Neuroscience. Crime, culpability, and the adolescent brain.
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Adolescent↗
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Results for “Impulsive Behavior”
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Trichotillomania and obsessive-compulsive disorder.
Trichotillomania, a disorder characterized by repetitive hair pulling, has been only recently systemically investigated. Such research was encouraged by data that showed obsessive-compulsive disorder, which is also characterized by ritual behaviors, responds selectively to serotonin reuptake inhibitors. In this review, we consider similarities and contrasts in the diagnosis, demographics, phenomenology, neurochemistry, neuropsychiatry, and treatment of trichotillomania and obsessive-compulsive disorder. We argue that a view of trichotillomania as an obsessive-compulsive spectrum disorder that may involve disturbances in grooming behaviors comprises a useful clinical and research heuristic. Nevertheless, there may also be important differences between the two disorders; in particular, trichotillomania has a number of characteristics in common with impulsive disorders. Further empirical investigation is necessary to determine the nature of these complex disorders and their relationship to one another.
Adolescent↗
Bulimia: the emergence of a syndrome.
The literature on bulimia, which has regarded it as a psychiatric entity or as a form of disordered eating, suggests that this behaviour is now widespread among the obese, among those with anorexia nervosa and those of normal weight. While physiological, psychological and sociocultural explanations and forms of treatment have been proposed, a holistic perspective on the context in which it occurs can distinguish bulimia nervosa and bulimarexia from 'simple' bulimia.
Adolescent↗
Evaluation of violence and dangerous behavior associated with mental illness.
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Child Behavior Disorders↗
Neurocognitive disorders in psychiatry: a case example of diagnostic and treatment dilemmas.
We present a case example that illustrates the diagnostic and treatment difficulties engendered by adult psychiatric patients with primary behavioral problems and neurocognitive disorders. In the case cited, the neuropsychological evaluation plays a significant role in reconceptualizing a patient who had accrued multiple psychiatric diagnoses including schizophrenia, borderline personality, and impulse control disorder. Formal examination revealed deficits in language, executive, and attentional functions that were far greater than had been expected and led to a major change in treatment strategy, including successful trial of imipramine and nadolol and more structured milieu therapy. The cognitive deficit and intrapsychic conflict models are used to demonstrate the critical aspects of our diagnostic reclassification of the patient to Neurodevelopmental Disorder of Unknown Etiology and Auditory Attention Deficit Disorder.
Adult↗
Factors associated with risk for subsequent injuries after traumatic spinal cord injury.
OBJECTIVES: To identify the annual incidence and risk factors for subsequent injury among subjects with preexisting spinal cord injury (SCI). DESIGN: Cross-sectional, mailed survey. SETTING: A specialty hospital in the southeastern United States. PARTICIPANTS: Subjects (N=1328) with SCI participated in this study (response rate, 72%), each of whom met the following inclusion criteria: (1) traumatic SCI with residual impairment American Spinal Injury Association (ASIA) grades A through D, (2) nonsurgical onset, (3) age 18 years or older at the time of the study, and (4) a minimum of 12 months post-SCI. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: A general health assessment survey was used that required participants to report the number of injuries that were severe enough to require treatment in a clinic, emergency department, or hospital in the past year, as well as whether any injury resulted in hospitalization. Risk measures included the Behavioral Risk Factor Surveillance System, CAGE, Zuckerman-Kuhlman Personality Questionnaire, Multidimensional Health Locus of Control scale, and prescription medication usage. RESULTS: Nineteen percent of participants reported at least 1 injury within the past year, with an annual incidence of.33 when considering those with multiple injuries. Twenty-seven percent of those with at least 1 injury reported 1 or more injury-related hospitalizations in the past year. Being younger; having an ASIA grade D injury; higher sensation-seeking scores; heavy drinking; and prescription medication use for pain, spasticity, depression, and sleep were associated with a greater likelihood of subsequent injuries. CONCLUSIONS: Subsequent injuries impact nearly 20% of people with SCI annually; yet, this problem has received little attention in the literature. Further study is needed to identify the costs, severity, and circumstances surrounding injury to design prevention programs that target risk behaviors.
Activities of Daily Living↗
Use of warning messages to modify gambling beliefs and behavior in a laboratory investigation.
This laboratory study assessed the effectiveness of warning messages intended to aid in the control of gambling. Participants were 120 undergraduate students from an urban state university who reported previous gambling activity. They were recruited to play a computerized roulette game with imaginary money. Money left at the end of play was exchanged for raffle tickets for a prize drawing. Participants were randomly assigned to 1 of 2 conditions. In the warning-message condition, participants received an educational component discussing common irrational beliefs expressed by gamblers and, while playing roulette, viewed brief messages that addressed irrational gambling beliefs. In the control condition, participants received an educational component on the history of roulette but no warning messages. Participants in the warning-message condition reported significantly fewer irrational beliefs and demonstrated less risky gambling behavior than those in the control condition.
