Biomedical subjects

S L Luk

Publications and source records attributed to S L Luk.

At least 19 recordsLinked to original sources

PubMed1999

Parent reported preschool attention deficit hyperactivity: measurement and validity.

This is a two stage community study of 320 preschool children aged between two and a half to five years. An Attention Deficit Hyperactivity Scale (ADH-P) was constructed. A first stage sample was screened by asking parents to fill in the ADH-P and the Behaviour Check List (BCL) for behaviour problems; 116 children were included in the second stage. Reliability of the ADH-P was tested and found to be satisfactory. Its validity was also supported by teacher's report and clinical observation. Based on the parent report, the children were divided into four groups: pure hyperactive, pure behaviour problem, mixed and no problem groups. External correlates and psychopathology were examined among them. The mixed group had more symptoms, poor maternal mental health, high social adversities, poor prosocial behaviour and high help seeking. Whilst significant associations were also present between these correlates and pure behaviour problems, the situation was substantially worse when hyperactivity co-existed with behaviour problems.

Attention Deficit Disorder with Hyperactivity↗

PubMed1999

DSM-IV and ICD-10: a comparison of the correlates of ADHD and hyperkinetic disorder.

OBJECTIVE: To examine directly the extent to which ICD-10 hyperkinetic disorder and DSM-IV attention-deficit/hyperactivity disorder (ADHD) identify the same children with the same difficulties. METHOD: Participants were children referred for symptoms of overactivity, inattention, and impulsivity, and a normal control group. Diagnostic criteria for ICD-10 hyperkinetic disorder and DSM-IV ADHD were applied retrospectively. Four groups were identified: hyperkinetic disorder and ADHD (n = 21), ADHD only (n = 22), clinic control (n = 15), and normal control (n = 19). The groups were compared on measures reflecting the central characteristics of ADHD, neurodevelopmental functioning, academic and cognitive functioning, and the presence of conduct problems. RESULTS: There is some evidence of increased symptom severity in the combined diagnostic group. Few differences emerged on measures of neurodevelopmental, academic, and cognitive functioning. Rates of conduct disturbance were similar in both ADHD groups. CONCLUSIONS: DSM-IV criteria identify a broader group of children than those identified by ICD-10. However, there is substantial overlap between the groups formed with these different criteria.

Adolescent↗

PubMed1998

Recognition and classification of psychopathology in preschool children.

OBJECTIVE: The aim of this paper is to offer a critical overview of research on preschool psychopathology, and to propose a working classification based on the empirical evidence. METHOD: All of the existing factor and cluster analytic studies, and those studies that attempted to establish the reliability and validity of the subcategories in preschool behaviour disorder were reviewed. Applicability of the current classifications (DSM-IV and ICD-10) to preschool age was examined. RESULTS: Empirical evidence suggests a well-established, externalising and internalising dichotomy, and a developmental problems factor where the instrument included these problems. There was also a strong tendency for the externalising and internalising symptoms to overlap. Within the externalising factor, there is evidence suggesting that attention deficit hyperactivity should be separated out and recognised. Categories in the DSM-IV and ICD-10 classification did not correspond with the statistically derived groups. CONCLUSION: A classification of preschool psychopathology that incorporates the age-specific disorders and risk factors is proposed. This is likely to increase the awareness of researchers, taxonomists and clinicians of psychopathology in preschool children, thereby leading to an early recognition.

Attention Deficit and Disruptive Behavior Disorder↗

PubMed1997

The identification of pervasive hyperactivity: is clinic observation necessary?

Three groups of hyperactive children (clinic observed, reported and situational) and a normal control group were compared on measures of behavioural, developmental and cognitive functioning. The clinic observed and reported groups did not differ significantly on any of the dependent variables. Situationally hyperactive children were less active, and had fewer behavioural and social difficulties than children with pervasive hyperactivity. Normal control subjects were distinguished by their better academic and social performance, and the absence of behaviour problems, language delay and hearing concerns. The data support the distinction between pervasive and situational hyperactivity, but not the separation of pervasive hyperactivity into clinic observable and reported hyperactivity.

Achievement↗

PubMed1996

Help-seeking for behavior problems by parents of preschool children: a community study.

