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Biomedical subjects

W Matthys

Publications and source records attributed to W Matthys.

At least 19 recordsLinked to original sources
PubMed2006

Adolescent outcome of disruptive behaviour disorder in children who had been treated in in-patient and day-treatment settings.

Although several studies have been conducted on the longitudinal course of childhood disruptive behaviours in community samples and in general psychiatric samples, little is known about adolescent adjustment in psychiatrically treated disruptive behaviour disorder (DBD) children. We examined a sample of adolescents (n = 47) who had been treated as children in an in-patient and/or day-treatment setting because of their severely disruptive behaviour. At follow-up, we found that half of the adolescents had a DBD diagnosis, and on average higher numbers of participants ever used soft drugs, had ever been in court, were not attending school when this was mandatory, and were smoking on a daily basis, as compared to comparison groups. There was, however, a large variance among the adolescents of our sample. When outcome was defined in terms of DBD diagnosis, living status, delinquency, school attendance, and smoking behaviour, 38 % had a positive outcome and 34 % had a poor outcome. For clinical purposes, it is important to recognise that there are large individual differences in outcome.

Adolescent↗
PubMed2006

Do social information-processing models explain aggressive behaviour by children with mild intellectual disabilities in residential care?

BACKGROUND: This study aimed to examine whether the social information-processing model (SIP model) applies to aggressive behaviour by children with mild intellectual disabilities (MID). The response-decision element of SIP was expected to be unnecessary to explain aggressive behaviour in these children, and SIP was expected to mediate the relation between social schemata and aggressive behaviour. METHOD: SIP and aggressive behaviour of 130 10- to 14-year-old children with MID in residential care were assessed. The fit of various SIP models was tested with structural equation modelling. RESULTS: The response-decision process was found not to be necessary to explain aggressive behaviour. Social schemata were indirectly related to aggressive behaviour with aggressive response generation as mediating variable. CONCLUSIONS: Implications for SIP theory and intervention are discussed.

Adolescent↗
PubMed2005

Do children do what they say? Responses to hypothetical and real-life social problems in children with mild intellectual disabilities and behaviour problems.

BACKGROUND: Most research on children's social problem-solving skills is based on responses to hypothetical vignettes. Just how these responses relate to actual behaviour in real-life social situations is, however, unclear, particularly for children with mild intellectual disabilities (MID). METHOD: In the present study, the spontaneous and selected responses of 56 children with MID to hypothetical situations from the Social Problem-Solving Test for children with MID (SPT-MID) were compared to their actual behaviour in comparable staged standardized real-life conflict situations. Correlations to externalizing behaviour problems were assessed using the Teacher's Report Form (TRF). RESULTS: The results show children with MID and accompanying externalizing behaviour problems to behave more aggressively in the staged real-life conflicts and provide more spontaneous aggressive responses to the hypothetical vignettes than children with MID and no accompanying externalizing behaviour problems; they did not, however, select more aggressive responses from the hypothetical options provided. A moderate correlation was found between the aggressiveness of the spontaneous responses in the hypothetical situations and actual behaviour in the staged real-life situations. In addition, both the spontaneous aggressive responses under hypothetical circumstances and the actual aggressive behaviour under staged real-life circumstances were related to teacher-rated aggressive behaviour in the classroom. CONCLUSIONS: It is concluded that the hypothetical vignettes from the SPT-MID do provide information on both the actual behaviour and knowledge of social problem-solving skills of children with MID.

Aggression↗
PubMed2002

Effective treatments of school-aged conduct disordered children: recommendations for changing clinical and research practices.

The present article discusses reviews, meta-analytical and other relevant outcome studies of treating school-aged conduct-disordered children. Meta-analytical studies of Parent Management Training and Cognitive-behavioural Therapy for the child have demonstrated that these interventions affect conduct disorder in children positively. However, most studies involved in these meta-analyses are conducted in research conditions and are not representative of the treatment effectiveness in everyday clinical practice. We believe there is a gap between the so-called efficacy studies in research conditions and the effectiveness studies in clinical practice and we discuss how clinical and research practice could be brought together.

Adolescent↗
PubMed2001

The assessment of the situational specificity of children's problems behaviour in peer-peer context.

