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Biomedical subjects

M D Rapport

Publications and source records attributed to M D Rapport.

At least 19 recordsLinked to original sources
PubMed1992

The effects of methylphenidate and lithium on attention and activity level.

Seven psychiatrically hospitalized prepubertal children were treated with methylphenidate, placebo, lithium carbonate alone and in combination with methylphenidate. Children met DSM-III-R criteria for both disruptive behavior disorder and bipolar or major depressive disorder by structured interview and consensus diagnosis. Parents, children, teachers, staff, and raters were blind to medication condition. Children were rated weekly on measures of attention and activity to determine whether medications alone or in combination produced a differential effect on these variables. The nosological and practical implications of the results are discussed.

Arousal↗
PubMed1992

Lithium in hospitalized children at 4 and 8 weeks: mood, behavior and cognitive effects.

Eleven psychiatrically hospitalized children were treated with lithium carbonate for a minimum of 8 weeks. Based on literature review, their psychopathology, diagnoses and family history suggested they would be positive lithium responders. Weekly ratings in behavioral domains showed children's improvement in areas of self control, aggression and irritability, more obvious at 8 than 4 weeks. However, of seven children studied with double blind crossover, improvement behaviorally and cognitively was maintained on placebo. Only three of 11 children improved enough to be discharged on lithium. Implications of lithium's anti-aggressive and anti-manic effects in children are discussed.

Affect↗
PubMed1991

Serum cholesterol and aggressive behavior in psychiatrically hospitalized children.

The relationship between serum cholesterol and a number of measures of impulsiveness and aggression was examined in 38 prepubertal, psychiatrically hospitalized children. Although care was taken to use reports and direct observations of both variables within 2 weeks of admission and 8 weeks later, no consistent relationship was found. The reasons for these findings are discussed.

Adolescent↗
PubMed1989

Attention deficit disorder with hyperactivity and methylphenidate: the effects of dose and mastery level on children's learning performance.

This investigation examined the relationship between methylphenidate (MPH) and the learning and recall of paired associations by children with attention deficit disorder with hyperactivity (ADDH). Forty-five children with ADDH were randomly assigned to one of three groups (novel, partial mastery, and mastery learning) that varied in the amount of previous learning of paired associations and participated in a double-blind, placebo-control, repeated-measures-across-dose (crossover) design. Each child received four doses of MPH (5 mg, 10 mg, 15 mg, and 20 mg) and a placebo in a random, counterbalanced sequence. The results indicated that both the rate of acquisition and accuracy in learning paired associations were significantly, but differentially, affected by MPH dose and the degree of learning mastery. The implications of these results for psychopharmacological research and the monitoring of psychostimulant effects on children's learning performance in academic settings are discussed.

Association Learning↗
PubMed1988

Attention deficit disorder and methylphenidate: a multi-step analysis of dose-response effects on children's cardiovascular functioning.

The present study investigated the effects of methylphenidate (MPH) on the resting heart rate of 47 children with Attention Deficit Disorder/Hyperactivity. Children participated in a double-blind, placebo control, within subject (cross-over) design and received each of 5 doses of MPH in a counterbalanced sequence. A multi-step analysis was used to examine the dose-response relationship, contribution of pre-stimulus levels of HR (i.e. the initial value), and potential interaction between dosage and time on resting HR. Results indicated that higher dosages are linearly related to increasing levels of HR and that these effects are dependent upon both the initial HR value and the time course of the medication.

Attention Deficit Disorder with Hyperactivity↗
PubMed1988

ADDH and methylphenidate responders: effects on behavior controlled by complex reinforcement schedules.

One of the most effective treatments for children with Attention Deficit Disorder with Hyperactivity (ADDH) has been the prescription of methylphenidate (MPH). While laboratory-based evidence indicates that MPH effects may be rate-dependent, little is known about changes evinced in operant behavior controlled by complex reinforcement schedules. The present study examined the effects of several doses of MPH on the operant key-pressing behavior of 20 children with ADDH who were favorable responders to the drug. Following a drug-free training period, each child performed the task across all doses in a randomly assigned sequence under double-blind placebo control conditions. Rate-dependent effects were found for both high- and low-rate reinforcement schedules. The strength of these effects varied across dose. These results have implications for the nature of rate-dependent phenomena in humans and investigations of treatment parameters in the pharmacotherapy of children with ADDH.

Attention Deficit Disorder with Hyperactivity↗
PubMed1986

Hyperactivity and frustration: the influence of control over and size of rewards in delaying gratification.

