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S V Faraone

Publications and source records attributed to S V Faraone.

268 records · Page 15Linked to original sources
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Neuropsychological performance in chronic schizophrenia in response to neuroleptic dose reduction.

The effect of 80%-90% neuroleptic dose reductions on neuropsychological function in schizophrenic and schizoaffective patients was examined in a prospective study. A neuropsychological battery was administered in the week prior to neuroleptic reduction followed by retesting at least 6 weeks postreduction. Patients were retested only if they did not relapse after reduction. The design allowed neuropsychological changes due to neuroleptic medications to be assessed independently of general clinical change. Neuropsychological performance was generally stable and unchanging. However, there was a trend toward significant improvement on a dichotic digits task based in improvement in left ear accuracy. Negative symptoms diminished after reduction. Compared with a normal control group, schizophrenics' initial laterality index showed a significantly exaggerated right ear advantage (REA); after reduction, the REA was no longer different from controls. The findings indicate that neuropsychological changes in a small sample of older nonrelapsing chronic schizophrenics are modest. The data suggest that neuroleptics may impair right hemisphere functions in some patients.

Adult↗
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The relationship between DSM-III personality disorders and the five-factor model of personality.

Two hundred twenty-four first-degree relatives of patients with psychotic disorders were administered the Structured Interview for DSM-III Personality Disorders (SIDP) and completed a self-report instrument to assess dimensions of the five-factor model of personality. All of the DSM-III personality disorders were related to one or more dimensions of the five personality factors; however, the correlations were generally low. It seems that the five personality factors describe important features of DSM-III personality disorders, but are not sufficient to completely explain their characteristics. Future use of the five-factor model in conjunction with personality disorder diagnoses may provide useful information for clinical work and research purposes.

Adolescent↗
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Empirical determination of thresholds for case identification: validation of the Personality Diagnostic Questionnaire-Revised.

The Personality Diagnostic Questionnaire-Revised (PDQ-R) was sent to first-degree relatives of major psychotic patients for identification of DSM-III-R personality disorders (PDs). Responses to the PDQ-R were interpreted both literally and empirically, and compared with the Structured Interview for DSM-III PDs (SIDP) as the standard. For literal interpretation, symptoms reported were counted directly for case identification using fixed DSM-III-R thresholds. The empirical approach adjusted the threshold for case identification to maximize concordance with the SIDP. Comparison of the two methods showed that using empirically determined thresholds in some scales gives better concordance with the SIDP. For the dependent and histrionic PD scales, the improvements were statistically significant. The area under the receiver operating characteristic (ROC) curve was computed for each PDQ-R scale to summarize its discriminatory capability across all thresholds. Areas under the ROC curve indicated that the schizoid, schizotypal, borderline, dependent, passive-aggressive, and histrionic PD scales in the PDQ-R have better discriminatory qualities than other PDQ-R scales.

Adult↗
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Motor preference, major depression and psychosocial dysfunction among children with attention deficit hyperactivity disorder.

Since left motor preference has been hypothesized to lead to increased risk for psychopathology and cognitive deficits, it is possible that it may confer greater vulnerability for these problems to attention deficit hyperactivity disorder (ADHD) children. Subjects were 6-17 year-old boys with DSM-III-R ADHD (N = 140) and normal controls (N = 120) and their first-degree relatives. Information on motor preference was obtained in a standardized manner blind to the proband's clinical status. Although no excess of non-right motor preference was identified in ADHD probands compared with normal controls, the non-right motor preference observed in ADHD probands was partly familial and was associated with significantly increased risk for major depressive disorder and impaired psychosocial functioning. Non-right motor preference in ADHD probands significantly increases the risk for major depression and impaired psychosocial functioning. These findings raise the possibility of alterations in cerebral dominance which may be implicated in the expression of specific problems in some patients with ADHD. Further research is needed to replicate these findings and to directly assess cerebral functioning in ADHD.

Adolescent↗
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Familial and sporadic schizophrenia. A simulation study of statistical power.

The importance of genetic factors in schizophrenia is clear but the mechanism involved remains obscure. Etiological heterogeneity may be responsible. Recently there has been interest in a putative distinction between genetic and environmental forms of the illness based on a positive or negative family history of the disorder. Those with a positive family history are classified as 'familial' and are considered to be more likely to have the genetic form of the illness. Those with a negative family history are classified as 'sporadic' and considered more likely to have an environmental form of the illness. This paper reports the results of a Monte Carlo simulation study with varying rates of misclassification to determine the statistical power of comparisons between familial and sporadic groups. For a large sample (n = 175) statistical power was moderate to good for effect sizes greater than or equal to 1.0 standard deviation unit and positive predictive value of 0.3 or greater.

