Publications (14)46.69 Total impact
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Article: Who Are Connected to the Pittsburgh Jewish Community?
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ABSTRACT: The United Jewish Federation of Greater Pittsburgh (PUJF) began a campaign to improve community planning, especially to determine programmatic priorities. Among the many questions they sought to answer was the relationship between childhood programs and retention of adults as active members of the community. We propose a new model to examine the relationship between childhood activities and adult connection to the community that looks at the adult activities in the community at the same time, while avoiding ad hoc indexes of connection. Using this model, we find evidence that childhood trips to Israel and participation in youth groups are most related to active adult members of the community. These results are robust to several model assumptions, including the assumption that the survey nonresponse did not bias the results.Contemporary Jewry 04/2012; 29(3):301-316. -
Article: Menstrual effects on mood symptoms in treated women with bipolar disorder.
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ABSTRACT: Reports suggest women with bipolar disorder (BD) have high rates of perimenstrual mood worsening. In this prospective study, the authors compared healthy controls and depressed and euthymic BD patients on medications on mood levels, psychosocial function, and physical symptoms in the late luteal versus the early follicular phase. At baseline, the lifetime diagnosis of bipolar I disorder or bipolar II disorder, current mood episode, and absence of premenstrual dysphoric disorder in controls were confirmed with the Structured Clinical Interview for DSM-IV Disorders. Subjects were assessed across three menstrual cycles during the late luteal and early follicular phases. Clinicians administered the Structured Interview Guide for the Hamilton Depression Rating Scale and the Mania Rating Scale to assess levels of depression and hypomania/mania, respectively. Subjects completed self-report ratings on psychosocial function and perceived stress and tracked daily mood and physical symptoms on the National Institute of Mental Health LifeChart and the Daily Rating Form. Ovulation was verified objectively with mid-cycle luteinizing hormone urine dipsticks and serum progesterone levels. The sample characteristics were similar among the three patient groups of healthy controls (n = 10), BD-euthymic (n = 6), and BD-depressed (n = 5). The two-way analysis of variance indicated a significant difference among the diagnostic groups on depression scores, psychosocial functioning, and levels of perceived stress. There was no significant difference for menstrual phase or the interaction of menstrual phase by diagnostic group. Mood symptom level, psychosocial functioning, perceived stress, and physical discomfort were unrelated to menstrual phase in patients with BD. Appropriate maintenance treatment may prevent menstrual related mood symptoms. Use of an objective marker of ovulation is critical for research involving menstrual related outcomes.Bipolar Disorders 05/2011; 13(3):310-7. · 5.29 Impact Factor -
Article: Seasonal effects on depression risk and suicidal symptoms in postpartum women.
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ABSTRACT: Postpartum depression (PPD) is the most common complication of childbirth. Suicide is a leading cause of maternal death in the first postpartum year. Depressed mothers often have suicidal ideation (SI). Depression and suicidality may vary across the seasons. Previous studies of seasonality and PPD were relatively small or encumbered by study design constraints. We examined the possible relationship between seasonality, depression, and SI in 9,339 new mothers. From 2006 to 2010, the investigators screened women within 4-6 weeks postpartum with the Edinburgh Postnatal Depression Scale (EPDS). We used spectral analysis to explore seasonal variation in risk for depression and suicidality. The study team screened 9,339 new mothers, of whom 1,316 (14%) women had positive depression scores (EPDS≥10) which suggest PPD risk; 294 (3%) women had SI (item 10≥1). A positive EPDS was associated significantly with SI. PPD risk varied significantly across 12-months-risk was highest in December. We detected no seasonal variation in SI. Effects of seasonal light variation may contribute to increased risk for depressive symptoms. Suicidality could be related to maternal depression but not seasonal variation.Depression and Anxiety 03/2011; 28(5):400-5. · 4.18 Impact Factor -
Article: Brief report: trajectories of glycemic control over early to middle adolescence.
