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Biomedical subjects

H Van Engeland

Publications and source records attributed to H Van Engeland.

14 recordsLinked to original sources

Unresponsiveness to psychosocial stress in a subgroup of autistic-like children, multiple complex developmental disorder.

In this study, we tried to replicate the finding of a diminished cortisol response to stress in autistic-like patients in a more homogenous Multiple Complex Developmental Disorder (MCDD) group. MCDD forms a distinct group within the autistic-like disorders, characterized by impaired regulation of anxiety and affective state, impaired social behavior/sensitivity, and thought disorder. A number of MCDD children develop schizophrenia in adult life. Responses to a psychosocial stressor, consisting of speaking in public while recorded on video, were measured in 10 MCDD children and 12 healthy control children. The public speaking test was imbedded in a two-hour test session, and compared to a control test session. Hypothalamic-pituitary-adrenal (HPA) responses were measured on salivary cortisol at about 20-minute intervals. Heart rate was measured continuously. Delta AUC's were computed for both heart rate (dAUCHR) and salivary cortisol (dAUCCORT), as a measure of response to the test.The public speaking task resulted in significant responses in heart rate and salivary cortisol in healthy control children, but not in MCDD children. dAUCHR was 3.28+/-2.37 in healthy control children, but -0.09+/-1.73 in MCDD children (t=3.31, P<0.01). dAUCCORT was 3.22+/-3.16 in healthy control children, but 0. 17+/-1.74 in MCDD children (t=2.72, P<0.05).The impaired responses to psychosocial stress found in MCDD children may be the result of their limited abilities to react adequately to their (social) environment. The same impairment in stress processing has been found in schizophrenia, and might be a factor in the vulnerability of these MCDD children to develop schizophrenia.

Adrenal Glands↗

Visual sustained attention in a child psychiatric population.

OBJECTIVE: To increase knowledge of the diversity and specificity of sustained attention deficits in children with attention-deficit hyperactivity disorder (ADHD), with special reference to the issue of distinguishing between children with ADHD and children with other psychiatric diagnoses. METHOD: A visual sustained attention task was used to compare 52 boys with ADHD with 55 normal controls, 29 boys with oppositional defiant disorder or conduct disorder (ODD/CD), 29 boys with anxiety or dysthymia (ANX/DYS), 43 boys with pervasive developmental disorder, 24 boys with ADHD plus ODD/CD, and 14 boys with ADHD plus ANX/DYS. RESULTS: Compared with normal controls, children with ADHD were slower, were more inaccurate, were more impulsive, were less responsive to feedback, and showed less perceptual sensitivity and stability of performance, resulting in a marked decrease in vigilance over time. Unresponsiveness to feedback and the extent of the decrease in vigilance during time on task were found to be the only factors that distinguished children with ADHD from children with other diagnoses. CONCLUSION: Although only children with ADHD are characterized primarily by "attention deficit," sustained attention deficit is common to a certain extent to all children with psychiatric disorders.

Anxiety↗

Attentional capacity, a probe ERP study: differences between children with attention-deficit hyperactivity disorder and normal control children and effects of methylphenidate.

In the present study it was investigated whether the smaller P3s in attention-deficit hyperactivity disorder (ADHD) children are caused by a shortage of capacity underlying P3 processes or whether they are due to a capacity allocation problem. Also, effects of methylphenidate on these processes were investigated. Performance and event-related potentials (ERPs) of 14 ADHD and 14 control children were measured using an irrelevant-probe technique. Three types of task irrelevant visual probes (standards, deviants, and novels) were presented against the background of two visual tasks that varied in task difficulty. The parietal P3 wave was measured in response to task stimuli and probes. ADHD subjects made significantly fewer correct detections than normal controls in both the easy and the hard tasks. Controls showed an enhanced P3 to task-relevant stimuli in the hard task, whereas ADHD children did not. Probe (novel) P3 amplitudes decreased from the easy to the hard task to the same extent in both groups. Methylphenidate enhanced the percentage of correct responses and task P3 amplitudes in both the easy and the hard task but probe P3 amplitudes were not influenced by methylphenidate. It was concluded that ADHD children do not suffer from a shortage in attentional capacity; rather, the evidence is in favor of a problem with capacity allocation. Furthermore, methylphenidate had enhancing effects on performance and ERPs, but did not improve the capacity-allocation deficit.

