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Sample records for defiant disorder multiple

  1. Oppositional Defiant Disorder (ODD)

    Science.gov (United States)

    ... separation or divorce and differences in expectations and parenting styles. Your child's key medical information, including other physical ... way to prevent oppositional defiant disorder. However, positive parenting and ... child's self-esteem and rebuild a positive relationship between you and ...

  2. ADHD and Oppositional Defiant Disorder

    OpenAIRE

    J Gordon Millichap

    2003-01-01

    The outcome of 131 children with ADHD (101 males, 30 females; mean age 5 years, range 3 to 7 years) with and without oppositional defiant disorder (ODD) was determined in a prospective study at the University of Goteborg, Sweden.

  3. ADHD and Oppositional Defiant Disorder

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2003-10-01

    Full Text Available The outcome of 131 children with ADHD (101 males, 30 females; mean age 5 years, range 3 to 7 years with and without oppositional defiant disorder (ODD was determined in a prospective study at the University of Goteborg, Sweden.

  4. Oppositional Defiant Disorder in Adults with ADHD

    Science.gov (United States)

    Reimherr, Frederick W.; Marchant, Barrie K.; Olsen, John L.; Wender, Paul H.; Robison, Reid J.

    2013-01-01

    Objective: Oppositional defiant disorder (ODD) is the most common comorbid condition in childhood ADHD. This trial was prospectively designed to explore ODD symptoms in ADHD adults. Method: A total of 86 patients in this placebo-controlled, double-blind trial of methylphenidate transdermal system (MTS) were categorized based on the presence of ODD…

  5. Perspectives on Oppositional Defiant Disorder, Conduct Disorder, and Psychopathic Features

    Science.gov (United States)

    Loeber, Rolf; Burke, Jeffrey; Pardini, Dustin A.

    2009-01-01

    This paper presents a few perspectives on oppositional defiant disorder (ODD), conduct disorder (CD), and early forms of psychopathy. The developmental changes and stability of each, and the interrelationship between the three conditions are reviewed, and correlates and predictors are highlighted. The paper also examines effective interventions…

  6. Prevalence of oppositional defiant disorder in Spain.

    Science.gov (United States)

    López-Villalobos, José Antonio; Andrés-De Llano, Jesús María; Rodríguez-Molinero, Luis; Garrido-Redondo, Mercedes; Sacristán-Martín, Ana María; Martínez-Rivera, María Teresa; Alberola-López, Susana; Sánchez-Azón, María Isabel

    2014-01-01

    Oppositional defiant disorder (ODD) is characterized by a pattern of negative, defiant, disobedient and hostile behavior toward authority figures. ODD is one of the most frequent reasons for clinical consultation on mental health during childhood and adolescence. ODD has a high morbidity and dysfunction, and has important implications for the future if not treated early. To determine the prevalence of ODD in schoolchildren aged 6-16 years in Castile and Leon (Spain). Population study with a stratified multistage sample, and a proportional cluster design. Sample analyzed: 1,049. Cases were defined according to DSM-IV criteria. An overall prevalence rate of 5.6% was found (95% CI: 4.2%-7%). Male gender prevalence=6.8%; female=4.3%. Prevalence in secondary education=6.2%; primary education=5.3%. No significant differences by gender, age, grade, type of school, or demographic area were found. ODD prevalence without considering functional impairment, such as is performed in some research, would increase the prevalence to 7.4%. ODD cases have significantly worse academic outcomes (overall academic performance, reading, maths and writing), and worse classroom behavior (relationship with peers, respect for rules, organizational skills, academic tasks, and disruption of the class). Castile and Leon has a prevalence rate of ODD slightly higher to that observed in international publications. Depending on the distribution by age, morbidity and clinical dysfunctional impact, an early diagnosis and a preventive intervention are required for health planning. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

  7. The neurobiology of oppositional defiant disorder and conduct disorder: Altered functioning in three mental domains

    NARCIS (Netherlands)

    Matthys, W.C.H.J.; Vanderschuren, L.J.M.J.; Schutter, D.J.L.G.

    2013-01-01

    This review discusses neurobiological studies of oppositional defiant disorder and conduct disorder within the conceptual framework of three interrelated mental domains: punishment processing, reward processing, and cognitive control. First, impaired fear conditioning, reduced cortisol reactivity to

  8. ADHD with Comorbid Oppositional Defiant Disorder or Conduct Disorder: Discrete or Nondistinct Disruptive Behavior Disorders?

    Science.gov (United States)

    Connor, Daniel F.; Doerfler, Leonard A.

    2008-01-01

    Objective: In children with ADHD who have comorbid disruptive behavior diagnoses distinctions between oppositional defiant disorder (ODD) and conduct disorder (CD) remain unclear. The authors investigate differences between ODD and CD in a large clinical sample of children with ADHD. Method: Consecutively referred and systematically assessed male…

  9. ADHD with Comorbid Oppositional Defiant Disorder or Conduct Disorder: Discrete or Nondistinct Disruptive Behavior Disorders?

    Science.gov (United States)

    Connor, Daniel F.; Doerfler, Leonard A.

    2008-01-01

    Objective: In children with ADHD who have comorbid disruptive behavior diagnoses distinctions between oppositional defiant disorder (ODD) and conduct disorder (CD) remain unclear. The authors investigate differences between ODD and CD in a large clinical sample of children with ADHD. Method: Consecutively referred and systematically assessed male…

  10. Dimensions of Oppositional Defiant Disorder as Predictors of Depression and Conduct Disorder in Preadolescent Girls

    Science.gov (United States)

    Burke, Jeffrey D.; Hipwell, Alison E.; Loeber, Rolf

    2010-01-01

    Objective: To examine whether oppositional defiant disorder (ODD) rather than conduct disorder (CD) may explain the comorbidity between behavioral disorders and depression; to test whether distinct affective and behavioral dimensions can be discerned within the symptoms of ODD; and to determine whether an affective dimension of ODD symptoms is…

  11. Source-Specific Oppositional Defiant Disorder among Inner-City Children: Prospective Prediction and Moderation

    Science.gov (United States)

    Drabick, Deborah A. G.; Bubier, Jennifer; Chen, Diane; Price, Julia; Lanza, H. Isabella

    2011-01-01

    We examined prospective prediction from parent- and teacher-reported oppositional defiant disorder (ODD) symptoms to parent-reported ODD, conduct disorder (CD), major depressive disorder (MDD), and generalized anxiety disorder symptoms and whether child executive functioning abilities moderated these relations among an urban, low-income sample of…

  12. Callous unemotional traits, autism spectrum disorder symptoms and empathy in boys with oppositional defiant disorder or conduct disorder

    NARCIS (Netherlands)

    Pijper, Jarla; de Wied, Minet; van Rijn, Sophie; van Goozen, Stephanie; Swaab, Hanna; Meeus, W.H.J.

    2016-01-01

    This study examined additive and interactive effects of callous unemotional (CU) traits and autism spectrum disorders (ASD) symptoms in relation to trait empathy, in boys with oppositional defiant disorder (ODD) or conduct disorder (CD). Participants were 49 boys with ODD/CD, aged between 7-12 years

  13. A Genetic Study of Attention Deficit Hyperactivity Disorder, Conduct Disorder, Oppositional Defiant Disorder and Reading Disability: Aetiological Overlaps and Implications

    Science.gov (United States)

    Martin, Neilson C.; Levy, Florence; Pieka, Jan; Hay, David A.

    2006-01-01

    Attention Deficit Hyperactivity Disorder (ADHD) commonly co-occurs with Oppositional Defiant Disorder, Conduct Disorder and Reading Disability. Twin studies are an important approach to understanding and modelling potential causes of such comorbidity. Univariate and bivariate genetic models were fitted to maternal report data from 2040 families of…

  14. Trajectories of Oppositional Defiant Disorder Irritability Symptoms in Preschool Children.

    Science.gov (United States)

    Ezpeleta, Lourdes; Granero, Roser; de la Osa, Núria; Trepat, Esther; Domènech, Josep M

    2016-01-01

    This study traces the developmental course of irritability symptoms in oppositional defiant disorder (ODD) from ages 3-5 and examines the psychopathological outcomes of the different trajectories at age 6. A sample of 622 3-year-old preschoolers (311 were boys), followed up until age 6, was assessed yearly with a semi-structured diagnostic interview with parents and at age 6 with questionnaires answered by parents, teachers and children. Growth-Mixture-Modeling yielded five trajectories of irritability levels for the whole sample (high-persistent 3.5%, decreasing 3.8%, increasing 2.6%, low-persistent 44.1% and null 46.0%). Among the children who presented with ODD during preschool age, three trajectories of irritability symptoms resulted (high-persistent 31.9%, decreasing 34.9% and increasing 33.2%). Null, low-persistent and decreasing irritability courses in the sample as a whole gave very similar discriminative capacity for children's psychopathological state at age 6, while the increasing and high-persistent categories involved poorer clinical outcomes than the null course. For ODD children, the high-persistent and increasing trajectories of irritability predicted disruptive behavior disorders, comorbidity, high level of functional impairment, internalizing and externalizing problems and low anger control at age 6. Irritability identifies a subset of ODD children at high risk of poorer longitudinal psychopathological and functional outcomes. It might be clinically relevant to identify this subset of ODD children with a high number of irritability symptoms throughout development with a view to preventing comorbid and future adverse longitudinal outcomes.

  15. Symptoms of Conduct Disorder, Oppositional Defiant Disorder, Attention-Deficit/Hyperactivity Disorder, and Callous-Unemotional Traits as Unique Predictors of Psychosocial Maladjustment in Boys: Advancing an Evidence Base for DSM-V

    Science.gov (United States)

    Pardini, Dustin A.; Fite, Paula J.

    2010-01-01

    Objective: The incremental utility of symptoms of conduct disorder (CD), oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), and callous-unemotional (CU) traits for predicting psychosocial outcomes across multiple domains was examined in a community sample of 1,517 boys. Method: Several outcomes were assessed…

  16. Functional Outcomes of Child and Adolescent Oppositional Defiant Disorder Symptoms in Young Adult Men

    Science.gov (United States)

    Burke, Jeffrey D.; Rowe, Richard; Boylan, Khrista

    2014-01-01

    Background: Oppositional defiant disorder (ODD) is considered to be a disorder of childhood, yet evidence suggests that prevalence rates of the disorder are stable into late adolescence and trajectories of symptoms persist into young adulthood. Functional outcomes associated with ODD through childhood and adolescence include conflict within…

  17. Practice Parameter for the Assessment and Treatment of Children and Adolescents with Oppositional Defiant Disorder

    Science.gov (United States)

    Journal of the American Academy of Child and Adolescent Psychiatry, 2007

    2007-01-01

    Oppositional defiant disorder (ODD) is a common clinical problem in children and adolescents. Oppositionality and associated types of aggressive behavior are among the most common referral problems in child psychiatry. Grouped among the disruptive behavior disorders, ODD is frequently comorbid with other psychiatric conditions and often precedes…

  18. Parental Emotion Coaching and Child Emotion Regulation as Protective Factors for Children with Oppositional Defiant Disorder

    Science.gov (United States)

    Dunsmore, Julie C.; Booker, Jordan A.; Ollendick, Thomas H.

    2013-01-01

    We assessed linkages of mothers' emotion coaching and children's emotion regulation and emotion lability/negativity with children's adjustment in 72 mother-child dyads seeking treatment for oppositional defiant disorder (ODD). Dyads completed the questionnaires and discussed emotion-related family events. Maternal emotion coaching was associated…

  19. Predictive Validity of DSM-IV Oppositional Defiant and Conduct Disorders in Clinically Referred Preschoolers

    Science.gov (United States)

    Keenan, Kate; Boeldt, Debra; Chen, Diane; Coyne, Claire; Donald, Radiah; Duax, Jeanne; Hart, Katherine; Perrott, Jennifer; Strickland, Jennifer; Danis, Barbara; Hill, Carri; Davis, Shante; Kampani, Smita; Humphries, Marisha

    2011-01-01

    Background: Diagnostic validity of oppositional defiant and conduct disorders (ODD and CD) for preschoolers has been questioned based on concerns regarding the ability to differentiate normative, transient disruptive behavior from clinical symptoms. Data on concurrent validity have accumulated, but predictive validity is limited. Predictive…

  20. Dimensions of Oppositional Defiant Disorder in 3-Year-Old Preschoolers

    Science.gov (United States)

    Ezpeleta, Lourdes; Granero, Roser; de la Osa, Nuria; Penelo, Eva; Domenech, Josep M.

    2012-01-01

    Background: To test the factor structure of oppositional defiant disorder (ODD) symptoms and to study the relationships between the proposed dimensions and external variables in a community sample of preschool children. Method: A sample of 1,341 3-year-old preschoolers was randomly selected and screened for a double-phase design. In total, 622…

  1. The influence of comorbid oppositional defiant disorder on white matter microstructure in attention-deficit/hyperactivity disorder

    NARCIS (Netherlands)

    van Ewijk, Hanneke; Noordermeer, Siri D. S.; Heslenfeld, Dirk J.; Luman, Marjolein; Hartman, Catharina A.; Hoekstra, Pieter J.; Faraone, Stephen V.; Franke, Barbara; Buitelaar, Jan K.; Oosterlaan, J.

    2016-01-01

    Attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) are highly comorbid disorders. ADHD has been associated with altered white matter (WM) microstructure, though the literature is inconsistent, which may be due to differences in the in- or exclusion of participant

  2. Beyond Symptom Counts for Diagnosing Oppositional Defiant Disorder and Conduct Disorder?

    Science.gov (United States)

    Lindhiem, Oliver; Bennett, Charles B; Hipwell, Alison E; Pardini, Dustin A

    2015-10-01

    Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD) are among the most commonly diagnosed childhood behavioral health disorders. Although there is substantial evidence of heterogeneity of symptom presentations, DSM diagnoses of CD and ODD are formally diagnosed on the basis of symptom counts without regard to individual symptom patterns. We used unidimensional item response theory (IRT) two-parameter logistic (2PL) models to examine item parameters for the individual symptoms of CD and ODD using data on 6,491 adolescents (ages 13-17) from the National Comorbidity Study: Adolescent Supplement (NCS-A). For each disorder, the symptoms differed in terms of severity and discrimination parameters. As a result, some adolescents who were above DSM diagnostic thresholds for disruptive behavior disorders exhibited lower levels of the underlying construct than others below the thresholds, based on their unique symptom profile. In terms of incremental benefit, our results suggested an advantage of latent trait scores for CD but not ODD.

  3. Variability in emotional/behavioral problems in boys with oppositional defiant disorder or conduct disorder : the role of arousal

    NARCIS (Netherlands)

    Schoorl, Jantiene; Van Rijn, Sophie; De Wied, Minet; Van Goozen, Stephanie H M; Swaab, Hanna

    2016-01-01

    It is often reported that children with oppositional defiant disorder (ODD) or conduct disorder (CD) are under-aroused. However, the evidence is mixed, with some children with ODD/CD displaying high arousal. This has led to the hypothesis that different profiles of arousal dysfunction may exist

  4. Impaired Neurocognitive Functions Affect Social Learning Processes in Oppositional Defiant Disorder and Conduct Disorder: Implications for Interventions

    Science.gov (United States)

    Matthys, Walter; Vanderschuren, Louk J. M. J.; Schutter, Dennis J. L. G.; Lochman, John E.

    2012-01-01

    In this review, a conceptualization of oppositional defiant (ODD) and conduct disorder (CD) is presented according to which social learning processes in these disorders are affected by neurocognitive dysfunctions. Neurobiological studies in ODD and CD suggest that the ability to make associations between behaviors and negative and positive…

  5. Impaired Neurocognitive Functions Affect Social Learning Processes in Oppositional Defiant Disorder and Conduct Disorder: Implications for Intervention

    NARCIS (Netherlands)

    Matthys, W.C.H.J.; Vanderschuren, L.J.M.J.; Schutter, D.J.L.G.; Lochman, J.E.

    2012-01-01

    In this review, a conceptualization of oppositional defiant (ODD) and conduct disorder (CD) is presented according to which social learning processes in these disorders are affected by neurocognitive dysfunctions. Neurobiological studies in ODD and CD suggest that the ability to make associations be

  6. Preschool Oppositional Defiant Disorder: A Disorder of Negative Affect, Surgency, and Disagreeableness.

    Science.gov (United States)

    Zastrow, Brittany L; Martel, Michelle M; Widiger, Thomas A

    2016-10-21

    Oppositional defiant disorder (ODD) is conceptualized as a disorder of negative affect and low effortful control. Yet empirical tests of trait associations with ODD remain limited. The current study examined the relationship between temperament and personality traits and Diagnostic and Statistical Manual of Mental Disorders (5th ed.) ODD symptom domains and related impairment in a preschool-age sample. Participants were 109 children ages 3-6 (59% male), overrecruited for ODD from the community, and their primary caregivers (87% mothers). ODD symptoms and impairment were measured using the Kiddie-Disruptive Behavior Disorder Schedule, temperament traits were measured using parent report on the Child Behavior Questionnaire and the Laboratory Temperament Assessment Battery, and personality traits were measured using examiner report on the California Child Q-Sort. Results suggest that high negative affect was associated with all three ODD symptom domains, whereas low agreeableness was specifically associated with the angry/irritable ODD symptom domain, and high surgency was associated with the argumentative/defiant and vindictive ODD symptom domains. Negative affect and surgency interacted with agreeableness to predict impairment, but not symptoms: Low agreeableness was associated with high impairment, regardless of other trait levels, whereas high negative affect and high surgency predicted high impairment in the presence of high agreeableness. Overall, results suggest ODD is a disorder of high negative affect. Furthermore, low agreeableness is differentially associated with affective ODD symptoms, and high surgency is associated with behavioral ODD symptoms. These traits interact in complex ways to predict impairment. Therefore, negative affect, agreeableness, and surgency may be useful early markers of ODD symptoms and impairment.