OBJECTIVE: To identify barriers to seeking help for preschool behavior problems and understand the pattern of service utilization. METHOD: Altogether, 320 preschool children from eight preschool centers were studied using a two-stage design. After the initial screening, a more detailed assessment was carried out in the second stage involving semistructured interviews with parents and children. Parents also completed a service utilization questionnaire during the first stage and General Health Questionnaire, Family Assessment Device, and life events questions during the second stage. RESULTS: Only 19% of those with preschool behavior disorder crossed all the filters in reaching for help. The most common perceived barriers to help-seeking were that problems would get better by themselves or that parents should be strong enough to handle them. The major blocks to help-seeking were at two levels, in parents recognizing the presence of a problem and in overcoming the perceived barriers by the parents. Parents sought help from the informal agencies more often than from the formal. Help was sought significantly less often by those who had parental separation, low income, or multiple adversities, all of which were known to be significantly associated with behavior disorder. CONCLUSION: These findings indicate the need to educate and influence the parents' attitude to help-seeking, target those at risk to develop behavior disorder, and develop better consultation-liaison service with the informal agencies.

Child Behavior Disorders↗

PubMed1996

Pattern of preschool behavior problems in New Zealand, using the Behavior Check List.

OBJECTIVE: The main aim of the study was to identify the pattern of behaviour problems in preschool children to enable early recognition and intervention. METHODOLOGY: Three hundred and twenty children, in eight randomly selected preschool centres, aged between 2.5 and 5 years, were included in the study. Parents completed the Behaviour Check List (BCL),a screening measure for preschool behaviour problems. RESULTS: Dependency, temper tantrums, and being difficult to manage were the commonly rated symptoms when moderate-severe problems were examined. Developmental problems decreased with increasing age, while relationship problems and worries that were cognitively mediated worsened. There were no major differences in the patterns between boys and girls. On cross-cultural comparison, parents in New Zealand rated their children lower on the BCL compared to those in the UK. Factor analysis of the BCL yielded seven factors. The two main factors 'predominantly conduct' and 'predominantly emotional' consisted of a mixture of conduct (difficulty in managing, temper tantrums, sibling rivalry) and emotional (unhappy mood, worry, fears) problems. The other five factors were related to developmental problems. CONCLUSIONS: These results help clinicians identify the emerging pattern of preschool behaviour problems that change with increasing age and vary with differing cultures. Categorical presentation of preschool behaviour problems support the view that they should be included in a classification system.

Adult↗

PubMed1996

Separation and comorbidity of hyperactivity and conduct disturbance in Chinese schoolboys.

In a two-stage community study of 3069 Chinese schoolboys in Hong Kong, those entering stage 2 were classified by scores on Rutter's teacher and parent questionnaires into: (1) a mixed hyperactive/conduct-disturbed (HA-CD) group; (2) a pure hyperactive (HA) group; (3) a pure conduct-disturbed (CD) group; and (4) a normal control group. The four groups of children were compared on a series of psychosocial, cognitive and neurodevelopmental measures. This was followed by a regression analysis to examine the specificity of the differential patterns of associations between HA and CD. There was a mix of negative and positive findings defying a simple, definitive conclusion. However, the positive findings that did emerge supported a growing body of recent literature which favoured a separation of HA from CD and their cross-cultural validity: the former was associated with neurodevelopmental impairments, the latter with family disharmony. The mixed condition, HA-CD, was a hybrid of its two constituent conditions, displaying the attributes of both.

Achievement↗

PubMed1996

The diagnosis and prevalence of hyperactivity in Chinese schoolboys.

