Profile Subgroups Research Articles

Reliability and Validity of the Turkish Adaptation of VITACORA-19 in Patients with Psoriatic Arthritis.

This study aims to evaluate the reliability and validity of the Turkish language version of VITACORA-19 (psoriatic arthritis quality of life questionnaire) in patients with psoriatic arthritis. The Turkish version of VITACORA-19 questionnaire was obtained after a translation and back translation process. The study sample included 61 PsA patients (22 males, 39 females; mean age 46.5±12.2 years; range 19 to 71 years). To assess the test-retest reliability of the Turkish VITACORA-19, the questionnaire was reapplied 10 to 15 days after the first interview (interclass correlation coefficient). Cronbach's alpha (a) was used to evaluate the internal consistency. VITACORA-19 was compared with visual analog scale for physician and patient global assessments, the Health Assessment Questionnaire, and Nottingham Health Profile for construct validity. The internal structure of VITACORA-19 was examined by factor analysis. The individual item intraclass correlation coefficient ranged from 0.77 to 0.98 and Cronbach's alpha ranged from 0.77 to 0.98. The Cronbach's alpha value for whole scale was determined as 0.96. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.90, and Bartlett's test of sphericity had a p<0.001. Turkish VITACORA-19 total scores were correlated negatively with Health Assessment Questionnaire, visual analog scale for pain, and Nottingham Health Profile subgroups, and positively with physician and patient global assessments (p<0.01). Turkish version of VITACORA-19 questionnaire is a reliable and valid measure for health-related quality of life in Turkish patients with psoriatic arthritis.

Differing Psychologically Derived Clusters in People With Chronic Low Back Pain are Associated With Different Multidimensional Profiles.

To explore the existence of subgroups in a cohort with chronic low back pain (n=294) based upon data from multiple psychological questionnaires, and profile subgroups on data from multiple dimensions. Psychological questionnaires considered as indicator variables entered into latent class analysis included: Depression, Anxiety, Stress scales, Thought Suppression and Behavioural Endurance subscales (Avoidance Endurance questionnaire), Chronic Pain Acceptance Questionnaire (short-form), Pain Catastrophising Scale, Pain Self-Efficacy Questionnaire, and Fear-Avoidance Beliefs Questionnaire. Multidimensional profiling of derived clusters included: demographics, pain characteristics, pain responses to movement, behaviors associated with pain, body perception, pain sensitivity, and health and lifestyle factors. Three clusters were derived. Cluster 1 (23.5%) was characterized by low Cognitive and Affective Questionnaire scores, with the exception of fear-avoidance beliefs. Cluster 2 (58.8%) was characterized by relatively elevated thought suppression, catastrophizing, and fear-avoidance beliefs, but lower pain self-efficacy, depression, anxiety, and stress. Cluster 3 (17.7%) had the highest scores across cognitive and affective questionnaires.Cluster 1 reported significantly lower pain intensity and bothersomeness than other clusters. Disability, stressful life events, and low back region perceptual distortion increased progressively from cluster 1 to cluster 3, whereas mindfulness progressively decreased. Clusters 2 and 3 had more people with an increase in pain following repeated forward and backward spinal bending, and more people with increasing pain following bending, than cluster 1. Cluster 3 had significantly greater lumbar pressure pain sensitivity, more undiagnosed comorbid symptoms, and more widespread pain than other clusters. Clinical implications relating to presentations of each cluster are postulated.

Emerging adults in substance misuse intervention: preintervention characteristics and responses to a motivation-enhancing program.

