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Biomedical subjects

P H Wender

Publications and source records attributed to P H Wender.

At least 19 recordsLinked to original sources

Risk for affective disorder and alcohol and other drug abuse in the relatives of affectively ill adoptees.

We investigated the risk for substance abuse in the biological relatives of adoptees with affective illness, controlling for potential confounds, and additionally assessed risk by probands' and relatives' gender. Our sample consisted of 67 index adoptees with affective illness, matched control adoptees, and their biological and adoptive relatives. Both affective illness and substance abuse were more common in the biological relatives of affectively ill adoptees than in controls' relatives. Affective illness was more common than substance abuse among female index biological relatives, with the opposite pattern observed among male relatives.

Adoption

Spontaneous selective attention in schizophrenia.

A visual word identification task was used to measure the type of selective attention that occurs spontaneously when there are multiple stimuli, all potentially relevant, and insufficient time to process each of them fully. This task presents two words simultaneously, one above the other, for 200 ms, and periodically requires the subject to identify either the upper or the lower word. We tested schizophrenic patients, manic-depressive patients, and normal controls under a baseline divided attention condition with no predictability and then introduced a degree of predictability into the upper location that normally results in selective attention to the lower nonpredictable location. In both the divided attention and the selective attention conditions, the schizophrenic group was just as accurate in identifying words as the other two groups, indicating no deficit in the rate of information processing. However, spontaneous selective attention under conditions of predictability was abnormal in the schizophrenic patients: They paid more attention to the predictable than to the nonpredictable source of information, consequently processing different, not less, information than normal subjects. Abnormal values on a ratio measure of selective attention occurred in 85% of the schizophrenic patients compared with only 30% of the manic-depressives and 20% of the normal subjects.

Adult

Bupropion treatment of attention-deficit hyperactivity disorder in adults.

The authors treated 19 adults with attention-deficit hyperactivity disorder with an open trial of bupropion. These patients had received maintenance stimulant medication or monoamine oxidase inhibitors for an average of 3.7 years. Fourteen of the patients experienced moderate to marked benefit from bupropion; ten of these patients chose to continue bupropion rather than their former medication. These results suggest that bupropion may be an alternative to stimulants in treating some adults with attention-deficit hyperactivity disorder.

Adult

An open trial of L-tyrosine in the treatment of attention deficit disorder, residual type.

To elucidate the role of catecholamines in attention deficit disorder, the authors conducted an open 8-week trial of L-tyrosine in 12 adults with attention deficit disorder, residual type. Eight showed marked to moderate clinical response in 2 weeks; at 6 weeks these eight developed tolerance, suggesting that L-tyrosine is not useful in attention deficit disorder, residual type.

Adult

MMPI assessment of psychopathology in the adopted-away offspring of schizophrenics.

Previous studies completed in Denmark show a higher frequency of schizophrenia-related psychopathology in the adopted offspring of schizophrenics than in matched controls. This study adds a psychometric dimension to the earlier reports with an analysis of psychopathology in the adopted offspring of schizophrenics based on the Minnesota Multiphasic Personality Inventory (MMPI). A combination of MMPI criteria and interview-based diagnosis identifies 22% of the index cases and 6% of the control cases (P less than .01) as having a schizophrenia spectrum disorder. The findings support a genetic hypothesis, but the use of the MMPI does not fully clarify some issues raised in the earlier reports.

Adult

Pupillary and heart rate reactivity in children with minimal brain dysfunction.

This study attempted to replicate and extend previous findings on autonomic arousal and responsivity in children with diagnoses of minimal brain dysfunction (MBD). Pupil size, heart rate, skin conductance, and skin temperature were recorded from 32 MBD and 45 control children during a session that included presentation of visual stimuli, simple reaction time (RT), a cold pressor procedure, and rest periods. The MBD children were tested both off and on clinical dosages of stimulant drugs in a crossover design. Evidence of higher than normal arousal levels in the unmedicated MBD Ss was obtained from resting skin conductance and, more tenuously, from pupil size. Lower phasic responsivity in the MBD children was evidenced by slower RT, less cardiac deceleration to both light and RT stimuli, and smaller pupil dilation to the RT stimuli. Spontaneous pupillary constrictions during "rest" periods, presumably indicating drowsiness, were observed about equally in MBD and control children. Stimulant drugs raised arousal levels but did not reverse the responsivity deficits. The lower phasic reactivity in the MBD group and the effects of stimulant drugs on arousal indices confirm earlier reports. The finding of higher arousal in drug-free MBD children is incompatible with the low arousal hypothesis of MBD but is consistent with a previous report of the effects of a stimulating environment on these children.

Adolescent

Schizophrenics' adopting parents. Psychiatric status.

With the exception of one finding in one experiment, adoption studies have demonstrated that genetic and not rearing factors play an etiological role in the schizophrenias. In that one study, clinical evaluations showed the biological parents of schizophrenics as more disturbed than the adopting parents of schizophrenics, who were, in turn, slightly more disturbed than the adopting parents of normal persons. Both the biological and the adopting parents of schizophrenics showed an equivalent degree of Rorschach pathology, suggesting the possible role of a learned communication disorder in the schizophrenic disorders. A replicative study were performed, employing the same design but utilizing a systematic sample. Structured interviews and tests were administered to the biological parents of nongenetic retardates. Structured clinical evaluation showed the biological parents of schizophrenics to be more disturbed than the other two groups, between whom there was no difference in psychopathology. With analysis of the Rorschach tests, the biological parents of schizophrenics showed significantly more Rorschach pathology than found in the other two groups, whose degree of disorder was the same. This study again confirms the role of genetic factors and fails to show an environmental component in the etiology of the schizophrenias.