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ABSTRACT: To identify distinct patterns of glycemic control over early to middle adolescence, and to determine whether psychosocial variables predicted those patterns. We used trajectory analysis to examine glycemic control over 5 years among adolescents with type 1 diabetes who were of age 12 on average at study start (n = 132). Well-being, relationships, and self-care behavior were assessed with in-person interviews. Blood glucose testing was determined from blood glucose meters, and missed clinic appointments and glycosolated hemoglobin were obtained from medical records. We identified two distinct clusters of individuals, a stable good glycemic control group and a poorer deteriorating glycemic control group. Individuals in the deteriorating control group were characterized by higher peer conflict, more negative diabetes emotions, fewer blood glucose tests, and more missed clinic appointments. Psychosocial variables and behavioral markers of self-care may predict the course of glycemic control over early to middle adolescence.Journal of Pediatric Psychology 11/2010; 35(10):1161-7. · 2.91 Impact Factor -
Article: Identification and prediction of distress trajectories in the first year after a breast cancer diagnosis.
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ABSTRACT: In this article, we aim to (a) identify distinct trajectories of psychological distress in the first year after a breast cancer diagnosis in women treated with adjuvant therapy and (b) explore possible predictors of these trajectories, that is, demographic, medical, and personal characteristics. The 171 patients were assessed after diagnosis, after surgery, after adjuvant treatment, in the reentry phase, and in the (short-term) survivorship phase (2 and 6 months after the end of treatment, respectively). Psychological distress was assessed with the 12-item General Health Questionnaire. There were four trajectories of distress: a group that experienced no distress (36.3%), a group that experienced distress only in the active treatment phase (33.3%), a group that experienced distress in the reentry and survivorship phase (15.2%), and a group that experienced chronic distress (15.2%). Personality and physical complaints resulting from adjuvant treatment could distinguish the distress trajectories. Mastery was the only unique predictor. Most patients were not distressed in response to breast cancer or only temporarily so. Yet, a minority of patients became or remained distressed after the end of treatment.Health Psychology 03/2010; 29(2):160-8. · 3.87 Impact Factor -
Article: Evidence of dysregulated peripheral oxytocin release among depressed women.
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ABSTRACT: Oxytocin is a hypothalamic neuropeptide that plays a key role in mammalian female reproductive function. Animal research indicates that central oxytocin facilitates adaptive social attachments and modulates stress and anxiety responses. Major depression is prevalent among postpubertal females, and is associated with perturbations in social attachments, dysregulation of the hypothalamic-pituitary-adrenal stress axis, and elevated levels of anxiety. Thus, depressed women may be at risk to display oxytocin dysregulation. The current study was developed to compare patterns of peripheral oxytocin release exhibited by depressed and nondepressed women. Currently depressed (N = 17) and never-depressed (N = 17) women participated in a laboratory protocol designed to stimulate, measure, and compare peripheral oxytocin release in response to two tasks: an affiliation-focused Guided Imagery task and a Speech Stress task. Intermittent blood samples were drawn over the course of two, 1-hour sessions including 20-minute baseline, 10-minute task, and 30-minute recovery periods. The 10-minute laboratory tasks did not induce identifiable, acute changes in peripheral oxytocin. However, as compared with nondepressed controls, depressed women displayed greater variability in pulsatile oxytocin release over the course of both 1-hour sessions, and greater oxytocin concentrations during the 1-hour affiliation-focused imagery session. Oxytocin concentrations obtained during the imagery session were also associated with greater symptoms of depression, anxiety, and interpersonal dysfunction. Depressed women are more likely than controls to display a dysregulated pattern of peripheral oxytocin release. Further research is warranted to elucidate the clinical significance of peripheral oxytocin release in both depressed and nondepressed women.Psychosomatic Medicine 12/2008; 70(9):967-75. · 3.97 Impact Factor -
Article: Generalizing from clinical trial data: a case study. The risk of suicidality among pediatric antidepressant users.
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ABSTRACT: For the results of randomized controlled clinical trials (RCTs) and related meta-analyses to be useful in practice, they must be relevant to a definable group of patients in a particular clinical setting. To the extent this is so, we say that the trial is generalizable or externally valid. Although concern about the generalizability of the results of RCTs is often discussed, there are few examples of methods for assessing the generalizability of clinical trial data. In this paper, we describe and illustrate an approach for making what we call generalizability judgments and illustrate the approach in the context of a case study of the risk of suicidality among pediatric antidepressant users.Statistics in Medicine 06/2008; 27(11):1801-13. · 1.88 Impact Factor -
Article: Comprehensive analysis of APOE and selected proximate markers for late-onset Alzheimer's disease: patterns of linkage disequilibrium and disease/marker association.