Background Emerging adulthood is an age of particularly risky behavior. Substance misuse during this phase of life can be the beginning of longer-term problems, making intervention programs particularly important. This study’s purposes were to identify alcohol use profile subgroups, describe the preintervention characteristics of each, and assess how many participants transitioned to lower-risk profiles during the course of the intervention.MethodsWe used latent transition analyses to categorize 1183 people court ordered to attend Prime For Life® (PFL), a motivation-enhancing program, into preintervention and postintervention profiles. We then assessed how many made transitions between these profiles during the course of the intervention.ResultsProfiles included two low-risk statuses (abstinence and light drinking) and two high-risk statuses (occasional heavy drinking and frequent heavy drinking). We found that people in profile subgroups that reflected heavier 90-day preintervention drinking were likely to transition to profiles reflecting postintervention intentions for lower-risk drinking in the subsequent 90 days. In contrast, the likelihood of transitioning from a lower-risk to a higher-risk profile was extremely low. These positive changes were found for people of both sexes and for those above versus below the legal drinking age, albeit for more women than men in the heaviest drinking group.ConclusionsFindings showed positive changes during intervention for many emerging adult participants attending PFL. Further research is needed that include comparison conditions, as well as examine longer-term outcomes in this population.

Somatosensory nociceptive characteristics differentiate subgroups in people with chronic low back pain: a cluster analysis.

The objectives of this study were to explore the existence of subgroups in a cohort with chronic low back pain (n = 294) based on the results of multimodal sensory testing and profile subgroups on demographic, psychological, lifestyle, and general health factors. Bedside (2-point discrimination, brush, vibration and pinprick perception, temporal summation on repeated monofilament stimulation) and laboratory (mechanical detection threshold, pressure, heat and cold pain thresholds, conditioned pain modulation) sensory testing were examined at wrist and lumbar sites. Data were entered into principal component analysis, and 5 component scores were entered into latent class analysis. Three clusters, with different sensory characteristics, were derived. Cluster 1 (31.9%) was characterised by average to high temperature and pressure pain sensitivity. Cluster 2 (52.0%) was characterised by average to high pressure pain sensitivity. Cluster 3 (16.0%) was characterised by low temperature and pressure pain sensitivity. Temporal summation occurred significantly more frequently in cluster 1. Subgroups were profiled on pain intensity, disability, depression, anxiety, stress, life events, fear avoidance, catastrophizing, perception of the low back region, comorbidities, body mass index, multiple pain sites, sleep, and activity levels. Clusters 1 and 2 had a significantly greater proportion of female participants and higher depression and sleep disturbance scores than cluster 3. The proportion of participants undertaking <300 minutes per week of moderate activity was significantly greater in cluster 1 than in clusters 2 and 3. Low back pain, therefore, does not appear to be homogeneous. Pain mechanisms relating to presentations of each subgroup were postulated. Future research may investigate prognoses and interventions tailored towards these subgroups.

Can we rely on predicted basal metabolic rate in chronic pancreatitis outpatients?

Malnutrition is a common complication to chronic pancreatitis (CP) and many patients need nutritional support. An accurate estimation of the basal metabolic rate (BMR) is essential when appropriate nutritional support is to be initiated, but in the clinical settings BMR is cumbersome to measure. We therefore investigated whether BMR can be reliable predicted from a standard formula (the Harris-Benedict equation) in CP outpatients. Twenty-eight patients with clinical stable CP and no current alcohol abuse were enrolled. Patients were stratified according to nutritional risk using the Nutrition Risk Screening 2002 system. Body composition was estimated using bioelectrical impedance. BMR was measured using indirect calorimetry and predicted using the Harris-Benedict equation based on anthropometric data. The average predicted BMR was 1371±216kcal/day compared to an average measured BMR of 1399±231kcal/day (P=0.4). The corresponding limits of agreement were-347 to 290kcal/day. Twenty-two patients (79%) had a measured BMR between 85 and 115% of the predicted BMR. When analysing patients stratified according to nutritional risk profiles, no differences between predicted and measured BMR were evident for any of the risk profile subgroups (all P>0.2). The BMR was correlated to fat free mass determined by bioelectrical impedance (rho=0.55; P=0.003), while no effect modification was seen from nutritional risk stratification in a linear regression analysis (P=0.4). The Harris-Benedict equation reliable predicts the measured BMR in four out of five clinical stable CP outpatients with no current alcohol abuse.

