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Behavior and achievement of cleft palate children.

Forty-four cleft lip and palate/palate only children were individually matched with forty-four normal school children on the basis of sex, age, grade, intelligence and socioeconomic status. All children received behavioral ratings by classroom teachers, and achievement test scores were obtained. The cleft children were rated by teachers as displaying significantly greater inhibition of impulse (internalizing behavior). Cleft children also were significantly lower on overall basic skills achievement test scores. It was suggested that cleft children may be responding to the social-behavioral environment which may include negative social responses from others.

Achievement↗

Academic achievement and psychological adjustment in short children. The National Cooperative Growth Study.

Limited information is available on the educational and behavioral functioning of short children. Through 27 participating medical centers, we administered a battery of psychologic tests to 166 children referred for growth hormone (GH) treatment (5 to 16 years) who were below the third percentile for height (mean height = -2.7 SD). The sample consisted of 86 children with isolated growth-hormone deficiency (GHD) and 80 children with idiopathic short stature (ISS). Despite average intelligence, absence of significant family dysfunction, and advantaged social background, a large number of children had academic underachievement. Both groups showed significant discrepancy (p < .01) between IQ and achievement scores in reading (6%), spelling (10%), and arithmetic (13%) and a higher-than-expected rate of behavior problems (GHD, 12%, p < .0001; ISS, 10%, p < .0001). Behavior problems included elevated rates of internalizing behavior (e.g., anxiety, somatic complaints) and externalizing behavior (e.g., impulsive, distractable, attention-seeking). Social competence was reduced in school-related activities for GHD patients (6%, p < .03). The high frequency of underachievement, behavior problems, and reduced social competency in these children suggests that short stature itself may predispose them to some of their difficulties. Alternately, parents of short, underachieving children may be more likely to seek help. In addition, some problems may be caused by factors related to specific diagnoses.

Adaptation, Psychological↗

Construct validation of children's behavior problem dimensions: relationship to activity level, impulsivity, and soft neurological signs.

A construct validation study of dimensions of children's behavior problems was carried out with use of multiple linear regression. The Ss were 76 latency-aged boys in residential treatment. The dimensions involved were Conduct Disorder and Inadequacy-Immaturity. The predictor variables were activity level, impulsivity, and soft signs of neurological damage. Results indicated that Conduct Disorder was significantly predicted by activity level, in combination with impulsivity. Inadequacy-Immaturity was significantly predicted by activity level and soft signs. A third dimension, Personality Disorder, was found to be uncorrelated with the three predictor variables.

Child↗

Distinguishing BIS-mediated and BAS-mediated disinhibition mechanisms: a comparison of disinhibition models of Gray (1981, 1987) and of Patterson and Newman (1993).

The theoretical framework developed by J. A. Gray (1981, 1987a, 1987b) was used to study disinhibitory behavior. Using a point-scoring reaction time procedure, 4 different experiments were conducted to differentiate 2 disinhibitory mechanisms associated with the behavioral activation system (BAS) and the behavioral inhibition system (BIS). Consistent with the work of C. M. Patterson and J. P. Newman (1993), the BAS-mediated mechanism was related to a lack of inhibition in reward-directed behavior after introducing an occasional aversive contingency and to deficits in learning from aversive cues when responding for reward (Experiments 1-3). The BIS-mediated mechanism was related to a higher ability to extinguish aversive associations (Experiment 1), a lower aversive generalization gradient (Experiment 3), and a lower interference with appetitive behavior in the presence of aversive stimuli (Experiment 4).

Adult↗

[Suicidal behavior in adolescents].

Suicidal actions of 156 children and adolescents aged 11-17 years are analyzed. An attempt is made to classify suicidal behaviours according to psychopatho-dynamic signs into certain definite syndromes (balanced, persistent, ambivalent, impulsive and demonstrative suicidal actions) and to differentiate them depending on the degree of suicide intention into "suicidal" and "parasuicidal".

Adolescent↗

Latent structure analysis of DSM-IV borderline personality disorder criteria.