In both theory and research the general issue of the extent to which children's problem behaviour is generalised across situations, and to what extent it is situation specific, has been neglected. In the clinical assessment of disordered children, too, little attention has been paid to the specific situations in which these children display their inappropriate behaviour. In this study the Taxonomy of Problematic Social Situations (TOPS) (Dodge, McClaskey, & Feldman, 1985) was employed. This is a questionnaire in which the child's teacher is asked to rate the likelihood of a child responding in an inappropriate manner in a specific situation. Characteristics of TOPS were investigated both in randomly selected normal school children and in boys with a conduct disorder. Four factors appeared to underlie the TOPS scores from 652 randomly selected boys and girls from grades 1 to 6, these being: teachers' scores for the types of problem situation Being Disadvantaged, Coping with Competition, Social Expectations of Peers, and Teacher Expectations. Because of the high internal consistency of the four factors, TOPS was abbreviated to a TOPS-Short Form (18 instead of 44 items). The four-factor model was cross-validated by means of a second sample of 326 boys and girls. A model with only one general problem behaviour factor did not fit the data of both samples. When the four specific factors were added a satisfactory fit resulted. Moreover, it was found that in the first sample 52% of the variance was explained by the general factor, whereas 18% of the variance was explained by the four specific factors together. Thus, the extent to which problem behaviour is situation specific should not be disregarded. In all four types of problem situation, boys showed more inappropriate behaviour than girls. With increasing age, children were rated as being more competent in dealing with the problem situation Being Disadvantaged. Teachers rated the four types of problem situation as more problematic for boys with a conduct disorder (N = 42) than for normal control boys (N = 67). Conduct disordered boys also differed individually in the number of situational types that were problematic for them. With respect to clinical implications, the identification of the particular social context in which a conduct disordered child displays his or her inappropriate behaviour may help refine treatment goals: more adequate social functioning should be aimed at specifically in those situations that are problematic.

Aggression↗
PubMed2000

Hypothalamic-pituitary-adrenal axis and autonomic nervous system activity in disruptive children and matched controls.

OBJECTIVES: To investigate whether a pattern of lower autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis activity is found in children with disruptive behavior disorders (DBD) under nonstressful and stressful conditions, and whether such a pattern would correspond with their feelings of control and negative emotionality. METHOD: The effects of stress were studied by comparing cortisol response, heart rate (HR), skin conductance level (SCL), and subjective feelings of 26 children with DBD and 26 matched normal controls. An additional 12 normal control children were studied in a nonstress control condition. RESULTS: Baseline HR and SCL but not cortisol were lower in the DBD group. Stress significantly affected cortisol, HR, SCL, and negative moods, although children with DBD showed a weaker HPA stress response and the difference between the groups was greater under stress. CONCLUSIONS: Children with DBD are characterized by lower ANS activity and HPA axis responsivity, but higher levels of emotional arousal. It is possible that in children with DBD the HPA axis and ANS, on the one hand, and their emotional arousal, on the other, are less well coordinated. It is speculated that this could be due to differences in genetic makeup or to stressful conditions during pre- or postnatal life.

Affect↗
PubMed2000

Increased adrenal androgen functioning in children with oppositional defiant disorder: a comparison with psychiatric and normal controls.

OBJECTIVE: To examine the relationship between adrenal androgens and aggression in children with oppositional and antisocial behavior and to compare their levels with those of psychiatric and normal controls. METHOD: Dehydroepiandrosterone sulfate (DHEAS) was measured in 24 children with oppositional defiant disorder (ODD), 42 psychiatric controls (including 20 children with attention-deficit/hyperactivity disorder [ADHD]), and 30 normal controls. The children's parents filled out the Child Behavior Checklist (CBCL). RESULTS: Children with ODD had higher DHEAS levels than either the psychiatric control or normal control groups; DHEAS levels of the latter groups did not differ. Moreover, it was possible to classify children as having either ODD or ADHD on the basis of their DHEAS levels, whereas this was not the case on the basis of the CBCL data. CONCLUSIONS: The results indicate that adrenal androgen functioning is specifically elevated in children with ODD. It is speculated that the mechanism could be a shift in balance of ACTH-beta-endorphin functioning in the hypothalamic-pituitary-adrenal axis due to early stress or genetic factors.

Adrenal Glands↗
PubMed1999

Pituitary-adrenal reactivity in a child psychiatric population: salivary cortisol response to stressors.

The aim of this explorative study was to investigate whether physical and psychological challenges are effective in inducing a cortisol response in psychiatric and control children, and if so whether the cortisol response can discriminate between diagnostic groups and is related to psychiatric symptoms. Fifty-two patients, including children with dysthymia, oppositional defiant disorder/conduct disorder, pervasive developmental disorder, not otherwise specified (PDDNOS) and attention deficit hyperactivity disorder, were compared to 15 healthy control children. Symptomatology was scored using the Child Behaviour Checklist. The response to both psychological and physical challenges was assessed by measuring salivary cortisol and heart rate. Physical challenge, but not psychological challenge, resulted in an overall increase in heart rate and saliva cortisol. Dysthymic and PDDNOS patients showed a diminished cortisol response, in spite of a significant increase in heart rate. These groups scored highest on the symptom factor withdrawal. Withdrawal was negatively correlated with the cortisol response. Thus, physical exercise is effective in inducing a salivary cortisol response in children. Dysthymic and PDDNOS patients have a disturbed pituitary-adrenal function in relation to physical stress, that may be associated with withdrawal.