Predicting Health-Related Quality of Life from the Psychosocial Profiles of Youth Seeking Treatment for Obesity

To identify, in a sample of youth seeking treatment for obesity, subgroups of youth characterized by distinct profiles of psychosocial functioning and to examine whether psychosocial subgroup membership predicted treatment outcomes. Baseline psychosocial profiles identified using cluster analysis techniques were used to predict treatment outcomes (i.e., health-related quality of life, BMI z scores). Participants were 92 youths seeking treatment for obesity (mean age = 11.6 years, mean body mass index for age and sex = 30.5) and their caregivers. Three distinct psychosocial profile subgroups were identified. Subgroups with higher levels of psychosocial problems had poorer health-related quality of life outcomes posttreatment and at 12-month follow-up. Subgroup membership did not predict weight outcomes. Youth seeking weight management treatment may present with patterns of psychosocial difficulties with implications for treatment outcomes. Weight treatment interventions should be tailored to meet the needs of youth with higher levels of psychosocial problems.

The role of allergy in the etiopathogenesis of idiopathic sudden sensorineural hearing loss

To evaluate the role of allergy in the etiopathogenesis of sudden hearing loss using cytokine profile, allergic parameters, and lymphocyte subgroups, a total of 31 patients aged between 30 and 62 years (mean age: 42.48 ± 15.86 years) with the diagnosis of sudden hearing loss were enrolled in the study between 2008 and 2011. The control group comprised 30 age-matched adult subjects accepted as clinically healthy individuals living in the same region with comparable socioeconomic parameters. The patient and the control group were questioned for history of allergy. Lymphocyte subgroups in the peripheral blood were evaluated using Becton-Dickinson monoclonal CD4, CD8, CD19, and CD23 antibodies. In the patient and control groups, the levels of IFN- γ, IL4, IL10, and total IgE were measured and compared between the groups. Skin test was used for detection of inhaler allergens in the patient and the control groups, and specific IgE tests were performed using the RAST method for food allergens. The Spearman's rho correlation, the unpaired t test, the Mann-Whitney U test, and the Shapiro-Wilk test were used to determine the differences between the groups. The limit for statistical significance was p < 0.05. When the patient and the control group were compared, the differences between CD4, CD23, IL4, IL10, and IgE were statistically significant. On analyses of the patients' serum samples, strongly positive correlations were determined between IgE and CD23, IL10, IL4; IL4 and IL10, CD23, CD4; IL10 and CD23, CD4 (Spearman rho, p = 0.000), while a weakly positive correlation was found between IgE and CD4 (Spearman rho, p = 0.020). A correlation between IFN-γ and CD4 was weakly negative (Spearman rho, p = 0.040). The total IgE levels were estimated to be above the normal reference ranges (0-100 IU/ml) in 25.8 % of the cases in the patient group. History of allergy was found in 61.9 % of the patients. The results of this study substantiate the role of allergy in the etiopathogenesis of sudden hearing loss. We think that during the diagnostic work-up of these patients allergy should be interrogated seriously, necessary tests should be performed, and allergy should be considered in the decision-making process of the treatment of sudden hearing loss.

Profiling alumni of a Brazilian public dental school

BackgroundFollow-up studies of former students are an efficient way to organize the entire process of professional training and curriculum evaluation. The aim of this study was to identify professional profile subgroups based on job-related variables in a sample of former students of a Brazilian public dental school.MethodsA web-based password-protected questionnaire was sent to 633 registered dentists who graduated from the Federal University of Goias between 1988 and 2007. Job-related information was retrieved from 14 closed questions, on subjects such as gender, occupational routine, training, profits, income status, and self-perception of professional career, generating an automatic database for analysis. The two-step cluster method was used for dividing dentists into groups on the basis of minimal within-group and maximal between-group variation, using job-related variables to represent attributes upon which the clustering was based.ResultsThere were 322 respondents (50.9%), predominantly female (64.9%) and the mean age was 34 years (SD = 6.0). The automatic selection of an optimal number of clusters included 289 cases (89.8%) in 3 natural clusters. Clusters 1, 2 and 3 included 52.2%, 30.8% and 17.0% of the sample respectively. Interpretation of within-group rank of variable importance for cluster segmentation resulted in the following characterization of clusters: Cluster 1 - specialist dentists with higher profits and positive views of the profession; Cluster 2 - general dental practitioners in small cities; Cluster 3 - underpaid and less motivated dentists with negative views of the profession. Male dentists were predominant in cluster 1 and females in cluster 3. One-way Anova showed that age and time since graduation were significantly lower in Cluster 2 (P < 0.001). Alternative solutions with 4 and 5 clusters revealed specific discrimination of Cluster 1 by gender and dental education professionals.ConclusionsCluster analysis was a valuable method for identifying natural grouping with relatively homogeneous cases, providing potentially meaningful information for professional orientation in dentistry in a variety of professional situations and environments.

