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Biomedical subjects

K A Loveland

Publications and source records attributed to K A Loveland.

At least 19 recordsLinked to original sources

Judgments of social appropriateness by children and adolescents with autism.

Children and adolescents with autism (autism group, n = 19) and those without autism (Nonautism group, n = 19) of similar age and IQ were asked to make judgments of the social appropriateness of 24 videotaped, staged scenes with adult actors. Each scene depicted an appropriate or an inappropriate interaction. Half contained verbalizations, and half did not. After each scene, the participant was asked: (1) Was that o.k. or was something wrong with it? If the participant judged the scene was wrong, she or he was asked: (2) What was wrong with it?; and (3) Why was that wrong? Both groups correctly identified inappropriate behaviors most of the time, and correct behaviors almost all of the time. However, the Nonautism group detected inappropriate behaviors significantly more often than the Autism group, for verbal but not nonverbal scenes. It was also significantly easier for both groups to identify inappropriate behaviors in the nonverbal than in the verbal scenes. Ratings of the explanations given for Question 3 differed significantly between the groups for verbal but not for nonverbal scenes, with Nonautism participants more likely to give explanations involving social norms and principles, and the Autism group more likely to give explanations that were irrelevant or idiosyncratic.

Adolescent↗

The brief psychiatric rating scale for children (BPRS-C): validity and reliability of an anchored version.

OBJECTIVE: Because the accuracy of problems reported by referred children may be compromised by their academic, cognitive, or motivational limitations, clinician rating forms may contribute to the accurate assessment of youth adjustment. One such measure, the 21-item Brief Psychiatric Rating Scale for Children (BPRS-C), received psychometric study to estimate its potential contribution to the measurement of symptom dimensions. BPRS-C reliability and concurrent validity were calculated for youths who were receiving psychiatric services within a medical school department. METHOD: Five hundred forty-seven children aged 3 to 18 years were rated by faculty or trainees; a subsample of 90 was concurrently rated by two observers. BPRS-C psychometric performance was demonstrated through interrater agreement, factor analysis, and multivariate analyses of variance across seven diagnosis-based groups. RESULTS: Although items and scales demonstrated substantial reliability and concurrent validity, item factor analysis revealed a few apparent errors in item-to-scale assignment. These errors were minimized by the use of three new second-order factor-derived scales: Internalization, Developmental Maladjustment, and Externalization. CONCLUSIONS: The BPRS-C can be easily integrated into academic clinical practice and is a reliable and valid method of child description. Additional study of three new BPRS-C factor scales and the application of the BPRS-C to the quantification of clinician observation of child symptomatic status are warranted.

Adolescent↗

Gender-related physiologic differences in human neonates and the greater vulnerability of males to developmental brain disorders.

OBJECTIVE: To examine whether gender-specific physiologic differences are present at birth and can be a basis for gender-specific vulnerability to developmental disorders in males. We report on three studies of male-female physiologic and structural differences in neonates and their relevance to observed differences in the incidence of developmental disorders in males. METHODS: Study I: 56 neonates were examined for cardiac reactivity to the Moro reflex. Study II: 863 neonates' basic anthropometric data were examined to demonstrate gender-specific differences in body proportions as a possible basis for psychophysiologic differences. Study III: Developmental data on 1000 one- to 26-week-old infants were analyzed for gender-specific developmental differences in rhythmic patterns of sleeping and eating. RESULTS: Study I: There were gender-related differences in heart rate reactivity (male > female). Study II: Male newborns had significantly larger head/chest proportions, suggesting that they may have a greater metabolic demand, related to brain size. Study III: Mothers reported that infant males' sleeping rhythm developed significantly later than females', and that they slept for shorter periods at night. CONCLUSIONS: Gender-related vulnerability in brain development is proposed, based on physiologic differences during a specific early sensitive period in development. This hypothesis may help to explain the overrepresentation of males reported for most developmental disorders.

Analysis of Variance↗

The roles of inhibin and related peptides in gonadal function.

