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XYY syndrome, stigmatization, social class, and aggression: study of 15 cases.

This is a paper about the relationship of stigmatization to social class in XYY individuals, and of this relationship to manifestations of agressive behavior. The sample comprised 15 men and youths with the XYY syndrome; 8 were identified in a survey of institutions for males with behavior disorders and 7 were privately referred. All had been stigmatized by physique and appearance and/or behavior. The most frequent stigmatizing features were excessive height for age, excessive impulsiveness in behavior, and excessive temper tantrums in childhood; these were present in all cases. Antisocial or law-breaking behavior was present in 13 cases. Stigmatization did not correlate with socioeconomic class, rated according to the Shevky and Bell scale as modified to suit the study. However, the consequences of stigmatization were class related in that the lower the class, the greater the chance that the XYY individual would spend time in the penal as well as the medical system of society.

Adolescent↗

[Compulsive phenomena in children with tic disorder and attention deficit-hyperactive disorder].

Tic disorders (TD), obsessive-compulsive disorders (OCD) and attention-deficit/hyperactivity disorder (ADHD) are often associated with deficits of impulse control and aggressive behavior. Tic disorders and OCD are closely related on epidemiological, psychopathological and neurobiological levels, whereas ADHD and OCD phenomena seem to be at opposite poles. Research evidence on the clinical significance of associated obsessive-compulsive behavior is reviewed and linked to our own new data. Thus the analyses of a worldwide database on Tourette's Syndrome (TS) (N = 4,833) showed that that the associated symptomatology of the OCD spectrum has to emphasized. In further investigations, premonitory sensorimotor phenomena reminiscent of OCD were more frequent in children with tic disorders as they grew older. Obsessive-compulsive behavior concomitant with TS was particularly associated with impulsive and aggressive behavior, as well as with depression and anxiety. The data suggest a reduced serotonergic transmission. Self-reports by children with ADHD, as opposed to those by their parents, mentioned a significantly higher quantitative degree of OC phenomena than those by children with TS. These findings suggest that OC symptoms in children with ADHD have so far been neglected in assessments by others. In summary, a complex psychopathological pattern of tic, OC behavior, impulsivity and internalizing symptomatology emerges that requires discriminating assessment and treatment.

Adolescent↗

Impulsivity, aggression, and neuroendocrine responses to serotonergic stimulation in substance abusers.

Alterations in the activity of central serotonergic systems have been implicated in impulsive and aggressive behavior. We examined the neuroendocrine and psychological responses of 24 substance users with differing levels of aggressiveness and impulsivity to the oral administration of an indirect serotonin agonist fenfluramine (60 mg) or placebo given in a double-blind crossover design. All subjects were volunteers on a closed research ward and were abstinent from drugs for a minimum of 5 days. Baseline plasma prolactin (PRL) levels were greater in the groups with higher levels of self-reported aggressiveness and impulsivity. When adjusted for the baseline, PRL and cortisol responses 180 min after fenfluramine administration were significantly elevated in subjects with higher levels of aggressiveness and impulsivity. Peak cortisol levels were correlated with impulsivity. PRL and cortisol responses to fenfluramine were more strongly correlated with impulsivity than aggressiveness. Also, the more impulsive subjects reported a decrease in subjective states of depression, hostility and anxiety after drug treatment. These data further support the hypothesis of altered serotonergic activity in aggressive and impulsive behaviors.

Adult↗

Urinary free cortisol output and disruptive behavior in children.

Hostile, impulsive, and aggressive behaviors have been associated with decreased urinary free cortisol (UFC) output. This is the first study to assess 24-hour UFC output in disruptive behavior disorders. The UFC of 19 boys with attention deficit and/or conduct disorder was compared with that of 19 age, race, and IQ matched normal controls studied as inpatients. Continuous Performance Test scores showed greater impulsivity in the disruptive group. UFC output did not differ between groups. However, UFC and difficulty were positively correlated on the continuous performance test in the form of longer interstimulus intervals and longer reaction times.

Adolescent↗

Self-report vs. laboratory measures of aggression as predictors of substance abuse.