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ABSTRACT: The epsilon(4) allele of APOE confers a two- to fourfold increased risk for late-onset Alzheimer's disease (LOAD), but LOAD pathology does not all fit neatly around APOE. It is conceivable that genetic variation proximate to APOE contributes to LOAD risk. Therefore, we investigated the degree of linkage disequilibrium (LD) for a comprehensive set of 50 SNPs in and surrounding APOE using a substantial Caucasian sample of 1100 chromosomes. SNPs in APOE were further molecularly haplotyped to determine their phases. One set of SNPs in TOMM40, roughly 15 kb upstream of APOE, showed intriguing LD with the epsilon(4) allele and was strongly associated with the risk for developing LOAD. However, when all the SNPs were entered into a logit model, only the effect of APOE epsilon(4) remained significant. These observations diminish the possibility that loci in the TOMM40 gene may have a major effect on the risk for LOAD in Caucasians.Genomics 07/2007; 89(6):655-65. · 3.02 Impact Factor -
Article: Evaluation of a susceptibility gene for schizophrenia: genotype based meta-analysis of RGS4 polymorphisms from thirteen independent samples.
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ABSTRACT: Associations between schizophrenia (SCZ) and polymorphisms at the regulator of G-protein signaling 4 (RGS4) gene have been reported (single nucleotide polymorphisms [SNPs] 1, 4, 7, and 18). Yet, similar to other SCZ candidate genes, studies have been inconsistent with respect to the associated alleles. In an effort to resolve the role for RGS4 in SCZ susceptibility, we undertook a genotype-based meta-analysis using both published and unpublished family-based and case-control samples (total n = 13,807). The family-based dataset consisted of 10 samples (2160 families). Significant associations with individual SNPs/haplotypes were not observed. In contrast, global analysis revealed significant transmission distortion (p = .0009). Specifically, analyses suggested overtransmission of two common haplotypes that account for the vast majority of all haplotypes. Separate analyses of 3486 cases and 3755 control samples (eight samples) detected a significant association with SNP 4 (p = .01). Individual haplotype analyses were not significant, but evaluation of test statistics from individual samples suggested significant associations. Our collaborative meta-analysis represents one of the largest SCZ association studies to date. No individual risk factor arose from our analyses, but interpretation of these results is not straightforward. Our analyses suggest risk due to at least two common haplotypes in the presence of heterogeneity. Similar analysis for other putative susceptibility genes is warranted.Biological Psychiatry 08/2006; 60(2):152-62. · 8.28 Impact Factor -
Article: The role of care location in diagnosis and treatment of pediatric psychosocial conditions.
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ABSTRACT: Racial differences in diagnosis and treatment of psychosocial conditions have been well documented. It is unclear if these differences represent variance in prevalence or are actually disparities in care driven by social factors, income-related differences, or differences in the actual location of care. We used 4 years of National Ambulatory Medical Care Surveys and National Hospital Ambulatory Medical Care Surveys as source for data on visits to private offices and hospital-based clinics. In addition to the standard practice of combining surveys across years, we used a "supersurvey" approach to combining the 2 distinct surveys. In our roughly 20,000 sampled visits, we confirmed the higher concentration of low-income children in visits to hospital-based clinics (p <.001), but saw no significant racial difference (p =.104). After controlling for race, income, and other demographics, we found that visits to hospital-based clinics were significantly more likely to include a diagnosis of depression (odds ratio [OR], 4.4; p =.011), but that there was no statistically significant difference in other psychosocial diagnoses. Once a diagnosis is made, there is no evidence of differences in treatment or follow-up between office-based or hospital clinic-based providers. Our analyses support previously gathered evidence for differences in economic status of the clientele of private offices and hospital-based clinics. We surprisingly found visits to clinics to be more likely to include a depression diagnosis, but this may be an artifact of the data reflecting visits rather than patients. We found no evidence that treatment or follow-up is different for the disadvantaged who use clinics rather than private offices.Journal of Developmental & Behavioral Pediatrics 06/2006; 27(3):219-25. · 2.13 Impact Factor -
Article: Do antidepressants cause suicidality in children? A Bayesian meta-analysis.