Male breast cancer: A survey at the Helsinki University Central Hospital during 1981–2006

Background. The purpose was to analyze the behavior of male breast cancer. Methods. Fifty-eight male breast cancer patients were treated at the HUCH during 1981–2006. Data on risk factors, tumor characteristics, clinical presentation, treatment and survival were obtained by chart review. Results. Presentation occurred at a median age of 63 years, most often due to a self-detected lump. The median size of the primary tumor was 1.8 cm and 14% were T4 tumors. Forty-seven percent had lymph node metastases and 4% distant metastases at diagnosis. Ductal carcinoma was the most common tumor type. All tumors with known receptor status were positive for estrogen receptor (ER) and 79% for progesterone receptor (PgR). Her-2 overexpression was found in 2/19 patients (11%). A family history of breast cancer, obesity, high alcohol intake and liver cirrhosis were the most often seen risk factors. Nineteen percent had one or two other malignancies, the most common second malignancy being prostate cancer in 7%. Ninety-seven percent were operated by mastectomy and 90% by axillary evacuation while sentinel node biopsy alone was done only in 7%. Sixty percent of the patients received radiotherapy, 64% adjuvant hormonal treatment, 20% adjuvant chemotherapy, and 2% adjuvant trastuzumab. Fourteen patients (25%) experienced a relapse of which 60% were distant, bone being the most common site. During follow-up 21 patients (37%) died, of whom nine of breast cancer and 12 due to other causes. The 5-year overall survival (OS) was 75%. Conclusions. Male breast cancer behaves and is today treated in many respects like postmenopausal breast cancer. However, due to rudimentary breast tissue the symptoms, diagnosis and especially a higher amount of T4 tumors differ from that of females. Also the risk factor profile and histologic subgroups seem different. The 5-year OS of 75% is clearly higher than 44% reported at our institution in 1982.

Comparison of soft and hard tissue profiles of orthognathic surgery patients treated recently and 20 years earlier

The aim of this study was to assess, by means of lateral cephalometric radiographs, any differences in the pretreatment soft and hard tissue facial profiles of patients who relatively recently underwent orthognathic surgery compared with those whose surgery occurred 20 years before. The pretreatment soft and hard tissue profiles of 91 orthognathic surgery patients were analyzed. These patients were divided into 2 groups. The first group consisted of 35 patients that were treated within the period from 1982 to 1986. The second group included 56 patients treated between 2000 and 2002. To assess patients' hard and soft tissue profiles, 4 cephalometric variables were evaluated on their pretreatment lateral cephalograms. For each of the 4 variables used, the patients were divided into one of 3 different profile subgroups: orthognathic, retrognathic, or prognathic profile. According to the distribution of profiles in each of the 2 groups, a qualitative comparison was made. Descriptive statistics and chi-squared tests were performed to access the possible differences at P < .05. By comparing pretreatment facial profiles between the 2 groups using the soft and hard tissue measurements, it was demonstrated that some changes actually occurred over the years. These differences in the profiles between the 2 groups indicated that orthodontic-surgical patients treated more recently exhibited smaller deviations from the norm than those treated in the earlier period. These findings may reflect possible changes in what is currently considered to be acceptable.