Adult↗
The Yale Children's Inventory--a screening tool for attention deficits and related disorders. Normative data for boys.
Norwegian populated-based normative data on the Yale Children's Inventory (YCI) were provided for boys. All parents of boys aged 8 through 11 years in the county of Hammerfest received the YCI, and 77% responded. Mean scores on the YCI scales attention, activity, tractability, and fine motor were significantly lower in the Norwegian sample compared to the US normative data. Factor analysis of the 40 scale items yielded factors that corresponded generally well to the YCI scale constructs derived from US samples. We conclude that the scale constructs of the YCI seem to be transferable across these two cultures, but that restandardization is warranted. Further research is needed to establish cut-off values for clinical screening purposes. The Yale Children's Inventory has the potential to become a valuable screening tool for behavioral problems at school-age.
Attention Deficit Disorder with Hyperactivity↗
[Attention deficit/hyperactivity disorders among three-to-six-year-olds treated in medical practices--a national survey].
OBJECTIVE: The aim of the study is to calculate prevalence rates of symptoms and diagnoses of Attention Deficit-/Hyperactivity Disorders (ADHD) in preschoolers, and to assess functional impairment as well as comorbid symptoms by means of parents and teacher symptom checklists. METHOD: N = 708 kindergarten- and preschool-children were recruited nationwide by pediatricians or child and adolescent psychiatrists. The U8/U9 sample (n = 521 children) was assessed during a routine pediatric screening. The clinical sample consisted of n = 187 children who were rated as having ADHD problems by the physician. The children were assessed by age-adapted ADHD Symptom-Checklists (Fremdbeurteilungsbogen für Aufmerksamkeitsdefizit-/Hyperaktivitätsstörungen im Vorschulalter FBB-ADHS-V) rated by parents and teachers. Additionally, the physicians rated ADHD symptoms and comorbid symptoms. RESULTS: Based on diagnosis criteria of DSM-IV and the parental ratings in U8/U9, 11.3% of the children fulfilled the criteria for one of the three ADHD diagnoses (ICD 10: 3.8%). The prevalence rate was lower in teacher ratings (6.6%) (ICD 10: 1.5%), and in both the parent and teacher ratings 4.2% of the children fulfilled the DSM-IV criteria for ADHD (ICD 10: 1.2%). Higher prevalence rates and comorbidities were found in the clinical sample. The need for professional help (counseling/treatment) is much higher than the treatment the parents and children actually received. CONCLUSION: International prevalence rates can be applied. Despite methodological restrictions, such as a lack of representativeness and possible pre-selection effects, this study demonstrates the relevance of prevention and intervention programmes.
Aggression↗
Treatment of children with Williams syndrome with methylphenidate.
Children with Williams syndrome frequently present with symptoms of attention deficit hyperactivity disorder (ADHD), but there is little information that stimulant medication is useful in this population. A series of double-blind, placebo-controlled case studies was used to evaluate the cognitive and behavioral effects of methylphenidate on four children with Williams syndrome. Teachers and mothers completed behavioral rating scales and cognitive tests of attention, learning and memory, and academic productivity and accuracy in mathematics in each medication condition. Two of the children responded favorably in terms of decreased impulsivity, decreased irritability, and lower activity level as well as improved ability to pay attention. Methylphenidate is a useful adjunct in the treatment of some children with Williams syndrome.
Adolescent↗
Fixed-interval performance and self-control in children.
Operant responses of 16 children (mean age 6 years and 1 month) were reinforced according to different fixed-interval schedules (with interreinforcer intervals of 20, 30, or 40 s) in which the reinforcers were either 20-s or 40-s presentations of a cartoon. In another procedure, they received training on a self-control paradigm in which both reinforcer delay (0.5 s or 40 s) and reinforcer duration (20 s or 40 s of cartoons) varied, and subjects were offered a choice between various combinations of delay and duration. Individual differences in behavior under the self-control procedure were precisely mirrored by individual differences under the fixed-interval schedule. Children who chose the smaller immediate reinforcer on the self-control procedure (impulsive) produced short postreinforcement pauses and high response rates in the fixed-interval conditions, and both measures changed little with changes in fixed-interval value. Conversely, children who chose the larger delayed reinforcer in the self-control condition (the self-controlled subjects) exhibited lower response rates and long postreinforcement pauses, which changed systematically with changes in the interval, in their fixed-interval performances.
Child↗
Aggression: instinct or symptom?
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Aggression↗
The drifters. Children of disorganized lower-class families. Family functioning: a psychosocial perspective.
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Adaptation, Psychological↗
Response acquisition with delayed reinforcement in a rodent model of attention-deficit/hyperactivity disorder (ADHD).
