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Biomedical subjects

Herman van Engeland

Publications and source records attributed to Herman van Engeland.

At least 37 records · Page 2Linked to original sources
PubMed2005

Dose-related effect of methylphenidate on stopping and changing in children with attention-deficit/hyperactivity disorder.

PURPOSE: The effect of methylphenidate (MPH) on inhibitory control as assessed by the stop task in children with attention-deficit/hyperactivity disorder (ADHD) could be influenced by task difficulty and may be mediated by attention. SUBJECTS AND METHODS: Fifteen children with ADHD performed the stop and the change task after placebo, 0.5 and 1.0 mg/kg MPH in a within-subject design. RESULTS: Linear-trend analysis showed a similar effect of MPH in both tasks and a stronger effect for inhibitory control than for attention. Furthermore, a correlation was found between blood serum metabolites of norepinephrine and dopamine for attentional measures and inhibitory control measures, respectively. DISCUSSION AND CONCLUSION: In children with ADHD MPH could act primarily on inhibitory control, and is not influenced by task difficulty. Also, attention and inhibitory control could have differential pharmacological profiles.

Adolescent↗
PubMed2005

Adolescent anorexia nervosa patients have a discrepancy between neurophysiological responses and self-reported emotional arousal to psychosocial stress.

In both clinical practice and research, eating disorder patients are reported to have difficulties in identifying and describing their feelings. They are often described as being unaware of the linkage between their feelings and their behavior. The present study experimentally induced emotions in adolescent anorexia nervosa (AN) patients to examine both self-reported emotional arousal and neurophysiological responses. A group of 10 AN patients and a group of 22 healthy controls (HC) were compared with respect to changes in self-reported emotional arousal and neurophysiological responses, heart rate (HR) and HPA-axis response (cortisol in saliva) during a public speaking test inducing anxious stress. The AN group reported higher levels of anxiety, as a result of stress, but this was not reflected in their HR or cortisol response. By contrast, in the HC group higher levels of self-reported anxiety coincided with clear increases in HR and cortisol. The data indicate that AN patients, in contrast to healthy individuals, show a discordance between self-reported emotional and neurophysiological arousal during psychosocial stress.

Adolescent↗
PubMed2005

Reactive and proactive aggression in children--a review of theory, findings and the relevance for child and adolescent psychiatry.

The clinical population of aggressive children diagnosed as having an oppositional defiant disorder (ODD) or a conduct disorder (CD) is heterogeneous, both with respect to behaviour and aetiology. Recently, the following distinction has been proposed that might further clarify this heterogeneity: reactive aggression is an aggressive response to a perceived threat or provocation, whereas proactive aggression is defined as behaviour that anticipates a reward. In this article we examine various aspects of this distinction. We will [1] examine the evidence that reactive and proactive aggression are distinct phenomena by discussing the theories underlying the distinction between the subtypes in humans and we briefly review evidence for a similar distinction in animals; [2] we critically review the literature on the measurement in children via questionnaires and behavioural observations; we then point out that the correlation observed between the subtypes is due to the fact that many children show both types of aggression; [3] we review the literature on specific characteristics of the subtypes giving attention to social information processing, peer status, biological correlates and developmental history, and demonstrate that there is some evidence to suggest that reactive and proactive aggression are distinct dimensions; [4] we discuss the relevance of the distinction between reactive and proactive aggression for child and adolescent psychiatry.

Adolescent↗
PubMed2005

Prediction of adolescent outcome in children with disruptive behaviour disorders--a study of neurobiological, psychological and family factors.

In this preliminary study we explored the predictive influence of various family, psychological, demographic, and neurobiological characteristics on the persistence of antisocial behaviour in adolescence. Existing data were combined with case-records in a sample of 47 disruptive behaviour disordered (DBD) children who had been treated in in-patient and/or day-treatment units when they were between seven to 12 years old. Parent-rated and self-rated externalizing problem scores and the presence of a DBD diagnosis served as the outcome measures in adolescence. We used linear regression analyses to examine the predictors of adolescent outcome. A lower basal skin conductance level (SCL) was repeatedly found to predict poor adolescent outcome, either when rated by parents or by participants themselves. In addition, comorbid attention-deficit hyperactivity disorder, one aspect of performance on the door-opening task, and a mother of low socioeconomic status also predicted that a child would have more antisocial problems in adolescence, depending on the type of outcome measure. Results of this study support the fearlessness theory, according to which low activity of the autonomous nervous system, as manifested by low SCL, is related to the effectiveness of socializing punishment and accordingly to poor socialization and adolescent outcome.

