Faculty Bibliography
Searched for:
school:SOM
Department/Unit:Child and Adolescent Psychiatry
Total Results:
11507
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
Synaptic adaptation and odor-background segmentation
Habituation is a form of non-associative memory that plays an important role in filtering stable or redundant inputs. The present study examines the contribution of habituation and cortical adaptation to odor-background segmentation. Segmentation of target odorants from background odorants is a fundamental computational requirement for the olfactory system. Recent electrophysiological data have shown that odor specific adaptation in piriform cortex neurons, mediated at least partially by synaptic adaptation between the olfactory bulb outputs and piriform cortex pyramidal cells, may provide an ideal mechanism for odor-background segmentation. This rapid synaptic adaptation acts as a filter to enhance cortical responsiveness to changing stimuli, while reducing responsiveness to static, potentially background stimuli. Using previously developed computational models of the olfactory system, we here show how synaptic adaptation at the olfactory bulb input to the piriform cortex, as demonstrated electrophysiologically, creates odor specific adaptation. We show how this known feature of olfactory cortical processing can contribute to adaptation to a background odor and to odor-background segmentation. We then show in a behavioral experiment that the odor-background segmentation is perceptually important and functions at the same time-scale as the synaptic adaptation observed between the olfactory bulb and cortex
PMID: 17141533
ISSN: 1074-7427
CID: 94323
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
fMRI predictors of treatment outcome in pediatric anxiety disorders
INTRODUCTION: A growing number of studies have found evidence that anxiety and depressive disorders are associated with atypical amygdala hyperactivation, which decreases with effective treatment. Interest has emerged in this phenomenon as a possible biological marker for individuals who are likely to benefit from tailored treatment approaches. OBJECTIVE: The present study was designed to examine relationships between pretreatment amygdala activity and treatment response in a sample of anxious children and adolescents. MATERIALS AND METHODS: Participants, who were diagnosed predominantly with generalized anxiety disorder (GAD), underwent functional magnetic resonance imaging (fMRI) scanning before treatment with fluoxetine or cognitive behavioral therapy (CBT). RESULTS: Results indicated significant negative associations between degree of left amygdala activation and measures of posttreatment symptom improvement in the group, as a whole. DISCUSSION: Taken together with research on associations between adult amygdala activation and treatment response, these findings suggest that patients whose pretreatment amygdala activity is the strongest may be particularly likely to respond well to such widely used treatments as selective serotonin reuptake inhibitor (SSRI) medications and CBT.
PMID: 16972100
ISSN: 0033-3158
CID: 161950
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
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
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
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
Preferential incorporation of adult-generated granule cells into spatial memory networks in the dentate gyrus
Throughout adulthood, new neurons are continuously added to the dentate gyrus, a hippocampal subregion that is important in spatial learning. Whether these adult-generated granule cells become functionally integrated into memory networks is not known. We used immunohistochemical approaches to visualize the recruitment of new neurons into circuits supporting water maze memory in intact mice. We show that as new granule cells mature, they are increasingly likely to be incorporated into circuits supporting spatial memory. By the time the cells are 4 or more weeks of age, they are more likely than existing granule cells to be recruited into circuits supporting spatial memory. This preferential recruitment supports the idea that new neurons make a unique contribution to memory processing in the dentate gyrus.
PMID: 17277773
ISSN: 1097-6256
CID: 4625222