Inhibin A and B are dimeric proteins capable of suppressing FSH both in vitro and in vivo. The principal form in the male is inhibin B which is produced in the testis and circulates to inhibit pituitary FSH secretion. Activin A, B and AB are dimeric proteins that share the same beta subunits with the inhibins but, in contrast, stimulate FSH secretion. Although activin A circulates, castration does not lead to a decrease in serum concentrations, indicating that the testis is not the major source of activin A. In the circulation, the activins are bound to a structurally unrelated binding protein, follistatin, that neutralizes the biological actions of these proteins. The subunits of the inhibins/activins as well as follistatin are also produced locally within the pituitary and their levels can be modulated by testosterone and gonadotrophin releasing hormone as well as by autocrine mechanisms. Consequently, the output of FSH is dependent of the balance between local processes and the circulating feedback exerted by testosterone and inhibin. There is increasing data to support the local gonadal production of not only inhibin but also activin and follistatin by both germ cells and somatic cells such as the Sertoli cells. Evidence is accumulating to support the concept that these proteins exert local regulatory mechanisms in the testis.

Activins↗

Attention in HIV-infected children: results from the Hemophilia Growth and Development Study.

Attentional functioning was examined in three groups of 7- to 19-year-old male participants with hemophilia: (1) HIV seronegative controls (HIV-, N = 66), (2) HIV seropositive participants with CD4+ lymphocyte counts greater than or equal to 200 (HIV+ CD4+ > or = 200, N = 79), and (3) severely immune suppressed HIV seropositive participants (HIV+ CD4+ < 200, N = 28). Two measures sensitive to attention deficits were used: the Continuous Performance Test (CPT) and the Span of Apprehension (Span). On the CPT, there was a decrement in attention in both HIV+ groups, as indexed by an increase in false alarm rate from Block 1 to Block 3, that was not present in the HIV- group. The longer the HIV+ children were required to sustain attention to the CPT, the more they responded to the incorrect stimulus. This effect decreased as age increased. Span percent correct and latency to correct were associated with the presence of a premorbid history of intracerebral hemorrhage, but were not sensitive to HIV status or degree of immune suppression in the HIV+ children, suggesting morbidity related to hemophilia. The remaining CPT and Span variables--hit rate, sensitivity, latency, percent correct, and latency to correct--showed the expected associations with age, but none showed conclusive associations with HIV status or immune suppression in the HIV+ participants.

Adolescent↗

HIV-associated changes in adaptive, emotional, and behavioral functioning in children and adolescents with hemophilia: results from the Hemophilia Growth and Development Study.

OBJECTIVE: To assess changes in adaptive, emotional, and behavioral functioning over four years in children and adolescents with hemophilia and with or without HIV infection and to evaluate the relationship of these changes to immune status. METHODS: Participants were 277 HIV-seropositive and 126 HIV-seronegative boys with hemophilia. Participants with HIV infection were divided into three groups based on trajectory of immune functioning (CD4+ cell counts) over the course of the study. Caregivers completed the Vineland Adaptive Behavior Scales and Pediatric Behavior Scale (PBS). RESULTS: Results showed declining Vineland Communication scores for participants with consistently poor immune functioning. These participants also started with more PBS Attention Deficit and Deviation symptoms, which then decreased more sharply than for other groups. Low CD4+ counts were consistently associated with more Health and Depression-Anxiety symptoms on the PBS. However, with few exceptions, group means remained within normal limits. CONCLUSIONS: According to their caregivers, boys with hemophilia and HIV infection showed considerable resilience with regard to adaptive behavior and emotional and behavioral problems. However, over time changes occurred in these areas that appear to be related to immune functioning.

Adaptation, Psychological↗

Patterns of behavioral adjustment and maladjustment in mental retardation: comparison of children with and without ADHD.

A variety of behavioral and emotional problems have been associated with attention deficit disorder with hyperactivity (ADHD) in children of average intellect. In contrast, little is known about concomitant behavioral and emotional problems in children with ADHD and mental retardation. In this study, we used the Personality Inventory for Children-Revised to assess the behavioral adjustment of 48 children with mental retardation and ADHD compared to that of 47 children with mental retardation without ADHD. The ADHD group had significantly more symptoms of depression, family conflict, noncompliance, anxiety, hyperactivity, inadequate social skills, and academic problems. Results are strongly suggestive of significant behavioral and emotional problems in children with ADHD and mental retardation, thus mirroring the pattern associated with ADHD in the general school-age population.

Adolescent↗

Testisin, a new human serine proteinase expressed by premeiotic testicular germ cells and lost in testicular germ cell tumors.