The spontaneously hypertensive rat (SHR) has been shown to exhibit behavioral characteristics analogous to those exhibited by humans diagnosed with attention-deficit/hyperactivity disorder (ADHD). The present study was conducted to further evaluate the validity of the SHR model of ADHD by characterizing learning of a novel response under conditions of delayed reinforcement. Seven experimentally naïve SHRs and a control group of seven normotensive Wistar-Kyoto (WKY) rats were exposed to a contingency where one lever press initiated pellet delivery after a 15-s, resetting delay. Rats in both groups acquired lever pressing, and the pattern of acquisition was well described with a three-parameter, sigmoidal equation. Response acquisition was retarded in the SHRs; they took longer to acquire the behavior, exhibited lower response rates and earned fewer reinforcers over the course of the experiment. When reinforcer delivery was made immediate in a subsequent condition, the SHRs exhibited higher response rates than the WKY, suggesting that the lower rates of responding seen in the SHRs were due to the reinforcer delay. The results replicate previous research on response acquisition with delayed reinforcement and provide further validation of the SHR strain as a model of ADHD. Like humans diagnosed with ADHD, the SHRs appear to be hypersensitive to delayed consequences, which in the present context, interfered with learning a novel behavior.
Animals↗
The Good Behavior Game: a best practice candidate as a universal behavioral vaccine.
A "behavioral vaccine" provides an inoculation against morbidity or mortality, impacting physical, mental, or behavior disorders. An historical example of a behavioral vaccine is antiseptic hand washing to reduce childbed fever. In current society, issues with high levels of morbidity, such as substance abuse, delinquency, youth violence, and other behavioral disorders (multiproblems), cry out for a low-cost, widespread strategy as simple as antiseptic hand washing. Congruent research findings from longitudinal studies, twin studies, and other investigations suggest that a possibility might exist for a behavioral vaccine for multiproblem behavior. A simple behavioral strategy called the Good Behavior Game (GBG), which reinforces inhibition in a group context of elementary school, has substantial previous research to consider its use as a behavioral vaccine. The GBG is not a curriculum but rather a simple behavioral procedure from applied behavior analysis. Approximately 20 independent replications of the GBG across different grade levels, different types of students, different settings, and some with long-term follow-up show strong, consistent impact on impulsive, disruptive behaviors of children and teens as well as reductions in substance use or serious antisocial behaviors. The GBG, named as a "best practice" for the prevention of substance abuse or violent behavior by a number of federal agencies, is unique because it is the only practice implemented by individual teachers that is documented to have long-term effects. Presently, the GBG is only used in a small number of settings. However, near universal use of the GBG, in major political jurisdictions during the elementary years, could substantially reduce the incidence of substance use, antisocial behavior, and other adverse developmental or social consequences at a very modest cost, with very positive cost-effectiveness ratios.
Absenteeism↗
Cognitive tempo in educable mentally retarded children.
The present study investigated the relationship of time and errors on the Matching Familiar Figures test to the mental age of 40 Caucasian male, educable mentally retarded (EMR) children. The children, who ranged in age from six to 18 years, had intelligence test scores of less than 80, were exhibiting problems in adaptive behavior, and were all receiving special education services. An ANOVA revealed that with increasing mental age, elapsed time to first response increased and errors decreased, thus indicating a mental age developmental decrease in impulsivity. For all subjects, time was inversely related to errors. The data suggest that the development of cognitive tempo in EMR children parallels that of nonhandicapped children.
Adolescent↗
Development of conduct problems and peer rejection in preschool children: a social systems analysis.
The development of impulsive-aggressive problem behavior and peer rejection was examined in sixty 4- to 5-year-old boys from low-income family backgrounds. Children's sociometric status and behavioral adjustment were assessed longitudinally at the beginning and end of the preschool year, and related to measures of peer interaction at three different points in time. Boys identified as socially rejected and aggressive in the beginning of the year were highly likely to be identified as such at the end of the year. Early in the preschool year, these children contributed to their own rejection by initiating socially aversive exchanges with peers. Although peers clearly perceived these problems, they did not reciprocate with counteraggression at first. However, as time passed, peers began to actively victimize these children, and most of the aggression on the part of victims became reactive in nature. Thus, the current findings strongly support a transactional model of the development of early peer rejection and conduct problems.
Aggression↗
A comparison of anticonvulsants in the treatment of impulsive aggression.
This study compared the behavioral effects of 3 anticonvulsants in impulsive aggressive men. In a double-blind, placebo-controlled, parallel groups design, participants were randomly assigned to 1 of 4 6-week treatments: phenytoin (n = 7), carbamazepine (n = 7), valproate (n = 7), or placebo (n = 8). The efficacy measure was the average aggression score, a global severity index from the Overt Aggression Scale (J. M. Silver & S. C. Yudofsky, 1991). Analysis showed a significant reduction in impulsive aggression during all 3 anticonvulsant conditions compared with placebo. However, the treatment effect during carbamazepine administration was slightly delayed compared with phenytoin and valproate. These findings suggest that increased use of anticonvulsants could make a significant impact in the control of impulsive aggression in both mental health and criminal justice settings.
Adult↗