  7. Negative parenting behavior and childhood oppositional defiant disorder: differential moderation by positive and negative peer regard.

    Science.gov (United States)

    Tung, Irene; Lee, Steve S

    2014-01-01

    Although negative parenting behavior and peer status are independently associated with childhood conduct problems (e.g., oppositional defiant disorder (ODD)), relatively little is known about their interplay, particularly in relation to differentiated measures of positive and negative peer regard. To improve the specificity of the association of negative parenting behavior and peer factors with ODD, we explored the potential interaction of parenting and peer status in a sample of 169 five-to ten-year-old ethnically diverse children with and without attention-deficit/hyperactivity disorder (ADHD) assessed using multiple measures (i.e., rating scales, interview) and informants (i.e., parents, teachers). Controlling for children's age, sex, number of ADHD symptoms, and parents' race-ethnicity, peer acceptance inversely predicted and inconsistent discipline, harsh punishment, and peer rejection were each positively associated with ODD symptom severity. Interactive influences were also evident such that inconsistent discipline and harsh punishment each predicted elevated ODD but only among children experiencing low peer acceptance or high peer rejection. These findings suggest that supportive environments, including peer acceptance, may protect children from negative outcomes associated with inconsistent discipline and harsh punishment. Findings are integrated with theories of social support, and we additionally consider implications for intervention and prevention.

  8. Predictive validity of childhood oppositional defiant disorder and conduct disorder: implications for the DSM-V.

    Science.gov (United States)

    Burke, Jeffrey D; Waldman, Irwin; Lahey, Benjamin B

    2010-11-01

    Data are presented from 3 studies of children and adolescents to evaluate the predictive validity of childhood oppositional defiant disorder (ODD) and conduct disorder (CD) as defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV; American Psychiatric Association, 1994) and the International Classification of Diseases, Version 10 (ICD-10; World Health Organization, 1992). The present analyses strongly support the predictive validity of these diagnoses by showing that they predict both future psychopathology and enduring functional impairment. Furthermore, the present findings generally support the hierarchical developmental hypothesis in DSM-IV that some children with ODD progress to childhood-onset CD, and some youth with CD progress to antisocial personality disorder (APD). Nonetheless, they reveal that CD does not always co-occur with ODD, particularly during adolescence. Importantly, the present findings suggest that ICD-10 diagnostic criteria for ODD, which treat CD symptoms as ODD symptoms when diagnostic criteria for CD are not met, identify more functionally impaired children than the more restrictive DSM-IV definition of ODD. Filling this "hole" in the DSM-IV criteria for ODD should be a priority for the DSM-V. In addition, the present findings suggest that although the psychopathic trait of interpersonal callousness in childhood independently predicts future APD, these findings do not confirm the hypothesis that callousness distinguishes a subset of children with CD with an elevated risk for APD.

  9. Understanding the Covariation among Childhood Externalizing Symptoms: Genetic and Environmental Influences on Conduct Disorder, Attention Deficit Hyperactivity Disorder, and Oppositional Defiant Disorder Symptoms.

    Science.gov (United States)

    Dick, Danielle M.; Viken, Richard J.; Kaprio, Jaakko; Pulkkinen, Lea; Rose, Richard J.

    2005-01-01

    Conduct disorder (CD), attention deficit hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD) are common childhood externalizing disorders that frequently co-occur. However, the causes of their comorbidity are not well understood. To address that question, we analyzed data from >600 Finnish twin pairs, who completed standardized…

  10. Factors related to the comorbidity between oppositional defiant disorder and anxiety disorders in preschool children.

    Science.gov (United States)

    Martín, Virginia; Granero, Roser; Domènech, Josep Maria; Ezpeleta, Lourdes

    2017-03-01

    The aim of the study is to identify factors related to comorbid oppositional defiant disorder (ODD) and anxiety disorders (ADs). A sample of 622 children was assessed longitudinally at 3 and 5 years of age. At baseline, there were 310 boys (49.8%), most participants were of Caucasian-white ethnicity (89.1%) and attended to public school (64.0%), and families' socioeconomic status was 64.3% medium-high, 14.1% medium and 20.5% medium-low. Children diagnosed with ODD and/or AD were selected: n = 103 at 3 years of age (44 ODD, 42 AD and 17 ODD + AD) and n = 106 at 5 years of age (31 ODD, 60 AD and 15 ODD + AD). High levels of the child's negative affectivity and the mother's aggressive behavior (versus AD), and high scores in the father's psychopathology measurements (versus ODD) were related to the presence of comorbid ODD + AD at 3 years of age. High scores in approach-positive anticipation, fears (only in boys, in girls the reverse effect occurred) compared to ODD and AD independently and aggressive behavior (versus AD), and low scores for smiling and laughter (versus ODD only and AD only) were predictive of comorbidity at the 5 years of age. Temperament traits may be a common factor in explaining longitudinal ODD + AD comorbidity.

  11. Trajectories of Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder Symptoms as Precursors of Borderline Personality Disorder Symptoms in Adolescent Girls

    Science.gov (United States)

    Stepp, Stephanie D.; Burke, Jeffrey D.; Hipwell, Alison E.; Loeber, Rolf

    2012-01-01

    Little empirical evidence exists regarding the developmental links between childhood psychopathology and borderline personality disorder (BPD) in adolescence. The current study addresses this gap by examining symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) as potential precursors. ADHD and BPD…

  12. CBCL Clinical Scales Discriminate ADHD Youth with Structured-Interview Derived Diagnosis of Oppositional Defiant Disorder (ODD)

    Science.gov (United States)

    Biederman, Joseph; Ball, Sarah W.; Monuteaux, Michael C.; Kaiser, Roselinde; Faraone, Stephen V.

    2008-01-01

    Objective: To evaluate the association between the clinical scales of the child behavior checklist (CBCL) and the comorbid diagnosis of oppositional defiant disorder (ODD) in a large sample of youth with attention deficit hyperactivity disorder (ADHD). Method: The sample consisted of 101 girls and 106 boys ages 6 to 17 with ADHD. Conditional…

  13. Risk factors for comorbid oppositional defiant disorder in attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Noordermeer, Siri D S; Luman, Marjolein; Weeda, Wouter D; Buitelaar, Jan K; Richards, Jennifer S; Hartman, Catharina A; Hoekstra, Pieter J; Franke, Barbara; Heslenfeld, Dirk J; Oosterlaan, Jaap

    2017-03-10

    Oppositional defiant disorder (ODD) is highly prevalent in attention-deficit/hyperactivity disorder (ADHD). Individuals with both ADHD and ODD (ADHD + ODD) show a considerably worse prognosis compared with individuals with either ADHD or ODD. Therefore, identification of risk factors for ADHD + ODD is essential and may contribute to the development of (early) preventive interventions. Participants were matched for age, gender, and ADHD-subtype (diagnostic groups), and did not differ in IQ. Predictors included pre- and perinatal risk factors (pregnancy duration, birth weight, maternal smoking during pregnancy), transgenerational factors (parental ADHD; parental warmth and criticism in diagnostic groups), and postnatal risk factors (parental socioeconomic status [SES], adverse life events, deviant peer affiliation). Three models were assessed, investigating risk factors for ADHD-only versus controls (N = 86), ADHD + ODD versus controls (N = 86), and ADHD + ODD versus ADHD-only (N = 90). Adverse life events and parental ADHD were risk factors for both ADHD + ODD and ADHD-only, and more adverse life events were an even stronger risk factor for comorbid ODD compared with ADHD-only. For ADHD + ODD, but not ADHD-only, parental criticism, deviant peer affiliation, and parental SES acted as risk factors. Maternal smoking during pregnancy acted as minor risk factor for ADHD-only, while higher birth weight acted as minor risk factor for ADHD + ODD. No effects of age were present. Findings emphasise the importance of these factors in the development of comorbid ODD. The identified risk factors may prove to be essential in preventive interventions for comorbid ODD in ADHD, highlighting the need for parent-focused interventions to take these factors into account.

  14. Therapeutic Assessment for Preadolescent Boys with Oppositional Defiant Disorder: A Replicated Single-Case Time-Series Design

    Science.gov (United States)

    Smith, Justin D.; Handler, Leonard; Nash, Michael R.

    2010-01-01

    The Therapeutic Assessment (TA) model is a relatively new treatment approach that fuses assessment and psychotherapy. The study examines the efficacy of this model with preadolescent boys with oppositional defiant disorder and their families. A replicated single-case time-series design with daily measures is used to assess the effects of TA and to…

  15. The impact of parenting on the associations between child aggression subtypes and oppositional defiant disorder symptoms.

    Science.gov (United States)

    Pederson, Casey A; Fite, Paula J

    2014-12-01

    The current study evaluated parenting behaviors (i.e., parental monitoring, inconsistent discipline, parental involvement, positive parenting, and corporal punishment) as moderators of the link between proactive and reactive aggression and oppositional defiant disorder (ODD) symptoms in a community sample of 89 children ranging from 9 to 12 years of age (M = 10.44, SD = 1.14; 56 % male). Reactive, but not proactive, aggression was uniquely positively associated with ODD symptoms. Additionally, inconsistent discipline moderated the association between proactive, but not reactive, aggression and ODD symptoms, such that proactive aggression was associated with ODD symptoms only when levels of inconsistent discipline were high. Findings appear to suggest that associations between these aggression subtypes and ODD symptoms are influenced by different factors, with inconsistent discipline indicated in the association between proactively aggressive behavior and ODD symptoms. Implications for intervention are discussed.

  16. Oral health status, dental anxiety, and behavior-management problems in children with oppositional defiant disorder.

    Science.gov (United States)

    Aminabadi, Naser A; Najafpour, Ebrahim; Erfanparast, Leila; Jamali, Zahra; Pournaghi-Azar, Fatemeh; Tamjid-Shabestari, Shabnam; Shirazi, Sajjad

    2016-02-01

    Mental disorders have been shown to affect children's oral health. This study was carried out to investigate the oral health status, dental anxiety (DA), and behavior-management problems (BMPs) during dental treatment in 6- to 9-yr-old children with oppositional defiant disorder (ODD)/attention-deficit hyperactivity disorder (ADHD). The study and control groups included 40 children with ODD/ADHD and 80 normal children, respectively. All participants received an amalgam restoration. During the procedure, the children's behavior was assessed using the Frankl Rating Scale and the Verbal Skill Scale. Parents rated their children's DA using the parental version of the Children's Fear Survey Schedule-Dental subscale (CFSS-DS). Comorbid anxiety disorders were assessed using the Kiddie-Sads-Present and Lifetime Version questionnaire. Oral health status was assessed using the gingival index and the decayed, missing, and filled teeth score for permanent (DMFT) and primary (dmft) teeth. The findings showed that DA and BMPs were significantly higher in children with ODD/ADHD than in the controls. Furthermore, the frequency of DA and BMPs was higher in children with both ODD/ADHD and a comorbid anxiety disorder than in those without comorbid anxiety disorder. Children with ODD/ADHD had significantly higher DMFT/dmft scores than those in the control group, whereas the difference in gingival index was not statistically significant. In conclusion, children with ODD/ADHD had higher levels of DA, BMP and poorer oral health status. © 2015 Eur J Oral Sci.

  17. Effect of Methylphenidate on Emotional Dysregulation in Children With Attention-Deficit/Hyperactivity Disorder + Oppositional Defiant Disorder/Conduct Disorder.

    Science.gov (United States)

    Kutlu, Ayse; Akyol Ardic, Ulku; Ercan, Eyup Sabri

    2017-04-01

    Emotional dysregulation (ED) is a frequent feature of attention-deficit/hyperactivity disorder (ADHD). It can be observed as a dysregulation profile or a deficient emotional self-regulation (DESR) profile. Oppositional defiant disorder/conduct disorder (ODD/CD) comorbidity is prevalent in ADHD and known to be related with ED. The first-line treatment of ADHD includes psychostimulants, but their effects on ED are not well studied. This study aimed to evaluate the outcomes of methylphenidate (MPH) treatment on ED in ADHD + ODD/CD cases. A total of 118 ADHD + ODD/CD patients with a mean age of 9.0 ± 1.9 years were treated with MPH for 1 year. Also, parents of cases were recruited for a parent-training program, which initiated after first month of MPH treatment. Symptom severity was assessed at baseline and 12th month by Turgay Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Based Child and Adolescent Behavior Disorders Screening and Rating Scale-Parent Form, Children Depression Inventory, Child Behavior Checklist 4-18 years, and Parental Acceptance and Rejection Questionnaire-Mother Form. Emotional dysregulation (DESR + DP) was present in 85.6% of cases. Conduct disorder was significantly higher in patients with DP, whereas ODD was significantly higher in the DESR and non-ED groups (P < 0.0001). Symptoms of ADHD and ED were significantly improved with 1-year of MPH treatment (P < 0.05). The improvement in ED was independent of improvement in ADHD symptoms and parent training (P < 0.05). Emotional dysregulation is highly prevalent in disruptive behavioral disorders as ODD and CD, which are comorbid with ADHD. The MPH treatment is effective on ED independently from other clinical determinants.

  18. Understanding Trait and Sources Effects in Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder Rating Scales: Mothers', Fathers', and Teachers' Ratings of Children from the Balearic Islands

    Science.gov (United States)

    Servera, Mateu; Lorenzo-Seva, Urbano; Cardo, Esther; Rodriguez-Fornells, Antoni; Burns, G. Leonard

    2010-01-01

    Confirmatory factor analysis was used to model a multitrait (attention deficit hyperactivity disorder [ADHD]-inattention, ADHD-hyperactivity/impulsivity, oppositional defiant disorder [ODD]) by multisource (mothers, fathers, and teachers) matrix to determine the convergent and discriminant validity of ratings by mothers, fathers, and teachers.…

  19. Family Functioning in Attention Deficit Hyperactivity Disorder with or without Oppositional Defiant Disorder/Conduct Disorder Comorbidity

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    Sebla Gokce Imren

    2013-02-01

    Full Text Available Purpose: The purpose of the study was to examine family functioning in attention deficit and hyperactivity disorder (ADHD and ADHD comorbid with oppositional defiant disorder ( ODD or conduct disorder ( CD. Method: Forty nine children and adolescents diagnosed with ADHD and forty eight controls (aged 8-16 years were assesed with Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version; Parents completed the McMaster Family Assessment Device (FAD for family functioning which asseses 6 dimensions of family functioning ( problem solving, communication, behavior control, affective involvement, affective responsiveness, and roles and also includes a general functioning subscale. Results: 34.7 % of the ADHD children had comorbid psychiatric disorders, and the major comorbidity was ODD (24.5 %. ADHD families scored high at the level of “unhealthy functioning “ in the problem solving, roles, affective involvement, general functioning, and behavior control subscales of FAD. Besides, problem solving behaviour and general functioning were significantly poorer than control families and they had more difficulties in area of roles. When DEHB was comorbid with ODD or DB, all areas of family functioning as measured by FAD were scored high at the level of “unhealthy functioning “. Additionally, general functioning and affective responsiveness were significantly poorer than ADHD without ODD or DB comorbidity. Discussion: Recent studies revealed that ADHD and especially ADHD comorbid with ODD or DB may disrupt family functioning in many ways. In this study, the families of children and adolescents with ADHD and ADHD comorbid with ODD or DB had poorer family functioning in most of the subscales of FAD. Treatment of children and adolescents diagnosed with ADHD especially comorbid with ODD or DB should include parental treatment and intervention addressing parental skills, and family functioning. [Cukurova Med J 2013; 38(1.000: 22-30

  20. Sex Differences in the Prevalence of Oppositional Defiant Disorder During Middle Childhood: a Meta-Analysis.

    Science.gov (United States)

    Demmer, David H; Hooley, Merrilyn; Sheen, Jade; McGillivray, Jane A; Lum, Jarrad A G

    2017-02-01

    This review provides a meta-analysed male:female prevalence ratio of oppositional defiant disorder (ODD) during middle childhood in non-referred children. It also analyses sex differences in prevalence across cultures and over time. A systematic search for studies via the following sources was conducted: PsycInfo, Web of Knowledge, Medline Complete, Scopus, EMBASE, InfoRMIT, Psychological and Behavioural Sciences Collection, Cochrane Library, PubMed and ProQuest Health. The studies presented in two previous systematic reviews were also added to the search results. Inclusion/exclusion criteria were then applied and final studies were appraised for their methodological quality. Nineteen independent effect sizes met full inclusion criteria (aggregated sample N = 44,107). Overall, the prevalence of ODD was significantly higher in boys than girls (RR = 1.59, 95 % CI [1.36, 1.86], p  0.05). Sex differences in prevalence were significant in studies published prior to and post the year 2000 (RR = 1.57, 95 % CI [1.22, 2.02], p  0.05). The sex differences in ODD prevalence are discussed within the context of (i) predominant theories of sex differences in externalising behaviours, and (ii) departure from the sex-differences pattern found for other disruptive behavioural disorders.

