Hyperactives as young adults: past and current antisocial behavior (stealing, drug abuse) and moral development [proceedings].
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Biomedical subjects
Publications and source records attributed to L Hechtman.
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Eighteen pairs of young adult hyperactives and controls, matched for age, sex, IQ and socioeconomic class and education completed, were assessed on tests of social skills and self-esteem. Hyperactive subjects had significantly more difficulty than matched controls in social skills tests which involved direct oral responses than those involving written responses. This would suggest that the hyperactive young adults cognitively know what the most appropriate response would be from a number of possibilities, but have problems spontaneously producing such a response. Situations dealing with heterosocial and assertion situations were more difficult for hyperactives than job interview situations. Hyperactive young adults also scored significantly worse than matched controls on a number of self-esteem tests, thus supporting the findings of previous psychiatric assessments and the California Psychological Inventory. Finally, no significant correlations were found between the self-esteem and social skills tests. Possible explanations for the findings are discussed.
The behavioral characteristics of the hyperactive child are described at different stages of development. Recent and sometimes controversial research findings are discussed with respect to prevalence, etiology, treatment, and outcome. It is concluded that this syndrome can best be understood in terms of interactions between social, psychological, and biological variables.
This study reports on a variety of outcome variables from 75 hyperactive and 44 matched control subjects aged 17 to 24 years (mean ages, 19.5 and 19.0 years, respectively). All hyperactive subjects have been followed up for 10 to 12 years; they were first evaluated at 6 to 12 years of age. None of the hyperactive subjects was treated with methylphenidate, although a subgroup received chlorpromazine or a mixture of drugs (excluding methylphenidate). The hyperactive subjects had less education than the controls and a history of more car accidents and more geographical moves. However, only a minority were still engaged in continued antisocial behavior or had evidence of severe psychopathology. No subjects were found to be psychotic, but two were diagnosed as borderline psychotic. There was evidence that hyperactive subjects had some continued symptoms from the hyperkinetic child syndrome, including impulsive personality traits.
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Height, weight, pulse rate and blood pressure were measured in 65 hyperactive individuals 17 to 24 years of age who had not taken stimulant medication during childhood and in 39 control subjects matched for age, sex, intelligence quotient and socioeconomic class. There were no significant differences in the physiologic measures between the two groups. Both the hyperactive and the control subjects seemed to have reached their growth plateau by the age of 17 to 24 years, though the exact time the plateau was reached was not determined. Hyperactive individuals who had taken phenothiazines during childhood were significantly taller (P less than 0.046) than those who had never taken medication. This finding may reflect stimulation of growth by phenothiazines at a critical period of growth, but more detailed reserach on this finding is necessary. The physiologic measures obtained in the hyperactive individuals who had never taken stimulant medication provide an important baseline against which to assess values in hyperactive individuals who have taken such medication.
In a 10-year follow-up study electroencephalograms (EEGs) of 31 hyperactive and 27 matched control subjects of mean ages 19.17 and 18.59 years respectively showed no significant differences in any of the features assessed. Sequential EEGs, available for only the hyperactive subjects, suggested that a much greater proportion were normal at the 10-year follow-up assessment than at the 5-year follow-up assessment and that the normalization tended to take place mainly in the second 5-year period. This supports the hypothesis that EEG abnormalities of hyperactive persons are those of an immature pattern that tends to normalize with age. Correlation between EEG findings at the 10-year follow-up assessment and global outcome measures was not significant. Initial and 5-year EEGs also failed to predict global outcome at the 10-year follow-up assessment.
Thirty-five individuals aged 17 to 24 in whom severe chronic hyperactivity had been diagnosed 10 years before were studied together with 25 matched controls. There were no significant differences in mean height or weight or in electroencephalographic findings, but the mean pulse rate was significantly higher in the hyperactive group. Cognitive style tests indicated continued difficulty in reflection (resulting in more errors) but less impulsivity (longer reaction time) in the hyperactive individuals. Compared with controls, hyperactive subjects were continuing to have more scholastic difficulty, although this difference seemed to be less pronounced than 5 years before. Their adjustment in work situations and living arrangements did not differ significantly from that of the controls. Restlessness, both reported and observed, continued to be a problem for the hyperactive individuals, and socialization skills and sense of well-being continued to be poorer than in the controls. The hyperactive individuals did not show significantly more antisocial behaviour, nonmedical use of drugs or serious psychiatric disturbances.