Humans↗
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The genetics of schizophrenia. Current knowledge and future directions.

Multiple research paradigms have provided evidence for a substantial genetic component in the etiology of schizophrenic disorders. This article reviews the major research strategies which have been employed in the examination of the genetic hypothesis in schizophrenia. Family studies have provided overwhelming support regarding familial transmission but cannot clearly resolve issues related to genetic-versus-environmental mechanisms. Twin and adoption studies, however, offer consistent evidence for a substantial genetic component and indicate environmental familial factors to be much less important. Quantitative modeling studies represent more specific attempts to identify the genetic mechanism and mode of inheritance responsible for the familial distribution of schizophrenia. To date, however, these quantitative models have not unequivocally supported a specific mode of genetic transmission. For instance, relevant studies provide little support for the mechanism of single major locus inheritance. Furthermore, although a mechanism involving two, three, or four loci cannot be ruled out, there is no compelling support for such models. The multifactorial polygenic model has received the most support and indicates that genetic factors play a greater role than environmental factors in familial transmission. A mixed genetic model including both a multifactorial component and a single major locus cannot be ruled out. Finally, studies of linkage analysis offer a more powerful technique used for testing the hypothesis of a single pathogenic gene, but the results of linkage analysis in schizophrenia are still preliminary and inconsistent. Evidence for a chromosome 5 gene locus has been provided in some studies but not replicated in others. The important implications of genetic-phenotypic heterogeneity and methodological deficiencies are discussed with respect to limitations on the interpretability of these studies and directions for future research.

Adoption↗
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Tourette's syndrome: what are the influences of gender and comorbid obsessive-compulsive disorder?

OBJECTIVE: To explore the influence of gender and comorbid obsessive-compulsive disorder (OCD) on the phenomenology of Tourette's syndrome (TS). METHOD: TS proband groups defined by gender and comorbid OCD status were compared on a variety of sociodemographic variables, clinical characteristics, and perinatal complications. RESULTS: Compared to females, males more often onset with rage and had ever experienced any form of simple tics. Females onset with compulsive tics more often than males. Probands with comorbid OCD were more likely than those without OCD to onset with complex tics. Delivery complications, especially forceps deliveries, were associated with being male and with having OCD. Fetal exposure to relatively high levels of coffee, cigarettes, or alcohol predicted OCD in TS probands. Diagnosis of TS occurred at later ages among females than among males. Males and females displayed different age distributions. CONCLUSIONS: Males and females tend to experience different kinds of symptoms at onset. However, the overall experience of TS appears to be similar for both groups. Perinatal brain injury is implicated in the etiology of TS in some boys. Early brain injury may cause or exacerbate the development of OCD in some TS sufferers.

Adolescent↗
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Associations between childhood asthma and ADHD: issues of psychiatric comorbidity and familiality.

OBJECTIVE: In this paper we evaluate the association between asthma and attention-deficit hyperactivity disorder (ADHD), addressing issues of comorbidity and familiality by formulating and testing competing hypotheses. METHOD: Subjects were 6- to 17-year-old boys with DSM-III-R ADHD (N = 140) and normal controls (N = 120) and their first-degree relatives. Information on asthma was obtained from the mothers in a standardized manner blind to the proband's clinical status. RESULTS: The risk for asthma did not meaningfully differ between ADHD and control children. Relatives of ADHD probands with and without asthma were at significantly greater risk for ADHD than relatives of normal controls. In contrast, the risk for asthma was significantly elevated only among relatives of children with ADHD plus asthma. CONCLUSIONS: These findings argue against a substantial etiological or pathophysiological relationship between the two conditions but suggest that ADHD and asthma are independently transmitted in families. Thus, the observation of ADHD symptoms in an asthmatic child should not be dismissed out of hand as being a consequence of asthma since many asthmatic ADHD children may actually have ADHD.

Adolescent↗
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Behavioral inhibition in childhood: a risk factor for anxiety disorders.