Adolescent↗
PubMed1999

Plasma monoamine metabolites and aggression: two studies of normal and oppositional defiant disorder children.

In two studies the relationship between plasma monoamine metabolites and different parameters of aggression were examined in children suffering from severe aggression and antisocial behavior. No prior studies have related measures of serotonergic function to experimentally elicited aggression and only a few included healthy comparison groups. Plasma 5-HIAA, HVA and MHPG were measured in 15 boys with a oppositional defiant disorder (ODD) and 25 normal controls (NC) (study 1), and 22 ODD and 25 NC children (study 2). On a separate occasion each subject had the opportunity to behave aggressively towards an opponent. 5-HIAA and HVA were significantly lower in the ODD than NC group and both parameters were significantly inversely correlated with aggression and delinquency. These findings were replicated in the second study: The results of the study support a role for serotonergic functioning in persistent antisocial and aggressive behavior in young children.

Aggression↗
PubMed1999

Deficient social problem-solving in boys with ODD/CD, with ADHD, and with both disorders.

OBJECTIVE: To study social problem-solving skills in psychiatrically defined aggressive boys, starting from Dodge's social information-processing model. METHOD: Videotaped stimuli of problematic social situations and questions were presented to elicit responses that indicate boys' social problem-solving skills (encoding and interpretation of social cues, generation of possible responses, evaluation of responses, self-efficacy evaluation, and response selection). Boys aged 7 to 12 years with oppositional defiant or conduct disorder (ODD/CD) (n = 48), attention-deficit hyperactivity disorder (ADHD) (n = 27), and both disorders (ODD/CD + ADHD) (n = 29) were involved as well as a normal control group (n = 37) and a psychiatric control group with internalizing disorders (n = 23). RESULTS: When compared with normal controls, boys with ADHD, with ODD/CD, and with ODD/CD + ADHD encoded fewer social cues and generated fewer responses. Boys with ODD/CD and with ODD/CD + ADHD moreover were more confident in their ability to enact an aggressive response than normal controls. When ODD/CD boys and ODD/CD + ADHD boys were given the opportunity to select a response from various types of responses shown, they selected an aggressive response more often than normal controls. Thus, in ADHD boys social problem-solving was affected only in encoding and in the generation of responses, whereas in ODD/CD and ODD/CD + ADHD boys social problem-solving was affected throughout the process. CONCLUSION: For the further study of social problem-solving in aggressive children, it is essential to differentiate between children with ADHD and children with ODD/CD and ODD/CD + ADHD.

Aggression↗
PubMed1998

Salivary cortisol and cardiovascular activity during stress in oppositional-defiant disorder boys and normal controls.

BACKGROUND: Arousal-regulating mechanisms are important in explaining individual differences in antisocial behavior. METHODS: Alterations in salivary cortisol concentration and cardiovascular activity were studied in 21 boys with oppositional defiant disorder (ODD) and 31 normal controls (NC) during a 2-hour stressful procedure involving frustration and provocation. RESULTS: Baseline levels of heart rate (HR) were significantly lower in the ODD group, but their HR levels were higher during provocation and frustration. Cortisol levels in the ODD group were overall lower than those of the NC group, and the effect of stress seemed to be minimal and similar for both groups; however, individual differences were large. Since anxiety plays an important mediating role in cortisol response, subjects were divided into one of four groups based on the intensity of their externalizing behavior and anxiousness. Cortisol increase due to stress exposure was strongest in highly externalizing and highly anxious subjects; cortisol decrease was strongest in those subjects who were high in externalizing behavior and low in anxiousness. CONCLUSIONS: The results of the study support an important role for hypothalamic-pituitary-adrenal axis sympathetic autonomic functioning in persistent antisocial behavior in young boys.

Aggression↗
PubMed1998

Adrenal androgens and aggression in conduct disorder prepubertal boys and normal controls.

BACKGROUND: The evidence for a role of androgens in human aggression is less convincing than in animals. We examined the relationship between androgens and aggression in prepubertal boys who were diagnosed as suffering from severe aggression and antisocial behavior. METHODS: Plasma levels of testosterone (T), androstenedione (A), and dehydroepiandrosterone sulphate (DHEAS) were measured in 15 boys with a conduct disorder (CD) and 25 normal control (NC) boys. Parents and teachers of the children rated the intensity of aggression and delinquency over the last 6 months. RESULTS: CD boys had significantly higher levels of DHEAS and marginally significantly higher levels of A; there were no differences in T. Moreover, DHEAS levels were significantly positively correlated with the intensity of aggression and delinquency as rated by both parents and teachers. CONCLUSIONS: The results suggest that adrenal androgen functioning plays an important role in the onset and maintenance, of aggression in young boys.