Patterns of Sexual Risk Behavior Change Among Sexually Transmitted Infection Clinic Patients

Effective interventions to reduce sexually transmitted infection (STI) risk behaviors are most potent in the short term and are not uniformly effective for all people. The present study examined patterns of sexual behavior change among 238 men and 104 women who received risk reduction counseling in a public STI clinic and were followed for 9 months with a 1-year retrospective clinic chart abstraction for newly diagnosed STI. A two-stage, multivariate cluster analysis was performed on four risk behavior difference scores (follow-up - baseline) for 1-month, 3-month, 6-month, and 9-month follow-up frequencies of unprotected vaginal and anal intercourse. Cluster analysis identified three profile subgroups: Subgroup 1 had lower levels of risk behavior at all time points; Subgroup 2 had significant reductions in risk over time; and Subgroup 3 demonstrated significant increases in risk over time. Analyses on variables external to the cluster analysis found that the three profile subgroups differed on numbers of sex partners, substance use, sensation seeking, indicators of risk reduction motivation and behavioral skills, and contracting new STI. STI clinic patients with varying profiles of sexual behavior change were, therefore, differentiated by factors relevant to STI interventions.

Profiles of child sexual abuse cases in Ireland: an archival study

Objective: This study aimed to profile subgroups of CSA cases referred for assessment at two national CSA assessment centers in Ireland. Method: Historical and clinical data for 150 CSA cases were drawn from records of two Dublin-based national specialist sexual abuse assessment and therapeutic centers. Three main comparisons were made involving: (1) 113 confirmed CSA cases and 37 unconfirmed CSA cases, (2) 55 confirmed CSA cases that displayed clinically significant behavior problems, and the 56 confirmed CSA cases without significant adjustment difficulties, and (3) 19 confirmed CSA cases in which violence was a central feature, and 79 confirmed cases in which violence was not a central feature. Results: There were three main findings. (1) More unconfirmed cases were male; had single or separated parents; and a father with a criminal history. As a group, the confirmed cases were largely youngsters who had been abused by male adults or adolescents outside their nuclear family and who subsequently were well supported by one or two parents. (2) Poorly adjusted CSA victims had a history of coercive violent abuse while better adjusted children were victims of nonviolent abuse. (3) Victims of violent CSA were more likely to have experienced penetrative abuse and to display more externalizing behavior problems. Conclusions: Confirmed and unconfirmed CSA cases, well and poorly adjusted CSA cases, and victims of violent and nonviolent CSA referred for assessment at two national CSA assessment centers in Ireland had distinctive clinical profiles.

Identifying multiple recidivists in a state hospital population.

Of 195 patients admitted to a state hospital over a four-month period, 74 were multiple recidivists. Nearly half of the 195 patients could be assigned to one of six profile subgroups of recidivists described in a previous study. Because of the high rate of medication noncompliance in this state hospital sample (65 percent), noncompliance alone was not an adequate predictor of multiple recidivism. The study found that membership in a profile subgroup coupled with factors related to gender, medication noncompliance, homelessness, and arrest history may be a more useful way of predicting multiple recidivism in samples of newly admitted patients.

Reasons for admission among six profile subgroups of recidivists of inpatient services.

The incidence pattern of medication and program non compliance, violent acts, suicide attempts and chemical abuse defined as reasons for hospital admission was evaluated in a total sample (n = 416) of recidivists and their six constituent profile subgroups (n = 272). The total sample was drawn from two different state-operated hospitals and two different time periods. The incidence pattern observed for the total sample in order of descending priority was medication non compliance, program non compliance, chemical abuse, violent acts and suicide attempts. The incidence pattern ordering and the relevant percentages of occurrence were observed for both hospitals. There were time period differences in the ordering and percentages of the reasons for admission which revealed an increase in both medication and program non compliance as well as chemical abuse in the more recent sample. There were also specific subgroup differences in the incidence pattern concerning some reasons for admission. These subgroup differences are discussed in detail.