We have cloned and characterized a cDNA encoding a new human serine proteinase, testisin, that is abundantly expressed only in the testis and is lost in testicular tumors. The testisin cDNA was identified by homology cloning using degenerate primers directed at conserved sequence motifs within the catalytic regions of serine proteinases. It is 1073 nucleotides long, including 942 nucleotides of open reading frame and a 113-nucleotide 3' untranslated sequence. Northern and dot blot analyses of RNA from a range of normal human tissues revealed a 1.4-kb mRNA species that was present only in testis, which was not detected in eight of eight testicular tumors. Testisin cDNA is predicted to encode a protein of 314 amino acids, which consists of a 19-amino acid (aa) signal peptide, a 22-aa proregion, and a 273-aa catalytic domain, including a unique 17-aa COOH-terminal hydrophobic extension that is predicted to function as a membrane anchor. The deduced amino acid sequence of testisin shows 44% identity to prostasin and contains features that are typical of serine proteinases with trypsin-like substrate specificity. Antipeptide antibodies directed against the testisin polypeptide detected an immunoreactive testisin protein of Mr 35,000-39,000 in cell lysates from COS-7 cells that were transiently transfected with testisin cDNA. Immunostaining of normal testicular tissue showed that testisin was expressed in the cytoplasm and on the plasma membrane of premeiotic germ cells. No staining was detected in eight of eight germ cell-derived testicular tumors. In addition, the testisin gene was localized by fluorescence in situ hybridization to the short arm of human chromosome 16 (16p13.3), a region that has been associated with allellic imbalance and loss of heterozygosity in sporadic testicular tumors. These findings demonstrate a new cell surface serine proteinase, loss of which may have a direct or indirect role in the progression of testicular tumors of germ cell origin.

Adult↗

Assessment of orientation: relationship between informant report and direct measures.

Although informant reports of everyday functioning are often used in dementia assessments, the actual correspondence between such indirect reports of functioning and actual performance has not been examined. Orientation results on the Dementia Questionnaire for Mentally Retarded Persons were compared to those obtained in direct assessment of orientation of 138 adults with mental retardation. Fair to good agreement was found between informant report and direct assessment. However, for some orientation items, nonverbal IQ, cause of mental retardation, and age affected the level of agreement. Thus, both informant report and direct measures of orientation are necessary in dementia assessments, and further work is needed on informant scale validation.

Activities of Daily Living↗

Hemophilia growth and development study: relationships between neuropsychological, neurological, and MRI findings at baseline.

OBJECTIVE: To determine the effects of human immunodeficiency virus (HIV) infection on children's development by identifying neurological and environmental variables associated with neuropsychological measures of cognitive development in HIV-seronegative (HIV-) and HIV-seropositive (HIV+)children and adolescents with hemophilia. METHODS: Participants (N = 298; 60% HIV+) were males ages 7-19 years enrolled in the Hemophilia Growth and Development Study (HGDS). Least squares modeling was used to determine whether there was a difference at baseline in mean neuropsychological test scores by HIV status, age, and neurological baseline findings, adjusting for selected environmental and medical history variables. RESULTS: The participants were within age expectations for general intelligence. Variables associated with lowered neuropsychological performance included academic problems, coordination and/or gait abnormalities, parents' education, and previous head trauma. CONCLUSIONS: Hemophilia-related morbidity has a subtle adverse influence on cognitive performance. HIV infection was not associated with neuropsychological dysfunction in this group even when MRI abnormalities were present.

Adolescent↗

Dementia in adults with Down syndrome: diagnostic challenges.

Although dementia associated with Down syndrome is often presumed to be progressive and irreversible, variations in disease course have been described. In addition, prevalence rates have varied widely among studies. This interim report is a description of the status of 70 adults with Down syndrome who are being followed for signs of dementia. Of the 70, 12 met all criteria for dementia, 40 met subsets of criteria, and 18 met no criteria. Information is provided on instruments used, rationale for choice and revision of instruments as well as criteria used to identify dementia and changes in the status of the participants. The results suggest that extreme care is needed when diagnosing dementia in adults with Down syndrome, for both clinical and research purposes.

Adult↗

Emotion recognition in autism: verbal and nonverbal information.

This study examined the roles of verbal and nonverbal sources of information in the ability of persons with and without autism to recognize emotion. Child, adolescent, and young adult participants in four groups [Lower Functioning Autism (LFA) (n = 17), High Functioning Autism (HFA) (n = 18), Lower Functioning Comparison (LFC) (n = 18), and High Functioning Comparison (HFC) (n = 23)] identified emotions shown (happy, angry, sad, surprised, or neutral) in video clips of individuals expressing emotion verbally, nonverbally, or both. Verbal expressions of emotion were either Explicit, Implicit, or Neutral, whereas nonverbal expressions were Animate or Flat (3 x 2). Pairwise ANCOVAs indicated no group differences between HFA and HFC groups or between the LFA and LFC groups, and indicated instead group differences between higher and lower functioning persons. With groups collapsed into High Functioning (HF) and Lower Functioning (LF), significant group differences were found. Performance of LF individuals suggested they had difficulty inferring how a person felt based on what the person said, if the emotion was not explicitly named. Performance of HF individuals suggested they relied more on nonverbal than on verbal information to determine a speaker's emotion, except where the emotion was explicitly named. Results suggested that persons with autistic spectrum disorders can use affective information from multiple sources in much the same ways as persons of comparable developmental level without autism.

