A co-morbidity of alcohol dependence with other psychiatric disorders in young adult Mexican Americans.

BACKGROUND: Mexican Americans comprise one of the most rapidly growing populations in the U.S. However, information on the co-morbidity of alcohol dependence with other psychiatric disorders in Mexican Americans is sparse. METHODS: Demographic information, DSM-III-R diagnoses, and information differentiating independent from substance-induced anxiety and affective disorders were obtained from 240 Mexican American young adults residing in select areas of San Diego. RESULTS: A high prevalence of alcohol dependence was found in this population. There was significant co-morbidity between alcohol dependence and anxiety, affective, conduct/antisocial, and other substance dependence disorders. Eight percent of the anxiety disorders and 26% of the affective disorders were found to be substance-induced. CONCLUSION: High rates and substantial co-morbidity of alcohol dependence with psychiatric and other substance use disorders were found in this population. These data may be helpful in designing prevention and intervention programs for this high-risk population.

Activities of daily living in women with advanced breast cancer.

PURPOSE/OBJECTIVES: To detail the daily activities of women with advanced breast cancer. DESIGN: Descriptive, qualitative. SETTING: Six clinical sites in New England. Of the six sites, three were urban, one was suburban, and two were rural, with three sites being comprehensive cancer centers. SAMPLE: 84 women with a confirmed diagnosis of stage IV breast cancer with a life expectancy of four months or more. METHODS: A secondary analysis of an expressive writing intervention study control group. As part of the control writing group, participants kept handwritten activity logs for four consecutive days. Standard content analysis procedures were used to analyze the transcribed activity logs. MAIN RESEARCH VARIABLES: Activities of daily living in women with advanced breast cancer. FINDINGS: 22 codes were identified that depicted the daily activities of participants. Subsequent analysis merged the 22 codes into six themes. CONCLUSIONS: Findings demonstrated that patients with advanced breast cancer are living very full, active lives despite numerous symptoms and cancer treatments. IMPLICATIONS FOR NURSING: The study serves as a foundation for the development of interventions to enhance daily functioning. Oncology nurses should counsel women with advanced cancer regarding pacing and self-care activities.

Prevalence and predictors of complementary therapy use in advanced-stage breast cancer patients.

PURPOSE: Information on the use of complementary therapies in patients with advanced-stage cancer is limited. Given the disease and treatment complexities associated with the care of patients with metastatic cancer, oncology clinicians would benefit from having an appreciation of the extent of usage of unconventional, adjunctive therapies among these patients. This study evaluated the prevalence and demographic predictors of complementary therapy use in a sample of women with metastatic breast cancer. METHODS: Subjects with stage IV breast cancer were recruited from six treatment facilities in New England. A written, mailed survey assessing complementary therapy use and sociodemographic information was completed by each subject, while disease and treatment information was obtained from medical records. Descriptive statistics and multivariate logistic regression analyses were conducted. RESULTS: Of the 173 participants, 78% used at least one type of complementary therapy, 43% used two or more types, and 23% used three or more types, excluding spiritual practices and physical exercise. When including spiritual practices and physical exercise, 90% used at least one complementary therapy, 70% used two or more types, and 45% used three or more types. Visits to alternative health practitioners were predicted by younger age (P = .009) and higher education level (P = .002). Younger participants (P = .045) were more likely to use and spend more money on vitamins and herbal products (P = .02). CONCLUSIONS: Use of unconventional therapies is pervasive among metastatic breast cancer patients, particularly among those who are younger and highly educated. Oncology providers need to assess patients' complementary therapy use and consider potential interactions with prescribed treatment protocols.

Electrophysiological responses to affective stimuli in American Indians experiencing trauma with and without PTSD.

American Indians are at high risk for exposure to violence and other traumatic events, yet few studies have investigated posttraumatic stress disorder (PTSD) or its neurobiological consequences in Indian communities. In the present study, a sample of American Indians (n = 146) were given a structured diagnostic interview that additionally indexed traumatic life events and symptoms emerging following those events. Electroencephalogram (EEG) spectra and visual event-related potentials (ERPs) to happy, sad, and neutral faces were also recorded from each participant. Ninety-nine percent of the sample had experienced at least one category of trauma with the mean number being 5, 27% had experienced at least 8 categories, and 13% met DSM-IV criteria for PTSD. The PTSD group did not differ on any demographic or diagnostic variables from the larger sample. An electrophysiological signature for PTSD was found that included increases in high-frequency gamma activity (20-40 Hz, F = 8.7, P < 0.004) in frontal leads, higher N1 amplitudes to sad stimuli in frontotemporal leads (F = 12.4, P < 0.001, F = 5.0, P < 0.03), and longer latency P3 components to happy stimuli in midline, central, and right frontal leads (F = 4.7, P < 0.03; F = 4.1, P < 0.04; F = 4.0, P < 0.05). These findings were observed in participants with PTSD, but not in a group with equivalently high trauma counts. These findings suggest that PTSD is associated with EEG hyperarousal, higher attentional levels to sad stimuli, and slower processing of happy stimuli. They also partially confirm ERP data reported in combat victims with PTSD suggesting that PTSD may induce neurobiological consequences that transcend type of eliciting trauma as well as ethnic and cultural factors.