Adolescent↗

Deficient social problem-solving in boys with ODD/CD, with ADHD, and with both disorders.

OBJECTIVE: To study social problem-solving skills in psychiatrically defined aggressive boys, starting from Dodge's social information-processing model. METHOD: Videotaped stimuli of problematic social situations and questions were presented to elicit responses that indicate boys' social problem-solving skills (encoding and interpretation of social cues, generation of possible responses, evaluation of responses, self-efficacy evaluation, and response selection). Boys aged 7 to 12 years with oppositional defiant or conduct disorder (ODD/CD) (n = 48), attention-deficit hyperactivity disorder (ADHD) (n = 27), and both disorders (ODD/CD + ADHD) (n = 29) were involved as well as a normal control group (n = 37) and a psychiatric control group with internalizing disorders (n = 23). RESULTS: When compared with normal controls, boys with ADHD, with ODD/CD, and with ODD/CD + ADHD encoded fewer social cues and generated fewer responses. Boys with ODD/CD and with ODD/CD + ADHD moreover were more confident in their ability to enact an aggressive response than normal controls. When ODD/CD boys and ODD/CD + ADHD boys were given the opportunity to select a response from various types of responses shown, they selected an aggressive response more often than normal controls. Thus, in ADHD boys social problem-solving was affected only in encoding and in the generation of responses, whereas in ODD/CD and ODD/CD + ADHD boys social problem-solving was affected throughout the process. CONCLUSION: For the further study of social problem-solving in aggressive children, it is essential to differentiate between children with ADHD and children with ODD/CD and ODD/CD + ADHD.

Aggression↗

Perceptual and response interference in children with attention-deficit hyperactivity disorder, and the effects of methylphenidate.

Fourteen children with attention-deficit hyperactivity disorder (ADHD) and 14 normal control children were compared with respect to stimulus- and response-related processes. Subjects with ADHD took part in two additional sessions under methylphenidate or placebo. In both experiments, performance and electrophysiological measures such as the P2, N2, and P3 components of event-related potential and electromyogram (EMG) activity were measured during an Eriksen flanker task. In both groups of children, reaction times (RTs) to arrow stimuli incongruent with the target were longer than those to neutral stimuli (response interference), which were again slower than RTs to target-alone stimuli (perceptual interference). Children with ADHD made more errors to incongruent stimuli and showed more response interference. For correct responses, no differences between the groups in response interference effects on reaction time, P2, N2, and P3 latency, or EMG onset were found. Methylphenidate had a general enhancing effect on accuracy but did not specifically reduce interference from the flanking stimuli. Methylphenidate had no effects on RT, N2 and P2 latency, P3 amplitude or latency, or EMG activity. The conclusion that methylphenidate did not influence response processes contrasts sharply with findings reported by authors using the Sternberg memory search task.

Adolescent↗

Empirically based subgrouping of eating disorders in adolescents: a longitudinal perspective.

BACKGROUND: Successive DSM versions struggle with the heterogeneity of the eating disorders. Criteria were mainly based on clinical impressions and on descriptive and inferential studies. METHOD: In a study of 55 eating-disordered adolescents, we investigated whether patients could be grouped on an empirical basis, using principal components analysis (PCA) with optimal scoring (scaling), i.e. PCA with no a priori assumptions. Clustering was based on Morgan-Russell subscales, each measured four times over the course of illness. RESULTS: Contrary to DSM-IV criteria, patients did not cluster primarily on the basis of anorectic symptoms; the occurrence of bulimic symptoms was more dominant. Core symptomatology (preoccupation with food, disturbed body perception and inadequate sexual behaviour) did not differ between patients, either at referral or over time. CONCLUSIONS: These results support the spectrum hypothesis of the eating disorders, which considers them as one syndrome with different manifestations.

Adolescent↗

Plasma beta-endorphin concentrations in people with learning disability and self-injurious and/or autistic behaviour.

