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Education ?

Medical School Score Rankings
University of North Carolina (1965)
Top 25%

Awards & Distinctions ?

American Board of Internal Medicine

Publications & Research

Dr. Whitfield has contributed to 25 publications.
Title Adverse Childhood Experiences and Hallucinations.
Date February 2006
Journal Child Abuse & Neglect

OBJECTIVE: Little information is available about the contribution of multiple adverse childhood experiences (ACEs) to the likelihood of reporting hallucinations. We used data from the ACE study to assess this relationship. METHODS: We conducted a survey about childhood abuse and household dysfunction while growing up, with questions about health behaviors and outcomes in adulthood, which was completed by 17,337 adult HMO members in order to assess the independent relationship of 8 adverse childhood experiences and the total number of ACEs (ACE score) to experiencing hallucinations. We used logistic regression to assess the relationship of the ACE score to self-reported hallucinations. RESULTS: We found a statistically significant and graded relationship between histories of childhood trauma and histories of hallucinations that was independent of a history of substance abuse. Compared to persons with 0 ACEs, those with 7 or more ACEs had a five-fold increase in the risk of reporting hallucinations. CONCLUSION: These findings suggest that a history of childhood trauma should be looked for among persons with a history of hallucinations.

Title Long-term Consequences of Childhood Sexual Abuse by Gender of Victim.
Date September 2005
Journal American Journal of Preventive Medicine

BACKGROUND: Childhood sexual abuse (CSA) is a worldwide problem. Although most studies on the long-term consequences of CSA have focused on women, sexual abuse of both boys and girls is common. Thus, a comparison of the long-term effects of CSA by gender of the victim will provide perspective on the need for future research, prevention activities, and treatment of survivors. METHODS: A retrospective cohort study was conducted from 1995 to 1997 among 17,337 adult HMO members in San Diego, California. Participants completed a survey about abuse or household dysfunction during childhood, and multiple other health-related issues. Multivariate logistic regression was used to examine the relationships between severity of CSA (intercourse vs no intercourse) and long-term health and social problems (substance use and abuse, mental illness, and current problems with marriage and family) by gender of victim. Models controlled for exposure to other forms of adverse childhood experiences that co-occur with CSA. Among men, the relationship between the gender of the CSA perpetrator to the outcomes was also examined. RESULTS: Contact CSA was reported by 16% of males and 25% of females. Men reported female perpetration of CSA nearly 40% of the time, and women reported female perpetration of CSA 6% of the time. CSA significantly increased the risk of the outcomes. The magnitude of the increase was similar for men and women. For example, compared to reporting no sexual abuse, a history of suicide attempt was more than twice as likely among both men and women who experienced CSA (p<0.05). Compared with those who did not report CSA, men and women exposed to CSA were at a 40% increased risk of marrying an alcoholic, and a 40% to 50% increased risk of reporting current problems with their marriage (p<0.05). CONCLUSIONS: In this cohort of adult HMO members, experiencing CSA was common among both men and women. The long-term impact of CSA on multiple health and social problems was similar for both men and women. These findings strongly indicate that boys and girls are vulnerable to this form of childhood maltreatment; the similarity in the likelihood for multiple behavioral, mental, and social outcomes among men and women suggests the need to identify and treat all adults affected by CSA.

Title Adverse Childhood Experiences and the Risk of Depressive Disorders in Adulthood.
Date February 2005
Journal Journal of Affective Disorders

BACKGROUND: Research examining the association between childhood abuse and depressive disorders has frequently assessed abuse categorically, thus not permitting discernment of the cumulative impact of multiple types of abuse. As previous research has documented that adverse childhood experiences (ACEs) are highly interrelated, we examined the association between the number of such experiences (ACE score) and the risk of depressive disorders. METHODS: Retrospective cohort study of 9460 adult health maintenance organization members in a primary care clinic in San Diego, CA who completed a survey addressing a variety of health-related concerns, which included standardized assessments of lifetime and recent depressive disorders, childhood abuse and household dysfunction. RESULTS: Lifetime prevalence of depressive disorders was 23%. Childhood emotional abuse increased risk for lifetime depressive disorders, with adjusted odds ratios (ORs) of 2.7 [95% confidence interval (CI), 2.3-3.2] in women and 2.5 (95% CI, 1.9-3.2) in men. We found a strong, dose-response relationship between the ACE score and the probability of lifetime and recent depressive disorders (P<0.0001). This relationship was attenuated slightly when a history of growing up with a mentally ill household member was included in the model, but remained significant (P<0.001). CONCLUSIONS: The number of ACEs has a graded relationship to both lifetime and recent depressive disorders. These results suggest that exposure to ACEs is associated with increased risk of depressive disorders up to decades after their occurrence. Early recognition of childhood abuse and appropriate intervention may thus play an important role in the prevention of depressive disorders throughout the life span.

Title Adverse Childhood Experiences, Alcoholic Parents, and Later Risk of Alcoholism and Depression.
Date October 2002
Journal Psychiatric Services (washington, D.c.)