The aim of this study was to evaluate the structure of DSM-IV borderline personality disorder (BPD) criteria. The study group consisted of 564 consecutively admitted inpatients and outpatients. BPD criteria discriminatory power was tested by using corrected item-to-total and item-to-diagnosis correlations. Weighted least-squares (WLS) confirmatory factor analysis (CFA) was used to assess the fit of DSM-IV BPD unidimensional model. The categorical model of BPD was tested by exploratory latent class analysis (LCA). Item analysis suggested a hierarchy in BPD criteria discriminatory power, even if with different rank order with respect to the DSM-IV model. CFA showed a unifactorial structure with congeneric items as the best fitting model for DSM-IV BPD criteria (chi2 = 18.89, df= 27, P > .87). LCA showed evidence for three latent classes; heterogeneity was observed only among subjects falling below DSM-IV diagnostic threshold for BPD. These results support the categorical model of BPD, even if with several differences with respect to DSM-IV.

Adult↗

Factors related to seroconversion among homo- and bisexual men after attending a risk-reduction educational session.

Thirteen homosexual men, volunteers in a study of the natural history of HIV, who seroconverted to HIV after participating in an educational program on HIV prevention, were interviewed about the circumstances leading to their seroconversion. Six men had participated in unprotected anal intercourse with at least one partner whom they believed was HIV-negative. Four men attributed their conversion to mental health problems or to drug and alcohol use. Two men's seroconversions could not be ascertained and one man attributed seroconversion to a condom break. Most men who had learned how to avoid infection, and had successfully done so for a time, had knowingly engaged in unsafe behaviors because of strong emotional responses to certain partners or because of mental health or drug and alcohol-related problems. Skills training for dealing with partners who pressure men to behave unsafely is needed, as is mental health and drug and alcohol counseling for men at risk for HIV infection.

Acquired Immunodeficiency Syndrome↗

Hyperkinetic disorder in psychiatric clinic attenders.

Sixty-eight boys (age-range five to 11 years), referred to a child psychiatric clinic, were studied in order to determine the validity of a broadly-based concept of hyperkinetic syndrome, as generally employed in the USA. Hyperactivity was measured on the Conners' Teacher Questionnaire, the Conners' Parent Questionnaire and by systematic time-sampled observations of each child's behaviour during psychological testing. There were low and statistically insignificant correlations between these different measures of hyperkinesis. On the other hand, overactivity correlated highly with conduct disturbance. Psychiatrically abnormal children with and without hyperkinesis were compared on cognitive functioning, perinatal history, neurological examination, congenital anomalies and psycho-social circumstances. Few differences were found, and it was concluded that there was no evidence for the validity of a broad concept of hyperkinetic syndrome. Nevertheless, a small number of children were found who were overactive in all situations studied. These children had a variety of clinical diagnoses but differed significantly from their peers--matched for age, IQ and diagnosis--with respect to neurological anomalies, erratic responses on the Matching Familiar Figures Test, and early onset of hyperkinesis. It is suggested that this less common clinical picture of hyperkinesis may have some validity, but it remains uncertain whether it constitutes a distinct syndrome or rather a constitutional risk factor.

Attention↗

Disruptive, delinquent and aggressive behavior in female adolescents with a psychoactive substance use disorder: relation to executive cognitive functioning.

OBJECTIVE: This study had four objectives: (1) to determine whether female adolescents with a psychoactive substance use disorder are more impaired than controls on a battery of neuropsychological tests of Executive Cognitive Functioning (ECF); (2) to determine whether these individuals exhibit higher levels of disruptive, delinquent and aggressive behavior compared with controls; (3) to determine whether ECF is related to disruptive, delinquent and aggressive behavior in this population; and (4) to determine whether these relations are moderated by drug use. METHOD: Multiple indicators of ECF, and disruptive, delinquent and aggressive behavior, as well as drug use, were used to test these relations in a sample of 188 female adolescents who qualified for a DSM-III-R diagnosis of a psychoactive substance use disorder (PSUD) and 95 normal controls between the ages of 14-18 years (N = 283). RESULTS: Hierarchical multiple regression equations determined that ECF was related to disruptive, delinquent and aggressive behavior even when chronological age, SES and drug use were accounted for. The final regression models suggested that drug use was more strongly related to disruptive and delinquent behavior, whereas ECF was more strongly related to aggression. Drug use did not moderate any relation between ECF and the dependent measures. CONCLUSIONS: One implication of these results is that violence prevention and treatment outcomes may be ameliorated by incorporating cognitive habilitation of ECF as an integral component of multimodel interventions.

Adolescent↗

The treatment of enuresis: an overview.