BACKGROUND: This study was undertaken to examine the validity of different diagnostic definitions of hyperactivity in a Chinese population. Estimates of the prevalence of hyperactivity were made according to these different diagnostic definitions. METHOD: In a two-stage epidemiological study of hyperactivity in Hong Kong, 3069 Chinese schoolboys were screened by questionnaires; and a stratified sample of 611 of them entered a second stage for more detailed diagnostic assessment. RESULTS: Children with hyperkinetic disorder (ICD-10) or ADDH (DSM-III) both displayed significant hyperactive symptoms, but with somewhat different external correlates; hyperkinetic disorder tended to show more neurodevelopmental impairments, ADDH more cognitive and educational difficulties. These findings raise the possibility of heterogeneity in the disorders present with hyperactivity. The DSM-III-R category of ADHD was more common, and those extra cases, that did not overlap with ADDH or hyperkinetic disorder, included children with no obvious behavioural, cognitive or neurodevelopmental impairments. Hence ADHD may be an over-inclusive category. Prevalence rates for hyperkinetic disorder, ADDH and ADHD were respectively 0.78%, 6.1% and 8.9%. CONCLUSIONS: A disorder of hyperactivity does exist in the Chinese culture, displaying the same kinds of symptomatology and external correlates as in the West. The prevalence rates of hyperkinetic disorder and ADDH in Chinese schoolboys are on the low side when compared to those reported in Western studies.

Attention↗

PubMed1995

A community study of preschool behaviour disorder in New Zealand.

A two stage epidemiological study of 320 children aged between 2.5 and 5 years of age, from eight randomly selected preschool centres, was performed in order (1) to test the psychometrics of the Behaviour Check List (BCL), a parent report instrument for preschool children, (2) to estimate the prevalence, and (3) to describe the correlates of preschool behaviour disorder. After the initial screening using the BCL, the Hyperactivity Scale (HAS) and the Internalising Disorder Scale (IDS), parents were interviewed using the Behaviour Screening Questionnaire (BSQ); the children were examined using the Rutter and Graham's interview. Data was also collected on family functioning, maternal mental health, social adversity, development, physical health and perinatal history. The BCL was found to be a reliable and valid screening measure. A cut off point of 8+ was established for New Zealand preschoolers; this is lower than that in the UK sample, illustrating the importance of retesting the instruments in a different culture. The prevalence rate of behaviour problems based on clinical diagnosis was 22.5%. Results of logistic regression analysis showed that poor family functioning, poor maternal mental health and parental separation were associated significantly with behaviour disorder. This study emphasises the need to identify preschool behaviour disorder and associated risk factors to enable an early intervention.

Child Behavior Disorders↗

PubMed1993

Adolescent identity disorder: a case presenting with cultural identification problem.

A computer search of the psychiatric literature starting from 1983 showed no studies or clinical reports of Identity Disorder. A case history of a 15 year old Chinese boy with Identity Disorder presenting with cultural identification problems is described. Cultural identification among second generation immigrants is discussed in detail. Cultural factors can be very important in the consideration of Identity Crisis and Identity Disorder in adolescents.

Acculturation↗

PubMed1992

Language screening in preschool Chinese children.

The incidence of language delay in Chinese preschool children was studied by a stratified proportional sampling of all 3 year olds in Hong Kong. The Developmental Language Screening Scale (DLSS) devised for use with Cantonese speaking children was used to identify children with language delay. Of 855 children sampled in the stage I screening procedure, 4%, 2.8% and 3.3% were identified as having delay in verbal comprehension, expression or both respectively. The stage II clinical diagnostic study included a randomly selected group of children screened in stage I with or without any associated behavioural problem. Among these, 3.4% were identified as having a language delay using the Reynell Language Developmental Scale (RDLS) with a criterion of language age of less than or equal to two-thirds of the chronological age; 3% had specific language delay using the criteria of language age less than or equal to two-thirds the chronological age and developmental age more than or equal to two-thirds the chronological age. More boys were found to have language delay, although this was not statistically significant.

Child, Preschool↗

PubMed1991

The structure and prevalence of behavioral problems in Hong Kong preschool children.

Nearly all 3-year-old Chinese children in Hong Kong attend preschool facilities, making it possible to study their behavior in a group learning situation based upon teachers' perception. The Preschool Behavior Checklist (PBCL), a teacher's questionnaire, was applied to a random sample of 851 Chinese children, ages 36 to 48 months. The factor structure of the PBCL was very similar to that obtained from its original British study, supporting its usage cross-culturally. Prevalence of behavior disorder was high as defined by the PBCL. This reflected specific cultural demands at school settings. Significant sex differences were also found in the overall rate of behavior disorder and symptom patterns. As in other studies, boys had more hyperactive, conduct, and speech problems. The results suggested a certain degree of universality of symptomatology for children at the preschool level.

