The social phobia diagnostic questionnaire: preliminary validation of a new self-report diagnostic measure of social phobia.

BACKGROUND: The development and validation of the Social Phobia Diagnostic Questionnaire (SPDQ), a new self-report diagnostic instrument for social phobia is described in three separate studies. STUDY 1: The participants were 125 undergraduates seeking help for an anxiety disorder of whom 60 had social phobia. Receiver operating characteristics (ROC) analysis was conducted comparing SPDQ diagnoses and clinician-based Anxiety Disorder Interview Schedule-IV (ADIS-IV) diagnoses of social phobia. Diagnoses made by the SPDQ showed an 85% specificity, an 82% sensitivity and kappa agreement with the ADIS-IV of 0.66. STUDY 2: The participants were 462 undergraduates who completed the SPDQ and a battery of additional questionnaires. The SPDQ had good internal consistency (alpha=0.95), good split-half reliability (r=0.90) and strong convergent and discriminant validity. STUDY 3: The participants were 145 undergraduates who completed the SPDQ at two time points separated by 2 weeks as well as several additional questionnaires. Scores on the SAD, FNE and SISST of SPDQ categorized undergraduates were also compared to scores on these measures from 35 clinical community participants to determine the clinical validity of the SPDQ. The SPDQ had strong 2-week test-retest reliability and good convergent and discriminant validity. Undergraduates diagnosed with social phobia by the SPDQ were not significantly different on the SAD, FNE and SISST from the socially phobic community sample, but both groups had significantly higher scores than undergraduates identified by the SPDQ as not meeting criteria for social phobia, demonstrating clinical validity of the SPDQ. CONCLUSIONS: These three studies provide preliminary evidence of the strong psychometric properties of the SPDQ as a measure to identify socially phobic participants.

Lameness in a mare with signs of arteriovenous fistula.

A 5-year-old mare was evaluated for lameness and swelling of the right forelimb. Clinical findings, including peripheral edema, venous pulsation, palpable thrill in the cephalic vein, disparate arteriovenous oxygen tension differences between the left and right forelimbs, and Branham sign, were suggestive of arteriovenous fistula. Failure to identify the fistula by angiography was attributed to closure of the shunt during anesthesia. Surgical exploration of the affected limb to identify the shunt also was unsuccessful.

67Ga scintigraphy in postoperative synthetic graft infections.

Postoperative infections of synthetic vascular grafts are seldom diagnosed by conventional radiographic methods, leading to high morbidity and mortality. Gallium-67 scintigraphy was included in the diagnostic evaluation of five patients with suspected vascular graft infections. Abnormal accumulation of the radionuclide around the graft was present in all of these patients who were later determined to have paraprosthetic infections. Gallium-67 citrate scintigrams seem to be diagnostically effective in the difficult problem of paraprosthetic infection.

Is there a place for external grafting of arterial aneurysms in selected patients?

External grafting of aortic and iliac artery aneurysms has been accomplished in 33 highly selected poor risk patients over a period of eight years. This experience demonstrated that external grafting of aneurysms is a technically demanding operative procedure which is accompanied by significant early and late morbidity. The technique does effectively reduce the occurrence rate of late rupture of aneurysms, however, at least for the period of observation of this study. Thus, while external grafting certainly is not generally applicable, the procedure may be used to advantage in highly selected situations, possibly including: 1. Long segment aneurysms of the thoracic or thoraco-abdominal aorta. 2. Aneurysms involving the renal arteries in poor risk patients. 3. As reinforcement for dilated arterial segments adjacent to sites of vascular anastomosis.