  1. Clinical Characteristics of Preschool Children with Oppositional Defiant Disorder and Callous-Unemotional Traits

    Science.gov (United States)

    Ezpeleta, Lourdes; Granero, Roser; de la Osa, Núria; Domènech, Josep M.

    2015-01-01

    There is a need to know whether callous-unemotional (CU) traits identify a more severe group of oppositional defiant children (ODD). The aim of this study is to ascertain cross-sectionally and longitudinally the specific contribution of CU levels and the presence of ODD in the psychological state of preschool children from the general population. A total of 622 children were assessed longitudinally at ages 3 and 5 with a semi-structured diagnostic interview and questionnaires filled out by parents and teachers. In multivariate models simultaneously including ODD diagnosis and CU levels, controlling by socioeconomic status, ethnicity, sex, severity of conduct disorder symptoms and other comorbidity, high CU scores were related to higher levels of aggression, withdrawn, externalizing and global symptomatology, functional impairment and higher probability of comorbid disorders and use of services. The contribution of CU traits on children’s psychological state was not moderated by the presence/absence of ODD. Stability for CU traits and number of ODD-symptoms between ages 3 and 5 was statistically significant but moderate-low (intra-class correlation under .40). Assessment and identification of CU traits from preschool might help to identify a subset of children who could have socialization problems, not only among those with ODD but also among those without a diagnosis of conduct problems. PMID:26418062

  2. Parenting practices as mediating variables between parents' psychopathology and oppositional defiant disorder in preschoolers.

    Science.gov (United States)

    Trepat, Esther; Granero, Roser; Ezpeleta, Lourdes

    2014-01-01

    Oppositional defiant disorder (ODD) is very frequent in preschoolers. The severity and the long-term negative outcomes make the understanding of this disorder a priority. The goal in this study was to assess the mediating role of parenting practices in the relationship between parents' psychopathology and ODD in preschoolers. A community sample of 622 children was assessed longitudinally at age 3 and age 5. Parents reported on children's psychopathology through a diagnostic interview, and on their own psychological state and parenting style through questionnaires. At ages 3 and 5, corporal punishment mediated the relationships between mothers' anxiety-depression and ODD (in girls), between mothers' aggressive behavior and ODD (in boys), and between parents' rule-breaking and ODD both in boys and girls. For both sexes, there was a direct association between mothers' aggressive behavior score and ODD. The association between fathers' psychopathology and ODD was not mediated by the fathers' parenting practices. Fathers' anxiety-depression and aggressive behavior scores were directly associated with ODD. Parents' psychopathology must be explored and, in families where such psychopathology is a relevant variable, parenting practices must be addressed with a view to the prevention and treatment of children's ODD in the preschool years.

  3. Clinical Characteristics of Preschool Children with Oppositional Defiant Disorder and Callous-Unemotional Traits.

    Science.gov (United States)

    Ezpeleta, Lourdes; Granero, Roser; de la Osa, Núria; Domènech, Josep M

    2015-01-01

    There is a need to know whether callous-unemotional (CU) traits identify a more severe group of oppositional defiant children (ODD). The aim of this study is to ascertain cross-sectionally and longitudinally the specific contribution of CU levels and the presence of ODD in the psychological state of preschool children from the general population. A total of 622 children were assessed longitudinally at ages 3 and 5 with a semi-structured diagnostic interview and questionnaires filled out by parents and teachers. In multivariate models simultaneously including ODD diagnosis and CU levels, controlling by socioeconomic status, ethnicity, sex, severity of conduct disorder symptoms and other comorbidity, high CU scores were related to higher levels of aggression, withdrawn, externalizing and global symptomatology, functional impairment and higher probability of comorbid disorders and use of services. The contribution of CU traits on children's psychological state was not moderated by the presence/absence of ODD. Stability for CU traits and number of ODD-symptoms between ages 3 and 5 was statistically significant but moderate-low (intra-class correlation under .40). Assessment and identification of CU traits from preschool might help to identify a subset of children who could have socialization problems, not only among those with ODD but also among those without a diagnosis of conduct problems.

  4. Clinical Characteristics of Preschool Children with Oppositional Defiant Disorder and Callous-Unemotional Traits.

    Directory of Open Access Journals (Sweden)

    Lourdes Ezpeleta

    Full Text Available There is a need to know whether callous-unemotional (CU traits identify a more severe group of oppositional defiant children (ODD. The aim of this study is to ascertain cross-sectionally and longitudinally the specific contribution of CU levels and the presence of ODD in the psychological state of preschool children from the general population. A total of 622 children were assessed longitudinally at ages 3 and 5 with a semi-structured diagnostic interview and questionnaires filled out by parents and teachers. In multivariate models simultaneously including ODD diagnosis and CU levels, controlling by socioeconomic status, ethnicity, sex, severity of conduct disorder symptoms and other comorbidity, high CU scores were related to higher levels of aggression, withdrawn, externalizing and global symptomatology, functional impairment and higher probability of comorbid disorders and use of services. The contribution of CU traits on children's psychological state was not moderated by the presence/absence of ODD. Stability for CU traits and number of ODD-symptoms between ages 3 and 5 was statistically significant but moderate-low (intra-class correlation under .40. Assessment and identification of CU traits from preschool might help to identify a subset of children who could have socialization problems, not only among those with ODD but also among those without a diagnosis of conduct problems.

  5. Symptoms of conduct disorder, oppositional defiant disorder, attention-deficit/hyperactivity disorder, and callous-unemotional traits as unique predictors of psychosocial maladjustment in boys: advancing an evidence base for DSM-V.

    Science.gov (United States)

    Pardini, Dustin A; Fite, Paula J

    2010-11-01

    The incremental utility of symptoms of conduct disorder (CD), oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), and callous-unemotional (CU) traits for predicting psychosocial outcomes across multiple domains was examined in a community sample of 1,517 boys. Several outcomes were assessed semiannually across a 2-year follow-up, including antisocial behavior, internalizing problems, peer conflict, and academic difficulties. Official criminal charges were also examined across adolescence. CD symptoms emerged as the most robust predictor of future antisocial outcomes. However, ODD symptoms predicted later criminal charges and conduct problems, and CU traits were robustly associated with serious and persistent criminal behavior in boys. Attention-deficit/hyperactivity disorder symptoms predicted increases in oppositional defiant behavior and conduct problems over time and were uniquely related to future academic difficulties. Both ADHD and ODD symptoms predicted social and internalizing problems in boys, whereas CU traits were associated with decreased internalizing problems over time. The current findings have implications for revisions being considered as part of the DSM-V. Specifically, incorporating CU traits into the diagnostic criteria for Disruptive Behavior Disorders (DBD) may help to further delineate boys at risk for severe and persistent delinquency. Although currently prohibited, allowing a diagnosis of ODD when CD is present may provide unique prognostic information about boys who are at risk for future criminal behavior, social problems, and internalizing problems. Copyright © 2010 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  6. Socioeconomic status and oppositional defiant disorder in preschoolers: parenting practices and executive functioning as mediating variables

    Science.gov (United States)

    Granero, Roser; Louwaars, Leonie; Ezpeleta, Lourdes

    2015-01-01

    Objectives: To investigate the mediating mechanisms of oppositional defiant disorder (ODD) in preschoolers through pathways analysis, considering the family socioeconomic status (SES) as the independent variable and the parenting style and the children's executive functioning (EF) as the mediating factors. Method: The sample included 622 three-year-old children from the general population. Multi-informant reports from parents and teachers were analyzed. Results: Structural Equation Modeling showed that the associations between SES, EF, parenting style and ODD levels differed by children's gender: (a) for girls, the association of low SES and high ODD scores was partially mediated by difficulties in EF inhibition, and parenting practices defined by corporal punishment and inconsistent discipline obtained a quasi-significant indirect effect into the association between SES and ODD; (b) for boys, SES and EF (inhibition and emotional control) had a direct effect on ODD with no mediation. Conclusion: SES seems a good indicator to identify children at high-risk for prevention and intervention programs for ODD. Girls with ODD in families of low SES may particularly benefit from parent training practices and training in inhibition control. PMID:26441784

  7. Child maltreatment and interpersonal relationship among Chinese children with oppositional defiant disorder.

    Science.gov (United States)

    Lin, Xiuyun; Li, Longfeng; Chi, Peilian; Wang, Zhonghui; Heath, Melissa Allen; Du, Hongfei; Fang, Xiaoyi

    2016-01-01

    Child maltreatment negatively affects children's development and wellbeing. This study investigated the associations between child maltreatment (i.e., emotional neglect, emotional abuse, and physical abuse) and interpersonal functioning, including parent-child relationship, teacher-student relationship, and peer relationships among children with oppositional defiant disorder (ODD). A total of 256 children with ODD and their parents and class master teachers from Mainland China completed questionnaires. Results showed a negative correlation between emotional abuse (parent-reported) and children's interpersonal relationships with parents, teachers, and peers. Emotional neglect and physical abuse were related to poor parent-child relationships. Latent profile analysis revealed three profiles of child maltreatment among children with ODD. ODD children with more severe levels of one type of maltreatment were also more likely to have experienced severe levels of other types of maltreatment. Children with ODD who were in the group of high maltreatment had the poorest quality of interpersonal relationships. Our findings highlight the urgent need to prevent child maltreatment and promote more positive parenting in families with ODD children.

  8. Socioeconomic status and Oppositional Defiant Disorder in preschoolers: parenting practices and executive functioning as mediating variables

    Directory of Open Access Journals (Sweden)

    Roser eGranero

    2015-09-01

    Full Text Available Objectives. To investigate the mediating mechanisms of oppositional defiant disorder (ODD in preschoolers through pathways analysis, considering the family socioeconomic status (SES as the independent variable and the parenting style and the children’s executive functioning (EF as the mediating factors.Method. Sample included 622 three years-old children from the general population. Multi-informant reports from parents and teachers were analyzed.Results. Structural Equation Modeling showed that children’s gender achieved a moderating role into the pathways valuing the underlying process between SES, EF, parenting style and ODD levels: a for girls, the association of low SES and high ODD scores was mediated by parenting practices (punishment and inconsistent discipline and by difficulties in EF inhibition, and a direct predictive effect on ODD level was achieved for SES, punishment and inconsistence in rearing style and inhibition; b for boys, SES and EF (inhibition and emotional control had a direct effect on ODD with no mediation.Conclusion. SES seems a good indicator to identify at high-risk children for prevention and intervention programs for ODD. Girls with ODD in families of low SES may particularly benefit from parent training practices and training in inhibition control.

  9. Family routine moderates the relation between child impulsivity and oppositional defiant disorder symptoms.

    Science.gov (United States)

    Lanza, H Isabella; Drabick, Deborah A G

    2011-01-01

    Although child impulsivity is associated with oppositional defiant disorder (ODD) symptoms, few studies have examined whether family processes moderate this association. To address this gap, we tested whether child-reported family routine moderated the relation between child hyperactivity/impulsivity (HI) and ODD symptoms among a sample of low-income, urban, ethnic-minority children (N = 87, 51% male). Child HI and ODD symptoms were assessed using parent and teacher reports. HI also was indexed by a laboratory task. Family routine was assessed using child self-report. Hierarchical regression analyses indicated that family routine moderated child HI. Among children with higher levels of teacher-reported HI symptoms, lower levels of family routine were associated with higher levels of teacher-reported ODD symptoms compared to children with lower levels of teacher-reported HI symptoms. Children who self-reported higher levels of family routine were rated as low on teacher-reported ODD symptoms, regardless of teacher-reported HI levels. Parent report and laboratory measures of child HI did not produce significant interactions. Lower levels of family routine may confer risk for ODD symptoms among low-income, urban, ethnic-minority children experiencing higher levels of HI.

  10. Socioeconomic status and oppositional defiant disorder in preschoolers: parenting practices and executive functioning as mediating variables.

    Science.gov (United States)

    Granero, Roser; Louwaars, Leonie; Ezpeleta, Lourdes

    2015-01-01

    To investigate the mediating mechanisms of oppositional defiant disorder (ODD) in preschoolers through pathways analysis, considering the family socioeconomic status (SES) as the independent variable and the parenting style and the children's executive functioning (EF) as the mediating factors. The sample included 622 three-year-old children from the general population. Multi-informant reports from parents and teachers were analyzed. Structural Equation Modeling showed that the associations between SES, EF, parenting style and ODD levels differed by children's gender: (a) for girls, the association of low SES and high ODD scores was partially mediated by difficulties in EF inhibition, and parenting practices defined by corporal punishment and inconsistent discipline obtained a quasi-significant indirect effect into the association between SES and ODD; (b) for boys, SES and EF (inhibition and emotional control) had a direct effect on ODD with no mediation. SES seems a good indicator to identify children at high-risk for prevention and intervention programs for ODD. Girls with ODD in families of low SES may particularly benefit from parent training practices and training in inhibition control.

  11. Building an Evidence Base for DSM–5 Conceptualizations of Oppositional Defiant Disorder and Conduct Disorder: Introduction to the Special Section

    Science.gov (United States)

    Pardini, Dustin A.; Frick, Paul J.; Moffitt, Terrie E.

    2013-01-01

    The DSM–5 ADHD and Disruptive Behavior Disorders Work Group recently outlined a research agenda designed to support possible revisions to the diagnostic criteria for oppositional defiant disorder (ODD) and conduct disorder (CD). Some of the areas in need of further investigation include (a) examining the clinical utility of the current diagnostic system in girls, (b) further clarifying the developmental progression from ODD to CD, (c) determining whether facets of ODD symptoms can help explain heterotypic continuity and enhance predictive validity, (d) evaluating the clinical utility of a new subtyping scheme for CD on the basis of the presence of callous– unemotional traits, and (e) comparing the clinical utility of dimensional versus categorical conceptualizations of ODD and CD. This special section was organized in an attempt to provide data on these issues using a diverse array of longitudinal data sets consisting of both epidemiological and clinic-based samples that collectively cover a large developmental span ranging from childhood through early adulthood. PMID:21090874

  12. Hot and Cool Executive Functions in Children with Attention-Deficit/Hyperactivity Disorder and Comorbid Oppositional Defiant Disorder.

    Science.gov (United States)

    Antonini, Tanya N; Becker, Stephen P; Tamm, Leanne; Epstein, Jeffery N

    2015-09-01

    While neuropsychological deficits in both "hot" and "cool" executive functions (EFs) have been documented among individuals with attention-deficit/hyperactivity disorder (ADHD), these EF deficits are not universal across all individuals with this diagnosis. One potential moderator of executive dysfunction may be the presence of comorbid oppositional defiant disorder (ODD). This study examined the association between "hot" and "cool" EFs and comorbid ODD in children with ADHD. Thirty-three children with ADHD and comorbid ODD (ADHD+ODD), 67 with ADHD without ODD (ADHD-ODD), and 30 typically developing controls participated. Children were 7-12 years of age. "Cool" EFs were assessed with a spatial span task and a card sorting test. "Hot" EFs were assessed using a delay discounting task and a gambling task. ADHD-ODD and ADHD+ODD groups performed more poorly on "cool" EF tasks than controls, but did not differ from each other. Furthermore, the number of ADHD symptoms, but not ODD symptoms, was associated with "cool" EF scores. The three groups did not differ on "hot" EF tasks and the number of ADHD or ODD symptoms was unrelated to "hot" EF scores. In sum, children with ADHD presented with "cool" EF deficits which appear to be unrelated to ODD comorbidity. However, "hot" EF deficits were not present among children with ADHD, irrespective of comorbid ODD status.

  13. Impact of Oppositional Defiant Disorder Dimensions on the Temporal Ordering of Conduct Problems and Depression across Childhood and Adolescence in Girls

    Science.gov (United States)

    Hipwell, Alison E.; Stepp, Stephanie; Feng, Xin; Burke, Jeff; Battista, Deena R.; Loeber, Rolf; Keenan, Kate

    2011-01-01

    Background: Little is known about the role of oppositional defiant disorder (ODD) dimensions on the temporal unfolding of conduct disorder (CD) and depression in girls between childhood and adolescence. Method: The year-to-year associations between CD and depressive symptomatology were examined using nine waves of annually collected data (ages 8…

  14. Variability in emotional/behavioral problems in boys with oppositional defiant disorder or conduct disorder: the role of arousal.