Adolescent↗
PubMed2005

Variability in spatial normalization of pediatric and adult brain images.

OBJECTIVE: Normalization of brain images is a necessity for group comparisons of source analyses based on realistic head models. In this paper we compared the outcome of a linear registration method for brain images of psychiatric and control groups of different ages in order to assess the relative adequacy of normalization in such diverse groups. METHODS: Magnetic Resonance images (MRI) of the brains of pediatric and adolescent subjects (mean ages 19 and 10.5 years) with a pervasive developmental disorder (PDD) and their healthy controls were included. A simple voxel-wise test of the group variances in image intensities was performed to evaluate regional differences in registration quality. Dipole analysis of visual P1 was performed to establish whether source locations were comparable across groups. RESULTS: Significant differences between pediatric groups were found in white matter and thalamic regions of the brain. For all other group-wise comparisons, differences were confined to skull and neck regions. Dipole locations were found to be more anteriorly located in the adolescent groups. CONCLUSIONS: The normalization procedure used in this paper is based on a brain template of normal adult brains from a restricted age group, and the results show that the use of this method in pediatric groups is less adequate. The method seems suitable for use in psychiatric groups. Also, the generators of visual P1 in PDD patients were found to be comparable to controls. SIGNIFICANCE: The results suggest that this existing normalization method can be used in diverse populations, but is less suitable for pediatric images.

Adolescent↗
PubMed2005

A meta-analytic review of stopping performance in attention-deficit/hyperactivity disorder: deficient inhibitory motor control?

This review discusses whether deficient inhibitory motor control is the core deficit of attention-deficit/hyperactivity disorder (ADHD). Inhibitory motor control is commonly assessed using the stop-signal paradigm. Since the last meta-analysis that was performed, 33 new studies have appeared. The current meta-analysis revealed a significant difference between ADHD patients and matched controls in stop latency (stop-signal reaction time) in both children and adults. Basic reaction time was significantly longer in children with ADHD, but not in adults, and there was a significant interaction between the elongation of the latency to stop and to respond in adults, but not in children. Deficient inhibitory motor control may be less crucial in children than in adults with ADHD.

Adolescent↗
PubMed2005

A controlled study of formal thought disorder in children with autism and multiple complex developmental disorders.

UNLABELLED: Along with well-defined categories in classification systems (e.g., autistic disorders and attention-deficit/hyperactivity disorder (ADHD)), practitioners are confronted with many children showing mixed forms of developmental psychopathology. These clusters of symptoms are on the borderlines of more defined categories. The late Donald Cohen proposed heuristic criteria to study a group defined by impaired social sensitivity, impaired regulation of affect, and thinking disorders under the name multiple complex developmental disorders (MCDD). Although these children meet criteria for pervasive developmental disorder--not otherwise specified (PDD-NOS), they have additional important clinical features, such as thought disorder. After highlighting similarities and differences between MCDD and comparable groups (e.g., multidimensionally impaired children), this paper presents the findings of a study comparing formal thought disorder scores in children with MCDD to children with autism spectrum diagnoses, such as autistic disorder (AD), and to children with nonspectrum diagnoses, such as ADHD and anxiety disorders. METHODS: Videotaped speech samples of four groups of high-functioning, latency-aged children with MCDD, AD, ADHD, and anxiety disorders were compared to a control group of normal children using the Kiddie Formal Thought Disorder Rating Scale (K-FTDS). RESULTS: High formal thought disorder scores were found both in the AD and MCDD groups, low rates in the ADHD groups, and no thought disorder in the anxiety disorder and normal control groups. The severity of formal thought disorder was related to verbal IQ scores within the AD and MCDD groups. CONCLUSION: High formal thought scores in children with complex developmental disorders, such as AD and MCDD, appear to reflect impaired communication skills rather than early signs of psychosis.

Anxiety↗
PubMed2005

Long-term effects of risperidone in children with autism spectrum disorders: a placebo discontinuation study.

OBJECTIVE: The short-term benefit of risperidone in ameliorating severe disruptive behavior in pediatric patients with autism spectrum disorders is well established; however, only one placebo-controlled, long-term study of efficacy is available. METHOD: Thirty-six children with an autism spectrum disorder (5-17 years old) accompanied by severe tantrums, aggression, or self-injurious behavior, started 8-week open-label treatment with risperidone. Responders (n = 26) continued treatment for another 16 weeks, followed by a double-blind discontinuation (n = 24; two patients discontinued treatment because of weight gain) consisting of either 3 weeks of taper and 5 weeks of placebo only or continuing use of risperidone. Relapse was defined as a significant deterioration of symptoms based on clinical judgment and a parent questionnaire. RESULTS: Risperidone was superior to placebo in preventing relapse: this occurred in 3 of 12 patients continuing on risperidone versus 8 of 12 who switched to placebo (p = .049). Weight gain, increased appetite, anxiety, and fatigue were the most frequently reported side effects. CONCLUSIONS: This study indicates the effectiveness of risperidone during a period of several months, reducing disruptive behavior in about half of the children with autism spectrum disorders. The results provide a rationale for the continuing use of risperidone beyond 6 months, although considerable weight gain can limit the use of this agent.