Affective Symptoms↗

PubMed1991

Clinic observations in the assessment of pervasiveness of childhood hyperactivity.

Sixty-one boys, 6-12 years old, met both the diagnostic criteria of ADHD of DSM-III-R and hyperkinetic syndrome of ICD-9. They could be subdivided into two groups: 43 showed hyperactive symptoms in the clinic situation and 18 did not. The former group were younger and showed significantly poorer performance in measures of general intelligence, attention, cognitive styles, motor clumsiness and minor neurological deficits. Controlling for age and intelligence attenuated the differences, but significant differences remained in activity level, attention, and minor neurological deficits. This result suggests that direct observation is important in the assessment of pervasiveness of childhood hyperactivity.

Attention↗

PubMed1991

Behaviour disorder in pre-school children in Hong Kong. A two-stage epidemiological study.

A representative sample of 855 Hong-Kong Chinese children aged 36-48 months were assessed using the BSQ and the PBCL. Good reliability for both instruments were found. For the BSQ and PBCL, 12.75% and 27.5% were above the cut-off points of 10+ and 12+ respectively and 5.9% were above both cut-off points. In the second stage, 234 subjects were recruited by stratified random sampling according to the results of the screening state. A clinician interviewed the parent, child and teacher before making a diagnosis. The prevalence of behaviour disorder was: nil, 53.7%; dubious, 23.1%; mild, 18.0%; moderate, 4.5%; and severe, 0.7%. There were significantly more boys in the categories mild, moderate and severe.

Adult↗

PubMed1991

Cognitive-behavioural group therapy for Hong Kong Chinese adults with mental health problems.

Ninety-one Chinese in the community, aged between 18 and 45, with mental health problems ranging from mild to moderate degree, were treated by cognitive behavioural group therapy (CBGT) for a period of 3 months. All subjects were assessed on multiple measures at 4 time points: screening, pre-treatment (after 3 months), post-treatment and at 3-month follow-up. Attendance was good. A standard practice manual was developed to ensure consistent treatment by 2 group workers. After controlling for the placebo effect in the waiting period, treatment effect was demonstrated which was sustained after a three month period. The all-round improvement included a decrease in psychiatric symptoms, improvement in self-assessment, better and more social activities and being more able to cope with problems. In terms of psychiatric diagnosis, depressed subjects gained the most benefit and personality disorder subjects the least. Parents seemed to benefit more than non-parents.

Adaptation, Psychological↗

PubMed1990

A follow-up study of infantile autism in Hong Kong.

All 87 autistic children referred to the Department of Psychiatry from 1976 to 1986 were included as subjects. Their demographic, family, medical, and psychiatric characteristics were described. Sixty-six (75.9%) were traced for follow-up assessment. There was a striking similarity between the characteristics of our sample and those reported in other countries (e.g., sex ratio, intelligence, language ability, behavioral characteristics, and outcome). The finding of less family history of language delay, epilepsy, and sex difference are discussed.

Autistic Disorder↗

PubMed1990

Comparison of parent-referred and doctor-referred patients to child psychiatrists in Hong Kong: a research note.

The characteristics of 75 children referred to psychiatrists by medical practitioners in Hong Kong were compared with 56 children who were referred by their families to a community clinic. Their demographic characteristics, and the nature and severity of their illness, were quite similar. Medical practitioners tended to refer children with childhood psychosis and psychophysiological disorder. The reasons leading to different types of referral are discussed. A community child mental health clinic may be a useful model for providing psychiatric care to children in Hong Kong.

Child↗

PubMed1989

Conners' Teacher's Rating Scale--a validity study in Hong Kong.

The validity of the Conners' teacher's rating scale (CTRS) in Hong Kong Chinese school children was examined. It was found that CTRS could significantly differentiate a behaviorally deviant group and the normal population; that CTRS has a strong positive correlation with the teacher's decision to refer a child to a mental health professional; that the CTRS by itself is not useful as a diagnostic instrument; and finally, it cannot stand alone as a screening instrument in the epidemiological study of childhood hyperactivity.

Attention Deficit Disorder with Hyperactivity↗