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Department/Unit:Child and Adolescent Psychiatry

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The social re-orientation of adolescence: a neuroscience perspective on the process and its relation to psychopathology

Nelson, Eric E; Leibenluft, Ellen; McClure, Erin B; Pine, Daniel S
BACKGROUND: Many changes in social behavior take place during adolescence. Sexuality and romantic interests emerge during this time, and adolescents spend more time with peers and less time with parents and family. While such changes in social behavior have been well documented in the literature, relatively few neurophysiological explanations for these behavioral changes have been presented. METHOD: In this article we selectively review studies documenting (a) the neuronal circuits that are dedicated to the processing of social information; (b) the changes in social behavior that take place during adolescence; (c) developmental alterations in the adolescent brain; and (d) links between the emergence of mood and anxiety disorders in adolescence and changes in brain physiology occurring at that time. RESULTS: The convergence of evidence from this review indicates a relationship between development of brain physiology and developmental changes in social behavior. Specifically, the surge of gonadal steroids at puberty induces changes within the limbic system that alters the emotional attributions applied to social stimuli while the gradual maturation of the prefrontal cortex enables increasingly complex and controlled responses to social information. CONCLUSIONS: Observed alterations in adolescent social behavior reflect developmental changes in the brain social information processing network. We further speculate that dysregulation of the social information processing network in this critical period may contribute to the onset of mood and anxiety disorders during adolescence.
PMID: 15841674
ISSN: 0033-2917
CID: 161984

Co-parenting within foster care: Influences on child development [Dissertation]

Montalto, Daniela
Increasing evidence suggests that 'co-parenting', the extent to which parents function as partners or adversaries in their parenting roles, makes an independent contribution to child adjustment, beyond the influence of parenting alone (Cowan & McHale, 1996). This study is the first of its kind to extend the investigation of co-parenting to foster-care. Two measures of co-parenting in foster care were developed, a coding scheme for observations (Foster Care & Co-parenting Rating System; FCCRS) and a questionnaire (Co-parenting Events Scale; CES), to study the impact of co-parenting in foster care on behavior outcomes. Participants were 24 biological and foster parents and their 3 to 10 year old foster child (M = 6.9 years: SD = 2.6). Most families (over 90%) fell below the midpoint on the FCCRS supportive (M = 9.2, SD = 2.1) and unsupportive subscales (M = 6.6, SD = 1.5). Although a strong relationship was not found between FCCRS scales and child behavior, medium to large relationships were found for the CES. A significant large inverse effect was found for biological parents on CES and externalizing behavior problems, r = -.89, p = 02; large negative effects were also found for internalizing and total behavior problems, although not significant, r = -.59, p = .22 and r = -.69, p = .13, respectively. For foster parents, only a large negative effect was found between CES and internalizing behavior problems, r = -.68, p = .14. Social competence was only positively related to FCCRS supportive co-parenting, r = .40, p = .05, and inversely related to FCCRS unsupportive co-parenting, r = -.25, p = .25. Findings on the CES, though, should be interpreted with caution (n = 6) and need replication. Co-parenting patterns were subsequently more fully examined through exploratory analyses. Findings support the application of two new co-parenting measures in foster care and underscore the need for further research into the relationships between biological and foster families and child outcomes. The unique focus on the co-parenting relationship in foster care underscores important targets for intervention and prevention and emphasizes the need for services that are multimodal and designed to address child, family (foster and biological) and social factors.
PSYCH:2005-99012-358
ISSN: 0419-4217
CID: 74626

Feasibility of the MindMatters School Mental Health Promotion Program in American Schools

Evans, Steven W; Mullett, Elizabeth; Weist, Mark D; Franz, Kimberly
Assessed the feasibility of the Australian MindMatters program, a whole school mental health promotion program for application in the United States (U.S.). Forty-two participants representing school and community stakeholder groups from four U.S. communities (urban, rural, suburban, small town) evaluated the program for application in their communities through a research process involving discussion and endorsement ratings of relevance and likely impact. The majority of participants (85%) indicated that the program would help students in their community schools feel safe and valued, and participants indicated strong endorsement for MindMatters curriculum units focusing on suicide prevention and addressing bullying and harassment. Participants rated their own stakeholder group (e.g., teacher, school administrator, and parent) as being most likely to support and implement the program, suggesting that providing qualitative feedback on a program may help to increase a sense of ownership over it. Ideas for tailoring programs developed in other settings for application in local communities are discussed. (journal abstract)
PSYCH:2005-04139-008
ISSN: 0047-2891
CID: 67569

High-frequency oscillations are not necessary for simple olfactory discriminations in young rats

