Faculty Bibliography
Searched for:
school:SOM
Department/Unit:Child and Adolescent Psychiatry
Total Results:
11432
Journal of the American Academy of Child & Adolescent Psychiatry. 2007:46(3):341-55.DOI: 10.1097/chi.0b013e31802d0b3d
Cognitive flexibility in phenotypes of pediatric bipolar disorder
OBJECTIVE: Clinicians and researchers debate whether children with chronic, nonepisodic irritability should receive the diagnosis of bipolar disorder (BD). To address this debate, we evaluated cognitive flexibility, or the ability to adapt to changing contingencies, in three groups of children: narrow-phenotype BD (NP-BD; full-duration manic episodes of elevated/expansive mood; N = 50; 13.1 +/- 2.9 years), severe mood dysregulation (SMD; chronic, nonepisodic irritability; N = 44; 12.2 +/- 2.1 years), and healthy controls (N = 43; 13.6 +/- 2.4 years). Cognitive flexibility is relevant to symptoms of BD involving dysfunctional reward systems (e.g., excessive goal-directed activity and pleasure-seeking in mania; anhedonia in depression). METHOD: We studied simple and compound reversal stages of the intra-/extradimensional shift task and change task that involves inhibiting a prepotent response and substituting a novel response. RESULTS: On the simple reversal, NP-BD youths were significantly more impaired than both the SMD group and controls. On the compound reversal, NP-BD and SMD youths performed worse than controls. On the change task, NP-BD youths were slower to adapt than SMD subjects. CONCLUSIONS: Phenotypic differences in cognitive flexibility may reflect different brain/behavior mechanisms in these two patient populations.
PMID: 17314720
ISSN: 0890-8567
CID: 161938
Parental beliefs about the nature of ADHD behaviours and their relationship to referral intentions in preschool children
BACKGROUND: Parental beliefs about child problem behaviour have emerged as closely related to referral intentions to mental health services. METHODS: This study compared beliefs of severity, impact and advice seeking for attention deficit/hyperactivity disorder (ADHD) behaviours of parents whose preschool children present ADHD behaviours with those of parents whose children do not display such behaviours. Both parents of 295 preschoolers, aged 4-6 years, enrolled in kindergartens in Athens, filled in: (i) a questionnaire composed by a vignette describing a hypothetical 5-year-old child presenting ADHD symptoms followed by rating scales assessing dimensions of severity, impact and referral intention, and (ii) the 'Strengths and Difficulties Questionnaire' for screening ADHD behaviours in their own child. RESULTS: Results showed that almost half of the parents who reported ADHD behaviours in their own child replied that they had never met a child exhibiting such behaviours. These parents also perceived such behaviours as being less severe and with less negative family impact than parents who did not report such behaviours in their own child. CONCLUSIONS: Parents whose preschool child displays ADHD behaviours tend to perceive them as normal developmental patterns and may suspend the referral of the child. Implications of these findings for early identification of ADHD are discussed
PMID: 17291323
ISSN: 0305-1862
CID: 145920
Applying theory-driven approaches to understanding and modifying clinicians' behavior: what do we know?
OBJECTIVE: Despite major recent research advances, large gaps exist between accepted mental health knowledge and clinicians' real-world practices. Although hundreds of studies have successfully utilized basic behavioral science theories to understand, predict, and change patients' health behaviors, the extent to which these theories-most notably the theory of reasoned action (TRA) and its extension, the theory of planned behavior (TPB)-have been applied to understand and change clinician behavior is unclear. This article reviews the application of theory-driven approaches to understanding and changing clinician behaviors. METHODS: MEDLINE and PsycINFO databases were searched, along with bibliographies, textbooks on health behavior or public health, and references from experts, to find article titles that describe theory-driven approaches (TRA or TPB) to understanding and modifying health professionals' behavior. RESULTS: A total of 19 articles that detailed 20 studies described the use of TRA or TPB and clinicians' behavior. Eight articles describe the use of TRA or TPB with physicians, four relate to nurses, three relate to pharmacists, and two relate to health workers. Only two articles applied TRA or TPB to mental health clinicians. The body of work shows that different constructs of TRA or TPB predict intentions and behavior among different groups of clinicians and for different behaviors and guidelines. CONCLUSIONS: The number of studies on this topic is extremely limited, but they offer a rationale and a direction for future research as well as a theoretical basis for increasing the specificity and efficiency of clinician-targeted interventions.
PMID: 17325107
ISSN: 1075-2730
CID: 167926
Prevalence and correlates of early onset asthma and wheezing in a healthy birth cohort of 2- to 3-year olds
OBJECTIVE: The combined contribution of neonatal, perinatal, and maternal health, demographic, environmental, and family psychosocial factors to early onset asthma and wheezing in a healthy birth cohort was examined. METHODS: Participants included 1,158 ethnically and socioeconomically diverse parents of 2- and 3-year olds who completed mailed questionnaires. RESULTS: Asthma and wheezing prevalence was 8.4 and 8.1%, respectively. Asthma during pregnancy, smoking in the home, and being male increased risk for asthma diagnosis and wheezing whereas social support minimized risk for both. Shorter gestational age, exposure to violence, and maternal anxiety increased risk for wheezing. The negative impact of smoking in the home was greatest for children with shorter gestational ages and mothers with asthma during pregnancy. CONCLUSION: Findings confirm and extend previous work documenting demographic risks and highlight smoking, violent events, and social support in early onset asthma and wheezing. Findings illustrate the need for ecologically based interventions to treat asthma and wheezing in young children.