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    Schoorl, Jantiene; Van Rijn, Sophie; De Wied, Minet; Van Goozen, Stephanie H M; Swaab, Hanna

    2016-08-01

    It is often reported that children with oppositional defiant disorder (ODD) or conduct disorder (CD) are under-aroused. However, the evidence is mixed, with some children with ODD/CD displaying high arousal. This has led to the hypothesis that different profiles of arousal dysfunction may exist within children with ODD/CD. This knowledge could explain variability within children with ODD/CD, both in terms of specific types of aggression as well as comorbid symptoms (e.g., other emotional/behavioral problems). We measured heart rate variability (HRV), heart rate (HR) and skin conductance level (SCL) during rest and stress, and obtained parent and teacher reports of aggression, anxiety, attention problems and autism traits in a sample of 66 ODD/CD and 36 non-clinical boys (aged 8-12 years). The ODD/CD group scored significantly higher on aggression, anxiety, attention problems and autism traits than the controls; boys with ODD/CD also had higher resting HRs than controls, but HR stress, HRV and SCL did not differ. Hierarchical regressions showed different physiological profiles in subgroups of boys with ODD/CD based on their type of aggression; a pattern of high baseline HR and SCL, but low stress HRV was related to reactive aggression, whereas the opposite physiological pattern (low HR, low stress SCL, high stress HRV) was related to proactive aggression. Furthermore, high stress SCL was related to anxiety symptoms, whereas low stress SCL was related to attention problems. These findings are important because they indicate heterogeneity within boys with ODD/CD and highlight the importance of using physiology to differentiate boys with different ODD/CD subtypes.

  15. MULTI DISCIPLINARY APPROACH IN TREATING A GIRL CHILD DIAGNOSED WITH ATTENTION DEFICIT HYPER ACTIVE DISORDER AND OPPOSITIONAL DEFIANT DISORDER. A CASE REPORT

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    Rahul Shaik

    2015-08-01

    Full Text Available Background: The principle features of Attention deficit hyperactivity disorder (ADHD are hyperactivity, inattention and impulsivity. There is little evidence that confirms that Attention deficit hyperactivity disorder (ADHD is arising purely from child rearing methods or social factors.76 % of children with ADHD has a family history, and the similar cases can be seen in the family. The symptoms of more than 50 % of ADHD children will continue in adulthood which requires treatment. Most of the causes appear for ADHD are categorizing the condition in a group of neurobiological and genetic disorders. This does not mean to say that the influence of environmental factors on the severity of disorder, impairment and suffering the child may experience is nil, but those factors do not give rise to the condition by themselves. The chances of getting associated problems like Oppositional Defiant Disorder (ODD in children with ADHD is one-third to one-half and ODD is more common in boys with ADHD. These children are often non compliant, stubborn, defiant, have outbursts of temper, or become belligerent. Case description: This is a case report of a child who diagnosed as attention deficit hyper active disordered and Oppositional Defiant Disordered (ODD child, with finger contractures of right hand, which treated with medications, behavioral therapy, physiotherapy, relaxation techniques and music therapy as the means of rehabilitation. Outcome measures: The evaluation measures used are Nine-hole peg test, behavioral rating scale and a seven items temperament evaluation scale. Discussion: A holistic rehabilitation therapy increased attention, listening to suggestions, short stories and sleeping in time. Oppositional behaviors were also reduced both at home and school. Her relationships with parent, teachers and school mates were improved. Listening skills, attention, daily activities such as wake up, brushing, bathing, going to school in time were also

  16. The Effectiveness of Mindfulness-based Parenting Training on Anxiety, Depression and Aggression of Mothers with Children Suffering from Oppositional Defiant Disorder

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    SK Moradiyani Gizeh Rod

    2016-09-01

    Full Text Available Background & aim: Mothers with children suffering from Oppositional Defiant Disorder experience greater problems related to mental health including anxiety, depression and aggression. In this regard, the aim of the present study was to evaluate the effects of a mindfulness-based parenting training in anxiety, depression and aggression of mothers with children suffering from Oppositional Defiant Disorder.  Methods: The present semi-experimental study consisted of a pretest-posttest control group. The statistical population of the study included all mothers who had a female student with Oppositional defiant disorder (age group 6 to 12 years of primary school in Nour Abad, Iran. Sampling was conducted in two stages, random and purposive. For this purpose, 34 mothers of girls with Oppositional defiant disorder after purposive sampling were randomly assigned to experimental and control groups (17 in each of groups. The Child Behavioral Checklist (CBCL and Teacher Report Form (TRF with clinical interviews were used for screening. Also, the anxiety and depression inventory and aggression questionnaire were used to collect data in two conditions (pretest and posttest. Mindful parenting course was implemented for the experimental group in 8 sessions, 2 hours each. Data were analyzed using SPSS software (ver. 23, descriptive statistical parameters (mean and SD and univariate analysis of covariance (ANCOVA. Results: Results of ANCOVA indicated that the Mindful Parenting course directed to a statistically significant difference between pre-and post-test scores which led to decreasing scores of anxiety, depression and aggression. So that in the Post-stage, after controlling for pre-test scores, the experimental group reported less anxiety, depression and aggression compared to the control group. Conclusion: With regard to the effective use of Mindful Parenting course to decreasing symptom-related with anxiety, depression and aggression in mothers of girls

  17. The Associations Between Pre- and Postnatal Maternal Symptoms of Distress and Preschooler's Symptoms of ADHD, Oppositional Defiant Disorder, Conduct Disorder, and Anxiety

    DEFF Research Database (Denmark)

    Bendiksen, Bothild; Aase, Heidi; Diep, Lien My

    2015-01-01

    OBJECTIVE: The objective of this article is to examine the associations between pre- and postnatal maternal distress and preschooler's symptoms of ADHD, Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), and anxiety, by timing and gender. METHOD: Children, aged 3.5 years (N = 1...... distress significantly increased the average number of child symptoms, ranging between 3.8% for ADHD hyperactive-impulsive (ADHD-HI) and 8.7% for anxiety. The combination of high maternal scores of distress both pre- and postnatally were associated with increased risk of child symptoms of anxiety (relative...

  18. Trastorno oposicional desafiante: enfoques diagnóstico y terapéutico y trastornos asociados Oppositional defiant disorder: Diagnostic and therapeutic approaches, and associated disorders

    Directory of Open Access Journals (Sweden)

    Juan David Palacio Ortiz

    2008-01-01

    Full Text Available Se define el trastorno oposicional desafiante (TOD como un patrón recurrente de conducta negativista, desafiante, desobediente y hostil, dirigido a los padres y a las figuras de autoridad. Los estudios en países desarrollados han identificado factores cognitivos y conductuales errados, como los principales determinantes de una actitud negativa, opuesta y contraria a las normas establecidas; mientras que en países en vías de desarrollo, como Colombia, se destacan los factores ambientales como condicionantes de resiliencia y prosocialidad. En este artículo se presenta información general sobre el TOD, sus comorbilidades más frecuentes y su enfoque terapéutico.

    Oppositional-defiant disorder is defined by a repetitive pattern of negative, defiant, disobedient and hostile conduct, against parents and other authority figures. Surveys in developed countries have identified cognitive and misconduct risk factors as the main determinants of a negative attitude, opposed and contrary to social laws; but in developing countries, such as Colombia, environmental factors are the main determinants of resilience and prosociality. In this paper we present general information on TOD, its associated disorders, and its therapeutic approach. 

  19. Further evaluation of associations between attention-deficit/hyperactivity and oppositional defiant disorder symptoms and bullying-victimization in adolescence.

    Science.gov (United States)

    Fite, Paula J; Evans, Spencer C; Cooley, John L; Rubens, Sonia L

    2014-02-01

    Relations between symptoms of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) and bullying-victimization in adolescence are not yet clear. Accordingly, the current study evaluated these associations, with attention to gender differences, in a sample of predominantly Latino 9th-12th grade students (52.6 % male; mean grade level = 10.35, SD = 1.11). Further, the role of peer delinquency in these associations was evaluated. Findings indicated that ODD symptoms were more strongly associated with both bullying and victimization than ADHD symptoms, and the effects of ODD symptoms on physical forms of both bullying and victimization were stronger for males than females. The association between ODD symptoms and physical bullying was stronger at high levels of peer delinquency when compared to low levels of peer delinquency for both males and females. The role of peer delinquency in the link between ADHD symptoms and bullying and victimization appears to be gender specific and in need of further evaluation. Implications for the need to focus primarily on ODD symptoms for both bullying and victimization prevention and intervention are discussed.

  20. The dynamics of attentional and inhibitory functions in the presence of distracting stimuli in children with attention-deficit/hyperactivity disorder, high-functioning autism and oppositional defiant disorder

    Directory of Open Access Journals (Sweden)

    Aneta Rita Borkowska

    2016-06-01

    Full Text Available Objective: The objective of this study is to elucidate the specific nature of attention and response inhibition deficits in three clinical groups: attention-deficit/hyperactivity disorder, oppositional defiant disorder, and high-functioning autism, as compared to children with a typical development. The analysis approached task performance dynamics as a function of time and the presence of distracting stimuli. Material and method: 108 children aged 7–12 years participated in the study – 21 diagnosed with oppositional defiant disorder, 21 with high-functioning autism, 19 with attention-deficit/hyperactivity disorder; 47 made the control group. The study employed the MOXO-CPT to evaluate attention and inhibition functions. Results: Pairwise comparisons of clinical groups with typically-developing children in their performance on the entire test indicated considerable differences between the control group and children with both oppositional defiant disorders and attention-deficit/hyperactivity disorder, but not between healthy subjects and children with autism. Performance profiles varied depending on the group, i.e. the type of disorder, and the level of the test, i.e. stimulus duration and intensity, but they were different for the particular studied aspects of attention and/or inhibition. High levels of similarity in functioning for all clinical groups were found in the measures of response accuracy, i.e. sustained attention and the speed of accurate response. The tendency to provide unnecessary responses and difficulties in complying with rules were found only in children with oppositional-defiant disorders. Impulsiveness rates increased over time in the attention-deficit/hyperactivity disorder group, fluctuated over time in autism, while in the oppositional defiant disorder group performance was stable over time, but worse than in the control group. Conclusions: The dynamics of attentional and inhibitory control in clinical groups

  1. Multi-Level Family Factors and Affective and Behavioral Symptoms of Oppositional Defiant Disorder in Chinese Children

    Directory of Open Access Journals (Sweden)

    Yixin Tang

    2017-06-01

    Full Text Available Given the important role of family environment in children's psychological development, the objective of this study was to examine the linkages between family factors at the whole, dyadic, and individual levels and two dimensions (affective and behavioral of Oppositional Defiant Disorder (ODD symptoms in Chinese children. Participants comprised of 80 father-child dyads and 169 mother-child dyads from families with ODD children. The results indicated that multilevel family factors were differently associated with children's affective and behavioral ODD symptoms. All the family factors at the dyadic and individual levels were significantly associated with child affective ODD symptoms. However, only the most proximal factors (parent-child relationship and child emotion regulation, which were directly related to child were significantly related to child behavioral ODD symptoms. The present study extends the current knowledge regarding the relationships between family factors and two dimensions of child ODD symptoms by testing the comprehensive multilevel family factors model. This study also recommends that future interventions for ODD children should consider the multi-level family factors to enhance intervention efficacy.

  2. A Systematic Review and Meta-analysis of Neuroimaging in Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) Taking Attention-Deficit Hyperactivity Disorder (ADHD) Into Account.

    Science.gov (United States)

    Noordermeer, Siri D S; Luman, Marjolein; Oosterlaan, Jaap

    2016-03-01

    Oppositional defiant disorder (ODD) and conduct disorder (CD) are common behavioural disorders in childhood and adolescence and are associated with brain abnormalities. This systematic review and meta-analysis investigates structural (sMRI) and functional MRI (fMRI) findings in individuals with ODD/CD with and without attention-deficit hyperactivity disorder (ADHD). Online databases were searched for controlled studies, resulting in 12 sMRI and 17 fMRI studies. In line with current models on ODD/CD, studies were classified in hot and cool executive functioning (EF). Both the meta-analytic and narrative reviews showed evidence of smaller brain structures and lower brain activity in individuals with ODD/CD in mainly hot EF-related areas: bilateral amygdala, bilateral insula, right striatum, left medial/superior frontal gyrus, and left precuneus. Evidence was present in both structural and functional studies, and irrespective of the presence of ADHD comorbidity. There is strong evidence that abnormalities in the amygdala are specific for ODD/CD as compared to ADHD, and correlational studies further support the association between abnormalities in the amygdala and ODD/CD symptoms. Besides the left precuneus, there was no evidence for abnormalities in typical cool EF related structures, such as the cerebellum and dorsolateral prefrontal cortex. Resulting areas are associated with emotion-processing, error-monitoring, problem-solving and self-control; areas associated with neurocognitive and behavioural deficits implicated in ODD/CD. Our findings confirm the involvement of hot, and to a smaller extent cool, EF associated brain areas in ODD/CD, and support an integrated model for ODD/CD (e.g. Blair, Development and Psychopathology, 17(3), 865-891, 2005).

  3. Attention Deficit Hyperactivity Disorder comorbid oppositional defiant disorder and its predominately inattentive type: evidence for an association with COMT but not MAOA in a Chinese sample

    Directory of Open Access Journals (Sweden)

    Wang Yu-Feng

    2009-02-01

    Full Text Available Abstract Background There are three childhood disruptive behavior disorders (DBDs, attention deficit hyperactivity disorder (ADHD, oppositional defiant disorder (ODD, and conduct disorder (CD. The most common comorbid disorder in ADHD is ODD. DSM-IV describes three ADHD subtypes: predominantly inattentive type (ADHD-IA, predominantly hyperactive-impulsive type (ADHD-HI, and combined type (ADHD-C. Prior work suggests that specific candidate genes are associated with specific subtypes of ADHD in China. Our previous association studies between ADHD and functional polymorphisms of COMT and MAOA, consistently showed the low transcriptional activity alleles were preferentially transmitted to ADHD-IA boys. Thus, the goal of the present study is to test the hypothesis that COMT Val158Met and MAOA-uVNTR jointly contribute to the ODD phenotype among Chinese ADHD boys. Methods 171 Chinese boys between 6 and 17.5 years old (mean = 10.3, SD = 2.6 with complete COMT val158met and MAOA-uVNTR genotyping information were studied. We used logistic regression with genotypes as independent variables and the binary phenotype as the dependent variable. We used p Results Our results highlight the potential etiologic role of COMT in the ADHD with comorbid ODD and its predominately inattentive type in male Chinese subjects. ADHD with comorbid ODD was associated with homozygosity of the high-activity Val allele, while the predominantly inattentive ADHD subtype was associated with the low-activity Met allele. We found no evidence of association between the MAOA-uVNTR variant and ADHD with comorbid ODD or the ADHD-IA subtype. Conclusion Our study of attention deficit hyperactivity disorder comorbid oppositional defiant disorder and its predominately inattentive type highlights the potential etiologic role of COMT for ADHD children in China. But we failed to observe an interaction between COMT and MAOA, which suggests that epistasis between COMT and MAOA genes does not

  4. Gene‐set and multivariate genome‐wide association analysis of oppositional defiant behavior subtypes in attention‐deficit/hyperactivity disorder

    Science.gov (United States)

    van Donkelaar, Marjolein M. J.; Poelmans, Geert; Buitelaar, Jan K.; Sonuga‐Barke, Edmund J. S.; Stringaris, Argyris; consortium, IMAGE; Faraone, Stephen V.; Franke, Barbara; Steinhausen, Hans‐Christoph; van Hulzen, Kimm J. E.

    2015-01-01

    Oppositional defiant disorder (ODD) is a frequent psychiatric disorder seen in children and adolescents with attention‐deficit‐hyperactivity disorder (ADHD). ODD is also a common antecedent to both affective disorders and aggressive behaviors. Although the heritability of ODD has been estimated to be around 0.60, there has been little research into the molecular genetics of ODD. The present study examined the association of irritable and defiant/vindictive dimensions and categorical subtypes of ODD (based on latent class analyses) with previously described specific polymorphisms (DRD4 exon3 VNTR, 5‐HTTLPR, and seven OXTR SNPs) as well as with dopamine, serotonin, and oxytocin genes and pathways in a clinical sample of children and adolescents with ADHD. In addition, we performed a multivariate genome‐wide association study (GWAS) of the aforementioned ODD dimensions and subtypes. Apart from adjusting the analyses for age and sex, we controlled for “parental ability to cope with disruptive behavior.” None of the hypothesis‐driven analyses revealed a significant association with ODD dimensions and subtypes. Inadequate parenting behavior was significantly associated with all ODD dimensions and subtypes, most strongly with defiant/vindictive behaviors. In addition, the GWAS did not result in genome‐wide significant findings but bioinformatics and literature analyses revealed that the proteins encoded by 28 of the 53 top‐ranked genes functionally interact in a molecular landscape centered around Beta‐catenin signaling and involved in the regulation of neurite outgrowth. Our findings provide new insights into the molecular basis of ODD and inform future genetic studies of oppositional behavior. © 2015 The Authors. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics Published by Wiley Periodicals, Inc. PMID:26184070

  5. Emotion Regulation Difficulties in Boys with Oppositional Defiant Disorder/Conduct Disorder and the Relation with Comorbid Autism Traits and Attention Deficit Traits.

