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PubMed2002

Levetiracetam in autistic children: an open-label study.

The objectives of this study were to determine whether autistic children taking levetiracetam (1) showed improvement in the areas of aggression, impulsivity, hyperkinesis, and mood instability, and (2) showed a nootropic response. Ten white autistic boys ranging from 4 to 10 years were compared pretreatment and while taking levetiracetam for an average of 4.1 weeks. Inattention, hyperkinesis, and impulsivity were evaluated using the Achenbach Attention Problems scale, Conners DSM-IV Total scale, and the Conners Attention-Deficit Hyperactivity Disorder Index scale, all of which showed statistically significant improvements. Mood instability was measured with the Conners Global Index (CGI) Emotional Lability and CGI Total scales, both of which showed statistically significant improvements. Aggressive behavior, as measured with the Achenbach Aggression scale, showed statistically significant improvement only for subjects who were not recently weaned from medications that reduce aggression (e.g., risperidone, carbamazepine, desipramine). Levetiracetam may reduce hyperactivity, impulsivity, mood instability, and aggression in autistic children with these problems. No nootropic effect was observed.

Aggression↗
PubMed2003

A cluster-analytic investigation of MMPI profiles of serious male and female juvenile offenders.

OBJECTIVE: To use cluster analysis to identify psychological profiles and related mental health symptoms among male and female juvenile offenders. METHOD: Juvenile offenders (N = 141) incarcerated in the California Youth Authority completed the Minnesota Multiphasic Personality Inventory (MMPI) and the Massachusetts Youth Screening Instrument-Version 2 (MAYSI-2). RESULTS: MMPI cluster analysis revealed four distinct profiles: two for male and two for female juvenile offenders. Among males, we identified one Normative cluster with no clinically elevated scores. A second male cluster, labeled Disorganized, exhibited clinical elevations on scales 8 (Schizophrenia), 6 (Paranoia), 4 (Psychopathic Deviate), and 7 (Psychasthenia). Among females, two clinically elevated profiles emerged. One Impulsive-Antisocial cluster consisted of clinical elevations on scale 4 (Psychopathic Deviate), which has been consistently associated with delinquent and antisocial behavior. The second cluster, labeled Irritable-Isolated, produced elevations on MMPI scales 4 (Psychopathic Deviate), 8 (Schizophrenia), 6 (Paranoia), and 7 (Psychasthenia). There were no significant sex, ethnicity, or offense differences across clusters, but the clusters exhibit distinct psychiatric profiles (MMPI) and mental health symptoms (MAYSI-2). CONCLUSIONS: The findings indicate that not only do female offenders have more acute mental health symptoms and psychological disturbances than male offenders, they exhibit qualitatively distinct psychiatric profiles. Results reinforce the need for assessment of mental health symptoms for male and female juvenile offenders as well as sex-appropriate treatments.

Adolescent↗
PubMed1988

Parent-child correspondence in identification of firesetting among child psychiatric patients.

This study examined parent-child correspondence in assessing characteristics and correlates of the child's firesetting. Two-hundred and ninety-seven families (164 outpatients and 133 inpatients) were independently interviewed using questions modified from the Schedule for Affective Disorders and Schizophrenia for School-age Children. Parent-child correspondence for the presence or absence of individual behaviors and firesetting correlates was generally moderate-to-high for both samples, with outpatient families showing higher parent-child agreement in classifying the child's firesetting status. Few differences in correspondence due to child age or sex were found. The results are discussed in terms of the clinical assessment of firesetting and other antisocial behaviors and the role of child reports in case identification.

Adult↗
PubMed2000

Associations between plasma glucose and DSM-III-R cluster B personality traits in psychiatric outpatients.