Adolescent↗
PubMed2004

Neuropathological findings in autism.

Autism is currently viewed as a largely genetically determined neurodevelopmental disorder, although its underlying biological causes remain to be established. In this review, we examine the available neuropathological literature on autism and discuss the findings that have emerged. Classic neuropathological observations are rather consistent with respect to the limbic system (nine of 14 studied cases showed increased cell packing density and smaller neuronal size), the cerebellum (21 of 29 studied cases showed a decreased number of Purkinje cells, and in all of five cases that were examined for age-related morphological alterations, these changes were found in cerebellar nuclei and inferior olive) and the cerebral cortex (>50% of the studied cases showed features of cortical dysgenesis). However, all reported studies had to contend with the problem of small sample sizes, the use of quantification techniques not free of bias and assumptions, and high percentages of autistic subjects with comorbid mental retardation (at least 70%) or epilepsy (at least 40%). Furthermore, data from the limbic system and on age-related changes lack replication by independent groups. It is anticipated that future neuropathological studies hold great promise, especially as new techniques such as design-based stereology and gene expression are increasingly implemented and combined, larger samples are analysed, and younger subjects free of comorbidities are investigated.

Adolescent↗
PubMed2004

Emotional functioning in anorexia nervosa patients: adolescents compared to adults.

Studies concerning eating disorder patients have revealed the presence of alexithymia, depressive, and anxiety disorders. We compared these aspects of emotional functioning in two groups of anorexia nervosa (AN) patients: adolescents vs. adults. Forty-eight adolescent anorexia nervosa patients (ADO) and 23 adult anorexia nervosa patients (ADU) completed a battery of tasks and questionnaires to measure these different aspects of emotional functioning and to control for differences of a more general cognitive nature. Both groups showed marked resemblance; both had high alexithymia scores and performed worse on emotional tasks measuring aspects of alexithymia. Furthermore, both groups showed high percentages of depressive and anxiety disorders, with the ADU group scoring only higher on specific and social phobia than the ADO group. Adult and adolescent AN patient groups do not differ substantially with respect to emotional functioning.

Adolescent↗
PubMed2004

Emotional functioning in adolescent anorexia nervosa patients--a controlled study.

OBJECTIVE: In this study, emotional functioning of adolescent anorexia nervosa patients was compared with two control groups; another internalizing psychiatric outpatient group and a healthy control group. METHODS: Forty-eight anorexia nervosa patients (AN), 21 other psychiatric outpatients with depressive and/or anxiety disorders (PSYCH) and 48 healthy controls (HC) completed a battery of tasks and questionnaires designed to measure different aspects of emotional functioning. Cognitive (parallel) tasks were administered to control for differences of a cognitive nature. RESULTS: The AN and the PSYCH groups had clear deficits in emotional functioning compared to the HC group. Considering the data from the alexithymia questionnaire, it was the AN group who scored significantly worse on emotional functioning when compared to the HC group. Considering the data from the emotional tasks, both psychiatric groups performed worse than the HC group in their processing of visual emotional information and the PSYCH group had more difficulty in memorizing responses to auditory emotional stimuli than the AN and HC group. Furthermore, the PSYCH group processed auditory emotional information more slowly than the HC group. No differences between the three groups were found on the non-emotional, cognitive tasks. CONCLUSION: Both the AN and PSYCH patients show deficits in their processing of emotional information and details are discussed.

Adolescent↗
PubMed2004

Response perseveration and sensitivity to reward and punishment in boys with oppositional defiant disorder.

Response perseveration is the tendency to continue a response set for reward despite punishment. In the present study, response perseveration and sensitivity to reward and punishment were assessed in boys with oppositional defiant disorder (ODD). The study also examined the relation between punishment sensitivity and autonomic arousal. Nineteen ODD boys (mean age 9.8 years) and 20 normal control boys (NC) (mean age 9.7 years) were administered the door-opening task. In this task, the subject chooses either to open the next door or to stop playing; the opening of doors is initially rewarded and then increasingly punished. ODD boys opened more doors than NC boys. Following punishment, ODD boys took less time than NC boys before opening the next door, but did not differ from NC boys in time after reward. Mean skin conductance level was lower in ODD boys than in NC boys. The correlation coefficient between time after punishment and skin conductance level was moderately positive in the total sample. These results suggest that response perseveration in ODD boys is related to low punishment sensitivity and that skin conductance level is a marker of punishment sensitivity.