Adoption

Perinatal complications in offspring of psychotic parents.

The birth records of 78 subjects born to psychotic parents and 72 subjects born to normal parents were studied. No significant differences in the rates of pregnancy and birth complications (PBCs) were found between the offspring of psychotic parents and normal control parents. There were no differences between offspring born to psychotic mothers compared to psychotic fathers. Neither the onset of the parent's illness, nor the mother's age at delivery, nor the sex of the offspring seemed to influence the rate of PBCs. The offspring of chronic schizophrenic mothers and manic-depressive fathers had lower PBC rates than the offspring of parents of other diagnostic categories. The parents of these two groups, which were of a limited size, did not differ on any variable of significance, excepting the time of their first psychiatric hospital admission.

Adult

Diagnosis and treatment of minimal brain dysfunction in adults: a preliminary report.

Minimal brain dysfunction (MBD) has long been considered a disorder limited to childhood. A number of longitudinal and adoption studies suggest that MBD may persist into adult life where its existence is concealed by the application of a variety of diagnostic labels. In order to test the hypothesis that MBD does persist into adulthood, 15 putative MBD adults were identified on the basis of current MBD-like complaints, self-description of MBD characteristics in childhood, and a parental rating (on a standardized form) of "hyperactivity" in childhood. Eleven of the 15 subjects were given a double-blind trial of methylphenidate hydrochloride, and all 15 were given an open trial of pemoline, imipramine hydrochloride, or amitryptiline hydrochloride. Eight of the 11 showed a significant response to the double-blind trial of methylphenidate. Of the 15, eight showed a good response to stimulants or tricyclic antidepressants, two showed a moderately favorable response, and five were unresponsive to drug therapy.

Adult

Mental illness in the biological and adoptive families of adopted individuals who have become schizophrenic.

In a sample of 5483 adults who had been legally adopted early in life by persons not biologically related to them, 33 were identified, from mental hospital records for whom a diagnosis of definite schizophrenia (chronic, latent, or acute) could be agreed upon by four raters. An equal number of matched controls were selected from the sample of adopted individuals who had never been admitted to a mental hospital. Ninety percent of the living parents, siblings, and half-siblings, biological and adoptive, cooperated in an extensive psychiatric interview permitting a consensus diagnosis by three blind raters. Schizophrenia and uncertain schizophrenia were found to be significantly concentrated in the population genetically related to the schizophrenic adoptees. Their adoptive relatives did not differ from the control populations in the prevalence of schizophrenic illness.

Adoption

Some aspects of adoption in selected samples of adult adoptees.

Various aspects of adoption--psychopathology, age at placement, agency versus independent placement, best age to tell child he is adopted, etc.--are studied in three groups of adoptees: biological parent schizophrenic or manic-depressive; adoptive parent schizoprenic or manic-depressive; biological parent with no psychiatric history. Findings raise questions about a number of common assumptions regarding adoptees.

Adoption

Behavioral characteristics of children with chronic nonspecific diarrhea.

The authors obtained early case histories of 16 children with chronic nonspecific diarrhea and 16 control subjects and found that the index subjects had a significantly higher frequency of sleep problems, crying and irritability, digestive problems excluding diarrhea, overactivity, resistance to discipline, and family history of gastrointestinal problems. They conclude that these behavioral characteristics represent temperamental traits based on physiological factors, perhaps an imbalance of autonomic nervous system function. They speculate that chronic nonspecific diarrhea may occur in association with certain temperamental traits because both the somatic and psychic components stem from a common disturbance in autonomic nervous system function.

Child Behavior Disorders

Minimal brain dysfunction, stimulant drugs, and autonomic nervous system activity.

Autonomic base levels and responsivity to stimuli were investigated in normal and minimally brain dysfunctioned (MBD) children. Continuous recordings of skin conductance, heart rate, skin temperature, and respiration rate were made during rest, at presentation of tones, and when performing a reaction time task. No significant differences in base levels were obtained between normal and MBD children when not taking drugs, but stimulant medication increased skin conductance and heart rate and decreased skin temperature and reaction time. The MBD children were less reactive, autonomically, to all types of stimuli. Stimulant drugs decreased electrodermal responsivity, which was predictable from concurrent changes in base line skin conductance and skintemperature. The MBD performance deficits are not related to lower autonomic responsivity or lower absolute base levels of arousal, but MBD children may perform better at relatively high autonomic base levels.

Acoustic Stimulation

Parent-child relationships and psychopathological disorder in the child.

This report uses naturally occurring adoptions to tease apart the effects of heredity and rearing on the development of psychopathological disorder in the child. The quality of relationship between the child and his adoptive parents was assessed in four groups of subjects, and the degree of illness in the child was correlated with the quality of parent-child relationship. Quality of rearing and hereditary input both affect the development of psychopathological disorder, but the amount of variance explained by rearing tends to be low.

Adoption