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Department/Unit:Child and Adolescent Psychiatry

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Out of the toolbox: toddlers differentiate wobbly and wooden handrails

Berger, Sarah E; Adolph, Karen E; Lobo, Sharon A
This study examined whether 16-month-old walking infants take the material composition of a handrail into account when assessing its effectiveness as a tool to augment balance. Infants were encouraged to cross from one platform to another via bridges of various widths (10, 20, 40 cm) with either a "wobbly" (foam or latex) or a wooden handrail available for assistance. Infants attempted to walk over wider bridges more often than narrow ones, and attempts were more frequent when the sturdy wooden handrail was available. Infants tailored their exploratory behaviors, bridge-crossing strategies, and handrail-use strategies to the material properties of the rail.
PMID: 16274441
ISSN: 0009-3920
CID: 1651992

The role of treatment acceptability in the initiation of treatment for ADHD

Krain, Amy L; Kendall, Philip C; Power, Thomas J
Approximately 50% of families of children with ADHD fail to pursue, or adhere to, recommended treatments. The present study examines parent ratings of the acceptability of pharmacological and behavioral treatments for ADHD and the relationships between these ratings and subsequent pursuit of treatment. Fifty-five families whose children received an evaluation for ADHD completed questionnaires and were contacted 3 to 4 months later to assess their pursuit of treatment. Consistent with previous research, parents rated behavior therapy as more acceptable than medication. Parent ratings of medication acceptability significantly predict pursuit of pharmacological treatment, whereas ratings of the acceptability of behavior therapy do not predict pursuit of this treatment. Preliminary analyses found that Caucasian parents' ratings of medication are significantly higher than those of non-Caucasian parents. Furthermore, Caucasian families were more likely to pursue a recommendation for pharmacological treatment than non-Caucasian families. The clinical and research implications of these results are considered
PMID: 16371665
ISSN: 1087-0547
CID: 62744

The scourge of addiction: What the adolescent psychiatrist needs to know

Rosner, R
ISI:000241825500002
ISSN: 0065-2008
CID: 69304

Delusions in individuals with schizophrenia: factor structure, clinical correlates, and putative neurobiology

Kimhy, David; Goetz, Ray; Yale, Scott; Corcoran, Cheryl; Malaspina, Dolores
BACKGROUND: Delusions are a central feature of schizophrenia, yet our understanding of their neurobiology is limited. Attempt to link dimensions of psychopathology to putative neurobiological mechanisms depends on careful delineation of symptoms. Previous factor analytic studies of delusions in schizophrenia were limited by several methodological problems, including the use of patients medicated with antipsychotics, inclusion of nondelusion symptoms in the analyses, and/or inclusion of patients with psychotic disorders other than schizophrenia. These problems may have possibly biased the resulting factor structure and contributed to the inconclusive findings regarding the neurobiology of positive symptoms. Our goal is to examine the factor structure of delusions in antipsychotic-free individuals with diagnoses of schizophrenia/schizoaffective disorder. SAMPLING AND METHODS: We assessed 83 antipsychotic-free individuals with DSM-IV diagnoses of schizophrenia/schizoaffective disorder. A principal component analysis was conducted on the delusions symptoms of the SAPS. RESULTS: The principal component analysis resulted in three distinct and interpretable factors explaining 58.3% of the variance. The Delusions of Influence factor was comprised by delusions of being controlled, thought withdrawal, thought broadcasting, thought insertion, and mind reading. The Self-Significance Delusions factor was comprised by delusions of grandeur, reference, religious, and delusions of guilt/sin. The Delusions of Persecution factor was comprised solely by persecutory delusions. The three factors displayed distinct associations with hallucinations, bizarre behavior, attention, positive formal thought disorder, and avolition/apathy. CONCLUSIONS: The results indicate that delusions are best described by three distinct subtypes. The authors propose a novel model linking the three delusion subtypes, attributions to self/other, and putative neurobiological mechanisms. Implications for future research are discussed, as well as links to cognitive-behavioral conceptualizations of delusions
PMCID:3835525
PMID: 16269869
ISSN: 0254-4962
CID: 69096

The role of metabotropic glutamate receptors and cortical adaptation in habituation of odor-guided behavior

