, 2005), have demonstrated good compliance and minimal measurement reactivity. The posttreatment IVR program described by Mundt et al. (2006) is the most sophisticated to date. The participant interface of their IVR program included a daily survey with branching logic based on whether or not the patient drank. Each branch lead to further assessment questions, then both branches concluded with a relapse risk questionnaire. The IVR system also provided feedback, encouragement, and support based on participants’ responses. Patients could leave a message and/or request a call-back from the therapist.

The goal of the current study was to pilot test an IVR-based program, the Alcohol Therapeutic Interactive Voice Response (ATIVR), which was designed to facilitate the transition from outpatient Group CBT to the personal application of skills after Group CBT was completed. Using an uncontrolled, single-arm, pre–post design we examined the feasibility of incorporating ATIVR as a posttreatment addition to CBT at an outpatient clinic. A feasibility test is critical because client preferences for and engagement with automated treatments are largely unknown but they clearly will affect the utility, applicability, and efficacy of the treatment. In addition, we assessed the drinking outcomes of participants before and after 3 months of ATIVR, and their utilization of coping behaviors during the ATIVR phase.

/pdf/interactive-voice-response-for-relapse-prevention-following-3t0hpajhhr.pdf

Interactive voice response for relapse prevention following cognitive-behavioral therapy for alcohol use disorders: A pilot study.

Tienda online donde Comprar Dimensional Approaches in Diagnostic Classification. Refining the Research Agenda for DSM-V al precio 68,48 € de Darrel A. Regier | Paul J. Sirovatka | Hans-Ulrich Wittchen | Robert F. Krueger | Helena Chmura Kraemer | John E. Helzer, tienda de Libros de Medicina, Libros de Psiquiatria - Diagnostico clinico

Comprar Dimensional Approaches in Diagnostic Classification. Refining the Research Agenda for DSM-V | Darrel A. Regier | 9780890423431 | American Psychiatric Publishing

John E. Helzer

Papers

Stress and alcohol consumption in heavily drinking men: 2 years of daily data using interactive voice response.

Contribution of the six-month criterion to the predictive validity of the DSM-III definition of schizophrenia.

Interactive voice response technology can deliver alcohol screening and brief intervention in primary care.

Interactive voice response for relapse prevention following cognitive-behavioral therapy for alcohol use disorders: A pilot study.

Comprar Dimensional Approaches in Diagnostic Classification. Refining the Research Agenda for DSM-V | Darrel A. Regier | 9780890423431 | American Psychiatric Publishing