Measures of aggressive behavior, antisocial personality, criminality, and impulsivity were obtained on a sample of 85 drug abusing volunteers for studies at the Addiction Research Center in Baltimore. Measures included the Buss-Durkee Hostility Inventory, Diagnostic Interview Schedule Antisocial Personality Disorder diagnosis, Elliott-Huizinga Lifetime Events Scale, Eysenck's Impulsiveness-Venturesomeness-Empathy scales, and a laboratory measure of aggression patterned after the Buss 'aggression machine'. All of the self-report measures of aggression and antisocial personality were moderately correlated with each other, but did not correlate with the laboratory aggression measure. This laboratory measure, nevertheless, made a significant contribution to the prediction of certain substance abuse diagnoses over and above the contributions of the other measures.

Adult↗

Methylphenidate for pervasive developmental disorders: safety and efficacy of acute single dose test and ongoing therapy: an open-pilot study.

OBJECTIVE: The aim of this study was to investigate the effects of ongoing methylphenidate (MPH) on ADHD-related and autistic symptoms in Pervasive Developmental Disorders (PDD) in children who did not present any adverse effects to an initial acute dose administered at the clinic. METHODS: Participants included 13 subjects (12 males, with a mean age of 7.9 years) with PDD and moderate to severe hyperactivity/impulsivity. The severity of the symptoms assessment was based on Clinical Global Impression (CGI), Childhood Autism, Child Psychiatric and Conners Parent and Teacher Rating Scales (CPRS). Scores at baseline, and after 1 and 3 months of treatment, were compared to intent-to-treat analyses. RESULTS: One (1) hour after a single MPH dose (0.4 mg/kg), 5 subjects exhibited increased hyperactivity, stereotypes, dysphoria, or motor tics and were rated as minimally or much worse on the CGI Global Improvement Scale. They received no further treatment with MPH. Four (4) of the remaining subjects were rated as improved, and four as unchanged; they proceeded to a 12-week open trial of MPH. Two children remained unchanged: they discontinued treatment after 1 week on maximally tolerated doses. However, in group analyses, behavioral measures of hyperactivity and impulsivity improved significantly, while autism core symptom measures were unaffected. No significant adverse effects were observed in any of the 8 subjects. CONCLUSIONS: Administering a single MPH test dose may be useful in identifying children with PDD who may benefit from prolonged therapy.

Adolescent↗

Impulsivity in depressed children and adolescents: a comparison between behavioral and neuropsychological data.

Impulsivity at the neuropsychological and behavioral levels was investigated in a sample of drug-naive depressed children and adolescents. The performance of 21 patients with a current diagnosis of mood disorder was compared with that of 21 normal controls on tests of executive functions related to impulsivity (Matching Familiar Figures Test, Continuous Performance Test, Verbal Fluency, Stroop Test, and Walk-Don't Walk) and on impulsive/restless behavior on the Conners' Parent Rating Scale. Depressed children and adolescents showed a pattern of conservative response style, with slow reaction times and attentional problems, similar to that observed in adults, and a general delay/difficulty in response initiation on the Fluency Test. Depressed participants were rated by their parents as being significantly more impulsive/restless than controls. However, there was no evidence of an impulsive cognitive response style in more impulsive/restless patients. Symptom severity (Hamilton Rating Scale for Depression) and subjective mood state (Children's Depression Inventory) were also taken into account.

Adolescent↗

Impulsive choice in inbred strains of mice.

When humans or non-humans are given a choice between receiving a sooner-smaller (SS) reinforcer, or a later-larger (LL) reinforcer, the choice of a SS reinforcer represents impulsive choice whereas the choice of a LL reinforcer represents self-controlled choice. It has been suggested that both biological and genetic factors influence impulsive/self-control choice in this paradigm. In the present study, the inbred strains of BALB/c, C57BL/6, and DBA/2 mice were given a choice to press one of two levers in an operant chamber. Depending on their choice, mice received either a smaller reinforcer (one pellet delivered after 6s) sooner (SS) or a larger reinforcer (two pellets after 6, 9, 12, 18, or 30s) later (LL). Mice preference for the larger reinforcer decreased with longer delays. More importantly, the BALB/c mice chose the SS reinforcer more often than the C57BL/6 mice under the 9- and 12-s delays, and more often than the DBA/2 mice under the 9-s delay. This indicates that the choice pattern of the BALB/c strain is more "impulsive" than the other strains and suggests that specific gene configurations influence impulsive choice in mice.