OBJECTIVE: The study examined how growing up with alcoholic parents and having adverse childhood experiences are related to the risk of alcoholism and depression in adulthood. METHODS: In this retrospective cohort study, 9,346 adults who visited a primary care clinic of a large health maintenance organization completed a survey about nine adverse childhood experiences: experiencing childhood emotional, physical, and sexual abuse; witnessing domestic violence; parental separation or divorce; and growing up with drug-abusing, mentally ill, suicidal, or criminal household members. The associations between parental alcohol abuse, the adverse experiences, and alcoholism and depression in adulthood were assessed by logistic regression analyses. RESULTS: The risk of having had all nine of the adverse childhood experiences was significantly greater among the 20 percent of respondents who reported parental alcohol abuse. The number of adverse experiences had a graded relationship to alcoholism and depression in adulthood, independent of parental alcohol abuse. The prevalence of alcoholism was higher among persons who reported parental alcohol abuse, no matter how many adverse experiences they reported. The association between parental alcohol abuse and depression was accounted for by the higher risk of having adverse childhood experiences in alcoholic families. CONCLUSIONS: Children in alcoholic households are more likely to have adverse experiences. The risk of alcoholism and depression in adulthood increases as the number of reported adverse experiences increases regardless of parental alcohol abuse. Depression among adult children of alcoholics appears to be largely, if not solely, due to the greater likelihood of having had adverse childhood experiences in a home with alcohol-abusing parents.

Title Adverse Childhood Experiences and Trauma.
Date August 1998
Journal American Journal of Preventive Medicine
Title The Forgotten Difference: Ordinary Memory Versus Traumatic Memory.
Date January 1996
Journal Consciousness and Cognition
Title Advances in Alcoholism and Chemical Dependence.
Date November 1988
Journal The American Journal of Medicine
Title Adult Children of Alcoholics and Impaired Professionals.
Date June 1987
Journal Maryland Medical Journal (baltimore, Md. : 1985)
Title Splenomegaly. An Algorithmic Approach to Diagnosis.
Date February 1982
Journal Jama : the Journal of the American Medical Association
Title Non-drug Treatment of Alcohol Withdrawal.
Date April 1981
Journal Current Psychiatric Therapies
Title Medical Education and Alcoholism.
Date April 1981
Journal Maryland State Medical Journal
Title Children of Alcoholics: Treatment Issues.
Date September 1980
Journal Maryland State Medical Journal
Title Detoxification of 1,024 Alcoholic Patients Without Psychoactive Drugs.
Date May 1978
Journal Jama : the Journal of the American Medical Association

Most community-referred, ambulatory chronic alcoholics can be detoxified quickly and safety without the use of psychoactive drugs, according to our data. We believe such detoxification can be done most efficiently in a social setting, with the aid of a staff who will provide reassurance and reality orientation and who will monitor the patients' vital signs, general condition, and any specific problems.

Title Alcoholism Education: Early Development and Coordination at a New Medical School.
Date December 1975
Journal Maryland State Medical Journal
Title An Experimental Course in Scientific Methods.
Date October 1973
Journal British Journal of Medical Education
Title Self-liberation for Males.
Date May 1973
Journal The New England Journal of Medicine
Title Lead Encephalopathy in Adults.
Date May 1972
Journal The American Journal of Medicine
Title Tips on Diagnosing the Bleeding Patient.
Date January 1971
Journal Medical Times
Title Hematologic Abnormalities in Tuberculous Patients.
Date November 1970
Journal Archives of Internal Medicine
Title Promotional Nonsense.
Date June 1970
Journal The New England Journal of Medicine
Title Tuberculous Peritonitis.
Date February 1970
Journal The New England Journal of Medicine
Title The Patient with Lymphoma.
Date December 1968
Journal Gp
Title The Patient with Anemia: Diagnosis.
Date February 1968
Journal Journal of the Medical Association of the State of Alabama
Title Introductionexposing Misinformation Concerning Child Sexual Abuse and Adult Survivors.
Journal Journal of Child Sexual Abuse

This article introduces a special volume on misinformation about child sexual abuse. Despite extensive research findings on the long-term effects and consequences of child sexual abuse, misinformation on this topic is widespread. Several forces have worked to support and disseminate this erroneous information. Because it is difficult to comprehend the horror of sexual crimes against children, society's denial and disbelief have often unwittingly supported the agendas of those who want to discount or minimize the impact of these crimes. The media has also contributed to the aura of skepticism surrounding claims of sexual abuse and its mental health impact, and has reported favorably on controversial and unproven claims such as the “false memory syndrome.” In the hope of countering misinformation and thus raising the level of discourse to the engagement of real scientific issues, a number of well known and respected researchers and clinicians examine various facets of the problem.

Title The "false Memory" Defenseusing Disinformation and Junk Science In and Out of Court.
Journal Journal of Child Sexual Abuse

This article describes a seemingly sophisticated, but mostly contrived and often erroneous “false memory” defense, and compares it in a brief review to what the science says about the effect of trauma on memory. Child sexual abuse is widespread and dissociative/traumatic amnesia for it is common. Accused, convicted and self-confessed child molesters and their advocates have crafted a strategy that tries to negate their abusive, criminal behavior, which we can call a “false memory” defense. Each of 22 of the more commonly used components of this defense is described and discussed with respect to what the science says about them. Armed with this knowledge, survivors, their clinicians, and their attorneys will be better able to refute this defense of disinformation.

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