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Biomedical subjects

R Milich

Publications and source records attributed to R Milich.

At least 37 records · Page 2Linked to original sources
PubMed1991

Effects of background anger, provocation, and methylphenidate on emotional arousal and aggressive responding in attention-deficit hyperactivity disordered boys with and without concurrent aggressiveness.

We investigated the effects of background anger, provocation, and methylphenidate on emotional, physiological, and behavioral responding in children with attention-deficit hyperactivity disorder (ADHD) with and without concurrent aggression. Our study revealed that ADHD boys showed more emotional and physiological distress when exposed to an interaction in which an administrator chastised each boy's favorite counselor, compared to a friendly interaction between the two adults. The background anger manipulation did not affect the aggressive behavior of the boys against an opponent in an aggressive game. High-aggressive (HA) ADHD boys were more likely to respond to provocation with aggression than low-aggressive (LA) ADHD boys, but only LA boys showed increased physiological reactivity with increasing provocation. Methylphenidate resulted in increased heart rates under all conditions and did not interact with any of the other findings.

Adult↗
PubMed1991

Effects of methylphenidate on the persistence of ADHD boys following failure experiences.

We examined the effects of methylphenidate on the task persistence of 21 boys with attention-deficit hyperactivity disorder (ADHD), after they had been exposed to both solvable and insolvable problems. The boys attempted to solve 10 different find-a-word puzzles on each of 4 days, involving the crossing of medication (placebo vs. 0.3 mg/kg) and prior task difficulty (solvable vs. insolvable). The results revealed that medication prevented the decrement in performance following the insolvable problems that was evident with the placebo days. In addition, on medication compared with placebo, the boys were more likely to make external attributions for failure and internal attributions for success. The results are discussed in terms of the impact of medication on ADHD boys' performance as mediated by cognitive-motivational state mechanisms.

Achievement↗
PubMed1991

An examination of learned helplessness among attention-deficit hyperactivity disordered boys.

We employed a learned helplessness paradigm to compare the performance of 23 boys with attention-deficit hyperactivity disorder (ADHD) and a comparable group of 22 nonreferred boys. The boys attempted to solve two different sets of 10 find-a-word puzzles, one set following exposure to solvable puzzles, and one set following exposure to insolvable puzzles. Results revealed that the ADHD boys solved significantly fewer puzzles than did the control boys. In addition, the ADHD boys gave up on significantly more puzzles, and this was especially true following the insolvable condition when it occurred during the second set of puzzles. The ADHD boys also reported being more frustrated by the task than were the control boys. Finally, among the control boys, support was obtained for Diener and Dweck's (1978) distinction between mastery-oriented and helpless children. However, this distinction did not appear to operate in the same fashion for the ADHD boys.

Achievement↗
PubMed1991

Conditional probabilities of child interview symptoms in the diagnosis of attention deficit disorder.

Based upon the standardized interviews of 76 clinic-referred boys, children's reports of behaviors suggestive of attention deficit disorder (ADD) were examined to determine which symptoms were most efficient predictors of an ADD diagnosis. Unlike previous research that has focused exclusively upon the use of sensitivity and specificity rates, this investigation also employed the conditional probability rates of positive and negative predictive power to establish the diagnostic utility of symptoms. As such, this study attempted to establish the diagnostic efficiency of some of the child-reported symptoms and describes a new method to examine any criteria set that is to be used for classification purposes. Results indicated that the optimal child-reported predictors of an ADD diagnosis were not those symptoms typically considered hallmark indicators of the disorder. In addition, no symptom was found to be an efficient exclusion criterion for diagnosis. These findings are discussed in terms of the role of the child as informant for the diagnosis of children's behavior disorders and the need for multisource assessment.

Attention↗
PubMed1990

First impressions formed of boys with learning disabilities and attention deficit disorder.

The present study examined the first impressions that are formed of boys with either learning disabilities (LD), attention deficit disorder (ADD), or both disorders, in an effort to understand better why they are so often unpopular with and rejected by their peers. The intent of the study was to remedy methodological problems of previous first-impression studies to determine whether devaluation of boys with either LD or ADD after a brief exposure is a reliable and valid finding. To this end, physical attractiveness data were gathered, children were employed as judges, subgroups of stimulus children were formed, and situational demands were varied. Results indicated that the boys with either LD or ADD were devalued relative to controls on a variety of dependent variables, including popularity. Both situational demands, as well as judgments of physical attractiveness, appeared to play a role in accounting for these differences.