Associations between personality traits, measured with the Karolinska Scales of Personality, the Impulsiveness subscale from the Impulsiveness, Venturesomeness and Empathy (IVE) Inventory, and with self-assessed personality traits and disorders (SCID-II Screen Questionnaire), and plasma insulin, glucagon and glucose, respectively, were explored in a sample of 101 psychiatric outpatients of both sexes. No relationships between the peptide hormones and personality measures were found. However, fasting glucose values, which were all essentially within the normal biological variation, were significantly related to several personality measures. For males, a low blood glucose was associated with low stable general level of functioning, with high IVE Impulsiveness, and with self-assessed histrionic and narcissistic traits. High number of self-assessed personality traits for all cluster B personality disorders was strongly associated with high IVE Impulsiveness. The results of the present study support the generalizability of earlier findings from alcoholic impulsive offenders: in males, low blood glucose is associated with an extrovert and impulsive, acting-out behavior that includes the breaking of societal norms and rules. In contrast, for females a positive relationship between fasting glucose and self-assessed histrionic personality traits was found. Because no association between global level of functioning and glucose was found in women, these personality traits may not necessarily be maladaptive, as was the case for males.

Adult↗
PubMed1984

Arson: an unforeseen sequela of deinstitutionalization.

Did the shift from institutional to community-based services brought about by deinstitutionalization affect the nature or function of pathological fire setting? The author studied admissions to a state hospital that were precipitated by arson. During a 200-day period, 14 patients accounted for 16 admissions and 17 fires. The data indicate that fires are set by consumers of public sector mental health services to communicate a wish or a need for a change in location of those services. Communicative arson has caused property damage, personal injury, and death and has resulted in a backlash against community alternatives for psychiatric treatment.

Adolescent↗
PubMed1986

On the diagnosis of obsessive-compulsive disorder.

This article deals with the diagnostic criteria of obsessive-compulsive neurosis. Attention is given to the diagnostic problems related to patients presenting with symptoms similar to those that accompany obsessive-compulsive neurosis.

Anxiety Disorders↗
PubMed1986

The manipulative patient.

"Manipulative" is a popular but often misused description of behavior seen in some patients who come to psychiatric attention. The authors suggest a definition of "manipulation" which can impart helpful information about symptoms, diagnosis, and treatment. They survey the differential diagnosis of manipulative behavior and consider specific treatment strategies.

Antisocial Personality Disorder↗
PubMed2002

Inhibitory control in adults with Attention-Deficit/Hyperactivity Disorder.

OBJECTIVES: Children with Attention-Deficit/Hyperactivity Disorder (ADHD) have been found to be deficient in inhibitory control. The purpose of this study was to determine if adults with ADHD are also deficient in this domain. METHODS: The performance of 18 adults with ADHD and 18 normal controls was compared on the Stop Signal Paradigm, which is a test of inhibitory control. RESULTS: The adults with ADHD performed more poorly on the Stop Signal Paradigm than did the normal controls. The ADHD subjects exhibited a longer latency to respond to the stop signal than did the control subjects. CONCLUSIONS: The individuals with ADHD tested in this study showed an inhibitory control deficit. The results suggest that a deficit in inhibitory control is central to ADHD.

Adult↗
PubMed1982

Children who set fires: the clinical picture and a follow-up.

The study concerns 46 children who had set at least one fire and had been admitted to a psychiatric ward. Their firesetting behaviour has been related to variables such as age, IQ, and psychiatric disorder in parents, and to the distinction between children who present with firesetting as their chief problem and those in whom it is a secondary complaint. Thirty subjects were followed up after one to five years. Seven, all boys and all less than 13 years old, were still setting fires, but these were less serious than the ones set before treatment. The persistent firesetters may have come from less stable homes and they tended to be more antisocial at follow-up than children who no longer set fires.

Adolescent↗
PubMed2003

Impulsivity, emotion regulation, and developmental psychopathology: specificity versus generality of linkages.

