Soy protein may alleviate osteoarthritis symptoms.

Alternative and complementary therapeutic approaches, such as the use of a wide array of herbal, nutritional, and physical manipulations, are becoming popular for relieving symptoms of osteoarthritis (OA). The present study evaluated the efficacy of soy protein (SP) supplementation in relieving the pain and discomfort associated with OA. One hundred and thirty-five free-living individuals (64 men and 71 women) with diagnosed OA or with self-reported chronic knee joint pain not attributed to injury or rheumatoid arthritis were recruited for this double-blind, placebo-controlled, parallel design study. Study participants were assigned randomly to consume 40 g of either supplemental SP or milk-based protein (MP) daily for 3 months. Pain, knee range of motion, and overall physical activity were evaluated prior to the start of treatment and monthly thereafter. Serum levels of glycoprotein 39 (YKL-40), a marker of cartilage degradation, and insulin-like growth factor-I (IGF-I), a growth factor associated with cartilage synthesis, were assessed at baseline and at the end of the study. Overall, SP improved OA-associated symptoms such as range of motion and several factors associated with pain and quality of life in comparison to MP. However, these beneficial effects were mainly due to the effect of SP in men rather than women. Biochemical markers of cartilage metabolism further support the efficacy of SP in men as indicated by a significant increase in serum level of IGF-I and a significant decrease in serum level of YKL-40 compared to MP. This study is the first to provide evidence of possible beneficial effects of SP in the management of OA. Examining and verifying the long-term effects of SP on improving symptoms of OA, particularly in men, is warranted.

Television exposure in children after a terrorist incident.

This study examined the influence of bomb-related television viewing in the context of physical and emotional exposure on posttraumatic stress symptoms--intrusion, avoidance, and arousal--in middle school students following the 1995 Oklahoma City bombing. Over 2,000 middle school students in Oklahoma City were surveyed 7 weeks after the incident. The primary outcome measures were the total posttraumatic stress symptom score and symptom cluster scores at the time of assessment. Bomb-related television viewing in the aftermath of the disaster was extensive. Both emotional and television exposure were associated with posttraumatic stress at 7 weeks. Among children with no physical or emotional exposure, the degree of television exposure was directly related to posttraumatic stress symptomatology. These findings suggest that television viewing in the aftermath of a disaster may make a small contribution to subsequent posttraumatic stress symptomatology in children or that increased television viewing may be a sign of current distress and that it should be monitored. Future research should examine further whether early symptoms predict increased television viewing and/or whether television viewing predicts subsequent symptoms.

Characteristics of American-Indian clients seeking inpatient treatment for substance abuse.

OBJECTIVE: The current study was conducted as a preliminary examination of substance use and some of its correlates in nonreservation-residing American Indians. METHOD: A group of 522 American-Indian (AI) subjects (473 men) were compared with two sets of geographic controls: (1) an equal number of African Americans (AA) and (2) an equal number of European Americans (EA). All received treatment in the same facilities over the same time period. RESULTS: Contrary to expectations, the ethnic/racial groups were remarkably similar on a number of alcohol use variables, including the amount consumed in the 6 months prior to treatment and the number of previous treatments. Among those self-reporting as problem drinkers, there were group differences in the age of first drink (AA mean = 13.54, AI mean = 12.24 and EA mean = 11.71) and first drunk (AA mean = 15.80, AI mean = 14.23 and EA mean = 14.08) and the number of alcohol-related problems (AA mean = 7.52, AI mean = 8.49 and EA mean = 8.46). On these measures, AI and EA subjects did not differ whereas AA subjects reported a later age of onset and fewer negative consequences. EA and AI male subjects reported marijuana as their most frequently used "other" drug, whereas AA male subjects listed stimulants as their primary drugs. Regardless of ethnic/racial group, women did not differ on their drug(s) of choice, reporting stimulants as the most frequently abused drug (after accounting for alcohol use). CONCLUSIONS: This preliminary study is remarkable for the observed similarities among groups. Future studies using more rigorous sampling are needed to provide clarification of this preliminary study.

Neuropsychological deficits in sober alcoholics: influences of chronicity and recent alcohol consumption.

