Phenobarbital, propranolol, and aggression.
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Aggression↗
Biomedical subjects
A R Poindexter
Publications and source records attributed to A R Poindexter.
Incidence of short-sleep patterns in institutionalized individuals with profound mental retardation.
Sleep patterns of 103 individuals with profound mental retardation were explored. Hours of sleep were counted from night monitoring sheets for 21 months for those individuals in continuous residence on one area of a large ICF/MR. Forty individuals (38.8%) were found to have short-sleep patterns. Comparison of short-sleep and nonshort-sleep groups revealed no predictive factors for short-sleep except blindness. Diagnosis of cerebral palsy and sodium valproate usage were predictive for nonshort-sleep. Pattern type of short-sleep nights were also determined. Younger individuals had more difficulty initiating sleep than awakening early. Short-sleep patterns may interfere with habilitation activities and community adjustment. Techniques for minimizing possible negative consequences of short-sleep were discussed.
Adolescent↗
Changes in antiepileptic drug prescribing patterns in large institutions: preliminary results of a five-year experience.
Routine antiepileptic prescriptions were analyzed for stable cohorts from two large, state-run, Accreditation Council-certified ICFs/MR for the time period October 1, 1987, to April 1, 1992. Results indicated marked decrease in numbers of individuals receiving (a) more than two antiepileptic drugs concurrently and (b) barbiturates. Retrospective analyses revealed that (a) over 90% of a group undergoing barbiturate taper maintained the same or improved seizure control and (b) some adults undergoing barbiturate tapers improved in target behaviors. Findings indicate the feasibility of changing antiepileptic regimens utilizing individual case evaluation and treatment and suggest the importance of considering possible psychological and behavioral disturbances associated with barbiturate therapy for adults and children.
Adolescent↗
Staff perceptions of reinforcer responsiveness and aberrant behaviors in people with mental retardation.
Perceptions by staff of the classes of reinforcers and aberrant behaviors of a sample of 470 people with predominantly severe or profound mental retardation were explored. Principal components analysis of a 45-item survey suggested eight classes of reinforcers: consumable, verbal-speaker, visual-motor, social, physical-contact, passive-observer, play, and academic reinforcers. Stepwise multiple regression was used to predict five classes of maladaptive behaviors as measured by the Aberrant Behavior Checklist (irritability, lethargy, stereotypy, hyperactivity, and inappropriate speech) from the eight classes of reinforcers. Each class of psychopathology was related to a unique set of predictors. All classes of psychopathology could be predicted by staff perceptions of underresponsiveness to social reinforcers and overresponsiveness to consumable reinforcers. The findings of organized structures of reinforcers and their covariation with pathological behaviors have implications for research and intervention as well as theoretical value in defining aberrant behaviors in people with mental retardation.
Adolescent↗
Factor structure of the Motivation Assessment Scale for persons with mental retardation.
The rating scale used to assess the motivators of maladaptive behaviors in persons with mental retardation was the Motivation Assessment Scale. In the current study, we validated the factor structure of the scale on a sample of 118 subjects with predominately severe or profound mental retardation. They exhibited deviant behaviors such as self-injurious and tantrum behavior, aggression, and passivity. The results of the factor analysis with varimax rotation validated the assumptions of the developers of the scale that the motivators could be grouped into sensory, escape, attention, and tangible reinforcers. These four subscales are easily interpretable and should continue to provide valuable information.
Adult↗
Cross-validation of the factor structure of the Aberrant Behavior Checklist for persons with mental retardation.
The original factor structure of the Aberrant Behavior Checklist was cross-validated with an American sample of 470 persons with moderate to profound mental retardation, including nonambulatory individuals. The results of the factor analysis with varimax rotation essentially replicated previous findings, suggesting that the original five factors (Irritability, Lethargy, Stereotypic Behavior, Hyperactivity, and Inappropriate Speech) could be cross-validated by factor loadings of individual items. The original five scales continue to show high internal consistency. These factors are easily interpretable and should continue to provide valuable research and clinical information.
Adult↗
Hypogonadotropic hypogonadism in mentally retarded adults with microphthalmia and clinical anophthalmia.