Yadon, Carly A; Wilson, Donald A
Decreases in behavioral investigation of novel stimuli over time may be mediated by a variety of factors including changes in attention, internal state, and motivation. Sensory cortical adaptation, a decrease in sensory cortical responsiveness over prolonged stimulation, may also play a role. In olfaction, metabotropic glutamate receptors on cortical afferent pre-synaptic terminals have been shown to underlie both cortical sensory adaptation and habituation of odor-evoked reflexes. The present experiment examined whether blockade of sensory cortical adaptation through bilateral infusion of the group III metabotropic glutamate receptor antagonist cyclopropyl-4-phosphonophenylglycine (CPPG) into the anterior piriform cortex could reduce habituation of a more complex odor-driven behavior such as investigation of a scented object or a conspecific. The results demonstrate that time spent investigating a scented jar, or a conspecific, decreases over the course of a continuous 10 minute trial. Acute infusion of CPPG bilaterally into the anterior piriform cortex significantly enhanced the time spent investigating the scented jar compared to investigation time in control rats, without affecting overall behavioral activity levels. Infusions into the brain outside of the piriform cortex were without effect. CPPG infusion into the piriform cortex also produced an enhancement of time spent investigating a conspecific, although this effect was not significant
PMCID:1356178
PMID: 16322361
ISSN: 1072-0502
CID: 94326

A direct interview family study of obsessive-compulsive disorder. I

Fyer, Abby J; Lipsitz, Joshua D; Mannuzza, Salvatore; Aronowitz, Bonnie; Chapman, Timothy F
BACKGROUND: This and the companion paper present two sequential family studies of obsessive-compulsive disorder (OCD) conducted by the same research group, but with different sampling and best-estimate procedures. In addition to providing further data on familial transmission of OCD, we used comparison of disparate findings (moderate, specific familial aggregation in this first study versus a stronger effect for other anxiety disorders than for OCD alone in the second) to examine possible effects of proband characteristics and informant data on outcome. METHOD: In this initial study we interviewed 179 first-degree relatives of 72 OCD probands and 112 relatives of 32 never mentally ill (NMI) controls. Informant data were obtained on an additional 126 relatives (total 'combined' samples of 263 and 154 respectively). Analyses used best-estimate diagnoses made by consensus of two 'blinded' senior clinicians who reviewed all diagnostic materials including proband informant data about relatives. RESULTS: Significantly higher risk for OCD but not other anxiety disorders was found in relatives of OCD probands compared to relatives of controls in both the directly interviewed and combined samples. There was no relationship between proband age at onset of OCD and strength of familial aggregation. CONCLUSIONS: These data indicate moderate familial aggregation of OCD, but do not support increased transmission by early onset probands, or a familial relationship between OCD and other anxiety disorders with the possible exception of generalized anxiety disorder
PMID: 16219119
ISSN: 0033-2917
CID: 95353

A direct interview family study of obsessive-compulsive disorder. II. Contribution of proband informant information

Lipsitz, Joshua D; Mannuzza, Salvatore; Chapman, Timothy F; Foa, Edna B; Franklin, Martin E; Goodwin, Renee D; Fyer, Abby J
BACKGROUND: Overall findings of our first direct interview family study of obsessive-compulsive disorder (OCD) indicated that OCD is familial. In this replication study, we carefully examined the role of informant data in ascertaining OCD in relatives. METHOD: We interviewed 112 relatives of 57 OCD patients and 115 relatives of 41 not ill controls predominantly by telephone. Additional analyses included a combined sample of relatives about whom any diagnostic information was available (228 OCD and 239 controls). To examine the contribution of proband information about relatives, we considered two sets of best-estimate diagnoses. First, we ascertained best-estimate diagnoses for relatives using information from direct interviews and from all informants except the proband. Then, we re-diagnosed relatives based on all available information, including reports from the proband about their relatives. RESULTS: When relative diagnoses were derived without the benefit of proband informant reports, no evidence of familial OCD transmission was found. When diagnoses were made including information from the proband about the relative, evidence of familial OCD was found, but only when the diagnostic threshold was lowered to include cases with probable OCD or OCD symptoms. Other diagnoses (generalized anxiety disorder, social phobia, drug use disorder) were also higher among OCD relatives. CONCLUSIONS: This second study provides less robust support for familial transmission of OCD. Evidence for familial transmission of OCD was found only when diagnoses were made using information from the affected proband about their relatives. Taken in context of past findings, our own inconsistent results suggest that OCD may be heterogeneous with regard to familial transmission. Also, more careful attention should be paid to the contribution of informant reports, especially from relatives affected by the same disorder
PMID: 16219120
ISSN: 0033-2917
CID: 95352