BACKGROUND: It has been suggested that the key variable in reduced plasma immunoreactive beta-endorphin concentrations in autistic subjects may be concomitant self-injurious behaviour. METHOD: We studied morning levels of plasma beta-endorphin in 33 learning disabled people with self-injurious and/or autistic behaviour. RESULTS: The beta-endorphin level of the subjects with severe self-injurious behaviour proved to be significantly lower than of autistic subjects without severe self-injurious behaviour (3.6 (1.4) pmol/l v. 5.8 (4.3) pmol/l; t-test: P = 0.045. Replication: 3.7 (1.1) pmol/l v. 5.7 (3.8) pmol/l; t-test: P = 0.043). Individuals with mild and occasional self-injurious behaviour were found to have beta-endorphin levels comparable to those without self-injurious behaviour. Further, subjects being treated with neuroleptics and lower beta-endorphin levels than untreated subjects. CONCLUSIONS: These results stress that in any study of opioid systems of learning disabled people, it is very important to differentiate between people with and without severe self-injurious behaviour. The results support the idea that severe self-injurious behaviour may be related to functional disturbances in the endogenous opioid system.

Adult↗

Behavior of conduct disordered children in interaction with each other and with normal peers.

This study investigated the behavior of children with conduct disorder or oppositional defiant disorder (CD/ODD) in interaction with each other and with normal control (NC) children in a semi-standardized setting over a period of 25 minutes. This short time turned out to be sufficient to demonstrate the behavioral manifestations of CD/ODD in children's interactions with peers. In addition, the role of the interactional partner on antisocial behaviour of CD/ODD children became apparent.

Aggression↗

Differences between conduct disordered and normal control children in their tendencies to escalate or neutralize conflicts when interacting with normal peers.

The behavior of conduct disordered (CD) children was compared with normal control (NC) children in interaction with normal peers. Dyads consisting of a) a CD child and a normal peer and b) an NC child and the same normal peer as in a) were observed. CD boys were less able than NC boys to neutralize incipient conflicts. Hitherto most behavioral studies of CD boys have concentrated on their tendency to escalate conflicts but have paid very little attention to their difficulty in neutralizing conflicts.

Aggression↗

A controlled multivariate chart review of multiple complex developmental disorder.

OBJECTIVE: The primary aim of the study was to ascertain the usefulness and the validity of the set of criteria proposed to define a subgroup within the DSM-III-R category of pervasive developmental disorder-not otherwise specified under the name of multiple complex developmental disorder (MCDD). METHOD: A multivariate analysis (cluster and principal-components analysis) was performed on the characteristics, reliably extracted from the charts of 105 children with MCDD, 32 with autistic disorder, 51 with externalizing disorders, and 56 with internalizing disorders, all with an IQ greater than 70, fully assessed in our department between 1984 and 1991. RESULTS: The main finding was a strong correspondence between the classification of the cases by DSM-III-R categories and the subdivision by means of a multivariate cluster analysis. The cluster analysis did not discriminate between children with emotional and disruptive disorders. Furthermore, children with MCDD and autistic disorder were significantly different both on symptom factors ("psychotic thinking/anxiety," "aggression," "deficient interaction/communication," "stereotyped and rigid behavior," and "suspiciousness/odd interaction") and on factors that reflected developmental and environmental background variables. CONCLUSION: The results of this study add to the nosology of autistic spectrum disorders and lend additional support to the need for a separate subcategory of MCDD within DSM-V. Further corroboration of these results in independent (multicenter) samples will be required.

Autistic Disorder↗

Visual and somatosensory event-related brain potentials in autistic children and three different control groups.

Event-related potentials (ERPs) to visual and somatosensory stimuli, generated during an oddball task, were obtained in a group of autistic children and 3 control groups (normal, attention-deficit, and dyslectic children, respectively). The task included the presentation of standard, deviant, and novel stimuli and had a (between-group) passive vs. active (counting) condition. Research questions were whether (a) autistic children differ from other children with respect to the processing of visual and/or somatosensory stimuli, as measured in the amplitude of the N1, mismatch activity, and P3, (b) autistic children specifically have problems in the processing of distal (visual) stimuli, compared to the processing of proximal (somatosensory) stimuli, and (c) autistic children have an atypical lateralization pattern of ERP activity. Only in the autistic group a task effect on the visual P2N2 (mismatch activity) and larger P3s to novels than to deviants were found, in both the visual and the somatosensory modality. There also was a smaller occipital P3 to visual standard stimuli in the passive condition in the autistic group than in 2 control groups. We concluded that autistics (a) differ from several other groups of children with respect to the visual P2N2 and the visual and somatosensory P3, (b) show abnormalities in the processing of both proximal and distal stimuli, and (c) show no indication of abnormal lateralization of ERPs.

Adolescent↗