Adrenal Glands↗
PubMed1998

Differential effects of hydrocortisone and dexamethasone on cortisol suppression in a child psychiatric population.

The suppressive effect of hydrocortisone and dexamethasone on salivary cortisol was investigated in a 2-year study of pituitary-adrenal function in a variety of child psychiatric patients and healthy controls. Symptomatology was assessed using the Child Behavioral Checklist (CBCL). Cortisol day profiles were assessed at 2-h intervals from 0800 to 2000 h on three occasions. Dexamethasone and hydrocortisone were administered orally twice at 2000 h, the doses being adjusted for bodyweight according to the standard dexamethasone suppression test. Fifty-one patients, including patients with dysthymia, oppositional defiant disorder, pervasive developmental disorder, and attention deficit hyperactivity disorder, and ten age and sex matched controls participated. Basal cortisol levels in patients were generally lower than in controls. Both dexamethasone and hydrocortisone were effective in suppressing salivary cortisol, although dexamethasone was somewhat more potent and its effect lasted longer. Hyporesponsiveness to hydrocortisone, but not to dexamethasone, distinguished patients with dysthymia and oppositional defiant disorder from controls. Responsiveness to hydrocortisone was correlated with the symptom clusters social problems and anxious/depressed. The data support the idea that there exist syndrome aspecific disturbances in feedback activity beyond the level of the pituitary, i.e. at the hypothalamic level, at an early age. From this perspective, hydrocortisone suppression is a useful tool for studying pituitary-adrenal function in children. Behavioral correlates of these disturbances of pituitary-adrenal function should be determined.

Arousal↗
PubMed1998

The dominance of behavioural activation over behavioural inhibition in conduct disordered boys with or without attention deficit hyperactivity disorder.

On the basis of Gray's theory, Quay suggested that conduct disorder (CD) is associated with a Behavioural Activation System (BAS) that dominates over the Behavioural Inhibition System (BIS), whereas attention deficit hyperactivity disorder (ADHD) is characterised by an underactive BIS. Two studies were conducted to test the hypothesis that the dominance of the BAS over the BIS is more pronounced in CD comorbid with ADHD (CD/ADHD) than in CD alone. First of all, a response perseveration task was used, i.e. the door-opening task (Daugherty & Quay, 1991). In this game, the subject chooses either to open the next door or to stop playing; there is a steadily increasing ratio of punished responses to rewarded responses and a large number of doors opened is indicative of response perseveration. As expected, a steady increase in the number of doors opened was found across normal control (NC) boys, CD boys, and CD/ADHD boys (NC < CD < CD/ADHD). Second, the dominance of the BAS over the BIS was examined by observing the social behaviour of the child in interaction with a research assistant who alternately activated the BAS and the BIS while a game was played. The behaviour of the children was analysed according to ethological methods. Group differences in the frequencies of three out of five behavioural categories were in line with the results of the door-opening task (NC < CD < CD/ADHD).

Antisocial Personality Disorder↗
PubMed1997

Residential behavior therapy for children with conduct disorders.

Children with conduct disorders are often referred to residential treatment centers (RTCs). RTCs shorten the length of treatment and thus feel they need to reconceptualize the purpose and process of treatment. Two intervention strategies have been found to affect conduct disorder in outpatient settings: parent training programs that are based on operant learning principles and cognitive-behavioral programs that focus on the relation between cognition and behavior. These strategies should not be transferred to the RTC but adapted to the characteristics of residentially treated conduct disordered children and their parents. These methods should be used together to integrate and strengthen the various learning processes that residential treatment can foster. An outline is given of a comprehensive and integrated residential treatment program based on behavioral methods that have been proven to affect conduct disorder.

Attention Deficit and Disruptive Behavior Disorder↗
PubMed1995

Behavior of conduct disordered children in interaction with each other and with normal peers.

This study investigated the behavior of children with conduct disorder or oppositional defiant disorder (CD/ODD) in interaction with each other and with normal control (NC) children in a semi-standardized setting over a period of 25 minutes. This short time turned out to be sufficient to demonstrate the behavioral manifestations of CD/ODD in children's interactions with peers. In addition, the role of the interactional partner on antisocial behaviour of CD/ODD children became apparent.

Aggression↗
PubMed1995

Differences between conduct disordered and normal control children in their tendencies to escalate or neutralize conflicts when interacting with normal peers.

The behavior of conduct disordered (CD) children was compared with normal control (NC) children in interaction with normal peers. Dyads consisting of a) a CD child and a normal peer and b) an NC child and the same normal peer as in a) were observed. CD boys were less able than NC boys to neutralize incipient conflicts. Hitherto most behavioral studies of CD boys have concentrated on their tendency to escalate conflicts but have paid very little attention to their difficulty in neutralizing conflicts.

Aggression↗