Attention Deficit Disorder with Hyperactivity↗
PubMed1990

Stimulant medication use by primary care physicians in the treatment of attention deficit hyperactivity disorder.

Treatment of attention deficit hyperactivity disorder (ADHD), one of the most common behavioral disorders in children in the United States, remains controversial because of concern about stimulant medication use. Extending a previous study of pediatricians, the present study surveyed a random national sample of family practitioners and then directly screened 457 patients of 10 pediatricians and family practitioners in two small midwestern cities. Responses to the national survey indicated that stimulant medication remains the main treatment prescribed by primary care physicians for children with ADHD. In the direct patient screening, the prevalence of ADHD diagnoses was 5.3% (pediatricians) and 4.2% (family practitioners) of all elementary-school-aged children screened. Eighty-eight percent of these children were treated with methylphenidate. Although medication was considered an effective treatment by the parents of 85% of the children given the medication, efficacy was unrelated to the accuracy of diagnosis. When explicit DSM-III-R criteria were used, only 72% of those assigned a diagnosis of ADHD by the physicians would have received that diagnosis based on a structured psychiatric interview with the parents and only 53% received that diagnosis based on teacher report of symptoms, even when the child was not receiving medication. Although the majority of physicians (in both the surveys and the direct screenings) reported using at least some behavioral treatments with their patients, parents reported infrequent use of nonpharmacologic forms of therapy, such as behavior modification. These data thus indicate a relatively modest rate of stimulant medication use for ADHD, but a serious underuse of systematic behavioral treatments in primary care.(ABSTRACT TRUNCATED AT 250 WORDS)

Attention Deficit Disorder with Hyperactivity↗
PubMed1989

Attention-deficit hyperactivity disordered boys' evaluations of and attributions for task performance on medication versus placebo.

The present study examined the effects of stimulant medication on the self-evaluations of and attributions for task performance of 26 attention-deficit hyperactivity disordered boys. Each boy performed a continuous performance task twice, once while on medication and once while on placebo. Immediately following the completion of the task, the boys were asked a series of questions concerning their self-evaluations of, and attributions for, their performance. Two findings of note were obtained. First, medication, compared with placebo, increased the correspondence between the boys' self-evaluations and their performance. Second, the boys did not use medication as a frequent explanation for their performance, as others have predicted. In fact, the boys picked medication as an explanation for their successes significantly less often than either effort or ability.

Achievement↗
PubMed1988

Social communication patterns of attention-deficit-disordered boys.

This study was designed to compare the social communication patterns of attention-deficit-disordered (ADD) and normal boys. This was accomplished by employing a "TV Talk Show" social role-playing procedure in which the task required different strategies for the roles of "host" and "guest." Groups of ADD and normal elementary-age boys were formed, and each boy was paired with a normal class-mate. Measures of communication competence were coded from videotapes made of subject and partner social interactions while performing both roles. Results indicated that the ADD boys, in contrast to the control group, failed to modulate their social communication behaviors as task demands shifted. Additionally, the behavior of the ADD boys resulted in their normal partners' altering their response patterns in order to maintain the equilibrium in the dyadic interaction. These results suggest that the social behavior of ADD children is relatively independent of environmental requirements and may contribute to the inappropriate responding of others.

Attention Deficit Disorder with Hyperactivity↗
PubMed1987

Pediatricians' reported practices in the assessment and treatment of attention deficit disorders.