Five of 13 patients with microphthalmia or clinical anophthalmia studied in an institution of 650 mentally retarded adults had hypogonadotropic hypogonadism. Four males had low testosterone levels and sexual infantilism, manifesting as micropenis with small testes or cryptorchidism. One female had primary amenorrhea. All 5 patients had low gonadotropin levels, confirming a hypothalamic or pituitary basis for their hypogonadism. Thyroxin, thyroid stimulating hormone, prolactin, and A.M. cortisol were also measured and were normal. All patients with hypogonadotropic hypogonadism were chromosomally normal and had variable central nervous system defects, suggesting that they comprise a heterogeneous group of disorders. Microphthalmia or anophthalmia in a mentally retarded patient is associated with hypogonadotropic hypogonadism.
Abnormalities, Multiple↗
Psychotropic drug patterns in a large ICF/MR facility: a ten-year experience.
Psychotropic drug-prescribing patterns for a stable cohort of 474 persons in continuous residence at an ICF/MR facility for a 10-year period were recorded and classified by drug type. Results indicated a progressive, marked decrease in total psychotropic drug usage and changes in the type of drugs prescribed. The findings indicate the importance of physician awareness of drug side-effects and alternate treatment possibilities.
Adolescent↗
Platelet satellitism: experimental studies.
Platelet satellitism (PS), the in vitro phenomenon of platelets rosetting about nonlymphocytic leukocytes, is an uncommon and poorly understood finding reported in the ethylenediaminetetra-acetic acid (EDTA)-anticoagulated blood of patients with a wide variety of clinical conditions. This report presents experimental studies investigating the nature of this phenomenon by utilizing the blood of patients with platelet satellitism. Wet preparation studies and electron microscopy (transmission and scanning) demonstrated the morphologic sequences involved in the phenomenon, including eventual phagocytosis of platelets by neutrophils. The results of varying conditions such as time, temperature, and anticoagulant are described. All of five patients tested were found to have cryofibrinogenemia. Certain blood components from all of three patients tested were capable of inducing PS in normal whole blood, whereas components from normal subjects usually were not. In one patient (A), the PS-inducing capability appeared to be present in both plasma and platelets. In another patient (B) the PS-inducing capability was present in platelets (in both 1966 and 1975) and also in the cryosupernate of serum and plasma; among various antisera, antifibrinogen had the greatest ability to reduce the degree of PS in patient blood; addition of moderate amounts of CaCl2 and/or MgCl2 did not diminish the phenomenon; and two sisters and two daughters demonstrated no PS. In a third patient (C) the PS-inducing capability appeared to be largely concentrated in the cryoprecipitable fraction of plasma. These studies suggest that there are different factors in the patients' blood resulting in PS. Further studies showed PS could be induced in normal blood by adding certain nonprimate antihuman antisera (anti-IgM, antialbumin or antifibrinogen) and also by adding some preparations of normal washed platelets to the same individuals's normal whole blood. This indicates that the phenomenon of PS can be produced by factors other than those specifically present in patients with PS. Antigen-antibody complexes, either formed in vivo (mixed cryoglobulinemia) or in vitro, did not result in PS when mixed with normal blood. These and other studies suggest that PS can result from the presence of several different factors, usually proteins (in conjunction with EDTA), which probably attach to the surface of platelets apparently resulting in some alteration (such as change in surface charge) causing the platelets to be attracted to and phagocytosed by neutrophils.
Blood Platelet Disorders↗
Detection of unsuspected hemoglobin S by reticulocyte stain.
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Anemia, Sickle Cell↗
Aggression and psychopathology in persons with severe or profound mental retardation.
We examined aggression and psychopathology in persons with severe or profound mental retardation. Most aggressive episodes were directed toward other clients, and ratings of aggression were positively correlated with self-injury, stereotypic behavior, and being ambulatory. In a linear regression analysis of psychopathological correlates, aggression was most consistently predicted by dependent personality and psychosis. To better describe the construct of aggression, we also developed an Aggression-psychopathology scale. Persons with mental retardation and aggression were more likely to be impulsive, attention-seeking, dependent, socially inadequate, and anxious. Intensive efforts to modify the psychopathological correlates of aggression may improve treatment planning and outcome.
Adolescent↗