The treatment of enuresis has had a long and colorful history in world medical literature. Although some reasonable approaches to the problem exist, there are many conflicting theories about its etiology and consequently there are many recommended therapies. A perspective of literature encompassing the diverse fields of psychoanalysis, behavioral psychology, urology, pharmacology and sleep physiology is provided for the psychiatrist consultant dealing with the problem of enuresis.

Adolescent↗

Impulse and constraint: perspectives from personality psychology, convergence with theory in other areas, and potential for integration.

A behavioral dimension of impulse versus constraint has long been observed by personality psychologists. This article begins by reviewing processes underlying this dimension from the perspectives of several personality theories. Some cases of constraint reflect inhibition due to anxiety, but some theories suggest other roots for constraint. Theories from developmental psychology accommodate both possibilities by positing 2 sorts of control over action. These modes of influence strongly resemble those predicated in some personality theories and also 2 modes of function that are asserted by some cognitive and social psychological theories. Several further literatures are considered, to which 2-mode models seem to contribute meaningfully. The article closes by addressing questions raised by these ideas, including whether the issue of impulse versus constraint applies to avoidance as well as to approach.

Antisocial Personality Disorder↗

Norepinephrine function in personality disorder: plasma free MHPG correlates inversely with life history of aggression.

OBJECTIVE: Clinical and pre-clinical data suggest the possibility of a facilitory role for norepinephrine (NE) in impulsive-aggressive behavior. While clinical studies have focused on putative central measures of NE activity, few studies have been published using peripheral measures. In this study, the relationship between plasma free NE metabolite, plasma free 3-methoxy-4-hydroxyphenylglycol (pMHPG), and impulsive aggression was explored in subjects with personality disorder. METHODS: Subjects were 30 male subjects with personality disorder in whom basal plasma free MHPG concentrations were obtained. Aggression was assessed using the Life History of Aggression (LHA) assessment and the Buss-Durkee Aggression scales; impulsivity was assessed using the Barratt Impulsiveness and the Eysenck Personality Questionnaire Impulsivity scales. RESULTS: A significant inverse correlation was found between LHA-Aggression and pMHPG in these subjects. Correlations with other behavioral measures were not statistically significant. pMHPG was significantly lower among subjects with borderline personality disorder but not significantly lower after controlling for LHA-Aggression scores. CONCLUSION: These data suggest that pMHPG is inversely correlated with life history of aggression in subjects with personality disorder and that central and/or peripheral NE may play a role in modulating aggressive behavior in these subjects.

Adult↗

Child abuse and performance task assessments of executive functions in boys.

We examined executive functions using performance tasks in 126 boys aged 6 to 16 years. who attended public schools and therapeutic schools for children with emotional and behavioral problems. Children were further grouped based on the presence or absence of substantiated abuse histories. Based on their abuse histories and schools of origin, children were classified as Therapeutic, Abused (TA, N = 25). Therapeutic, Nonabused (TN, N = 52), and Public School (PS, N = 48). Controlling IQ and medication status, we compared children in the three groups on teacher ratings of behavior, on experimenter observations of behavior during testing, and on performance tasks challenging the capacities to inhibit an act in progress, and to passively avoid responses associated with adverse consequences. We examined mean group differences in symptoms, behaviors, and task performance, as well as differential age-dependent changes in these dimensions. Independent of abuse history, therapeutic school children demonstrated comparable levels of internalizing and externalizing symptoms, and comparable levels of redirections to task during testing-sessions, that were significantly higher than those of the public school children. Both groups of therapeutic school children also showed comparable overall performance on the capacities to inhibit an act in progress, and to passively avoid responses associated with adverse consequences that were poorer than the performance of children from the public school. Children with histories of substantiated abuse showed diminished improvement with increasing age in the capacity to passively avoid responses associated with adverse consequences when compared not only to the public school children, but also to the children from the therapeutic schools without histories of abuse. Our findings complement reports of behavioral observations of abused children, and reports associating child abuse with altered cognitive development in other areas of competence. They suggest that child abuse may negatively influence the expected developmental progression of competence in certain executive functions. This in turn could have implications for the nature and the persistence of certain forms of psychopathology associated with abuse and poor self-control. Given the cross-sectional nature of our data, however, longitudinal developmental studies of the relations between child abuse and executive functions are needed to elucidate the influence of abuse on the growth and development of such organizing principles of behavioral self-regulation.

Adolescent↗