    Directory of Open Access Journals (Sweden)

    Jantiene Schoorl

    Full Text Available Previous research has pointed towards a link between emotion dysregulation and aggressive behavior in children. Emotion regulation difficulties are not specific for children with persistent aggression problems, i.e. oppositional defiant disorder or conduct disorder (ODD/CD, children with other psychiatric conditions, such as autism spectrum disorders or attention-deficit/hyperactivity disorder, have emotion regulation difficulties too. On a behavioral level some overlap exists between these disorders and comorbidity is high. The aim of this study was therefore twofold: 1 to examine emotion regulation difficulties in 65 boys with ODD/CD in comparison to a non-clinical control group (NC of 38 boys (8-12 years using a performance measure (Ultimatum Game, parent report and self-report, and 2 to establish to what extent emotion regulation in the ODD/CD group was correlated with severity of autism and/or attention deficit traits. Results on the Ultimatum Game showed that the ODD/CD group rejected more ambiguous offers than the NC group, which is seen as an indication of poor emotion regulation. Parents also reported that the ODD/CD group experienced more emotion regulation problems in daily life than the NC group. In contrast to these cognitive and behavioral measures, self-reports did not reveal any difference, indicating that boys with ODD/CD do not perceive themselves as having impairments in regulating their emotions. Emotional decision making within the ODD/CD group was not related to variation in autism or attention deficit traits. These results support the idea that emotion dysregulation is an important problem within ODD/CD, yet boys with ODD/CD have reduced awareness of this.

  6. Emotion Regulation Difficulties in Boys with Oppositional Defiant Disorder/Conduct Disorder and the Relation with Comorbid Autism Traits and Attention Deficit Traits

    Science.gov (United States)

    Schoorl, Jantiene; van Rijn, Sophie; de Wied, Minet; van Goozen, Stephanie; Swaab, Hanna

    2016-01-01

    Previous research has pointed towards a link between emotion dysregulation and aggressive behavior in children. Emotion regulation difficulties are not specific for children with persistent aggression problems, i.e. oppositional defiant disorder or conduct disorder (ODD/CD), children with other psychiatric conditions, such as autism spectrum disorders or attention-deficit/hyperactivity disorder, have emotion regulation difficulties too. On a behavioral level some overlap exists between these disorders and comorbidity is high. The aim of this study was therefore twofold: 1) to examine emotion regulation difficulties in 65 boys with ODD/CD in comparison to a non-clinical control group (NC) of 38 boys (8–12 years) using a performance measure (Ultimatum Game), parent report and self-report, and 2) to establish to what extent emotion regulation in the ODD/CD group was correlated with severity of autism and/or attention deficit traits. Results on the Ultimatum Game showed that the ODD/CD group rejected more ambiguous offers than the NC group, which is seen as an indication of poor emotion regulation. Parents also reported that the ODD/CD group experienced more emotion regulation problems in daily life than the NC group. In contrast to these cognitive and behavioral measures, self-reports did not reveal any difference, indicating that boys with ODD/CD do not perceive themselves as having impairments in regulating their emotions. Emotional decision making within the ODD/CD group was not related to variation in autism or attention deficit traits. These results support the idea that emotion dysregulation is an important problem within ODD/CD, yet boys with ODD/CD have reduced awareness of this. PMID:27420110

  7. Oppositional Defiant and Conduct Disorder Behaviors in Boys with Autism Spectrum Disorder with and without Attention-Deficit Hyperactivity Disorder versus Several Comparison Samples

    Science.gov (United States)

    Guttmann-Steinmetz, Sarit; Gadow, Kenneth D.; DeVincent, Carla J.

    2009-01-01

    We compared disruptive behaviors in boys with either autism spectrum disorder (ASD) plus ADHD (n = 74), chronic multiple tic disorder plus ADHD (n = 47), ADHD Only (n = 59), or ASD Only (n = 107). Children were evaluated with parent and teacher versions of the Child Symptom Inventory-4 including parent- (n = 168) and teacher-rated (n = 173)…

  8. Emotion Socialization in the Context of Risk and Psychopathology: Maternal Emotion Coaching Predicts Better Treatment Outcomes for Emotionally Labile Children with Oppositional Defiant Disorder

    Science.gov (United States)

    Dunsmore, Julie C.; Booker, Jordan A.; Ollendick, Thomas H.; Greene, Ross W.

    2015-01-01

    We examined whether maternal emotion coaching at pre-treatment predicted children's treatment response following a 12-week program addressing children's Oppositional Defiant Disorder (ODD) symptoms. Eighty-nine mother-child dyads participated. At pre-treatment, mothers and children engaged in an emotion talk task. Mothers also reported their beliefs about emotions at pre-treatment and their child's disruptive behavior symptoms, emotion regulation, and emotion lability/negativity at pre-, mid-, and post-treatment. Clinicians reported children's symptom severity at pre- and post-treatment. Children's emotion lability/negativity moderated effects of maternal emotion coaching on children's post-treatment ODD symptoms, with stronger benefits of emotion coaching for children high in emotion lability/negativity. Results suggest that emotion coaching may promote treatment response for children with ODD who are especially at risk due to their emotionality. PMID:26848211

  9. Multiple personality disorder.

    Science.gov (United States)

    Salama, A A

    1995-02-01

    This paper presents a description of Multiple Personality Disorder--its development, etiology, and presentation. The paper stresses the criteria for diagnosis that can help professionals to identify individuals at an early stage. An overview of treatment approaches and indications for hospitalization, length of treatment, and goals are also explained.

  10. Oppositional defiant- and conduct disorder-like problems: neurodevelopmental predictors and genetic background in boys and girls, in a nationwide twin study

    Directory of Open Access Journals (Sweden)

    Nóra Kerekes

    2014-04-01

    Full Text Available Background. Previous research has supported gender-specific aetiological factors in oppositional defiant disorder (ODD and conduct disorder (CD. The aims of this study were to identify gender-specific associations between the behavioural problems–ODD/CD-like problems–and the neurodevelopmental disorders–attention deficit hyperactivity disorder (ADHD, autism spectrum disorder (ASD–and to investigate underlying genetic effects.Methods. 17,220 twins aged 9 or 12 were screened using the Autism–Tics, AD/HD and other Comorbidities inventory. The main covariates of ODD- and CD-like problems were investigated, and the relative importance of unique versus shared hereditary and environmental effects was estimated using twin model fitting.Results. Social interaction problems (one of the ASD subdomains was the strongest neurodevelopmental covariate of the behavioural problems in both genders, while ADHD-related hyperactivity/impulsiveness in boys and inattention in girls stood out as important covariates of CD-like problems. Genetic effects accounted for 50%–62% of the variance in behavioural problems, except in CD-like problems in girls (26%. Genetic and environmental effects linked to ADHD and ASD also influenced ODD-like problems in both genders and, to a lesser extent, CD-like problems in boys, but not in girls.Conclusions. The gender-specific patterns should be considered in the assessment and treatment, especially of CD.

  11. Functional impairment associated with symptoms of oppositional defiant disorder in preschool and early school boys and girls from the general population

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    Lourdes Ezpeleta

    2014-05-01

    Full Text Available Objective: To explore whether the symptoms and diagnosis of Oppositional Defiant Disorder (ODD, as defined in the DSM-IV, are equally impairing for girls and boys from the general population in the early school years. Method: A sample of 852 three to seven-year-old schoolchildren were screened out for a double-phase design. A total of 251 families were assessed with a diagnostic interview and with measures of functional impairment. Results: ODD symptoms and diagnosis were equally prevalent in boys and girls, but three to five-year-old girls had a higher prevalence of subthreshold ODD. There were no significant differences between boys and girls in the impact on use of services, treatment received and family burden associated with ODD symptoms and diagnosis. Although diagnosis of ODD was not associated with higher functional impairment by sex, individual symptoms and subthreshold diagnosis were more impairing for boys than for girls. Conclusion: Oppositionality may be measuring different things for boys and girls, and this possibility must be taken into account with a view to the correct identification of this problem in each sex.

  12. Multiple personality disorder following childbirth.

    Science.gov (United States)

    O'Dwyer, J M; Friedman, T

    1993-06-01

    A case of multiple personality disorder is described as a coping mechanism protecting the patient from the abuse to which she was subjected throughout her life. The multiple personalities became more prominent following the birth of a severely handicapped child.

  13. Mental Disorders - Multiple Languages

    Science.gov (United States)

    ... An Introduction) - español (Spanish) MP3 Healthy Roads Media Mental Disorders: MedlinePlus Health Topic - English Enfermedades mentales: Tema de salud de MedlinePlus - español (Spanish) National Library of Medicine ...

  14. Dimensions of multiple personality disorder.

    Science.gov (United States)

    Murray, J B

    1994-06-01

    Research on multiple personality disorder (MPD) has burgeoned, and large-scale investigations indicate that a typical MPD patient is a woman, a victim of childhood abuse (especially sexual abuse), a person whose symptoms meet criteria for other psychiatric disorders, and a person who would employ many psychological defenses. Treatment approaches have frequently included hypnotherapy, which requires skill and caution.

  15. Polygenic inheritance of Tourette syndrome, stuttering, attention deficit hyperactivity, conduct, and oppositional defiant disorder: The additive and subtractive effect of the three dopaminergic genes - DRD2, D{beta}H, and DAT1

    Energy Technology Data Exchange (ETDEWEB)

    Comings, D.E.; Wu, S.; Chiu, C.; Ring, R.H.; Gade, R.; Ahn, C.; Dietz, G.; Muhleman, D. [Hope Medical Center, Duarte, CA (United States)] [and others

    1996-05-31

    Polymorphisms of three different dopaminergic genes, dopamine D{sub 2} receptor (DRD2), dopamine {beta}-hydroxylase (D{beta}H), and dopamine transporter (DAT1), were examined in Tourette syndrome (TS) probands, their relatives, and controls. Each gene individually showed a significant correlation with various behavioral variables in these subjects. The additive and subtractive effects of the three genes were examined by genotyping all three genes in the same set of subjects. For 9 of 20 TS associated comorbid behaviors there was a significant linear association between the degree of loading for markers of three genes and the mean behavior scores. The behavior variables showing the significant associations were, in order, attention deficit hyperactivity disorder (ADHD), stuttering, oppositional defiant, tics, conduct, obsessive-compulsive, mania, alcohol abuse, and general anxiety - behaviors that constitute the most overt clinical aspects of TS. For 16 of the 20 behavior scores there was a linear progressive decrease in the mean score with progressively lesser loading for the three gene markers. These results suggest that TS, ADHD, stuttering, oppositional defiant and conduct disorder, and other behaviors associated with TS, are polygenic, due in part to these three dopaminergic genes, and that the genetics of other polygenic psychiatric disorders may be deciphered using this technique. 144 refs., 2 figs., 13 tabs.

  16. Trastornos de personalidad en padres de adolescentes violentos con diagnóstico de trastorno negativista desafiante y trastorno disocial Personality disorders in parents of violent adolescents diagnosed with oppositional defiant disorder and conduct disorder

    Directory of Open Access Journals (Sweden)

    Susana Quiroga

    2009-12-01

    Defiant Disorder and a Conduct Disorder. The Inventory of Personality Organization - IPO (Clarkin, J.; Foelsch, P. y Kernberg, O., 2001; Argentine Adaptation: Quiroga, 2003 was used with a sample of 60 parents (52 mothers and 8 fathers of early violent adolescents. The preliminary results show that most of the parents get scores which are higher that the cut-off point established in the non-clinical population in the first three primary IPO scales (Primitive Defenses, Identity Diffusion and Reality Testing.

  17. Autonomic disorders in multiple sclerosis.

    Science.gov (United States)

    Lensch, E; Jost, W H

    2011-01-01

    Multiple sclerosis is an inflammatory disease leading to disseminated lesions of the central nervous system resulting in both somatomotor and autonomic disturbances. These involve the central centers of the autonomic nervous system, as well as the automatic control and pathway systems. All autonomic functions may be disordered individually or in combined form. There is no other disease with a clinical picture so multifaceted. Besides cardiovascular dysfunctions disorders of bladder and rectum have become apparent. Somatomotor and autonomic disturbances occur with similar frequency; however the focused exam often heavily favors somatomotor symptoms. Autonomic disturbances should primarily be taken into account on history taking and clinical examination. Individual diagnosis and treatment is a secondary feature. Impairments of the autonomic nervous systems in multiple sclerosis are frequently overlooked.

  18. Autonomic Disorders in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    E. Lensch

    2011-01-01

    Full Text Available Multiple sclerosis is an inflammatory disease leading to disseminated lesions of the central nervous system resulting in both somatomotor and autonomic disturbances. These involve the central centers of the autonomic nervous system, as well as the automatic control and pathway systems. All autonomic functions may be disordered individually or in combined form. There is no other disease with a clinical picture so multifaceted. Besides cardiovascular dysfunctions disorders of bladder and rectum have become apparent. Somatomotor and autonomic disturbances occur with similar frequency; however the focused exam often heavily favors somatomotor symptoms. Autonomic disturbances should primarily be taken into account on history taking and clinical examination. Individual diagnosis and treatment is a secondary feature. Impairments of the autonomic nervous systems in multiple sclerosis are frequently overlooked.

  19. Parathyroid Disorders - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Parathyroid Disorders URL of this page: https://medlineplus.gov/ ... V W XYZ List of All Topics All Parathyroid Disorders - Multiple Languages To use the sharing features ...

  20. Emotional Disorders in People with Multiple Sclerosis

    Science.gov (United States)

    ... and their FAMILIES EMOTIONAL DISORDERS IN PEOPLE WITH MULTIPLE SCLEROSIS This fact sheet presents the current research on emotional disorders in multiple sclerosis (MS) and summarizes the main findings of a ...

  1. Joint Disorders - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Joint Disorders URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Joint Disorders - Multiple Languages To use the sharing features on ...

  2. Transtorno de oposição e desafio e transtorno de conduta: os desfechos no TDAH em adultos Oppositional defiant disorder and conduct disorder: their outcomes into adulthood

    Directory of Open Access Journals (Sweden)

    Eugenio Horacio Grevet

    2007-01-01

    Full Text Available Os autores examinam a influência dos transtornos de oposição e desafio (TOD, de conduta (TC e de personalidade anti-social (TPAS ao longo da vida do indivíduo com TDAH. Os principais achados mostram que o TDAH é modulado por essas comorbidades e que seu prognóstico é modificado dependendo da presença ou não desses transtornos. O transtorno de oposição e desafio intensificaria as características de impulsividade e isolacionismo do TDAH, porém não acarretaria em um aumento na incidência de TPAS na vida adulta. Já o TC associado ao TDAH implica um aumento significativo na impulsividade e agressividade, estando associado significativamente a TPAS e um pior prognóstico. A diferenciação entre os diferentes transtornos e seu correto diagnóstico é essencial para o tratamento adequado do TDAH. Futuros estudos precisam determinar se o tratamento do TDAH produziria uma mudança significativa no prognóstico desse grupo de pacientes.The authors examine the influence of oppositional defiant disorder (ODD, conduct disorder (CD and anti-social personality disorder (ASPD on attention deficit/hyperactivity disorder (ADHD across life span. The findings showed that ADHD is modulated by this comorbidities and ADHD prognosis is modified depending on the presence or the absence of those disorders. ODD intensifies ADHD impulsivity and isolationism, but does not lead to an increase in the prevalence of ASPD in adulthood. Otherwise, CD associated with ADHD increases significantly the levels of impulsivity and aggressiveness, is associated with ASPD and a poor outcome. The appropriate approach to ADHD must be based on the correct diagnosis of different comorbidities to predict the outcomes. Further studies are needed to investigate if the treatment of ADHD can produce a significant improvement on the outcomes of this group of patients.

