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B E Collins

Publications and source records attributed to B E Collins.

5 recordsLinked to original sources

Double-blind and triple-blind assessments of medication and placebo responses in hyperactive children.

Hyperactive boys taking psychostimulant medication were studied using a randomized, placebo-controlled, crossover design. Behavior ratings and medication guesstimates were obtained for the boys when they were given methylphenidate (Ritalin) and when they were given a placebo. The ratings showed positive medication-related changes, and the guesses, done by independent judges, were significantly better than chance. The pattern of ratings for double-blind and triple-blind raters was identical. These results imply that positive psychostimulant effects are not attributable to rater sensitization or expectancy. The medication-placebo differences were highly reliable for the group comparisons and were in the predicted direction for 21 of 22 individuals, but the magnitude of the change for many individuals was not dramatic. Implications for child psychopharmacology research and differences between clinical and experimental significance are discussed.

Child

Peer interaction in a structured communication task: comparisons of normal and hyperactive boys and of methylphenidate (Ritalin) and placebo effects.

Peer communication patterns were assessed as school-aged boys participated in a dyadic referential communication task. The responses of comparison boys were compared to those of hyperactive boys on methylphenidate (Ritalin) and on placebo in a double-blind crossover design. 2 separate systems for assessing communication were developed, a qualitative system designed to capture the "flavor" of interaction and a quantitative system focused on specific types of communicative content. Task products and completion times were also scored. The results suggest that hyperactive children, regardless of medication status, are less likely than comparison peers to (a) modulate ongoing or habitual behavior patterns in response to externally imposed shifts in role-appropriate behaviors; (b) maintain consistent, uninterrupted goal orientation; and (c) respond to subtle social learning opportunities. In this situation, methylphenidate appeared to have a greater impact on behavioral style than on competence, decreasing perceived intensity without influencing efficiency. A mild medication-induced dysphoria was also documented. Directions for future research and the need for caution in clinical interpretation are discussed.

Affect

A social ecology of hyperactive boys: medication effects in structured classroom environments.

Hyperactive boys on methylphenidate (Ritalin), hyperactive boys on placebo, and comparison boys were observed in quasi-naturalistic classroom settings. Ambient stimulation (quiet versus noisy conditions) and source of regulation (self-paced versus other-paced activities) were varied in a 2 x 2 design. Compared to their peers, hyperactive boys on placebo showed lower rates of task attention and higher rates of gross motor movement, regular and negative verbalization, noise-making, physical contact, social initiation, disruption, and acts that were perceived as energetic, inappropriate, or unexpected. Self-paced activities resulted in increased rates of verbalization, social initiation, and high-energy episodes. High ambient noise levels reduced task attention and increased the rates of many other behaviors including verbalization, physical contact, gross motor movement, and high-energy acts. Medication-by-situation interactions emerged for both classroom dimensions, with hyperactive boys on placebo being readily distinguishable from their peers under some classroom conditions and indistinguishable under other conditions. Moderate relationships were found between teacher ratings and many individual behavior categories. Discussion focused on (a) the merits and limitations of a social ecological research perspective, and (b) the implications of these findings for the design of intervention strategies.

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