This study examined the differential effects of frustration on normal children and those diagnosed as having Attention Deficit Disorder with Hyperactivity. Each group consisted of 16 boys between the ages of 6 and 8 years who were prematched for age, grade, and classroom placement. All children completed a series of arithmetic problems in order to earn toy rewards. Using a variant of Mischel's (1974) delay-of-gratification paradigm, children were presented with two choice-of-delay conditions in a randomly assigned, counterbalanced sequence: a free-choice conflict situation involving a long-passive or short-active reward delay, and a short-active delay. Results showed that a significantly greater proportion of hyperactive children chose to complete problems for an immediate reward compared to their normal control counterparts (p less than .01). Group differences were no longer apparent in the short-active delay trial. The results are discussed in terms of frustration tolerance and contributing factors such as cognitive-attentional style. Implications for treatment and future directions are delineated.

Attention Deficit Disorder with Hyperactivity↗
PubMed1986

Hyperactivity and methylphenidate: rate-dependent effects on attention.

The behavioral effects of CNS stimulants on attention deficit disorder (hyperactive) children's attention are inversely related to their pre-drug rate of behavior, i.e. the effects are rate-dependent. The strength and shape of this relationship are affected by dose and the child's unique reaction to the drug, yet appear unrelated to body weight. Dosage should be directly manipulated in pediatric psychopharmacological studies and the practice of using mg/kg dosage schedules may no longer be necessary.

Attention↗
PubMed1985

Methylphenidate in hyperactive children: differential effects of dose on academic, learning, and social behavior.

Methylphenidate (Ritalin) has been shown to have differential effects on hyperactive children's behavior as a function of dose level. In the present investigation, a triple-blind, placebo-control, within-subject (crossover) experimental design was employed in which 12 hyperactive boys between 6 and 10 years received three different dosages of methylphenidate (5, 10, and 15 mg) in a randomly assigned sequence. Dosage effects were assessed on clinic-(PAL--Paired Associates Learning test) and school-(percent on task, teacher ratings, work completion rates, and accuracy) related behaviors. For 10 of the children, classified as responders to medication by the PAL using the criteria of Swanson, Kinsbourne, and colleagues, a series of ANCOVAs with repeated measures showed significant dosage effects on teacher ratings (p less than .01), percent on task (p less than .01), academic accuracy (p less than .05), and assignment completion rates (p less than .05). PAL performance was also significantly enhanced (p less than .01) after optimal dose levels were considered. Subsequent trend analysis showed a significant positive linear relationship between dose and each of the dependent variables. A comparison of fixed-dose and miligram-per-kilogram plots showed that children's performance across the different dosages were clearly individualistic and task-specific, even when similar body weights were compared. The implications of using clinic-based testing to determine optimal medication responsivity were discussed.

Achievement↗
PubMed1985

Rate-dependency and hyperactivity: methylphenidate effects on operant responding.

The two most common treatment for hyperactivity are psychopharmacological regimens and behavior therapy. Although the concurrent use of stimulant medication has been purported to enhance a child's rate of responding under a behavior management program, studies examining the interaction of the two treatments have been unable to confirm this hypothesis. The present investigation sought to examine the effects of differing levels of methylphenidate hydrochloride (Ritalin) upon operant responding with hyperactive children. After an initial drug-free training period, 10 first through fourth grade hyperactive males performed an operant key-pressing task under a mult VR 5 FI 30 sec reinforcement schedule across four randomly determined, double-blind drug conditions (placebo, 5, 10, 15 mg). Only VR responding changed significantly during medication conditions; however, rate-dependent psychostimulant effects were found within both reinforcement schedules. Discrepancies with animal rate-dependency and implications for treatment and future research are discussed. Medication effects on operant responding appear to depend upon the reinforcement schedule and dose employed.

Attention Deficit Disorder with Hyperactivity↗
PubMed1985

Attention deficit disorder with hyperactivity: differential effects of methylphenidate on impulsivity.

The impulsivity component of attention deficit disorder with hyperactivity requires regulation because its effects interfere with children's school performance and persist into adulthood. The present investigation examined the effects of low to intermediate doses of methylphenidate on impulsivity (measured by the Matching Familiar Figures test, a primary index of cognitive tempo) in 14 children with attention deficit disorder with hyperactivity. The mean percentile error score in the highest dose (15 mg) group was significantly lower than those in placebo (P less than .01), 5-mg (P less than .01), and 10-mg (P less than .01) groups. Trend analysis revealed a linear relationship between dose and error score with total errors decreasing as dose increased. Changes in children's error scores were examined using both fixed-dose and milligram per kilogram data-plotting methods. This work demonstrates the need to consider specific task and child characteristics while assessing the child's responsivity to psychostimulants across a range of safe doses and a variety of behavioral domains.

Attention Deficit Disorder with Hyperactivity↗
PubMed1983

An interdisciplinary approach to the diagnosis and management of a complex case of postencephalitic behavioral disorder.

Postencephalitic behavioral syndrome secondary to measles is an almost extinct condition in Western culture. The present paper describes the clinical state of a 13-year-old pubertal female who presented nine years after the original acute febrile illness. In addition, an innovative behavioral approach to treatment of intractable seizures and aggressive behavior is described.

Adolescent↗