  3. Autism Symptoms in Attention-Deficit/Hyperactivity Disorder: A Familial Trait which Correlates with Conduct, Oppositional Defiant, Language and Motor Disorders

    Science.gov (United States)

    Mulligan, Aisling; Anney, Richard J. L; O'Regan, Myra; Chen, Wai; Butler, Louise; Fitzgerald, Michael; Buitelaar, Jan; Steinhausen, Hans-Christoph; Rothenberger, Aribert; Minderaa, Ruud; Nijmeijer, Judith; Hoekstra, Pieter J.; Oades, Robert D.; Roeyers, Herbert; Buschgens, Cathelijne; Christiansen, Hanna; Franke, Barbara; Gabriels, Isabel; Hartman, Catharina; Kuntsi, Jonna; Marco, Rafaela; Meidad, Sheera; Mueller, Ueli; Psychogiou, Lamprini; Rommelse, Nanda; Thompson, Margaret; Uebel, Henrik; Banaschewski, Tobias; Ebstein, Richard; Eisenberg, Jacques; Manor, Iris; Miranda, Ana; Mulas, Fernando; Sergeant, Joseph; Sonuga-Barke, Edmund; Asherson, Phil; Faraone, Stephen V.; Gill, Michael

    2009-01-01

    It is hypothesised that autism symptoms are present in Attention-Deficit/Hyperactivity Disorder (ADHD), are familial and index subtypes of ADHD. Autism symptoms were compared in 821 ADHD probands, 1050 siblings and 149 controls. Shared familiality of autism symptoms and ADHD was calculated using DeFries-Fulker analysis. Autism symptoms were higher…

  4. Autism symptoms in Attention-Deficit/Hyperactivity Disorder : A Familial trait which Correlates with Conduct, Oppositional Defiant, Language and Motor Disorders

    NARCIS (Netherlands)

    Mulligan, Aisling; Anney, Richard J. L.; O'Regan, Myra; Chen, Wai; Butler, Louise; Fitzgerald, Michael; Buitelaar, Jan; Steinhausen, Hans-Christoph; Rothenberger, Aribert; Minderaa, Ruud; Nijmeijer, Judith; Hoekstra, Pieter J.; Oades, Robert D.; Roeyers, Herbert; Buschgens, Cathelijne; Christiansen, Hanna; Franke, Barbara; Gabriels, Isabel; Hartman, Catharina; Kuntsi, Jonna; Marco, Rafaela; Meidad, Sheera; Mueller, Ueli; Psychogiou, Lamprini; Rommelse, Nanda; Thompson, Margaret; Uebel, Henrik; Banaschewski, Tobias; Ebstein, Richard; Eisenberg, Jacques; Manor, Iris; Miranda, Ana; Mulas, Fernando; Sergeant, Joseph; Sonuga-Barke, Edmund; Asherson, Phil; Faraone, Stephen V.; Gill, Michael

    It is hypothesised that autism symptoms are present in Attention-Deficit/Hyperactivity Disorder (ADHD), are familial and index subtypes of ADHD. Autism symptoms were compared in 821 ADHD probands, 1050 siblings and 149 controls. Shared familiality of autism symptoms and ADHD was calculated using

  5. Autism symptoms in Attention-Deficit/Hyperactivity Disorder : A Familial trait which Correlates with Conduct, Oppositional Defiant, Language and Motor Disorders

    NARCIS (Netherlands)

    Mulligan, Aisling; Anney, Richard J. L.; O'Regan, Myra; Chen, Wai; Butler, Louise; Fitzgerald, Michael; Buitelaar, Jan; Steinhausen, Hans-Christoph; Rothenberger, Aribert; Minderaa, Ruud; Nijmeijer, Judith; Hoekstra, Pieter J.; Oades, Robert D.; Roeyers, Herbert; Buschgens, Cathelijne; Christiansen, Hanna; Franke, Barbara; Gabriels, Isabel; Hartman, Catharina; Kuntsi, Jonna; Marco, Rafaela; Meidad, Sheera; Mueller, Ueli; Psychogiou, Lamprini; Rommelse, Nanda; Thompson, Margaret; Uebel, Henrik; Banaschewski, Tobias; Ebstein, Richard; Eisenberg, Jacques; Manor, Iris; Miranda, Ana; Mulas, Fernando; Sergeant, Joseph; Sonuga-Barke, Edmund; Asherson, Phil; Faraone, Stephen V.; Gill, Michael

    2009-01-01

    It is hypothesised that autism symptoms are present in Attention-Deficit/Hyperactivity Disorder (ADHD), are familial and index subtypes of ADHD. Autism symptoms were compared in 821 ADHD probands, 1050 siblings and 149 controls. Shared familiality of autism symptoms and ADHD was calculated using DeF

  6. Multiple personality disorder in Japan.

    Science.gov (United States)

    Fujii, Y; Suzuki, K; Sato, T; Murakami, Y; Takahashi, T

    1998-06-01

    The aim of this study was to determine whether the features of multiple personality disorder (MPD) in Japan are similar to those in North America, although a wide disparity exists in the prevalence of MPD between the two areas. In order to describe the features of MPD in Japan, we obtained clinical data from MPD case reports, including two of our own cases, published in Japanese academic journals and compared it with the data from other countries. The cases in Japan differed significantly from those in North America in the mean number of personalities and prevalence of sexual and/or physical abuse.

  7. Inattention, hyperactivity, oppositional-defiant symptoms and school failure.

    Science.gov (United States)

    Serra-Pinheiro, Maria Antonia; Mattos, Paulo; Regalla, Maria Angélica; de Souza, Isabella; Paixão, Cristiane

    2008-12-01

    Attention-deficit hyperactivity disorder (ADHD) is associated with school failure. Inattention has been mainly implicated for this association. Oppositional-defiant disorder's (ODD) impact on academic performance remains controversial, because of the high comorbidity between ODD and ADHD. To understand the role of inattention (IN), hyperactivity (H/I) and ODD in school failure. Parents and teachers filled out SNAP-IV questionnaires for 241 / 6th grade students. The associations of the scores of oppositional-defiant (OP), H/I and IN symptoms with school year failure were calculated. IN was strongly correlated with school failure. H/I and OP were not associated with school failure, when controlled for IN. OP and H/I symptoms do not play an important role in school failure, when controlled for IN symptoms. Our study supports the cross-cultural role of IN as a major predictor of school failure.

  8. Rorschach indicators of Multiple Personality Disorder.

    Science.gov (United States)

    Labott, S M; Leavitt, F; Braun, B G; Sachs, R G

    1992-08-01

    The increase in reported cases of Multiple Personality Disorder underscores a great need to differentiate clearly this from other psychiatric disorders and from simulation of Multiple Personality Disorder. Two sets of Rorschach signs have been advanced as clinical markers by their developers, namely Barach and also Wagner, Allison, and Wagner. As the Wagner signs are prevalent in much of the research on Rorschach responses in Multiple Personality Disorder, the purpose of the present study was to evaluate these signs using Wagner's administration and the resulting Rorschach protocols of 16 Multiple Personality Disorder patients and 16 psychiatric controls. Analysis indicated that this system was deficient in correctly classifying these 32 protocols. A new marker, the Splitting Response, emerged, however, which was more useful. This response, in combination with at least one Dissociative response, produced an accuracy rate of 94%. These new criteria may be useful aids in the detection of Multiple Personality Disorder from Rorschach protocols. Replication is urged.

  9. Children with ADHD and symptoms of oppositional defiant disorder improved in behavior when treated with methylphenidate and adjuvant risperidone, though weight gain was also observed - Results from a randomized, double-blind, placebo-controlled clinical trial.

    Science.gov (United States)

    Jahangard, Leila; Akbarian, Shahrokh; Haghighi, Mohammad; Ahmadpanah, Mohammad; Keshavarzi, Amir; Bajoghli, Hafez; Sadeghi Bahmani, Dena; Holsboer-Trachsler, Edith; Brand, Serge

    2017-05-01

    Children with ADHD often show symptoms of oppositional defiant disorders (ODD). We investigated the impact of adjuvant risperidone (RISP) to a standard treatment with methylphenidate (MPH) in children with ADHD and symptoms of ODD. Eighty-four children with ADHD and ODD (age: M=8.55; range: 7.28-9.95 years; 73.8% males) took part in a double-blind, randomized, placebo-controlled, clinical trial lasting eight weeks. Participants were randomly assigned either to the MPH+RISP (1mg/kg/d+0.5mg/d) or to the MPH+PLCO (1mg/kg/d+placebo) condition. Symptoms of ADHD, weight, height, and blood pressure were assessed at baseline, and at weeks 2, 4, 6 and 8. Symptoms of ADHD decreased over time, but more so in the MPH+RISP than in the MPH only condition. In the MPH+RISP condition weight, waist circumference and prolactine levels increased over time. Data suggest that adjuvant RISP improved symptoms in children with ADHD and ODD, but weight gain and higher prolactine levels were also observed, which are two alarming side effects. This may become an issue, once children become adolescents, a period of life in which body shape and body self-image are closely linked to self-confidence and peer acceptance. Health care professionals should carefully balance the short-term and long-term costs and benefits of administration of RISP.

  10. Transtorno desafiador de oposição: uma revisão de correlatos neurobiológicos e ambientais, comorbidades, tratamento e prognóstico Oppositional defiant disorder: a review of neurobiological and environmental correlates, comorbidities, treatment and prognosis

    Directory of Open Access Journals (Sweden)

    Maria Antonia Serra-Pinheiro

    2004-12-01

    Full Text Available Transtorno desafiador de oposição (TDO é uma entidade diagnóstica independente, mas é freqüentemente estudada em conjunto com transtorno de déficit de atenção/hiperatividade (TDAH ou com transtorno de conduta (TC. O objetivo deste artigo é o de fazer uma revisão das evidências existentes, obtidas por meio da base de dados PubMed, sobre achados neurobiológicos no transtorno desafiador de oposição, funcionamento familiar e escolar, comorbidades, prognóstico e opções terapêuticas para transtorno desafiador de oposição. A evidência de correlatos hormonais, genéticos e neurofuncionais de transtorno desafiador de oposição, a conexão com a família, as relações e desempenho escolares, a associação com transtornos do humor, ansiosos e disruptivos, o risco de evolução para transtorno de conduta e de persistência de sintomas de transtorno desafiador de oposição são descritos. Uma revisão do efeito da Terapia Cognitivo-Comportamental e tratamento farmacológico é apresentada. A análise das evidências disponíveis mostra que o impacto de transtorno desafiador de oposição não deve ser ignorado e que o transtorno desafiador de oposição deve ser devidamente abordado. O impacto do tratamento de transtorno desafiador de oposição no prognóstico de longo prazo dos pacientes ainda precisa ser determinado.Oppositional defiant disorder (ODD is an independent diagnostic entity but it is frequently studied in conjunction with Attention-Deficit Hyperactivity Disorder (ADHD or Conduct Disorder (CD. The purpose of this paper is to review the extant evidence, through the PubMed database, on the neurobiological correlates of oppositional defiant disorder and also describe the familiar and school functioning, comorbidities, prognosis and therapeutic options for oppositional defiant disorder. Evidence of hormonal, genetic and neurofunctional findings in oppositional defiant disorder, correlation with the family, school relations

  11. Multiple Family Group Service Model for Children With Disruptive Behavior Disorders: Child Outcomes at Post-Treatment.

    Science.gov (United States)

    Chacko, Anil; Gopalan, Geetha; Franco, Lydia; Dean-Assael, Kara; Jackson, Jerrold; Marcus, Sue; Hoagwood, Kimberly; McKay, Mary

    2015-06-01

    The purpose of this study was to determine the benefits of a multiple family group (MFG) service delivery model compared with services as usual (SAU) in improving the functioning of youth with oppositional defiant/conduct disorder in families residing in socioeconomically disadvantaged communities. Participants included 320 youth aged 7 to 11 and their families who were referred to participating outpatient clinics. Participants were assigned to the MFG or the SAU condition, with parent report of child oppositional behavior, social competence, and level of youth impairment as primary outcomes at post-treatment. Family engagement to MFG was measured by attendance to each group session. Caregivers of youth in the MFG service delivery model condition reported significant improvement in youth oppositional behavior and social competence compared with youth in the SAU condition. Impairment improved over time for both groups with no difference between treatment conditions. The MFG led to greater percentage of youth with clinically significant improvements in oppositional behavior. Attendance to the MFG was high, given the high-risk nature of the study population. The MFG service delivery model offers an efficient and engaging format to implement evidence-based approaches to improving functioning of youth with oppositional defiant and/or conduct disorder in families from socioeconomically disadvantaged communities.

  12. Effect of structural family therapy on ADHD children with oppositional defiant disorder%结构式家庭治疗对伴有对立违抗性障碍的ADHD患者的疗效研究

    Institute of Scientific and Technical Information of China (English)

    朱振爱; 廉鹏

    2009-01-01

    Objective: To examine the application of the structural family therapy in the treatment process to attention deficit hyperactivity disorder(ADHD) children with oppositional defiant disorder(ODD) Methods: Using a random group-ing and control-study method,54 children with ADHD accompanied by ODD were divided into the study group and the con-trol group. The control group received simple drug treatment. On the basis of drug therapy, the structural family therapy was adopted in the study group. After 3-month course of treatment, they were assessed after 1 week and 12 weeks admission using and Conners PSQ and Family Environment Scale, Chinese Version(FES-CV). The assessment results were statistical-ly treated. Results: After 12 weeks the study group and control group were significantly decreased in Impulsion-hyperactivit and Cormers Index of Hyperactivity but in the study group the behavior problems, learning problems, psychosomatic disor-der and anxiety factors were better than those in the control group. In the intervention group, the scales of factors of family cohesion, emotion expression, achievement orientation were significantly higher, while the conflict and control were signifi-cantly lower than those in the control group. Conclusion: Structural family therapy is an effective method in the treatment for ADHD children with oppositional defiant disorder(ODD).%目的 探讨结构式家庭治疗对伴有对立违抗性障碍的注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)患儿的效果.方法 54例患儿随机分为研究组和对照组,对照组单纯药物治疗,研究组采用家庭治疗合并药物.疗程3个月.于1周、12周用Conners父母用量表进行评定,对评定结果 进行统计学处理.家庭环境量表中文版(Family Environment Scale-Chinese Version,FES-CV)对治疗前后家庭环境的影响进行评定.结果 研究组与对照组行为治疗12周后,Conners父母用量表在多动-冲动、多动指数均显著

  13. Diversity in Pathways to Common Childhood Disruptive Behavior Disorders

    Science.gov (United States)

    Martel, Michelle M.; Nikolas, Molly; Jernigan, Katherine; Friderici, Karen; Nigg, Joel T.

    2012-01-01

    Oppositional-Defiant Disorder (ODD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are highly comorbid, a phenomenon thought to be due to shared etiological factors and mechanisms. Little work has attempted to chart multiple-level-of-analysis pathways (i.e., simultaneously including biological, environmental, and trait influences) to ODD and…

  14. Preschool Attention-Deficit/Hyperactivity and Oppositional Defiant Problems as Antecedents of School Bullying

    NARCIS (Netherlands)

    Verlinden, Marina; Jansen, Pauline W.; Veenstra, Rene; Jaddoe, Vincent W. V.; Hofman, Albert; Verhulst, Frank C.; Shaw, Philip; Tiemeier, Henning

    2015-01-01

    Objective: To examine whether early manifestations of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) increase children's later risk of bullying or victimization. Method: Using a population-based, prospective cohort, our multi-informant approach comprised repo

  15. 对立违抗性障碍儿童行为和自我意识的相关研究%Correlation study on behavioral problems and self-concept of children with oppositional defiant disorder

    Institute of Scientific and Technical Information of China (English)

    陈雷音; 罗学荣; 韦臻; 管冰清; 袁秀洪; 宁志军; 丁军; 杨伟

    2011-01-01

    Objective To investigate the behavioral problems and self-concept of children with oppositional defiant disorder (ODD) and the correlation between them. Methods The subjects came from a sample survey of primary and middle school students' mental status in 6 regions in Hunan province. Achenbach child behavior checklist (CBCL) was filled out by parents. The Children's self-concept scale (CSCS) was completed by children themselves. Results There were significant differences between the scores of ODD group and the normal control among all CBCL subscales except the activities scale, and the scores for the CSCS scales were all lower in patients with ODD than the control group except for the physical appearance and attributes (P <0.01 ). In addition, according to correlation analysis, the CBCL scores yielded small but significant correlations with the CSCS scores for children with ODD ( P < 0. 05 ). Conclusion Children with ODD have generally behavioral problems, poor social competence, and lower self-concept, whose behaviors were correlated with their self-concept.%目的:了解具有对立违抗性障碍(oppositional defiant disorder,ODD)儿童的行为特征和自我意识,并探讨二者之间的关系.方法:对来自湖南省中小学生心理健康状况流行病学调查研究中的全部对象进行DSM-IV诊断,其中符合ODD诊断标准的对象及对照组由父母填写Achenbach 儿童行为量表(CBCL),儿童自己填写儿童自我意识量表.结果:在CBCL各项目中除活动情况ODD组与对照组无差别外,余项差异均有统计学意义(P<0.01),儿童自我意识量表中ODD患者的行为、智力与学校表现、焦虑、合群、幸福与满足和总分均显著低于对照组(P<0.01),并且ODD患者的自我意识量表和CBCL具有低度相关,表现为自我意识量表的行为和总分分别与行为问题总分、外化性问题负相关,智力与学校情况、总分和社会能力总分正相关,合群与

  16. [Differential diagnosis of dissociative identity disorder (multiple personality disorder)].

    Science.gov (United States)

    Stübner, S; Völkl, G; Soyka, M

    1998-05-01

    Recently the concept of dissociative identity disorder (formerly known as multiple personality disorder) has attracted increasing public and scientific interest. However, it is rarely diagnosed in the clinical setting. the reported case of a 47-year-old woman with a history of child abuse demonstrates the problems of differential diagnosis. A number of psychopathologic symptoms pointed to a multiple personality disorder, but in the follow-up psychotic symptoms such as delusions, possible hallucinations and bizarre behavior clearly emerged. The differential diagnosis of dissociative identity disorder includes paranoid schizophrenia, as in the case described, borderline personality disorder, hysteria, simulation and the false memory syndrome. Finally, social and cultural factors have to be considered.

  17. Emotional Abilities in Children with Oppositional Defiant Disorder (ODD): Impairments in Perspective-Taking and Understanding Mixed Emotions are Associated with High Callous-Unemotional Traits.

    Science.gov (United States)

    O'Kearney, Richard; Salmon, Karen; Liwag, Maria; Fortune, Clare-Ann; Dawel, Amy

    2017-04-01

    Most studies of emotion abilities in disruptive children focus on emotion expression recognition. This study compared 74 children aged 4-8 years with ODD to 45 comparison children (33 healthy; 12 with an anxiety disorder) on behaviourally assessed measures of emotion perception, emotion perspective-taking, knowledge of emotions causes and understanding ambivalent emotions and on parent-reported cognitive and affective empathy. Adjusting for child's sex, age and expressive language ODD children showed a paucity in attributing causes to emotions but no other deficits relative to the comparison groups. ODD boys with high levels of callous-unemotional traits (CU) (n = 22) showed deficits relative to low CU ODD boys (n = 25) in emotion perspective-taking and in understanding ambivalent emotions. Low CU ODD boys did not differ from the healthy typically developing boys (n = 12). Impairments in emotion perceptive-taking and understanding mixed emotions in ODD boys are associated with the presence of a high level of CU.