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ABSTRACT: To quantify the risk of suicidal behavior/ideation (suicidality) for children who use antidepressants, the FDA collected randomized placebo-controlled trials of antidepressant efficacy in children. Although none of the 4487 children completed suicide, 1.7% exhibited suicidality. The FDA meta-analyzed these studies and found sufficient evidence of an increased risk to require a black-box warning on antidepressants for children. The FDA considered different drug formulations and psychiatric diagnoses to be equivalent in their effect on suicidality. If this assumption does not hold, the FDA analysis may have underestimated the variance of the risk estimate. We investigate the consequences of relaxing these assumptions. We extend the FDA analysis using a Bayesian hierarchical model that allows for a study-level component of variability and facilitates extensive sensitivity analyses. We found an association between antidepressant use and an increased risk of suicidality in studies where the diagnosis was major depressive disorder (odds ratio 2.3 [1.3, 3.8]), and where the antidepressant was an SSRI (odds ratio 2.2 [1.3, 3.6]). We did not find evidence for such an association in the complement sets of trials. Although the results based on the hierarchical model are insensitive to model perturbations, the robustness of the FDA's meta-analysis to model assumptions is less clear. These data have limited generalizability due to exclusion of patients with baseline risk of suicide and the use of relatively short duration trials. Because of model specification and interpretation issues raised in this paper, we conclude that the evidence supporting a causal link between antidepressant use and suicidality in children is weak. The use of Bayesian hierarchical models for meta-analysis has facilitated the incorporation of potentially important sources of variability and the use of sensitivity analysis to assess the consequences of model specifications and their impact on important regulatory decisions.Clinical Trials 02/2006; 3(2):73-90; discussion 91-8. · 1.92 Impact Factor -
Article: Using prior distributions to synthesize historical evidence: comments on the Goodman-Sladky case study of IVIg in Guillain-Barré syndrome.
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ABSTRACT: One feature of the Bayesian approach is that it provides methods for synthesizing what is known about a question of interest and provides a formalism based on the laws of probability for incorporating this auxiliary knowledge into the planning and the analysis of the next study. In this comment, we use elements of the Goodman-Sladky case study to illustrate (1) the use of Bayesian methods to quantify historical information about an intervention through the specification of a prior distribution, (2) an approach to the analysis of the sensitivity of the conclusions of a Bayesian analysis to the specification of the prior distribution, and (3) we comment on the role of research synthesis for combining information about an intervention from different data sources as a tool to help summarize evidence about the intervention.Clinical Trials 02/2005; 2(4):311-8; discussion 319-24, 364-78. · 1.92 Impact Factor -
Article: Psychological and physical adjustment to breast cancer over 4 years: identifying distinct trajectories of change.
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ABSTRACT: The goal of this study was to identify distinct trajectories of adjustment to breast cancer over 4 years as well as to distinguish among the different trajectories. The mental and physical functioning of 287 women with breast cancer who remained alive and disease free through 4 years of follow-up were examined. The majority of women showed slight and steady improvement in functioning with time, but subgroups of women were identified who showed marked improvement and marked deteriorations over time. Age successfully distinguished different trajectories of physical functioning. Indices of personal resources (i.e., self-image, optimism, perceived control) and social resources (i.e., social support) successfully distinguished different courses of mental and physical functioning.Health Psychology 02/2004; 23(1):3-15. · 3.87 Impact Factor -
Article: Evolutionary-based association analysis using haplotype data.
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ABSTRACT: Association studies, both family-based and population-based, can be powerful means of detecting disease-liability alleles. To increase the information of the test, various researchers have proposed targeting haplotypes. The larger number of haplotypes, however, relative to alleles at individual loci, could decrease power because of the additional degrees of freedom required for the test. An optimal strategy would focus the test on particular haplotypes or groups of haplotypes, much as is done with cladistic-based association analysis. First suggested by Templeton et al. ([1987] Genetics 117:343-351), such analyses use the evolutionary relationships among haplotypes to produce a limited set of hypothesis tests and to increase the interpretability of these tests. To more fully utilize the information contained in the evolutionary relationships among haplotypes and in the sample, we propose generalized linear models (GLM) for the analysis of data from family-based and population-based studies. These models fully account for haplotype phase ambiguity and allow for covariates. The models are encoded into a software package (the Evolutionary-Based Haplotype Analysis Package, EHAP), which also provides for various kinds of exploratory data analysis. The exploratory analyses, such as error checking, estimation of haplotype frequencies, and tools for building cladograms, should facilitate the implementation of cladistic-based association analysis with haplotypes.Genetic Epidemiology 08/2003; 25(1):48-58. · 3.44 Impact Factor
Top co-authors
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Institutions
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2003–2012
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Carnegie Mellon University
- • Department of Statistics
- • Department of Psychology
Pittsburgh, PA, USA
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