William F. Alvarez

impact of Event Scale: A Measure of Subjective Stress

&NA; Clinical, field, and experimental studies of response to potentially stressful life events give concordant findings: there is a general human tendency to undergo episodes of intrusive thinking and periods of avoidance. A scale of current subjective distress, related to a specific event, was based on a list of items composed of commonly reported experiences of intrusion and avoidance. Responses of 66 persons admitted to an outpatient clinic for the treatment of stress response syndromes indicated that the scale had a useful degree of significance and homogeneity. Empirical clusters supported the concept of subscores for intrusions and avoidance responses.

Migrants and Maltreatment: Comparative Evidence from Central Register Data.

This paper reports the results of a series of studies on the abuse and neglect of migrant farmworker children. These investigations were conducted between 1983 and 1985 in the states of New York, New Jersey, Pennsylvania, Florida, and Texas. Names of approximately 24,000 migrant children obtained from annual migrant education censuses were individually cross-referenced with the appropriate state data bases to determine if they had been involved in a confirmed incident of maltreatment. The information acquired was converted to incidence estimates that were contrasted with the rates for all children in the respective states and were decomposed to identify high-risk cohorts within the migrant population. One finding common to all five assessments was that migrant children were significantly more likely to be maltreated than other children, although these incidence rates varied appreciably from one state to another. The emphasis of this paper is on the unique methodology employed in the research, issues pertaining to provisions for accessing central registers and protecting confidentiality of subjects, the generalizability of the findings, and cross-state incidence differentials for both migrants and children from nonmigrant families.

Life events, risk factors, and coronary disease

Abstract Are high levels of stress from life events correlated with increased levels of smoking, blood pressure, and cholesterol? The authors used a life events questionnaire to determine the level of presumptive stress in a sample of 575 middle-aged men who were initially selected for inclusion in the larger, collaborative Multiple Risk Factor Intervention Trial (MRFIT). Significant differences in stress levels were found only between smokers and nonsmokers. Therefore, the authors suggest that smoking behavior be included as a variable in studies of the relationship between psychological stress and illness.

Child maltreatment among U.S. east coast migrant farm workers

This paper reports findings from a study that was conducted in 1983 to determine the incidence and patterns of child maltreatment among migrant farm worker families who reside in or travel through the Atlantic coastal region known as the Eastern Stream. These results are based on responses to a multipurpose mailed questionnaire that was administered to a sample of 2,207 migrant educators. Educational personnel from 14 of the 22 Eastern Stream states participated in this survey, which was designed to elicit information on the incidence of maltreatment in this population. The survey considered 13 different indicators of child abuse and neglect and six maltreatment forms. Another segment of the instrumentation secured information on the migrant population with which the respondents had direct contact so that an incidence rate could be formulated. The study conclusively established that the incidence of child maltreatment rate among migrant farm worker families, as perceived by migrant educators, was substantially higher than the rate observed for the population as a whole or even for families with approximately the same socioeconomic status. Comparative data are presented to place this primary research result in perspective and a more precise overall incidence estimate is derived. Differential rates of abuse and neglect within the migrant population and the factors that contribute to them are also considered.

News of Risk for Early Heart Disease as a Stressful Event

&NA; Modern prevention includes efforts to reduce the frequency of coronary heart disease by screening populations for certain risk factors, and then advising persons high in risk on how to alter their vulnerability. But what is the effect of telling persons they are at increased risk for such threatening events as heart attacks? Without such information they may not be motivated to change such behavior as cigarette smoking or to comply with blood pressure reducing regimens. With it, worry about their health status may increase. The present study examined such variables in 575 men with no previous symptoms of heart disease who were informed of increased risk and followed for three years. The men were divided at random into two groups of equal size. A Special Intervention group received repeated reminders of risk and procedures for cessation of smoking, reduction of blood pressure, and dietary alteration to lower serum cholesterol. A contrast group received usual medical care, as they saw fit, in response to the news of risk. At yearly intervals, scores on level of subjective distress, avoidance, and coping were obtained. One‐third of the men reported intrusive or avoidance experiences one year after receipt of the news of increased risk. The Special Intervention group, with its more frequent reminders, had significantly higher levels of intrusive ideas and feelings about the news of risk than the Usual Care group, and significantly higher levels of coping experiences.

Dyskinesia, antipsychotic-drug exposure and risk factors in a developmentally-disabled population

The relation between antipsychotic drug (APD) exposure and the prevalence of dyskinesia (DK) was examined in a large, developmentally-disabled (DD) population. Using qualitative data in a cross-sectional, retrospective design, the drug-exposed group was systematically compared with a non-drug-exposed group, controlling for age and gender. When the population was evaluated with no regard to APD-exposure, age and female gender were significant risk factors, as in many prior studies. When APD-exposure was considered, it proved to be a complex variable dependent on the recency of exposure to APD, and the outcome depended on the method of analysis: when APD-exposure was considered as a binomial variable (yes/no), the relationship between APD and DK was not significant; when APD-exposure was controlled for recency of exposure, however, a significant relationship between APD and DK was demonstrated (p less than 0.01) although the relationship accounted for less than 3% of the variance. Analysis of the relation between DK-prevalence and recency-of-APD-exposure revealed a pattern of diminished prevalence during APD use and increased prevalence during early withdrawal.

Differences in values between short-term and long-term therapists

Les auteurs etudient les propositions theoriques de Budman et Gurman a propos des principales differences dans les systemes de valeur des therapies a long terme et a court terme

Lifetime antipsychotic-drug exposure, dyskinesia and related movement disorders in the developmentally disabled

The relationship between dyskinesia and related movement disorders was examined as a function of cumulative exposure to antipsychotic drugs (APD). Lifetime drug-exposure histories were obtained for 162 developmentally disabled (DD) persons; drug-exposed groups were compared to nondrug-exposed groups. There were no statistically significant relationships between dyskinesia and the amount of lifetime APD exposure, nor between dyskinesia and the number of long-term APDs, mean exposure, peak exposure, recency of exposure, duration of exposure, changes in medication levels, number of drug interruptions, age, gender, cerebral palsy, epilepsy, or IQ. Of the other movement disorders, a positive relationship was noted only between akathisia and long-term APD exposure; the increased prevalence of akathisia persisted beyond four years after APD withdrawal.