Faculty Bibliography
Searched for:
school:SOM
Department/Unit:Child and Adolescent Psychiatry
Total Results:
11189
Commitment to assessment and treatment: comprehensive care for patients gravely disabled by alcohol use disorders
PMID: 23602314
ISSN: 0140-6736
CID: 335292
Memory reconsolidation
The formation, storage and use of memories is critical for normal adaptive functioning, including the execution of goal-directed behavior, thinking, problem solving and decision-making, and is at the center of a variety of cognitive, addictive, mood, anxiety, and developmental disorders. Memory also significantly contributes to the shaping of human personality and character, and to social interactions. Hence, understanding how memories are formed, stored, retrieved, modified, updated and used potentially impacts many areas in human life, including mental health.
PMID: 24028957
ISSN: 0960-9822
CID: 816622
[Neurobiology of autism and attention deficit hyperactivity disorder by means of neuroimaging techniques: convergences and divergences]
In the clinical area, some symptoms of attention deficit hyperactivity disorder (ADHD) also present in patients with autism spectrum disorders (ASD). Research has shown that there are alterations in brain circuits that have an impact upon specific cognitive and behavioural failures in each of these disorders. Yet, little research has been conducted on the brain correlates underlying both the similarities and the differences in the symptoms. In this review, the structural and functional meta-analytical studies that have been carried out to date on ADHD and ASD have been analysed. On the one hand, there are convergences in the attentional dorsal, executive functions, visual, somatomotor circuits and the default activation circuit. These similarities can account for the comorbid manifestations between the disorders, such as failure in the integration of information, fine motor control and specific attention processes. On the other hand, specifically in ADHD, there is a deficit in the reward circuit and in the attentional ventral, which are systems involved in the measurement of the effects of reinforcement and monitoring of attention. In ASD, the circuits that are most strongly affected are those involved in social cognition and language processes. In conclusion, there are neuronal correlates in both disorders that explain both the convergent and divergent clinical and behavioural manifestations.
PMCID:4102176
PMID: 23897144
ISSN: 1576-6578
CID: 4707592
Comparing social skill profiles of children with autism spectrum disorders versus children with attention deficit hyperactivity disorder: Where the deficits lie
Marked socialization impairment is evident in both individuals with autism spectrum disorders (ASD) and individuals with attention deficit/hyperactivity disorder (ADHD). The current study utilizes the Matson Evaluation of Social Skills for Youngsters-II (MESSY-II) to explore similarities and discrepancies in the social skill profiles of children with ASD and children with ADHD ages 6-9 years old and 10-16 years old. Children with ASD and children with ADHD were both found to be significantly deficient in social skills compared to atypically developing peers without an Axis I or Axis II diagnosis; however, specific skill deficits vary between the groups. In particular, children with ASD exhibited a lack of adaptive social skills whereas children with ADHD demonstrated social skill knowledge but an increased level of maladaptive social behavior. The trends of socialization impairment over time were also found to differ in children with ASD versus children with ADHD. While children with ASD remained at similar levels of adaptive social skill impairment over age groups, children with ADHD were found to become more socially impaired in more areas over time. The distinct patterns and trends of social skill deficit found in children with ASD and children with ADHD can inform treatments targeted toward the specific deficits observed within each disorder. (C) 2013 Elsevier Ltd. All rights reserved.
ISI:000323358400012
ISSN: 1750-9467
CID: 2690242
What influences clinicians' decisions about ADHD medication? Initial data from the Influences on Prescribing for ADHD Questionnaire (IPAQ)
Despite evidence for its efficacy and effectiveness, the use of medication for the treatment of ADHD remains controversial. Little is known about the factors that influence clinicians' decisions to use medication for ADHD. Here, we present initial data on the attitudes of prescribing clinicians from the Influences on Prescribing for ADHD Questionnaire (IPAQ)-a new clinician-completed, 40-item scale. The eight IPAQ subscales cover attitudes towards (1) treatment outcome optimisation, (2) the use of rule based over more informal approaches, (3) side effects, (4) symptoms control as the primary goal of treatment, (5) the influence of external pressure on medication-related decisions, (6) the value of taking the child's views into account, (7) long-term medication use and (8) the value of psychosocial approaches for the treatment of ADHD. Sixty-eight clinicians from Belgium and the UK took part. All subscales had acceptable levels of internal reliability (Chronbach's alpha = 0.62-0.78). Overall, clinicians reported taking a rule-based approach to prescribing with a focus on treatment optimisation, taking the child's view into account and valuing psycho-social approaches. They focused on treating broader patterns of impairment, but were wary of the potential side effects and long-term treatment. Psychiatrists scored high on their focus on symptom control and preference for long-term medication use, while paediatricians reported using more rule-based approaches. We identified four distinctive response profiles: (1) pro-psychosocial; (2) medication focused; (3) unsystematic; and (4) response optimizers. Future larger scale studies are required to replicate these profiles and to explore their relationship with prescribing behaviour and treatment outcomes.