Arousal↗
PubMed2004

Larger brains in medication naive high-functioning subjects with pervasive developmental disorder.

BACKGROUND: Are brain volumes of individuals with Pervasive Developmental Disorder (PDD) still enlarged in adolescence and adulthood, and if so, is this enlargement confined to the gray and/or the white matter and is it global or more prominent in specific brain regions. METHODS: Brain MRI scans were made of 21 adolescents with PDD and 21 closely matched controls. RESULTS: All brain volumes, except the white matter, were significantly larger in patients. After correction for brain volume, ventricular volumes remained significantly larger in patients. CONCLUSIONS: Patients showed a proportional, global increase in gray matter and cerebellum volume, and a disproportional increase in ventricular volumes. Thus, at least in high-functioning patients with PDD, brain enlargement may still be present in adult life.

Adult↗
PubMed2004

Stress responsivity in children with externalizing behavior disorders.

Patterns of lower autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis activity have been found in children with oppositional defiant disorder (ODD). The aim of the present study was to investigate whether children with attention-deficit/hyperactivity disorder (ADHD) differ from ODD children with (OD/AD) or without comorbid ADHD in ANS and HPA axis activity under baseline and stressful conditions. The effects of stress on cortisol, heart rate (HR), and skin conductance level (SCL) were studied in 95 children (26 normal control [NC] children and 69 child psychiatric patients referred for externalizing behavior problems [15 ODD, 31 OD/AD, and 23 ADHD]). No baseline differences were found in cortisol between the four groups. However, the ODD and OD/AD groups showed a significantly weaker cortisol response to stress compared to the ADHD and NC groups; the ADHD group had a similar cortisol response as the NC group. Within the ODD group this pattern of low cortisol responsivity was most clearly present in the more severely affected inpatients. With respect to HR, the ODD group had a significantly lower HR during baseline and stressful conditions. The higher HR levels in the OD/AD and ADHD groups were likely to be caused by methylphenidate. The externalizing groups had significantly lower SCL levels, and no differences were found between these groups. It was concluded that differences in cortisol responsivity during stress exposure are important in distinguishing within a group of children with externalizing behavior between those with ODD and ADHD.

Arousal↗
PubMed2004

Processing capacity in children and adolescents with pervasive developmental disorders.

This study sought to investigate whether the abnormally small P3 amplitudes observed in pervasive developmental disorder (PDD) are related to differences in processing capacity. PDD children and adolescents and their control groups participated in the study. Visual probe stimuli were presented during an auditory task with two levels of difficulty. Event-related potentials (ERP) were measured from 62 electrodes during task performance. All groups showed amplitude increases to auditory stimuli with increasing task load. Controls showed expected smaller P3 amplitudes to visual probes, whereas PDD subjects did not. The results suggest that autistic subjects show abnormal capacity allocation. Some of these abnormalities may dissolve over time, while others remain into adolescence.

Adolescent↗
PubMed2004

Magnetic resonance imaging of boys with attention-deficit/hyperactivity disorder and their unaffected siblings.

OBJECTIVE: To study the influence of increased familial risk for attention-deficit/hyperactivity disorder (ADHD) on brain morphology. METHOD: Volumetric cerebral measures based on whole brain magnetic resonance imaging scans from 30 boys with ADHD, 30 of their unaffected siblings, and 30 matched controls were compared. RESULTS: Both subjects with ADHD and their unaffected siblings displayed reductions in right prefrontal gray matter and left occipital gray and white matter of up to 9.1% (p < 0.05). Right cerebellar volume was reduced by 4.9% in subjects with ADHD (p = 0.026) but not in their unaffected siblings (p = 0.308). A 4.0% reduction in intracranial volume was found in subjects with ADHD (p = 0.031), while a trend was observed in their unaffected siblings (p = 0.068). CONCLUSIONS: The volumetric reductions in cortical gray and white matter in subjects with ADHD are also present in their unaffected siblings, suggesting that they are related to an increased familial risk for the disorder. In contrast, the cerebellum is unaffected in siblings, suggesting that the reduction in volume observed in subjects with ADHD may be more directly related to the pathophysiology of this disorder.

Adolescent↗