BACKGROUND: The relationships between severity of neuropsychological (NP) deficits and quantity and duration of alcoholic drinking remain controversial. Eckardt et al. (1998) proposed that NP deficits can be observed only if chronicity of alcohol abuse equals or exceeds 10 years. In this study we tested the hypothesis of Eckardt et al. and reexamined the relationship of NP performance and alcohol consumption. METHODS: One hundred sixty-two alcoholics and 165 controls completed a NP test battery at least 3 weeks after the alcoholics attained sobriety. Chronicity varied from 4 to 9 years for 55 alcoholics and from 10 to 33 years for the remaining 107. RESULTS: Compared to controls, both groups of alcoholics were impaired on the Shipley Vocabulary and Abstraction tests and on two versions of the Digit Symbol test, but there was no difference between the two alcoholic groups on any measure. Regression analyses that controlled for age and education showed that chronicity predicted less than 0.5% of the variance on NP measures. By contrast, a measure of recent alcohol consumption, the Quantity-Frequency Index, contributed significantly (approximately 5% of the variance) to the prediction of alcoholics' NP performance. CONCLUSIONS: These data provide weak support for a dose effect relationship between degree of NP impairment and level of alcoholic drinking in the past 6 months but no evidence for an influence of chronicity.

Posttraumatic stress responses in bereaved children after the Oklahoma City bombing.

OBJECTIVE: To investigate the responses of middle and high school students exposed to the 1995 Oklahoma City bombing across a spectrum of loss. METHOD: A questionnaire measuring exposure, personal consequences, initial response, and current posttraumatic stress and other symptoms was administered to 3,218 students 7 weeks after the explosion. RESULTS: More than one third of the sample knew someone killed in the explosion. Bereaved youths were more likely than nonbereaved peers to report immediate symptoms of arousal and fear, changes in their home and school environment, and posttraumatic stress symptoms. Retrospective measures of initial arousal and fear predicted posttraumatic stress symptoms at 7 weeks. CONCLUSIONS: The results support the literature addressing the role of initial response in posttraumatic stress symptom development. The study raises concern about the impact of television, and traumatized youths' reactivity to it, in the aftermath of disaster.

Clinical needs assessment of middle and high school students following the 1995 Oklahoma City bombing.

OBJECTIVE: This clinical assessment was designed to identify middle and high school students in need of formal evaluation for posttraumatic response symptoms following the 1995 bombing of the Alfred P. Murrah Federal Building in Oklahoma City. METHOD: A clinical needs assessment instrument was developed and administered to grade 6 through 12 students 7 weeks after the bombing (N = 3,218). RESULTS: More than 40% of the students reported knowing someone injured, and more than one-third reported knowing someone killed in the blast. Posttraumatic stress symptoms at 7 weeks significantly correlated with gender, exposure through knowing someone injured or killed, and bomb-related television viewing. CONCLUSIONS: This study documents the intensity of community exposure to the bombing and the lingering symptoms of stress. The assessment was used in planning for clinical service delivery, training professional responders, and supporting funding requests.

Effects of cues on memory in alcoholics and controls.

This study was conducted to determine whether alcoholics' memory difficulties are due, in part, to access (retrieval) or to availability (retention) deficits. Forty-four alcoholics (n = 20 females) and 44 controls (n = 22 females) learned a paired associate list consisting of 12 adjective-CCC trigram pairs. Half of the subjects in each group learned the list to a low degree of learning (DOL; 4/12 pairs); the remainder to a high DOL (8/12 pairs). Two distinct environmental contexts (providing implicit cues) were used during acquisition. Subjects then completed a cued recall (an explicit cue) test in either the same or a different room. Alcoholics were significantly inferior in the acquisition phase on trials required to reach criterion, regardless of DOL required [F(1,68) = 10.92, p = 0.002]. The main effect for implicit cuing was not significant; similarly, there were no significant interactions. In contrast, the explicit cue manipulation produced a significant group x DOL interaction on the number of trigrams correctly recalled [F = (1,77) = 6.38, p = 0.01]; alcoholics' recall did not benefit from the higher DOL in contrast to a significant improvement in recall by controls. The failure of alcoholics to demonstrate improvement with higher levels of learning is consistent with a deficit in the availability of information. The results confirm previous reports of recovering alcoholics' verbal learning and memory dysfunction, and suggest that these deficits may be attributed, in part, to a deficit in the availability of information (retention).

Neurocognitive function in alcoholic, schizophrenic, and dually diagnosed patients.

Neurocognitive functions were compared in alcoholic, schizophrenic, and dually diagnosed (schizophrenic and alcoholic) patients and community control volunteers. Participants (N = 52, n = 13 in each group) completed a brief battery including two measures of neuropsychological function and two affective measures. The neuropsychological tests included the Trail-Making Test Forms A and B and a face-recognition test. The affective measures included assessment of anxiety and depression. The major objective was to compare the patterns of neurocognitive performance among the four groups. The groups did not differ in mean age (35.37) or years of education (12.46). Compared with the community control and alcoholic groups, the schizophrenic groups reported higher mean depression (12.92 vs. 5.54) and mean state anxiety scores (60.73 vs. 46.04). Control subjects were generally, although not always significantly, superior to the other groups. Contrary to expectations, alcoholic patients were not consistently better than the schizophrenic groups, and dually diagnosed participants were not more impaired than schizophrenic patients without substance abuse histories. Thus, the interaction of schizophrenia and substance abuse did not have an additive effect on neurocognitive performance assessed in this study. More research using this complete four-group design and a larger neurocognitive battery is needed.