  18. Multiple Personality Disorder: Concepts and Cases.

    Science.gov (United States)

    Lindsley, Hope L.

    1992-01-01

    Presents two case examples illustrating nature and etiology of multiple personality disorder in two clients and describing their entry into counseling and progress through treatment. Compares and contrasts cases in areas of diagnosis, symptoms, history, and treatment. Suggests that mental health counselors combine firmness with flexibility in…

  19. Multiple Personality Disorder: Concepts and Cases.

    Science.gov (United States)

    Lindsley, Hope L.

    1992-01-01

    Presents two case examples illustrating nature and etiology of multiple personality disorder in two clients and describing their entry into counseling and progress through treatment. Compares and contrasts cases in areas of diagnosis, symptoms, history, and treatment. Suggests that mental health counselors combine firmness with flexibility in…

  20. Study of anxious and depressive emotion of attention deficit hyperactivity disorder with oppositional defiant disorder%伴对立违抗性障碍的注意缺陷多动障碍儿童焦虑抑郁情绪分析

    Institute of Scientific and Technical Information of China (English)

    黄广文; 苏林雁; 马敏; 何满芬; 谢高梅

    2013-01-01

    [Objective] To explore the emotional problem of attention deficit hyperactivity disorder (ADHD) with and without oppositional defiant disorder (ODD). [Methods] 55(59. 14%) ADHD children with ODD,38(40. 86%) ADHD children without ODD, 93 children were evaluated with the Screen for Child Anxiety Related Emotional Disorders (SCARED) and Depression Self-rating Scale for Children (DSRSC),and 93 parents completed family information. Anxious and depressive emotion problems were compared with two groups. [Result] The ADHD with ODD group showed significantly higher somatization/panic, general anxiety, separated anxiety, socialization phobia, school phobia and anxiety total score,depression total score U=2. 105~5. 145,P<0. 001~0. 05). [Conclusions] Children of ADHD with ODD have much more anxious and depressive emotion problems than simply ADHD. More attention should be paid to intervene the e-motional problem of children with ADHD and ODD.%[目的]了解伴与不伴对立违抗性障碍(oppositional defiant disorder,ODD)的注意缺陷/多动障碍(attention deficit hyperactivity disorder,ADHD)情绪问题. [方法]对门诊就诊儿童以DSM-IV中ADHD和ODD诊断标准进行诊断,得到ADHD伴ODD者55例(占总数中59.14%),ADHD不伴ODD者38例(占总数中40.86%).采用自行编制的家庭情况调查表,调查每一患儿情况.采用儿童焦虑性情绪障碍筛查表、儿童抑郁障碍自评量表评估儿童焦虑抑郁情绪.对两组儿童的焦虑抑郁情绪问题进行比较分析. [结果]ADHD+ ODD组在躯体/惊恐、广泛焦虑、分离焦虑、社交恐怖、学校恐怖及焦虑总分、抑郁总分得分均显著高于ADHD组(t=2.105~5.145,P<0.001~0.05). [结论]伴ODD的ADHD儿童比单纯ADHD儿童存在更为明显的焦虑抑郁性情绪问题.应注重ADHD、ODD儿童情绪问题干预.

  1. The pharmacological management of oppositional behaviour, conduct problems, and aggression in children and adolescents with attention-deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder: a systematic review and meta-analysis. Part 1: psychostimulants, alpha-2 agonists, and atomoxetine.

    Science.gov (United States)

    Pringsheim, Tamara; Hirsch, Lauren; Gardner, David; Gorman, Daniel A

    2015-02-01

    Children with attention-deficit hyperactivity disorder (ADHD) may have oppositional behaviour, conduct problems, and aggression. These symptoms vary in severity, and may be related to a comorbid diagnosis of oppositional defiant disorder (ODD) or conduct disorder (CD). Critical evaluation of the efficacy of ADHD medications may guide the clinician regarding the usefulness of medications for these symptoms. We performed a systematic review and meta-analysis of psychostimulants, alpha-2 agonists, and atomoxetine for oppositional behaviour, conduct problems, and aggression in youth with ADHD, ODD, and CD. The quality of evidence for medications was rated using the Grading of Recommendations Assessment, Development and Evaluation approach. Two systematic reviews and 20 randomized controlled trials were included. There is high-quality evidence that psychostimulants have a moderate-to-large effect on oppositional behaviour, conduct problems, and aggression in youth with ADHD, with and without ODD or CD. There is very-low-quality evidence that clonidine has a small effect on oppositional behaviour and conduct problems in youth with ADHD, with and without ODD or CD. There is moderate-quality evidence that guanfacine has a small-to-moderate effect on oppositional behaviour in youth with ADHD, with and without ODD. There is high-quality evidence that atomoxetine has a small effect on oppositional behaviour in youth with ADHD, with and without ODD or CD. Evidence indicates that psychostimulants, alpha-2 agonists, and atomoxetine can be beneficial for disruptive and aggressive behaviours in addition to core ADHD symptoms; however, psychostimulants generally provide the most benefit.

  2. Respiratory Sinus Arrhythmia and Heart Period in Infancy as Correlates of Later Oppositional Defiant and Callous-Unemotional Behaviors

    Science.gov (United States)

    Wagner, Nicholas; Mills-Koonce, Roger; Willoughby, Michael; Propper, Cathi; Rehder, Peter; Gueron-Sela, Noa

    2017-01-01

    Extant literature suggests that oppositional defiant disorder (ODD) and callous-unemotional (CU) behaviors in childhood and adolescence are associated with distinct patterns of psychophysiological functioning, and that individual differences in these patterns have implications for developmental pathways to disorder. Very little is known about the…

  3. Respiratory Sinus Arrhythmia and Heart Period in Infancy as Correlates of Later Oppositional Defiant and Callous-Unemotional Behaviors

    Science.gov (United States)

    Wagner, Nicholas; Mills-Koonce, Roger; Willoughby, Michael; Propper, Cathi; Rehder, Peter; Gueron-Sela, Noa

    2017-01-01

    Extant literature suggests that oppositional defiant disorder (ODD) and callous-unemotional (CU) behaviors in childhood and adolescence are associated with distinct patterns of psychophysiological functioning, and that individual differences in these patterns have implications for developmental pathways to disorder. Very little is known about the…

  4. CBCL Pediatric Bipolar Disorder Profile and ADHD: Comorbidity and Quantitative Trait Loci Analysis

    Science.gov (United States)

    McGough, James J.; Loo, Sandra K.; McCracken, James T.; Dang, Jeffery; Clark, Shaunna; Nelson, Stanley F.; Smalley, Susan L.

    2008-01-01

    The pediatric bipolar disorder profile of the Child Behavior checklist is used to differentiate patterns of comorbidity and to search for quantitative trait loci in multiple affected ADHD sibling pairs. The CBCL-PBD profiling identified 8 percent of individuals with severe psychopathology and increased rates of oppositional defiant, conduct and…

  5. CBCL Pediatric Bipolar Disorder Profile and ADHD: Comorbidity and Quantitative Trait Loci Analysis

    Science.gov (United States)

    McGough, James J.; Loo, Sandra K.; McCracken, James T.; Dang, Jeffery; Clark, Shaunna; Nelson, Stanley F.; Smalley, Susan L.

    2008-01-01

    The pediatric bipolar disorder profile of the Child Behavior checklist is used to differentiate patterns of comorbidity and to search for quantitative trait loci in multiple affected ADHD sibling pairs. The CBCL-PBD profiling identified 8 percent of individuals with severe psychopathology and increased rates of oppositional defiant, conduct and…

  6. Child abuse as an antecedent of multiple personality disorder.

    Science.gov (United States)

    Baldwin, L C

    1990-11-01

    Until recently, few cases of multiple personality disorder were diagnosed in children. Today, the number of cases is increasing at an alarming rate and appears to be most closely associated with repeated sexual and physical abuse. This paper focuses on reports of childhood multiple personality disorder in the literature, the etiology of this disorder, family dynamics, the differences between childhood and adult multiple personality disorder, credibility problems in children, reasons for failure to diagnose multiple personality disorder in children, treatment, and signs and symptoms to look for in the clinical setting.

  7. A follow-up study of parent training treatment in children with attention deficit hyperactivity disorder comorbidity oppositional defiant disorder%父母培训结合利他林治疗对立违抗障碍ADHD患儿疗效观察

    Institute of Scientific and Technical Information of China (English)

    张文武; 王晓笳; 程芳; 刘之旺; 袁红; 胡珍玉

    2011-01-01

    目的 评估父母培训八步法结合利他林的联合治疗方案对共患对立违抗障碍(ODD)的ADHD的疗效,探索合适的治疗方案.方法 对符合DSM-Ⅳ中ADHD+ODD诊断标准的患儿,用父母培训法联合利他林治疗与单用利他林的药物治疗进行随机对照,治疗10周后撤除父母培训法,在第34周进行随访.共完成观察病例62例,32例利他林治疗,30例联合治疗.以破坏性行为障碍评定量表(DBDRS)、家长压力问卷(PSI)、临床总体印象(CGI)等评估症状及疗效.结果 治疗前两组ADHD症状评分、ODD症状评分及CGI评分差异均无统计学意义(P值均>0.05);治疗10周末及随访34周末均一致显示,两组ADHD症状改善及疗效差异无统计学意义(P>0.05),联合治疗组对ODD症状的改善和疗效、减轻疾病严重程度和家长压力等方面优于单用利他林组(P<0.01);ODD症状的改善与注意缺陷症状的改善有正性相关( r=0.39,P<0.01).结论 父母培训结合利他林治疗共患ODD的ADHD疗效肯定,值得在临床推广.%Objective To assess the effectiveness of Russell Barkley's parent training combined with Ritalin in children with attention deficit hyperactivity disorder(ADHD) comorbidity oppositional defiant disorder) ODD). Methods Sixty-two children met DSM-IVADHD+ODD were randomized to parent training combined with Ritalin treatment group (30 cases) and only Ritalin treatment group (32 cases) for 10 weeks and were followed up at the 34th week. Before and after the treatment. Disruptive Behavior Disorder Rate Scale (DBDRS) , Parenting Stress Index ( FSI) and Clinical Global Impressions (CGI) were used to evaluate the symptom and effectiveness. Results Before treatment, there were no significant differences in the total score of the ADHD symptom and the ODD symptom(P>0.05). Both 10 weeks' treatment later and followed-up 34 weeks showed that there were no significant differences on progresses and effectiveness of the ADHD

  8. MULTIPLE PERSONALITY DISORDER FOLLOWING CONVERSION AND DISSOCIATIVE DISORDER NOS : A CASE REPORT

    OpenAIRE

    Jhingan, Harsh Prem; Aggarwal, Neeruj; Saxena, Shekhar; Gupta, Dhanesh K

    2000-01-01

    A case progressing from symptoms of conversion disorder to dissociative disorder and then to multiple personality disorder as per DSM-III-R criteria is being reported. The clinical implications are discussed.

  9. MULTIPLE PERSONALITY DISORDER FOLLOWING CONVERSION AND DISSOCIATIVE DISORDER NOS : A CASE REPORT

    OpenAIRE

    Jhingan, Harsh Prem; Aggarwal, Neeruj; Saxena, Shekhar; Gupta, Dhanesh K

    2000-01-01

    A case progressing from symptoms of conversion disorder to dissociative disorder and then to multiple personality disorder as per DSM-III-R criteria is being reported. The clinical implications are discussed.

  10. Multiple personality disorder following conversion and dissociative disorder nos : a case report.

    Science.gov (United States)

    Jhingan, H P; Aggarwal, N; Saxena, S; Gupta, D K

    2000-01-01

    A case progressing from symptoms of conversion disorder to dissociative disorder and then to multiple personality disorder as per DSM-III-R criteria is being reported. The clinical implications are discussed.

  11. Conduct behaviors and oppositional defiant behaviors in children and adolescents with ADHD.

    Science.gov (United States)

    Ghanizadeh, Ahmad

    2015-04-01

    There is controversy about the association among attention deficit hyperactivity disorder (ADHD), conduct disorder behaviors, and oppositional defiant behaviors. This study examines whether different subcategories of conduct behaviors co-occur in children with ADHD, and investigates the association of conduct behaviors with ADHD symptoms and oppositional defiant behavior, considering the covariant factors of parental age and educational level. A total of 441 children and adolescents with ADHD participated in this study - 342 (77.6%) boys and 99 girls (22.4%). Their mean age was 9.1 (standard deviation = 2.2) years. They came from families with 1 to 8 children. There were statistically significant correlations among different subcategories of conduct disorder (p conduct behaviors. The severity of hyperactivity/impulsivity was associated with the subcategory of "destruction of property." The inattentiveness score was associated with "aggression to people and animals." The current results do not suggest that conduct behaviors exclude oppositional defiant behaviors. The subcategories of conduct behaviors occur in a cluster rather than as a solitary behavior. Larger family size and lower educational level of the father increase the risk of aggression to people and animals in children with ADHD.

  12. Mimicry between mitochondrial disorder and multiple sclerosis.

    Science.gov (United States)

    Finsterer, Josef; Höftberger, Romana; Stöllberger, Claudia; Rolinski, Boris

    2012-06-01

    Under certain conditions or at certain stages of the disease course, multiple sclerosis (MS) and mitochondrial disorder (MID) may be differential diagnoses and thus may be confused with each other. In a 30 years old female MS was diagnosed at age 16 year upon recurrent sensory disturbances of the right lower leg, an "inflammatory" cerebrospinal fluid, and a cerebral MRI with multiple non-enhancing white matter lesions. Steroids were repeatedly given but because of rapid deterioration treatment was switched to interferon and mitoxantrone, without improvement. Fourteen years after onset the patient additionally presented with a history of rhabdomyolysis, hypothyroidism, ophthalmoparesis, anarthria, tetraspasticity, tetraparesis, and joint contractures. After MID had been diagnosed in her mother she was re-evaluated and elevated resting lactate, axonal polyneuropathy, and empty sella were additionally found. Muscle biopsy revealed myophagy, fat deposition, and type-II predominance, and biochemical investigations showed a deficiency of complex I and IV of the respiratory chain. MID was diagnosed also in the index patient. It is concluded that even if CSF investigations or imaging studies suggest MS, differentials such as MIDs need to be excluded before prescribing medication possibly toxic to a MID. An "inflammatory CSF" may also occur in MIDs.

  13. Analysis of psychological behavior features of different sexual children with oppositional defiant disorder%不同性别对立违抗性障碍患儿的心理行为特征

    Institute of Scientific and Technical Information of China (English)

    李冰; 王旸; 刘金同

    2016-01-01

    Objective To explore the psychological behavior features between different sexual children with oppositional defiant disorder(ODD).Methods The subjects were sampled from grade 1 to 5 in a primary school in Ji-nan,Shandong Province.According to the diagnosed criteria,42 pupils were diagnosed ODD,which was the study group,and 556 pupils without ODD became the control group.The pupils and their families were investigated and as-sessed by using Achenbach Child Behavior Checklist (CBCL).Results According to CBCL,there was extremely sig-nificantly higher score of depression,obsessive -compulsive,hyperactive,aggressive,interpersonal behaviors in ODD boys [(5.00 ±3.73)scores,(4.88 ±3.65)scores,(5.21 ±3.49)scores,(1 0.1 0 ±6.85)scores,(2.88 ±1 .99) scores]than those in healthy control group [(1 .65 ±2.61 )scores,(1 .91 ±2.65)scores,(2.46 ±2.63)scores, (3.95 ±4.52)scores,(1 .34 ±1 .61 )scores](t =4.31 ,3.90,4.76,4.33,4.40;P =0.000,0.000,0.001 ,0.000, 0.000).There was significantly higher score of symptoms of somatization,indiscipline,schizoid -like behaviors in ODD boys with [(2.38 ±2.50)scores,(2.63 ±2.70)scores,(3.1 7 ±2.35)scores]than those in healthy control group [(0.85 ±1 .63)scores,(0.1 3 ±1 .76)scores,(1 .51 ±1 .72)scores](t =2.94,2.85,3.37;P =0.007,0.009, 0.002).There was extremely significantly higher score of depression,communication disorder behaviors in ODD girls [(5.44 ±4.1 2)scores,(3.1 1 ±2.93)scores]than those in healthy control group with [(2.50 ±3.34)scores, (1 .36 ±2.08)scores](t =3.57,3.38;P =0.000,0.001 ).A significantly higher score of hyperactive,aggression, cruelty behaviors in ODD girls [(4.67 ±4.41 )scores,(9.33 ±7.82)scores,(1 .1 7 ±1 .79)scores]than those in healthy control group [(1 .87 ±2.38)scores,(3.1 9 ±4.08)scores,(0.24 ±0.66)scores](t =2.67,3.30,2.1 8;P =0.01 6,0.004,0.043).Conclusions According to CBCL,there were more psychological behavior problems in ODD children than healthy children.A significantly higher

  14. Dissociation in hypnosis and multiple personality disorder.

    Science.gov (United States)

    Bowers, K S

    1991-07-01

    The first part of this paper examines the concept of dissociation in the context of hypnosis. In particular, the neodissociative and social psychological models of hypnosis are compared. It is argued that the social psychological model, in describing hypnotic enactments as purposeful, does not adequately distinguish between behavior that is enacted "on purpose" and behavior that serves or achieves a purpose. 2 recent dissertations (Hughes, 1988; Miller, 1986) from the University of Waterloo are summarized, each of which supports the neodissociative view that hypnotic behavior can be purposeful (in the sense that the suggested state of affairs is achieved) and nonvolitional (in the sense that the suggested state of affairs is not achieved by high level executive initiative and ongoing effort). The second part of the paper employs a neodissociative view of hypnosis to help understand the current epidemic of multiple personality disorder (MPD). In particular, it is argued that many symptoms of MPD are implicitly suggested effects--particularly prone to occur in persons who have a lifelong tendency to use dissociative type defenses. The present author believes that this account is easier to sustain conceptually and empirically than the current view, which states that a secondary (tertiary, etc.) personality accounts for the striking phenomenological discontinuities experienced by MPD patients.