PMID: 16690752
ISSN: 0146-8693
CID: 177359
Baby carriage: infants walking with loads
Maintaining balance is a central problem for new walkers. To examine how infants cope with the additional balance control problems induced by load carriage, 14-month-olds were loaded with 15% of their body weight in shoulder-packs. Both symmetrical and asymmetrical loads disrupted alternating gait patterns and caused less mature footfall patterns. Walking was most severely compromised by back loads. Infants with less walking experience, lower levels of walking proficiency, and chubbier body proportions were more adversely affected. In addition, infants displayed a unique postural response to asymmetrical loads. In contrast to older children and adults, infants leaned with loads rather than in the opposite direction to the loads. Findings are discussed in terms of development from accommodation to compensatory strategies.
PMID: 17381796
ISSN: 0009-3920
CID: 1651942
Mapping autism risk loci using genetic linkage and chromosomal rearrangements
Autism spectrum disorders (ASDs) are common, heritable neurodevelopmental conditions. The genetic architecture of ASDs is complex, requiring large samples to overcome heterogeneity. Here we broaden coverage and sample size relative to other studies of ASDs by using Affymetrix 10K SNP arrays and 1,181 [corrected] families with at least two affected individuals, performing the largest linkage scan to date while also analyzing copy number variation in these families. Linkage and copy number variation analyses implicate chromosome 11p12-p13 and neurexins, respectively, among other candidate loci. Neurexins team with previously implicated neuroligins for glutamatergic synaptogenesis, highlighting glutamate-related genes as promising candidates for contributing to ASDs
PMCID:4867008
PMID: 17322880
ISSN: 1061-4036
CID: 104011
Performance on a virtual reality spatial memory navigation task in depressed patients
OBJECTIVE: Findings on spatial memory in depression have been inconsistent. A navigation task based on virtual reality may provide a more sensitive and consistent measure of the hippocampal-related spatial memory deficits associated with depression. METHOD: Performance on a novel virtual reality navigation task and a traditional measure of spatial memory was assessed in 30 depressed patients (unipolar and bipolar) and 19 normal comparison subjects. RESULTS: Depressed patients performed significantly worse than comparison subjects on the virtual reality task, as assessed by the number of locations found in the virtual town. Between-group differences were not detected on the traditional measure. The navigation task showed high test-retest reliability. CONCLUSIONS: Depressed patients performed worse than healthy subjects on a novel spatial memory task. Virtual reality navigation may provide a consistent, sensitive measure of cognitive deficits in patients with affective disorders, representing a mechanism to study a putative endophenotype for hippocampal function.
PMID: 17329478
ISSN: 0002-953x
CID: 161937
Journal of the American Academy of Child & Adolescent Psychiatry. 2007:46(3):323-31.DOI: 10.1097/chi.0b013e31802b9522
Social interaction behaviors discriminate young children with autism and Williams syndrome
OBJECTIVE: Autistic disorder (AD) and Williams syndrome (WS) are neurodevelopmental disorders characterized by contrasting abnormal social behavior (the former, socially avoidant; the latter, outwardly social); nonetheless, there are individuals with WS who display some behaviors that are characteristic of AD. We quantified the extent to which autism spectrum disorder (ASD) behaviors were present in children with WS. METHOD: Twenty children with WS (27-58 months) and 26 age- and IQ-equivalent children with AD were administered the Autism Diagnostic Observation Schedule (ADOS). ADOS behaviors were compared between groups. RESULTS: Two children with WS met DSM-IV criteria for AD, one of whom was also classified as having AD by the ADOS algorithm. Discriminant analysis of ADOS behaviors indicated that gesture, showing, and quality of social overtures best discriminated the groups. CONCLUSIONS: Although some children with WS demonstrated some ASD behaviors, and a minority of children with WS had coexisting AD, the symptom profile in WS was different from AD. Despite some deficits in communication behaviors, showing, and initiating joint attention, children with WS made social overtures and efforts to engage others, whereas children with AD tended not to do so
PMID: 17314718
ISSN: 0890-8567
CID: 143041
Blood pressure before and after electroconvulsive therapy in hypertensive and nonhypertensive patients
The effect of a course of electroconvulsive therapy (ECT) on blood pressure control in hypertensive patients has not been studied. We retrospectively examined pre- and post-ECT blood pressures in hypertensive and nonhypertensive patients. In neither group was there a statistically significant change in blood pressure with a course of ECT. We conclude that a course of ECT does not worsen blood pressure in hypertensive patients beyond the peritreatment period.
PMID: 17435564
ISSN: 1095-0680
CID: 169986
Psychometric properties of the Alabama parenting questionnaire-preschool revision
The psychometric properties of the Alabama Parenting Questionnaire-Preschool Revision (APQ-PR) were explored in a sample of hyperactive-inattentive preschool children (N = 47) and nonimpaired controls (N = 113). A subset of parents completed the questionnaire on 2 occasions, approximately 1 year apart. Factor analysis revealed a 3-factor solution, accounting for 32.28% of the variance. The resultant Positive Parenting, Negative/Inconsistent Parenting, and Punitive Parenting factors demonstrated good internal consistency and temporal stability. At baseline, parents of hyperactive-inattentive and control children did not differ on any APQ-PR subscale. However, over time parents of controls increased their use of positive parenting techniques, whereas the use of positive parenting practices decreased over time in the hyperactive-inattentive group.
PMID: 17206878
ISSN: 1537-4416
CID: 164607