Fletcher, Max L; Smith, Abigail M; Best, Aaron R; Wilson, Donald A
Individual olfactory bulb mitral/tufted cells respond preferentially to groups of molecularly similar odorants. Bulbar interneurons such as periglomerular and granule cells are thought to influence mitral/tufted odorant receptive fields through mechanisms such as lateral inhibition. The mitralgranule cell circuit is also important in the generation of the odor-evoked fast oscillations seen in the olfactory bulb local field potentials and hypothesized to be an important indicator of odor quality coding. Infant rats, however, lack a majority of these inhibitory interneurons until the second week of life. It is unclear if these developmental differences affect olfactory bulb odor coding or behavioral odor discrimination. The following experiments are aimed at better understanding odor coding and behavioral odor discrimination in the developing olfactory system. Single-unit recordings from mitral/tufted cells and local field-potential recordings from both the olfactory bulb and anterior piriform cortex were performed in freely breathing urethane-anesthetized rats (postnatal day 7 to adult). Age-dependent behavioral odor discrimination to a homologous series of ethyl esters was also examined using a cross-habituation paradigm. Odorants were equated in all experiments for concentration (150 ppm) using a flow dilution olfactometer. In concordance with the reduced interneuron population, local field potentials in neonates lacked detectable odor-evoked gamma-frequency oscillations that were observed in mature animals. However, mitral/tufted cell odorant receptive fields and behavioral odor discrimination did not significantly change, despite known substantial changes in local circuitry and neuronal populations, over the age range examined. The results suggest that high-frequency local field-potential oscillations do not reflect processes critical for simple odor discrimination
PMCID:2292205
PMID: 15673658
ISSN: 1529-2401
CID: 140382

Molecular genetic studies of ADHD: 1991 to 2004

Bobb, Aaron J; Castellanos, F Xavier; Addington, Anjene M; Rapoport, Judith L
Attention deficit hyperactivity disorder (ADHD)is highly heritable but is likely a complex disorder involving multiple genes of moderate effect (Smalley [1997: Am J Hum Genet 60:1276-12821]). Over 100 studies have examined the genetics of ADHD by linkage or association, though no article has presented a comprehensive overview of all published reports. We reviewed all ADHD studies, including 3 genome-wide linkage studies, and association studies of 94 polymorphisms in 33 candidate genes. To simplify comparisons across heterogeneous articles, demographics and comorbidity were ignored; analyses of subtype and haplotypes were excluded; and only the most positive finding for each polymorphism in a study was reported. Thirty-six percent of all findings were positive (P< 0.05), 17% were trends (0.05 <P < 0.15), and 47% were negative (P > 0.15). Studies utilizing dimensional measures of ADHD tended to result in higher rates of positive findings than those using categorical diagnoses (X(2) = 5.6, P = 0.018), and case-control studies tended to result in higher rates of positive findings than family-based studies (X(2) = 18.8, P < 0.001). However, for either dichotomy, no significant difference remained when analyzing only studies using both methods within the same population and polymorphism. Evidence for association exists for four genes in ADHD: the dopamine D4 and D5 receptors, and the dopamine and serotonin transporters; others are promising but need further replication, including the dopamine D2 and serotonin 2A receptors. All candidate gene approaches continue to face the problem of relatively low power, given modest odds ratios for even the best replicated genes
PMID: 15700344
ISSN: 1552-4841
CID: 64255

Prevention of peer rejection through a classroom-level intervention in middle school

Mikami, Amori Yee; Boucher, Margaret A; Humphreys, Keith
This project evaluated an intervention for preventing peer rejection in middle school that promoted social acceptance in the classroom environment. The systems-level and preventive focus of this intervention differed markedly from traditional interventions that target putative deficits within individual rejected children. In collaboration with 24 teachers and their classrooms, the intervention team led mixed groups of accepted and rejected children in cooperative games that required teamwork and mutual respect among all members in order to succeed. To reinforce these alliances between children, as well as to prevent future peer rejection, teachers were encouraged to use cooperative, teamwork-based group activities for academic instruction. The intervention was evaluated using a randomized control (waitlist) design. Results suggested that the intervention reduced the amount of self-reported peer rejection in classrooms. Implications for the further development and evaluation of systems-level interventions to prevent peer rejection are discussed. EDITORS' STRATEGIC IMPLICATIONS: The use of a systems-based prevention program shows promise for the prevention of children's perceived peer rejection. The authors demonstrate a model of university-community collaboration with a plan for sustainability and a focus on low-income and minority populations. Educators, school administrators, and researchers will be intrigued by the positive experiences of non-rejected peers and teachers in promoting a socially accepting school climate.
PMID: 15976927
ISSN: 0278-095x
CID: 555902