Psychological and sexual functioning among outpatient sexual offenders against children: A Minnesota Multiphasic Personality Inventory (MMPI) cluster analytic study

Multivariate clustering procedures were used to identify homogeneous subgroups of outpatient sex offenders against children (n=110)on the basis of the Minnesota Multiphasic Personality Inventory (MMPI). Results indicated a five-subgroup solution. Two within-normal-limits and two clinically elevated profile subgroups replicated subtypes found in previous cluster analytic studies of child sex offenders. The fifth subgroup appeared similar in MMPI profile pattern and elevation to a previously identified subtype of rapists. Discriminant analyses showed that subgroups differed along dimensions of cognitive disturbance and sexual functioning. Furthermore, levels of psychopathology corresponded with levels of sexual pathology. Results are discussed with reference to previous MMPI cluster analytic studies of sex offenders and theories of sexual aggression.

The Use of the MMPI in Predicting Treatment Participation Among Incarcerated Adult Rapists

Recent studies have questioned the ability of psychological tests to meaningfully describe groups of criminal sexual offenders. The present study utilized the MMPIs of fifty-five men convicted of rape to predict clinicians' ratings of treatment participation within a sex offender program. The subjects were part of an earlier study which reported the derivation of homogeneous MMPI profile subgroups of adult sex offenders. Results indicated a significant relationship between MMPI profile subgroup membership and treatment participation. Further, several MMPI scales were found to predict sex offenders' attendance to treatment groups and clinicians' ratings of subject participation. Results are discussed with respect to the MMPI and the sex offender literature. Suggestions for future research are offered.

MMPI Profile Subtypes of Incarcerated Sex Offenders Against Children

Sex offenders are heterogeneous in personality and behavioral characteristics. The present study was conducted to identify homogeneous subgroups of incarcerated sexual offenders against children on the basis of the Minnesota Multiphasic Personality Inventory (MMPI). Subjects were 90 men undergoing initial evaluation for a treatment program conducted through a state department of corrections. Hierarchical cluster analysis resulted in the identification of four profile subgroups. While two subgroups presented mean profiles within normal limits, the patterns indicated differences in personality functioning: one presenting signs of sociopathy and the other emotional disturbance. In contrast, the other two profile subgroups presented several scale elevations: One subgroup indicated anger and aggression and the other severe psychopathology. Both of the latter subgroups were similar to two rapist subtypes identified in previous research. Subgroups were further differentiated on the basis of psychosexual, affective, and psychosocial variables. Results suggest the existence of homogeneous subgroups of incarcerated sexual offenders against children as delineated by the MPPI.

Affective and personality characteristics of MMPI profile subgroups of incarcerated rapists

Psychometric studies attempting to understand adult rapists have primarily used the MMPI and have been of limited use. Also, psychodynamic theories have failed to provide objective criteria for classification. The present study attempted to integrate these two approaches. Using multivariate clustering procedures, five MMPI profile subgroups were identified. Subgroups replicated those identified in earlier studies. Subgroups were also differentiated along several sexual, affective, and personality measures independent of the MMPI. Results are integrated with psychodynamic theories of rape and implications of the findings and the utility of a classification system for rapists are discussed.

Cluster analytically derived MMPI profile subgroups of incarcerated adult rapists.

Sex offenders are known to be heterogeneous in their patterns of personality functioning and behavior. The present study conducted a multivariate cluster analysis on the MMPIs of 120 incarcerated adult male rapists. The analysis resulted in the identification of five MMPI profile subgroups. Additional differences among subgroups were identified in the circumstances of the crime and responses to the Multiphasic Sex Inventory. Levels of psychopathology, as indicated by the MMPI, ranged from slight to extreme. Results are discussed with reference to previous MMPI research with sex offenders. Suggestions for future research are offered.

Empirically derived MMPI profile subgroups of incarcerated homicide offenders.

Several classification systems have been developed to identify subgroups of criminals. Recently, investigations have attempted to derive empirical classifications of specific types of offenders. The present study investigated the occurrence of MMPI profile subgroups in a sample of incarcerated homicide offenders. One hundred and eighteen convicted male homicide offenders were the subjects. MMPIs were collected as a part of evaluations to determine eligibility for a work release program. Results identified four distinct profile subgroups, which ranged in levels of psychopathology from normal to severely disturbed. Subgroups are discussed with reference to previous research and the development of a taxonomic system for homicide offenders.