Childhood antecedents of anxiety disorders in adulthood remain poorly understood. We have, therefore, examined from longitudinal and familial perspectives the relationship between behavioral inhibition in children and anxiety disorders. We review a series of studies describing the association between behavioral inhibition and anxiety disorders in two independently ascertained and previously described samples of children. One sample was cross-sectional and clinically derived (Massachusetts General Hospital at-risk sample), and the other was epidemiologically derived and longitudinal (Kagan et al. longitudinal cohort). Our studies have found that (1) children of parents with panic disorder with agoraphobia, either alone or comorbid with major depressive disorder, are at increased risk for behavioral inhibition; (2) children identified as having behavioral inhibition have high rates of childhood-onset anxiety disorders themselves; (3) behavioral inhibition is associated with familial risk for anxiety disorders; (4) children with behavioral inhibition and anxiety disorders have greater familial loading of anxiety disorders; (5) children who remain inhibited over time are at highest risk for anxiety disorders in themselves and their families; and (6) these differences between inhibited children and not-inhibited controls become more robust at 3-year follow-up. Our research strongly indicates that behavioral inhibition is an identifiable early childhood predictor of later anxiety disorders.

Adolescent↗
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Is attention deficit hyperactivity disorder familial?

Using two sources of data, we review methodologic issues pertinent to family studies of attention deficit hyperactivity disorder to evaluate whether such studies define attention deficit hyperactivity disorder as a familial disorder. We systematically evaluate the relevant literature and provide a detailed overview of the Massachusetts General Hospital family-genetic studies of attention deficit disorder as defined in DSM-III and attention deficit hyperactivity disorder as defined in DSM-III-R. The available literature, and our double-blind, controlled studies indicate that attention deficit disorder and attention deficit hyperactivity disorder are familial. Moreover, the pattern of transmission of comorbid disorders suggests that attention deficit hyperactivity disorder is, from a familial perspective, distinct from anxiety disorders and learning disabilities. In contrast, attention deficit hyperactivity disorder with conduct disorder appears to be a familial subtype, and major depression appears to be a variable expression of the familial predisposition to attention deficit hyperactivity disorder. Although the available literature provides strong evidence for the familial transmission of attention deficit hyperactivity disorder, the mode of transmission requires further clarification. In addition, attention deficit hyperactivity disorder appears to be genetically heterogeneous, indicating that more work is needed to delineate genetically homogeneous subtypes and to describe the range of expression of their underlying genotypes. Family-genetic studies will continue to clarify the etiology and nosology of attention deficit hyperactivity disorder.

Adult↗
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Is attention-deficit hyperactivity disorder in adults a valid disorder?

Concerns have been raised regarding the validity of the diagnosis of attention-deficit hyperactivity disorder in adults. The purpose of this report is to evaluate critically whether this diagnosis in adults meets acceptable standards for diagnostic validity. A systematic search was conducted of the psychiatric and psychological literature for empirical studies dealing with adult attention-deficit hyperactivity disorder with childhood onset. These studies were examined for evidence of descriptive, predictive, and concurrent validity. The literature shows that this disorder can be reliably diagnosed in adults and that the diagnosis confers considerable power to forecast complications and treatment response. In addition, evidence is mounting for genetic transmission, specific treatment responses, and abnormalities in brain structure and function in affected individuals. Evidence from the literature is increasingly pointing to the validity of adult attention-deficit hyperactivity disorder.

Adult↗
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Schizophrenia: a review of genetic studies.

Despite the complexities of schizophrenia, notable progress has been achieved in its diagnosis and treatment over the last 25 years. In this article we review the genetic research that provides the foundation for continued advances. One of the bases of our current understanding involves the observation that schizophrenia often runs in families. The development and utilization of stringent, reliable diagnostic criteria, together with the advent of modern family, twin, and adoption paradigms, demonstrate the importance of genetic factors in understanding the familial basis of the disorder. Refinements in diagnostic criteria have also enabled advances in understanding the likely mode--or modes--of genetic transmission of both schizophrenia and related disorders. After reviewing representative studies in these areas, we examine genetic linkage studies and our progress toward identifying the genes that cause schizophrenia. Although consistent results have been difficult to obtain and much work remains to be done, evidence for areas of vulnerability has been converging at particular chromosomal sites (e.g., 6p, 8p, and 22q), allowing for cautious optimism. Finally, we discuss challenges and prospects for the new millennium, including the clinical and ethical implications of genetic investigations.

Chromosome Mapping↗