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Biomedical subjects

C R Ellis

Publications and source records attributed to C R Ellis.

13 recordsLinked to original sources
PubMed1996

Professionals' perceptions of psychotropic medication in residential facilities for individuals with mental retardation.

Professional staff in four state facilities for individuals with mental retardation were surveyed to determine their perceptions, knowledge and opinions regarding the use of psychotropic medication. A large majority of the 377 respondents indicated that the physicians in their facilities were primarily responsible for medication-related decisions. Under ideal conditions, however, all professional staff and parents were seen as having a greater influence in the decision-making process. Aggression, delusions and hallucinations, self-injury, other psychiatric disorders, and anxiety were rated as disorders most likely to result in medication therapy. Behaviour modification was viewed as a suitable alternative to drug treatment for acting out and aggression. The professionals indicated that behavioural observation was the most influential assessment technique in current usage, followed by global impressions and informal diaries. Over 80% of the respondents perceived their preservice and inservice training on issues related to the use of psychotropic medication to treat behaviour problems as inadequate, with 96% of them desiring continuing education. These findings were compared to data from similar studies of populations with other disabilities, and suggestions for modifications in the current decision-making processes related to the use of psychotropic medication in institutionalized individuals with mental retardation are discussed.

Adolescent↗
PubMed1994

Clinical effects of buspirone on intractable self-injury in adults with mental retardation.

OBJECTIVE: The efficacy of buspirone in controlling self-injurious behavior was examined in five individuals with mental retardation. Buspirone was used alone in two individuals and as an adjunct to thioridazine in the other three. METHOD: Standard behavioral observation methods were used to collect data on the number of self-injurious responses of the individuals during baseline and several doses of buspirone in an open trial. RESULTS: When compared with baseline levels, all five individuals showed some response to buspirone, with reductions in self-injury ranging from 13% to 72%, depending on the dose. The most effective dose of buspirone was 30 mg/day for three individuals and 52.5 mg/day for the other two. These individuals were maintained for 6 to 33 weeks on their most effective dose. Coexistent symptoms of anxiety did not predict a favorable response to buspirone therapy. CONCLUSIONS: Buspirone showed a mixed but generally favorable response in controlling intractable self-injury in this and four previous studies reporting similar cases. However, the drug should not be endorsed as a proved treatment for self-injury until similar results have been obtained from well-controlled studies of its efficacy.

Adult↗
PubMed1993

Fluoxetine treatment of severe self-injury in young adults with mental retardation.

Dysfunction of the serotonergic system has been implicated in the development and maintenance of self-injury in some persons with mental retardation. Several preliminary reports have suggested that fluoxetine, a drug that blocks the reuptake of serotonin, may decrease self-injury in these individuals. Of the 44 cases of self-injury treated with fluoxetine and previously reported in the literature, 42 demonstrated a beneficial response to the drug. We report four additional cases of adults with mental retardation whose self-injury was treated with fluoxetine. Each of these individuals benefited from fluoxetine to some extent, with average decreases in self-injury ranging from 20% to 88% when compared with baseline levels. These findings, combined with those from previously published case studies, emphasize the need for well-controlled studies to more adequately assess the effects of fluoxetine on self-injury.

Adult↗
PubMed1993

Factor structure of the Motivation Assessment Scale.

The Motivation Assessment Scale (MAS) was developed to provide clinical information on four hypothesized functions that may control problem behaviour in persons with developmental disabilities. The original four-factor structure of the MAS was based on face validity, with the items being grouped in terms of each of the hypothesized functions. Validation of the scale was provided in terms of correlations between teacher ratings of eight children on the MAS and ranking of the controlling variables from functional analogue tests. In this study, staff in residential facilities rated 60 residents and teachers in schools rated 96 students on the MAS. The target behaviour rated for both samples was self-injury, with the institutional sample engaging in the behaviour more than 15 times an hour and the school sample, less than 15 times an hour. The results of factor analyses, with varimax rotation, provided a conceptually meaningful factor structure with the institutional sample, but not with the school sample. The 16 MAS items resolved into four factors that were conceptually related to four conditions that may maintain problem behaviour (i.e. sensory, escape, attention and tangible). The results suggested that the original MAS has a robust factor structure and may be clinically useful in predicting the controlling functions of problem behaviours, if the target behaviours occur at a rate no less than 15 responses per hour.

Adult↗
PubMed1993

Self-mutilation.

Explore the source record for details and available documents.

Behavior Therapy↗
PubMed1992

Chronobiological aspects of epileptic phenomena: a literature review, implications for nursing and suggestions for research.