Animals↗

Impulsive nonconformity as a trait contributing to the prediction of psychotic-like and schizotypal symptoms.

A 51-item true-false Impulsive Nonconformity Scale was constructed to measure impulsive antisocial behavior of the sort often reported in the premorbid adjustment of some psychotics. Schizophrenics and schizoaffective patients (N = 46) scored higher on the scale than control (N = 76). An experimental group of 120 aberrantly high-scoring (2 SDs above the mean) college students and 176 control subjects were interviewed using modified versions of Weissman and Paykel's Social Adjustment Scale interview and Spitzer and Endicott's Schedule for Affective Disorders and Schizophrenia-Lifetime Version (SADS-L). The experimental subjects reported more antisocial and nonconforming behaviors than control subjects, supporting the construct validity of the scale as a measure of impulsive nonconformity, and reported more psychotic or psychotic-like experiences, more schizotypal experiences, and more depressive and manic or hypomanic symptoms, suggesting that a portion of the experimental subjects may be at elevated risk for psychosis and/or major affective disorder. Subjects who score aberrantly high on both the Impulsive Nonconformity Scale and our earlier Perceptual Aberration-Magical Ideation Scale are more aberrant on several other measures of schizophrenic-like cognitive slippage than are subjects who score high on only one of the two scales.

Adult↗

Serotonergic functioning in children with oppositional defiant disorder: a sumatriptan challenge study.

BACKGROUND: Several studies support the notion that disturbances in the central serotonergic function are related to impulsive aggression. There is recent evidence from studies on 5-HT(1B) knock-out mice that this specific receptor is involved in impulsive aggressive behavior. The aim of the present study was to investigate 5-HT(1B/1D) receptor functioning in normal intelligent hospitalized children with oppositional defiant disorder (ODD). METHODS: The growth hormone (GH) response to a challenge with the 5-HT(1B/1D) agonist sumatriptan was examined in 20 children with an ODD, of whom 13 had an attention-deficit/hyperactivity disorder comorbidity, and 15 normal control subjects (NC). Blood samples for growth hormone were collected repeatedly between 8:30 and 12:00 AM. Sumatriptan was administered at 10 AM. The effect of stress due to this procedure was assessed by measuring salivary cortisol. RESULTS: The GH response was significantly stronger in the children with ODD. After sumatriptan injection NC children showed a significant increase in cortisol; no such pattern was present in the ODD group. CONCLUSIONS: The results suggest that the postsynaptic 5-HT(1B/1D) receptor is functionally more sensitive in children with ODD.

Aggression↗

Serum cholesterol and impulsivity in personality disorders.

Decreased serum cholesterol has been associated with impulsive aggressive behaviors. This study was designed to explore the relationship between serum cholesterol levels and measures of impulsive aggression in personality disordered patients. Forty-two personality disordered patients (14 borderline personality disorder, 28 other personality disorders) were included. Fasting serum cholesterol was measured by standard enzymatic assay. An ANOVA was performed with factors of gender and diagnosis, looking at two-way interactions between the factors and serum cholesterol. Patients with borderline personality disorder were found to have significantly lower serum cholesterol than non-borderline personality disorders. A significant interaction effect was also seen between gender and diagnosis with the male patients having lower cholesterol levels. This study suggests there may be a relationship between borderline personality disorder and low serum cholesterol.

Adult↗

Impulsivity and bipolar disorder.

Impulsivity is frequently associated with bipolar disorder (BD) during manic episodes, but may also be present in euthymic bipolar patients. Aggression is an impulsivity-related behavior also found during manic episodes. The objective of this review is to further clarify the relationship between impulsivity and BD. A search in Medline and Psycinfo databases, combined with a manual search of selected references, was conducted to identify available literature on BD and impulsivity-related features. Although few studies have directly measured impulsivity in BD, available findings suggest that impulsivity is not only state-related, but also a trait component of BD, which could represent a core feature of the illness. Further research exploring the neurobiology of the impulsivity/BD relationship may contribute to elucidate the pathophysiology and to improve the diagnosis and treatment of this severe illness.

Aggression↗