Memory disturbance in multiple sclerosis: reconsideration of patterns of performance on the selective reminding test.

Comparison of the average performance by 99 patients with multiple sclerosis (MS) and 32 healthy controls on the Selective Reminding Test (SRT) suggested that the patients' memory deficits arose primarily from difficulties in retrieving information from long-term storage. However, six different cluster analysis methods indicated three distinct patterns of SRT performance by patients, emphasizing the heterogeneity of memory function in MS. Approximately 25% of the patients performed normally while about 22% exhibited a severe amnesia-like disturbance. The remaining patients (53%) showed mild to moderate memory impairments, but only two patients met strict operational criteria for "pure retrieval failure".

Behavioral dysfunction and cognitive efficiency in male and female alcoholics.

This study was conducted to examine the role of childhood behavioral disorders (CBDs) and residual attention deficit disorder (ADDRT) in alcohol-related cognitive dysfunction in male and female subjects. Alcoholic (n = 44 females, 56 males) and control (n = 40 females, 40 males) subjects completed assessments that included measures of CBDs, ADDRT, and cognitive and psychosocial functioning. Cognitive tests were specifically designed to assess efficiency in function. As expected, alcoholics were inferior to controls in their cognitive efficiency [F(1,171) = 10.43, p = 0.0015]. Alcoholics reported more CBDs [F(1,161) = 12.02, p = 0.0007], regardless of sex. They also reported more ADDRT [F(1,173) = 44.12, p = 0.0001] than did controls. There were also sex [F(1,173) = 13.31, p = 0.0004] and group by sex effects [F(1,173) = 3.93, p = 0.05]. Female alcoholics reported more ADDRT symptoms than any other group. Regression equations conducted to clarify the relation between group, sex, CBDs, ADDRT, and cognitive efficiency indicated that the best predictor of cognitive efficiency was group classification (alcoholic versus control). That is, although symptoms of behavioral disorders were reported significantly more frequently by both male and female alcoholic subjects, these symptoms could not account for the cognitive impairment observed in either sex.

Patterns of cognitive impairment among alcoholics: are there subtypes?

The mild generalized dysfunction hypothesis of alcohol abuse's deleterious effects on cognitive processes has gained support from a number of studies in which detoxified alcoholics have a lower mean performance level than peer controls on a variety of neuropsychological tests. This approach might obscure consistent but different patterns of preserved and impaired cognitive performance among subgroups of alcoholics, suggestive of alternative hypotheses. To test this possibility, neuropsychological test data from two large, independent samples of alcoholics (sample 1, n = 143; sample 2, n = 130) and controls (sample 1, n = 97; sample 2, n = 83) were subjected to separate centroid hierarchical cluster analyses. For both samples, the majority of alcoholics (94% and 94%) exhibited a pattern of impaired verbal and nonverbal performance and deficits in memory and perceptual motor skill, with normal motor skill. The alcoholics who did not fit this pattern showed more severe or wide-ranging impairments. These findings indicate that empirical support for the mild generalized dysfunction hypothesis of alcoholics' cognitive deficits is not an artifact of averaging.

Interpersonal problem-solving in male and female alcoholics.

This study compared the performance of alcoholics (18 male, 16 female) with community controls (15 male, 12 female) on the Adaptive Skills Battery (ASB), a test of interpersonal problem-solving. The ASB consists of 30 situations. Fifteen situations require subjects' typical responses and 15, their optimal responses. Male and female alcoholics were inferior to controls in their typical responses [F(1,57) = 45.22, p = 0.0001], but did not differ on the optimal responses (F less than 1). Further analyses indicated that decreased feelings of self-efficacy could not account for the alcoholic deficit. Females were superior to males in the optimal response condition [(F(1,56) = 9.90, p = 0.003]. No significant group x sex interactions were obtained. Performance on the ASB was not correlated with performance on traditional measures of problem-solving. Post-hoc correlational analyses revealed differential patterns between depression scores and performance for alcoholics and controls. These data suggest that (1) female and male alcoholics exhibit similar interpersonal problem-solving deficits, (2) alcoholic self-efficacy expectancies cannot account for the impairment, (3) the ASB appears to assess aspects of problem-solving not typically examined, and (4) the role of depression in alcoholic performance deserves continued empirical evaluation.