Alcohol Use Disorders: Special Topics

Ross, Stephen
Alcohol use disorders (AUDs) include a spectrum of alcohol-related disorders such as alcohol misuse, abuse, and dependence. AUDs are a group of common, chronic diseases caused by a complicated interaction between biological, psychological, social, and cultural factors. Approximately two-thirds of all American adults, 18 years of age and older, drink some alcohol during the course of a year. Moreover, approximately 7.5% of the United States population (approximately 14 million people) meet criteria for alcohol abuse or dependence. At present, there are two types of medications that are used to treat alcoholism. The first are aversive medications, with disulfiram being the most commonly used. By causing an aversive reaction when taken with alcohol, these medications deter further alcohol consumption through negative reinforcement. However, they are limited in utility unless given in a supervised setting. The second, are those that have anti-craving effects. One of the medications, naltrexone, an opiate antagonist, was first approved by the Food and Drug Administration in 1994. Since there is a limited number of biological interventions for alcoholism at present, most treatment consists of nonpharmacologic psychosocial treatments.
PSYCH:2005-01478-011
ISSN: 1082-6319
CID: 48893

Facial expressiveness in patients with schizophrenia compared to depressed patients and nonpatient comparison subjects

Tremeau, Fabien; Malaspina, Dolores; Duval, Fabrice; Correa, Humberto; Hager-Budny, Michaela; Coin-Bariou, Laura; Macher, Jean-Paul; Gorman, Jack M
OBJECTIVE: Blunted affect is a major symptom in schizophrenia, and affective deficits clinically encompass deficits in expressiveness. Emotion research and ethological studies have shown that patients with schizophrenia are impaired in various modalities of expressiveness (posed and spontaneous emotion expressions, coverbal gestures, and smiles). Similar deficits have been described in depression, but comparative studies have brought mixed results. Our aim was to study and compare facial expressive behaviors related to affective deficits in patients with schizophrenia, depressed patients, and nonpatient comparison subjects. METHOD: Fifty-eight nondepressed inpatients with schizophrenia, 25 nonpsychotic inpatients with unipolar depression, and 25 nonpatient comparison subjects were asked to reproduce facial emotional expressions. Then the subjects were asked to speak about a specific emotion for 2 minutes. Each time, six cross-cultural emotions were tested. Facial emotional expressions were rated with the Facial Action Coding System. The number of facial coverbal gestures (facial expressions that are tied to speech) and the number of words were calculated. RESULTS: In relation to nonpatient comparison subjects, both patient groups were impaired for all expressive variables. Few differences were found between schizophrenia and depression: depressed subjects had less spontaneous expressions of other-than-happiness emotions, but overall, they appeared more expressive. Fifteen patients with schizophrenia were tested without and with typical or atypical antipsychotic medications: no differences could be found in study performance. CONCLUSIONS: The patients with schizophrenia and the patients with depression presented similar deficits in various expressive modalities: posed and spontaneous emotional expression, smiling, coverbal gestures, and verbal output
PMID: 15625206
ISSN: 0002-953x
CID: 48726

A model of verbal memory impairments in schizophrenia: two systems and their associations with underlying cognitive processes and clinical symptoms

Brebion, Gildas; Gorman, Jack M; Malaspina, Dolores; Amador, Xavier
BACKGROUND: In a broad cognitive study of schizophrenia we investigated the relationships of verbal memory impairments with cognitive underpinnings on the one hand, and clinical symptomatology on the other. The results have been reported in previous papers. In this paper we show how all these data could be integrated into a consistent pattern of associations. METHOD: Fifty schizophrenic patients underwent a cognitive battery including a verbal memory task with free recall and recognition, a source memory task, and tests of processing speed and selective attention. Ratings for positive, negative and depressive symptoms were available for 40 of the patients. RESULTS: A factorial analysis revealed a distinction between measures of memory efficiency and measures of memory errors. The system of memory efficiency was associated with processing speed and selective attention at the cognitive level, and with depression at the symptom level. The system of memory errors was assumed to be underlain by source-monitoring deficits. These memory errors were increased by positive symptoms and decreased by certain negative symptoms. CONCLUSIONS: All the measures drawn from various memory tasks could be integrated into a model describing their associations with cognitive underpinnings and clinical symptomatology. This model provides a heuristic for the cognitive and pharmacological treatments of verbal memory impairments in schizophrenia, as well as for the understanding of positive symptoms
PMID: 15842036
ISSN: 0033-2917
CID: 69101

Are barriers to service and parental preference match for service related to urban child mental health service use?

Bannon, WM; McKay, MM
The authors sought to examine how parental preference match for service and various types of barriers to service relate to involvement in urban child mental health care. A single-group longitudinal design was used to examine whether service use at an outpatient child mental health clinic was related to parents receiving the type of service they reported wanting for their child at intake and various types of barriers to service. Families who received the service parents reported wanting for their child attended on average 2 treatment sessions more, whereas barriers were unrelated to service use. Considering parent preference for child mental health service may be an effective strategy in increasing service involvement in urban child mental health care.
ISI:000228902300004
ISSN: 1044-3894
CID: 1910852