Comparison of measured and estimated cognitive ability in older adolescents with and without ADHD

Miller, Carlin J; Marks, David J; Halperin, Jeffrey M
Premorbid intellectual function estimation is a crucial part of patient evaluation following a traumatic brain injury (TBI), especially in individuals with ADHD who are at higher risk for TBI compared to their non-ADHD peers. This study investigates the value of using regression-based estimates of intelligence for concurrently predicting measured intelligence in a sample of older adolescents with and without a childhood history of ADHD. Correlations between measured and estimated intelligence are highly significant in the full sample and in the individual groups. Adding reading performance to the regression equation increases the accounted-for variance in both groups. Results indicate that regression equations based on demographic characteristics constitute a valid method for estimating premorbid functioning in adolescents with ADHD and that they can play an essential role in the assessment of individuals with ADHD who sustain TBI, especially when measures of word reading are used to augment demographic estimates.
PMID: 16371667
ISSN: 1087-0547
CID: 164610

Sustained attention and response inhibition in young children at risk for Attention Deficit/Hyperactivity Disorder

Berwid, Olga G; Curko Kera, Elizabeth A; Marks, David J; Santra, Amita; Bender, Heidi A; Halperin, Jeffrey M
BACKGROUND: Studies of school-aged children, adolescents, and adults with Attention Deficit/Hyperactivity Disorder (ADHD) have variably shown ADHD-related impairment in both inhibitory control and sustained attention. However, few studies have examined ADHD-associated patterns of performance on these tasks among younger children (below age 7 years). METHODS: A combined continuous performance test and go/no-go task (CPT/GNG) and the Day-Night Stroop Task (DNST) were administered to an ethnically diverse sample of 3.44- to 6.95-year-old children rated by parents and teachers as being either high risk or low risk for ADHD. All children performed the DNST (N = 71) and a subset of the sample (N = 44) performed the CPT/GNG. Analyses assessed task validity as well as the effects of age and risk status. RESULTS: Significant main effects for age and risk status were found on all tasks. In addition, age x condition interactions were found for the CPT and DNST, which suggest that the tasks were sensitive to age-related changes in sustained attention and inhibitory control respectively. No significant risk status x condition interactions were found, suggesting that young children at risk for ADHD do not exhibit specific deficits in either inhibitory control or sustained attention. The most consistent effect related to risk status across tasks was the greater number of errors and longer and more variable reaction times on the part of children at risk for ADHD irrespective of condition. CONCLUSIONS: ADHD-associated decrements in performance on these tasks appear to be attributable either to generalized behavioral dysregulation or poor state regulation rather than to deficient inhibitory control.
PMID: 16238669
ISSN: 0021-9630
CID: 164611

Sexual violence and youth in South Africa: the need for community-based prevention interventions

Petersen, Inge; Bhana, Arvin; McKay, Mary
OBJECTIVES: South Africa is reported to have one of the highest rates of sexual violence in the world, with adolescent girls between the ages of 12-17 being particularly at risk. Given that adolescence is considered a critical developmental period for establishing normative sexual behavior, this study explored multiple levels of risk influences that render adolescent girls vulnerable to becoming victims of sexual violence and adolescent boys vulnerable to becoming perpetrators of such abuse in one South African community. METHOD: A case study approach using qualitative rapid focused ethnographic methods was used. This involved 10 focus group interviews and 10 individual interviews with a volunteer convenience sample of adolescent boys and girls between the ages of 14 and 16 years. RESULTS: Inductive thematic analysis revealed that there were indeed multiple levels of risk influences for adolescent girls and boys becoming either victims or perpetrators of sexual violence. Using the Theory of Triadic Influence as a framework, influences at the distal socio-cultural/environmental level included traditional notions of masculinity and normalization of inter-personal violence as well as poverty and the commodification of sex leading to rape supportive attitudes. Influences at the proximal situation context/social normative level included high-risk social norms as well as a weak adult and community protective shield. Finally, influences at the intra-personal level included low self-esteem and self-efficacy as well as inter-personal affective anger. CONCLUSION: Given the multiple levels of risk influences that need to be addressed to protect youth from becoming either perpetrators or victims of sexual violence in the South African context, prevention programs should necessarily be comprehensive, developmentally timed, and community-based.
PMID: 16263168
ISSN: 0145-2134
CID: 1910862