Impulsivity, closely related to the construct of response (dis)inhibition, is central to conceptions of both attention-deficit/hyperactivity (ADHD) and aggressive-spectrum or disruptive behavior disorders. The multifaceted nature of inhibitory deficits requires careful specification in any explanatory accounts of psychopathology. A host of brain regions and neural interconnections are involved in response inhibition; neural models are likely to be complex at the levels of neurotransmitter systems and white-matter tracts. Despite the substantial heritability of ADHD and the substantial continuity of early-onset forms of aggression, developmental processes (including gene-environment correlations and interactions) and transactional models are crucial to the unfolding of regulated versus dysregulated behavioral outcomes. Thus, stressful prenatal and childhood environments must be investigated with as much precision as genetic loci and neural pathways. Differentiating executive inhibition (believed to be largely dopaminergic and frontal/frontal-striatal in nature) from motivational inhibition (believed to be largely noradrenergic/serotonergic and limbic in nature) is necessary to distinguish subtypes of youth with attentional and aggressive problems, and to differentiate key etiologic processes. Indeed, the executive function deficits in children with ADHD appear to independent of their emotion dysregulation, which is specific to an aggressive subgroup. Sex differences in response inhibition and sex differences in its linkages to psychopathology are relatively unexplored. For progress in subsequent research to occur, the following are required: precision in measurement at both biological and behavioral levels; contrasts with clinical comparison samples and comorbid groups (as well as normal control samples); prospective longitudinal investigations; and attention to both developmental processes and contextual variables, including stressful life events, socialization practices, and cultural parameters.

Affect↗
PubMed2006

Borderline personality organization and psychopathic traits in nonclinical adolescents: relationships of identity diffusion, primitive defense mechanisms and reality testing with callousness and impulsivity traits.

Although psychotherapeutic observation and empirical data suggest a link between borderline and antisocial personality disorder or traits in adolescents, there is no study on the relationships of borderline personality organization (BPO) and psychopathic traits in adolescents. The aim of this study was to explore the relationship of structural criteria of (BPO) as assessed by the French version of the Borderline Personality Inventory (BPI), with psychopathic traits, as assessed by the French version of the Levenson Self-Report Psychopathy Scale (LSRP), in a nonclinical sample of 243 adolescents. Significant correlations were found between the BPI scales of identity diffusion, primitive defense mechanisms, impaired reality testing, and psychopathic traits of callousness and impulsivity, suggesting that BPO may contribute to psychopathic traits in nonforensic, nonclinical adolescents.

Adolescent↗
PubMed2003

Rate-decreasing effects of the atypical neuroleptic risperidone attenuated by conditions of reinforcement in a woman with mental retardation.

Effects of two doses of risperidone on the performance of a matching task under tangible reinforcement and nonreinforcement conditions were measured in a woman with mental retardation. In both conditions, time to complete the task increased and response rates decreased under two doses of risperidone. Accuracy was generally unchanged. These changes were much smaller in the tangible reinforcement condition; thus, reinforcement seemed to protect performance from the rate-decreasing effects of risperidone.

Adult↗
PubMed2001

[On the problem of erotomania].

Ten cases of erotomania with a clinical picture determined by isolated erotic delusion have been examined. Three stages in the disease course (catathymic, delusion systematization and residual) have been recognized. While diagnostic evaluating, an accordance of the disorders with Clerambault's syndrome in disease debut and an increase of erotomanic paranoia symptoms in pathological process development were taken into account. Premorbid personality abnormalities of schizoid spectrum, catathymic character of delusion with affective component in its formation, narrow range and concrete content of persecution ideas, expansive manifestations in the patient behavior and favorable outcome were found to characterize the isolated erotomania. The existence of special marginal types of erotomania, not corresponding to atypical paranoia spectrum (paranoia, paranomic schizophrenia) is assumed. Most of the patients were diagnosed as affected with schizotypic disorder (slow-progredient schizophrenia).

Adolescent↗
PubMed2005

[Clinical masks of bipolar disorders].

Bipolar disorders usually present as alternating episodes of melancholy and mania. However, other clinical situations appear in a masked form before being spotted. The principal one is hypomania that declares itself as an attenuated form of a manic episode. Its principal signs are an increase in energy, hyperactivity and disinhibition. In other cases, bipolar disorders express themselves as impulsive behaviours. More rarely, the mask of a bipolar illness is translated into behaviours such as intermittent alcohol abuse. The consummation of alcohol is sudden and paroxysmal. It is a type of dipsomania. Finally, bipolar disorders can express themselves as difficulty in impulse control. The two most frequent examples are impulse buying and pathological gambling.

Alcoholism↗