Adolescent↗

Comparison of sustained and selective attention in children who have mental retardation with and without attention deficit hyperactivity disorder.

Attention deficits have been demonstrated in children with attention deficit hyperactivity disorder (ADHD) in the general population, but little is known about attention deficits in children with ADHD who also have mental retardation. In this investigation, children with ADHD and mental retardation were compared to those with mental retardation without ADHD on tasks assessing sustained and selective attention. Although children with ADHD and mental retardation made fewer correct target detections and more commissions on a vigilance task, no compelling evidence emerged for sustained attention deficits. However, evidence did emerge that was suggestive of selective attention deficits in these children. Results also suggest that girls with mental retardation may be at a higher risk for ADHD than are girls in the general population.

Adolescent↗

Aging in adults with Down syndrome: report from a longitudinal study.

Changes in functioning related to aging were examined in 34 adults (14 females, 20 males) with Down syndrome who were 22 to 56 years of age. Changes in functioning over 3 to 4 years were examined, with age, IQ at entry into the study, and gender considered. Neither effects of age at entry nor change over time were significant, suggesting that changes related to aging in adults with Down syndrome were minimal. In contrast, IQ at entry had a significant effect on all performances, suggesting that any examination of aging must consider intellectual level. Results do not support the idea that adults with Down syndrome show rapid age-related declines in functioning apart from the occurrence of a progressive dementia such as Alzheimer's disease.

Adult↗

Hemophilia growth and development study: baseline neurodevelopmental findings.

Reported baseline findings from the neurological assessment component of the Hemophilia Growth and Development Study (HGDS). HIV-positive (HIV+; n = 207) and HIV-negative (HIV-; n = 126) young males with hemophilia ages 6 to 18 years, were enrolled in a prospective study of their growth and development. At baseline, HIV+ and HIV- subjects were not significantly different in test performance. The number of subjects exhibiting below-average performance in three or more areas assessed was about 25% overall. For both groups, mean test scores were within the average range. Academic and adaptive skills were lower than expected based on mean IQ scores, and more behavioral/emotional problems than expected were reported by parents. Absolute CD4 cell counts per mm3 were not related to neuropsychological performance at baseline. Results suggest that the subjects with HIV were relatively free of HIV-related neuropsychological impairment at baseline and that observed differences from a general population reflect effects of hemophilia as a chronic illness.

Adolescent↗

Hemophilia growth and development study. Design, methods, and entry data.

PURPOSE: The study design, research questions, and baseline data are presented from a multicenter longitudinal epidemiologic investigation of the impact of human immunodeficiency virus (HIV) infection on three areas of functioning in children and adolescents with hemophilia: physical growth and sexual maturation, immune function, and neurological and neuropsychological functioning. PATIENTS AND METHODS: Sixty-nine percent (n = 333) of a population of males between the ages of 6 and 19 years with moderate to severe hemophilia participated in a comprehensive baseline examination. Approximately 62% of the study group was HIV seropositive and 38% HIV seronegative. RESULTS: Adjusted for age, HIV-positive participants were three times as likely as HIV-negative participants to exhibit declines in height-for-age attainment (p = 0.05), twice as likely to have delays in sexual maturation (p = 0.414), and more than three times as likely to exhibit antibody levels that were not indicative of prior exposure or vaccination (p < 0.001). In addition, analysis of a comprehensive battery of neuropsychological tests showed that HIV-positive participants were 50% more likely to show scores approximately 1 SD below expected levels in three of nine functional areas (p = NS) compared with HIV-negative participants. CONCLUSIONS: Entry data for this study reveal a greater likelihood for HIV-positive children and adolescents with moderate to severe hemophilia to have abnormal growth, and to exhibit antibody levels not indicative of prior exposure to disease or vaccination, which could be attributed to HIV infection. Lowered neuropsychological test performance in both groups may be attributable to the deleterious effects of chronic illness. Data are being collected from a group of non-HIV infected non-hemophiliac siblings for comparison.

Adolescent↗