Every physiologic and psychologic variable studied heretofore demonstrates rhythmic fluctuations. Chronobiology is the field of study which examines these fluctuations. Chronobiology is highly significant to nursing practice, since human responses are affected by these rhythmic fluctuations. A review of the literature produced little information on epilepsy chronobiology. The status of research in epilepsy chronobiology remains at the basic science level. Continued research is a priority before nursing can use epilepsy chronobiology knowledge in the clinical setting.

Chronobiology Phenomena↗
PubMed1992

Recognition of facial expressions of emotion by persons with mental retardation. A matched comparison study.

Children and adults with mental retardation were tested on their ability to recognize facial expressions of emotion. The sample consisted of 80 children and adults with mental retardation and a control group of 80 nonhandicapped children matched on mental age and gender. Ekman and Friesen's normed photographs of the six basic emotions (anger, disgust, fear, happiness, sadness, and surprise) were used in a recognition task of facial expressions. Subjects were individually read two-sentence stories identifying a specific emotion, presented with a randomized array of the six photographs of the basic facial expressions of emotion, and then asked to select the photograph that depicted the emotion identified in the story. This procedure was repeated with 24 different stories, with each of the six basic emotions being represented four times. Results showed that, as a group, individuals with mental retardation were not as proficient as their mental-age-matched nonhandicapped control subjects at recognizing facial expressions of emotion. Although adults with mild mental retardation were more proficient at this task than those with moderate mental retardation, this finding was not true for children. There was a modest difference between the children with moderate mental retardation and their nonhandicapped matched controls in their ability to recognize facial expression of disgust.

Adolescent↗
PubMed1992

Enhancing the ability of adults with mental retardation to recognize facial expressions of emotion.

The ability to recognize accurately and respond appropriately to facial expressions of emotion is essential for interpersonal interaction. Individuals with mental retardation typically are deficient in these skills. The ability of 7 adults, 1 with severe and 6 with moderate mental retardation, to recognize facial expressions of emotion correctly was assessed. Then, they were taught this skill using a combination of a discrimination training procedure for differentiating facial movements, directed rehearsal, and Ekman and Friesen's "flashing photograph" technique. Their average increase in accuracy over baseline was at least 30% during the course of the training and over 50% during the last 5 days of the training phase. Further, these individuals were able to generalize their skills from posed photographs to videotaped role plays and were able to maintain their enhanced skills during the 8 to 9 months following the termination of training. This is the first study to show that individuals with mental retardation can be taught skills that enhance their ability to recognize facial expressions of emotion.

Adult↗
PubMed1991

Assessment and diagnosis of mental illness in persons with mental retardation. Methods and measures.

The assessment and diagnosis of psychiatric disorders in individuals with mental retardation has been a neglected area of research. However, current research indicates that these individuals suffer from the same range of psychiatric disorders that is evident in those who are not mentally retarded. A model of assessment and diagnosis of mental illness in this population is presented that incorporates psychiatric as well as behavioral methods. The emphasis is on the comprehensive assessment of an individual's behavior, based on family history, self and informant clinical interviews, rating scales, direct observations, and an experimental analysis of the target behaviors. The model provides the basis for making differential diagnoses in terms of related psychiatric disorders and between psychiatric disorders and behavior problems. Depression and schizophrenia are used as illustrative disorders to describe the application of this model. Given the paucity of literature on the assessment and diagnosis of mental illness in individuals with mental retardation, a number of suggestions are made regarding future research and refinement of the model.

Adult↗
PubMedDate not supplied

Effects of thioridazine and visual screening on stereotypy and social behavior in individuals with mental retardation.

Thioridazine and visual screening procedures are effective in reducing the stereotypic behaviors of individuals with mental retardation. A double-blind, placebo-controlled study, using alternating treatments within a multiple-baseline across subjects design, was conducted to assess the effects of two doses of thioridazine (1.25 and 2.5 mg/kg/day) and visual screening, alone and combined, on stereotypy and social behavior of three individuals with profound mental retardation. Functional analyses did not show demand, alone, social attention, or differential reinforcement conditions to maintain the subjects' stereotypy. Thioridazine was effective in producing modest reductions in stereotypy and minor increases in social behavior across subjects. The higher dose of thioridazine (2.5 mg/kg/day) was slightly more effective than the lower dose (1.25 mg/kg/day), and thioridazine plus visual screening was more effective than thioridazine alone. The most effective treatment was visual screening when used in the absence of thioridazine. This study demonstrates a method for assessing the impact of psychopharmacological and behavioral interventions in individuals for whom a behavioral treatment cannot be easily derived from a functional analysis of the maintaining conditions of the target behavior.

Adolescent↗