PMID: 23455602
ISSN: 1018-8827
CID: 903982
A comparison of tantrum behavior profiles in children with ASD, ADHD and comorbid ASD and ADHD
The present study was conducted to compare rates of tantrum behaviors in children with autism spectrum disorders (ASD) (n=255), attention-deficit/hyperactivity disorder (ADHD) (n=40) and children with comorbid ASD and ADHD (n=47). Parents/guardians of children aged 3-16 years were surveyed about their children's behaviors using the Autism Spectrum Disorders-Comorbidity for Children (ASD-C-C). Children with ADHD alone differed from children with ASD alone and children with comorbid ASD and ADHD on rates of tantrum behaviors. Examination of individual tantrum behavior items indicated that children with comorbid ASD and ADHD have a more similar symptom presentation to children with ASD than children with ADHD. This study adds to the literature on the presentation of common co-occurring behaviors of ASD when there is comorbid ADHD. The implications of these findings may aid in the assessment and treatment of tantrum behaviors in children with comorbid ASD and ADHD.
PMID: 23764824
ISSN: 1873-3379
CID: 2690202
Acquisition of multiple questions in the context of social conversation in children with autism
Verbal initiations, such as questions, are essential components of social conversation often lacking in children with autism. Building on research showing that single questions can be taught in isolation, this study used a multiple baseline design to investigate whether a self-management intervention was effective for teaching concurrent acquisition and discrimination of three social questions in the context of conversation. Following intervention, participants rapidly increased their appropriate use of all three questions in a conversational context and maintained these gains over time. The participants also used questions appropriately with partners uninvolved in treatment. Additionally, the occasional presence of appropriate questions during baseline coupled with rapid improvement during intervention support theories that a lack of question-asking may be motivation-based rather than ability-based.
PMCID:3631576
PMID: 23292139
ISSN: 0162-3257
CID: 1182022
The effectiveness of booster sessions in cbt treatment for child and adolescent mood and anxiety disorders
BACKGROUND: To investigate the effects of booster sessions in cognitive behavioral therapy (CBT) for children and adolescents with mood or anxiety disorders, whereas controlling for youth demographics (e.g., gender, age), primary diagnosis, and intervention characteristics (e.g., treatment modality, number of sessions). METHODS: Electronic databases were searched for CBT interventions for youth with mood and anxiety disorders. Fifty-three (k = 53) studies investigating 1,937 youth met criteria for inclusion. Booster sessions were examined using two case-controlled effect sizes: pre-post and pre-follow-up (6 months) effect sizes and employing weighted least squares (WLSs) regressions. RESULTS: Meta-analyses found pre-post studies with booster sessions had a larger effect size r = .58 (k = 15; 95% CI = 0.52-0.65; P < .01) than those without booster sessions r = .45 (k = 38; 95% CI = 0.41-0.49; P < .001). In the WLS regression analyses, controlling for demographic factors, primary diagnosis, and intervention characteristics, studies with booster sessions showed larger pre-post effect sizes than those without booster sessions (B = 0.13, P < .10). Similarly, pre-follow-up studies with booster sessions showed a larger effect size r = .64 (k = 10; 95% CI = 0.57-0.70; P < .10) than those without booster sessions r = .48 (k = 20; 95% CI = 0.42-0.53; P < .01). Also, in the WLS regression analyses, pre-follow-up studies showed larger effect sizes than those without booster sessions (B = 0.08, P < .01) after accounting for all control variables. CONCLUSIONS: Result suggests that CBT interventions with booster sessions are more effective and the effect is more sustainable for youth managing mood or anxiety disorders than CBT interventions without booster sessions.
PMID: 23596102
ISSN: 1091-4269
CID: 550032
Genetic relationship between five psychiatric disorders estimated from genome-wide SNPs
Most psychiatric disorders are moderately to highly heritable. The degree to which genetic variation is unique to individual disorders or shared across disorders is unclear. To examine shared genetic etiology, we use genome-wide genotype data from the Psychiatric Genomics Consortium (PGC) for cases and controls in schizophrenia, bipolar disorder, major depressive disorder, autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD). We apply univariate and bivariate methods for the estimation of genetic variation within and covariation between disorders. SNPs explained 17-29% of the variance in liability. The genetic correlation calculated using common SNPs was high between schizophrenia and bipolar disorder (0.68 +/- 0.04 s.e.), moderate between schizophrenia and major depressive disorder (0.43 +/- 0.06 s.e.), bipolar disorder and major depressive disorder (0.47 +/- 0.06 s.e.), and ADHD and major depressive disorder (0.32 +/- 0.07 s.e.), low between schizophrenia and ASD (0.16 +/- 0.06 s.e.) and non-significant for other pairs of disorders as well as between psychiatric disorders and the negative control of Crohn's disease. This empirical evidence of shared genetic etiology for psychiatric disorders can inform nosology and encourages the investigation of common pathophysiologies for related disorders.
PMCID:3800159
PMID: 23933821
ISSN: 1061-4036
CID: 904052
The 24-month course of manic symptoms in children
OBJECTIVES: The Longitudinal Assessment of Manic Symptoms (LAMS) study was designed to investigate phenomenology and establish predictors of functional outcomes in children with elevated manic symptoms. The purpose of this series of analyses was to determine whether the participants demonstrated different trajectories of parent-reported manic and biphasic symptoms over the first 24 months of follow-up and to describe the clinical characteristics of the trajectories. METHODS: The 707 participants were initially aged 6-12 years and ascertained from outpatient clinics associated with the four university-affiliated LAMS sites. There were 621 children whose parents/guardians' ratings scored >/= 12 on the Parent General Behavior Inventory-10-item Mania Form (PGBI-10M) and a matched random sample of 86 children whose parents/guardians' ratings scored
PMCID:3762908
PMID: 23799945
ISSN: 1398-5647
CID: 540442