This study examined, in a national survey, the assessment and treatment practices of pediatricians who care for children with attention deficit disorders (ADD). A questionnaire was sent to randomly selected members of the American Academy of Pediatrics (AAP), stratified by state. Of 417 (52%) responses returned, there were 290 (38%) completed questionnaires. It was found that most pediatricians did not utilize specific DSM-III criteria for ADD; however, they do rely on symptoms of distractibility, overactivity, and impulsivity, which are the behaviors central to the DSM-III diagnosis. In addition, learning difficulties were felt to be contributory. Parents were the most frequently reported sources of information about a child's behavior, but the histories provided by teachers, and psychoeducational reports, also were sought frequently. Many pediatricians still use diagnostic procedures that have recently come under question, such as soft neurologic signs, activity level in the office, and response to stimulant medication. Methylphenidate and behavior modification were the most frequent therapies employed. Over half of the respondents use periodic reevaluation with rating scales to determine medication efficacy, but very few use placebo trials. More recently trained pediatricians tended to rely more on behavioral treatments than did earlier trained physicians.

Attention Deficit Disorder with Hyperactivity↗
PubMed1987

Sustained release and standard methylphenidate effects on cognitive and social behavior in children with attention deficit disorder.

Two studies were conducted to investigate the relative effects of sustained release methylphenidate (Ritalin [SR-20]) and standard methylphenidate (Ritalin, 10 mg, administered twice daily). In the first study, 13 boys with attention deficit disorder participating in a summer treatment program went through a double-blind, within-subject trial of each form of methylphenidate and placebo. Measures of social and cognitive behavior were gathered in classroom and play settings. Although group analyses of the data showed that both drugs were effective and there were few differences between them, standard methylphenidate was superior to SR-20 on several important measures of disruptive behavior. Furthermore, analyses of individual responsivity showed clearly that most boys responded more positively to standard methylphenidate than to SR-20. The second study involved a partially overlapping group of nine boys with attention deficit disorder participating in the same summer treatment program. Also double-blind, within-subject, and placebo controlled, this study tracked the time courses of the two forms of methylphenidate. Both were shown to have similar time courses on the Abbreviated Conners Rating Scale and other measures, but SR-20 had a slower onset than did the standard drug form on a continuous performance task. Effects of SR-20 were still evident eight hours after ingestion.

Attention Deficit Disorder with Hyperactivity↗
PubMed1986

Dietary characteristics of hyperactive and control boys.

The purpose of this study was to examine the relationship between dietary habits and behavioral problems in hyperactive boys and to determine how successful parents are in maintaining their children on sugar-free diets. The mothers of 32 hyperactive boys aged 7 to 12 years and 26 matched controls completed 3-day diet records and food frequency interviews. The hyperactive boys were also evaluated in a playroom for impulsivity, compliance, attention, motor activity, memory, and learning. No differences were found in any of the measures of dietary content between the hyperactive and control groups. The only significant differences between those two groups were a lower socioeconomic status and a greater number of parents attempting sugar-restricted diets in the hyperactive group. Boys on sugar-restricted diets had only one significant dietary difference from those not restricted. Correlations between the information obtained in food frequency interviews and in 3-day diet histories were not significant (r = .06 to .33) for the hyperactive group, but the food frequency interviews were significant for the control group (r = .41 to .47). Four behavioral variables showed significant partial correlations with reported sugar intake. Overall, the results demonstrated that the diets of a group of hyperactive boys were similar to those of a control group. There appeared to be little difference between the diets of the families that attempted to restrict sugar and those that did not.

Child↗
PubMed1985

Effects of sucrose ingestion on the behavior of hyperactive boys.

A challenge design was used in two separate studies to investigate the effects of sucrose ingestion on the behavior and learning of hyperactive boys. In both studies, 16 boys were admitted to a clinical research center for 3 successive days, on each of which they were given a sucrose-free diet. On day 1, baseline levels on the learning tasks were established; on days 2 and 3 a challenge drink of either sucrose 1.75 gm/kg or a placebo (aspartame in equivalent sweetness) was presented, in a counterbalanced order. In the first study the challenge drink was administered 1 hour after lunch; in the second study it was given in the morning after an overnight fast. On days 2 and 3 of both studies, 37 behavioral (playroom observation and examiner ratings) and cognitive (learning and memory tasks) measures were collected, starting 1/2 hour after ingestion of the drink. The results of both studies revealed no differences between the boys' performance on the two challenge days. These findings undermine the hypothesis that sucrose plays a major role in accounting for the inappropriate behavior of hyperactive boys.

Aspartame↗