  15. Reflections on multiple personality disorder as a developmentally complex adaptation.

    Science.gov (United States)

    Armstrong, J G

    1994-01-01

    Recent advances in the understanding of multiple personality disorder provide the groundwork for its creative reconciliation with psychoanalysis. This paper uses psychoanalytic, modern developmental, and psychological assessment perspectives to conceptualize multiple personality disorder as a developmentally protective response to chronic childhood trauma. Implications of this theory for clinical work with these patients are discussed.

  16. 穴位循经按压融合心理疗法及辨证治疗多动症共患对立违抗障碍%Integration of acupoint channel pressing and psychotherapy and dialectical treatment of attention deficit hyperactivity disorder with oppositional defiant disorder

    Institute of Scientific and Technical Information of China (English)

    陈世英

    2013-01-01

    Objective It is to explore the effect of integration of acupoint channel pressing and psychotherapy and dialectical treatment on attention deficit hyperactivity disorder (ADHD) with oppositional defiant disorder (ODD). Methods 55 cases of the children with ADHD and ODD were randomly divided into 31 cases of the observation group treated with acupoint channel pressing by integration of psychotherapy and dialectical oral traditional Chinese medicine, 24 cases of the comparison group treated with methylphenidate. CRT standardization intelligence test was used to screen out the low intelligence influence on observation, after 4 weeks, the statistics for the traditional Chinese medicine syndrome scores before and after treatment and reduction rate of ADHD with ODD symptom score decrease were conducted. Results The effectiveness rate of the observation group was 94% , that of the comparison group was 62% , and the difference between the two groups was significant (P < 0. 005 ) . Conclusion Integration of acupoint channel pressing and psychotherapy and dialectical treatment can improve the integrated disorder symptoms of the child patients, it is also beneficial to solve the psychological treatment problems of the child patients.%目的 探讨穴位循经按压融合心理疗法及辨证治疗多动症(ADHD)共患对立违抗障碍(ODD)的效果.方法 将55例ADHD共患ODD患儿随机分为2组,观察组31例采用融入心理治疗的穴位循经按压加辨证口服中药治疗,对照组24例口服哌醋甲酯.参考CRT标准化智测筛除低智对观察的影响,4周后统计治疗前后中医证侯积分、ADHD共患ODD症状积分下降的减分率.结果 观察组有效率为94%,对照组为62%,2组比较有显著性差异(P<0.005).结论 融入心理疗法的穴位循经按压联合辩证治疗较好地改善患儿综合障碍症状,且有利于解决患儿心理治疗难题.

  17. Tracing developmental trajectories of oppositional defiant behaviors in preschool children.

    Directory of Open Access Journals (Sweden)

    Lourdes Ezpeleta

    Full Text Available Previous studies on developmental trajectories have used ad hoc definitions of oppositional defiant behaviors (ODB, which makes it difficult to compare results. This article defines developmental trajectories of ODB from ages 3-5 based on five different standard measurements derived from three separate instruments.A sample of 622 three-year-old preschoolers, followed up at ages 4, 5, and 6, was assessed with the five measures of oppositionality answered by parents and teachers. Growth-Mixture-Modeling (GMM estimated separate developmental trajectories for each ODB measure for ages 3 to 5.The number of classes-trajectories obtained in each GMM depended on the ODB measure, but two clear patterns emerged: four trajectories (persistent low, decreasers, increasers/high increasers, persistent moderate/persistent high or three trajectories (persistent low, decreasers, increasers/high increasers. Persistent high trajectories accounted for 4.4%-9.5% of the children. The trajectories emerging from the different ODB measures at ages 3 to 5 discriminated disruptive disorders, comorbidity, use of services, and impairment at age 6, and globally showed a similar pattern, summarizing longitudinal information on oppositionality in preschool children in a similar way.Trajectories resulting from standard scales of the questionnaires have predictive validity for identifying relevant clinical outcomes, but are measure-specific. The results contribute to knowledge about the development of ODB in preschool children.

  18. Tracing developmental trajectories of oppositional defiant behaviors in preschool children.

    Science.gov (United States)

    Ezpeleta, Lourdes; Granero, Roser; de la Osa, Núria; Navarro, José Blas; Penelo, Eva; Domènech, Josep M

    2014-01-01

    Previous studies on developmental trajectories have used ad hoc definitions of oppositional defiant behaviors (ODB), which makes it difficult to compare results. This article defines developmental trajectories of ODB from ages 3-5 based on five different standard measurements derived from three separate instruments. A sample of 622 three-year-old preschoolers, followed up at ages 4, 5, and 6, was assessed with the five measures of oppositionality answered by parents and teachers. Growth-Mixture-Modeling (GMM) estimated separate developmental trajectories for each ODB measure for ages 3 to 5. The number of classes-trajectories obtained in each GMM depended on the ODB measure, but two clear patterns emerged: four trajectories (persistent low, decreasers, increasers/high increasers, persistent moderate/persistent high) or three trajectories (persistent low, decreasers, increasers/high increasers). Persistent high trajectories accounted for 4.4%-9.5% of the children. The trajectories emerging from the different ODB measures at ages 3 to 5 discriminated disruptive disorders, comorbidity, use of services, and impairment at age 6, and globally showed a similar pattern, summarizing longitudinal information on oppositionality in preschool children in a similar way. Trajectories resulting from standard scales of the questionnaires have predictive validity for identifying relevant clinical outcomes, but are measure-specific. The results contribute to knowledge about the development of ODB in preschool children.

  19. Methylphenidate and Comorbid Anxiety Disorder in Children with both Chronic Multiple Tic Disorder and ADHD

    Science.gov (United States)

    Gadow, Kenneth D.; Nolan, Edith E.

    2011-01-01

    Objective: To determine if comorbid anxiety disorder is associated with differential response to immediate release methylphenidate (MPH-IR) in children with both ADHD and chronic multiple tic disorder (CMTD). Method: Children with (n = 17) and without (n = 37) diagnosed anxiety disorder (ANX) were evaluated in an 8-week, placebo-controlled trial…

  20. Case study: Malingering or multiple personality disorder?

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    Alba García-Cortés

    2017-03-01

    Full Text Available The dissociative identity disorder (DID can be considered a rare disorder because of its seemingly low prevalence. However, in recent years it points to the possible underdiagnosis because its complexity and confusion at the time of differential diagnosis. On the other hand, the malingering of mental psychopathology can have a major socio-economic and legal impact, particularly important in this type of disorder, given the inability it generates and its complex diagnostic. This paper refers the case of a patient admitted to the short-term hospitalization unit of Dr. Rodríguez Lafora Hospital (Madrid with depressive symptoms. Then the patient seemed to become a TID case. The evaluation consisted of a psychological history and the application of the Structured Inventory of Malingered Symptoms (SIMS and the Millon Clinical Multiaxial Inventory (MCMI-II. The results showed an altered personality profile as well as likely malingered symptoms, what prevented us from a DID diagnosis. In view of the results, possible implications of this case for the clinical setting are discussed.

  1. Mindfulness training for adolescents with externalizing disorders and their parents

    NARCIS (Netherlands)

    Bögels, S.M.; Hoogstad, B.; van Dun, L.; de Schutter, S.E.R.; Restifo, K.

    2008-01-01

    Mindfulness training was evaluated as a new treatment for attention and impulsivity problems in adolescents with a variety of different externalizing disorders: attention deficithyperactivity disorder, oppositional-defiant and/or conduct disorder, and autism spectrum disorder if characterized by

  2. A review of the dissociative disorders: from multiple personality disorder to the posttraumatic stress

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    Modesto J. Romero-López

    Full Text Available In this paper we review the idea of dissociation, dissociative disorders and their relationship with the processes of consciousness. We will deal specifically with multiple personality disorder and posttraumatic stress disorder. Both polarize the discussion of diagnostic categories with dissociative symptoms. This review compares the initial ideas (one century old with the current scenario and emerging trends in research, which are relating cognitive processes and dissociative phenomena and disorders from a neuroscientific approach. We discuss the ideas on dissociation, hypnosis and suicide associated with these disorders. There seems to be a lack of consensus as to the nature of dissociation with theoretical, empirical and clinical implications.

  3. 伴有对立违抗障碍注意缺陷多动障碍患儿智力和行为特征及与血清 5- 羟色胺水平的关系%Intellectual and behavioral characteristics and their relations with serum 5 hydroxytryptamine level in children with attention deficit hyperactivity disorder complicated by oppositional defiant disorder

    Institute of Scientific and Technical Information of China (English)

    高雪屏; 苏林雁; 谢光荣; 黄春香; 李雪荣

    2005-01-01

    BACKGROUND:Oppositional defiant disorder(ODD) often occurs as a comorbid condition of attention deficit hyperactivity disorder(ADHD),characterized by defiant behaviors.ADHD children with ODD have more extensive impairments than those with ADHD alone. Some studies suggest that decreased serum 5 hydroxytryptamine(5 HT) level is related to aggressive behavior in ADHD, but no relevant report is available in China. OBJECTIVE:To investigate the clinical features of ADHD with ODD,and their relations with serum 5 HT. DESIGN:A randomized case controlled study taking the ADHD children with or without ODD as the subjects for study. SETTING:Mental Health Institute of the Second Xiangya Hospital. PARTICIPANTS:Sixty one ADHD children(53 boys and 8 girls) aged 7 to 14 years visiting the Children's Clinic of Mental Health Institute of Central South University from June 2002 to May 2003 were recruited and divided into two groups based on the symptomatic criteria of ODD recommended by the Diagnostic and Statistical Manual of Mental Disorder(DSM Ⅳ ):ADHD group(n=33,without ODD) and ADHD+ ODD group(n=28). INTERVENTIONS:The parents of the enrolled children(n=61) were asked to complete the Achenbach child behavior checklist (CBCL),and the teachers(n=31) completed the teacher's report form (TRF).Two milliliters of fasting venous blood was drawn from these children and the serum separated by centrifugation for quantification of 5 HT using external standard method,and whole blood 5 HT was analyzed by LD 10AD high performance liquid chromatography(HPLC). MAIN OUTCOME MEASURES:Scores of CBCL,TRF and Chinese Wechsler Intelligence Scale for Children(C WISC) and serum 5 HT levels. RESULTS:In the ADHD+ ODD group,the scores of CBCL and TRF for externalizing, aggressive behaviors and total scores for behavioral problems rated by the parents and teachers were significantly higher than those of the ADHD group(t=2.28 to 3.76,P< 0.05 to 0.01);the former group also had significantly higher scores of

  4. [Affective and psychotic disorders in multiple sclerosis].

    Science.gov (United States)

    Pozuelo-Moyano, Beatriz; Benito-León, Julián

    2015-12-01

    Introduccion. La esclerosis multiple (EM) es la segunda causa mas importante de discapacidad de origen neurologico en los adultos jovenes. Tanto la sintomatologia fisica como la psiquiatrica (trastornos afectivos y psicoticos) impactan de manera negativa en la calidad de vida relacionada con la salud de los pacientes con EM. Objetivo. Elucidar de modo critico la prevalencia y la patogenia de los sintomas afectivos y psicoticos presentes en la EM. Desarrollo. Se incluye una actualizacion de los estudios publicados mas significativos que han analizado la prevalencia y la patogenia de la sintomatologia afectiva y psicotica en los pacientes con EM. Para explorar la asociacion entre los sintomas afectivos y psicoticos con la EM se ha revisado la evidencia disponible hasta el momento. Conclusiones. La depresion es el trastorno psiquiatrico mas frecuente en la EM. Es necesaria mas investigacion para elucidar los mecanismos subyacentes que pueden provocar sintomas afectivos y psicoticos en la EM. El control de dichos sintomas en los pacientes de EM podria mejorar su calidad de vida relacionada con la salud.

  5. Apresentação de uma versão em português para uso no Brasil do instrumento MTA-SNAP-IV de avaliação de sintomas de transtorno do déficit de atenção/hiperatividade e sintomas de transtorno desafiador e de oposição A Brazilian version of the MTA-SNAP-IV for evaluation of symptoms of attention-deficit/hyperactivity disorder and oppositional-defiant disorder

    Directory of Open Access Journals (Sweden)

    Paulo Mattos

    2006-12-01

    Full Text Available O instrumento SNAP-IV foi desenvolvido para avaliação de sintomas do transtorno do déficit de atenção/hiperatividade em crianças e adolescentes. Pode ser preenchido por pais ou professores e emprega os sintomas listados no Manual de Diagnóstico e Estatística das Perturbações Mentais (DSM-IV para transtorno do déficit de atenção/hiperatividade (critério A e transtorno desafiador e de oposição (TDO. OBJETIVOS: Elaborar uma versão em português, para uso no Brasil, do SNAP-IV utilizado no Multimodal Treatment Assessment Study. MÉTODO: Foi empregada uma metodologia de tradução, retrotradução, avaliação de equivalência semântica, sondagem na população-alvo e escolha de versão final. RESULTADOS: Após as etapas de tradução e retrotradução, 20 itens foram considerados semelhantes, seis foram considerados aproximados, e cinco, diferentes da sua versão original em inglês. A versão final foi escolhida após diversas considerações, incluindo a semelhança com o original, a facilidade de compreensão e a maior equivalência dos termos em diferentes regiões sociogeográficas do Brasil. CONCLUSÃO: A versão em português do SNAP-IV obtida permitirá um rastreio de sintomas de transtorno do déficit de atenção/hiperatividade e transtorno desafiador e de oposição de modo correspondente à versão original.The SNAP-IV questionnaire was developed to evaluate symptoms of attention-deficit/hyperactivity disorder in children and adolescents. It can be fulfilled by parents or teachers and consists of the symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV for attention-deficit/hyperactivity disorder (criterion A and oppositional-defiant disorder. OBJECTIVES: To develop a version of the SNAP-IV used in the Multimodal Treatment Assessment Study to be applied in Brazil. METHODS: Translation, back-translation, evaluation of semantic equivalence, debriefing and definition of a final version was

  6. The criminal responsibility of people with multiple personality disorder.

    Science.gov (United States)

    Saks, E

    1995-01-01

    Because multiple personality disorder (MPD) is more frequently diagnosed today than in the past, it is likely that more multiples will plead insanity. The courts are in a state of disarray as to how best to respond to these pleas. This article considers multiples' responsibility on three interpretations of the status of their alters: that they are different people; that they are different personalities; or that they are parts of one complex, deeply divided personality. On all three theories multiples are nonresponsible. Nevertheless, three rare circumstances exist under which multiples should be found guilty. The article concludes by indicating the kinds of issues psychiatry might explore to further assist the law in its analysis of the criminal responsibility of multiples.

  7. Multiple personality disorder and borderline personality disorder. Distinct entities or variations on a common theme?

    Science.gov (United States)

    Lauer, J; Black, D W; Keen, P

    1993-06-01

    We report data from a comparison of 14 subjects with multiple personality disorder (MPD) and 13 subjects with borderline personality disorder (BPD). There were few significant differences between the groups. The authors discuss the concept of MPD as an epiphenomenon of BPD, and argue their fundamental similarity.

  8. [Dispute over the multiple personality disorder: theoretical or practical dilemma?].

    Science.gov (United States)

    Stankiewicz, Sylwia; Golczyńska, Maria

    2006-01-01

    Dissociative identity disorder (DID) could also be referred to as multiple personality disorder (MPD). Due to rare occurrence and difficulty in its' identification it is infrequently diagnosed in Poland. The indicated disorder has been portrayed by the authors throughout the historical context, referring to initial 18th century's references concerning dissociation. A typical dissociatively disordered person has been characterized along with his individual personality categories such as: original personality, altered personality, host and personality fragment. Moreover various diagnosis criterions of DID have been introduced. DID has also been differentiated with other disorders: PTSD (post-traumatic stress disorder) and BPD (borderline personality disorder). A hypothesis has been set up, stating that DID is directly correlated with the trauma experienced during childhood, while PTSD is linked with traumatic lived-through events in the later period of ones' life. The most contemporary and frequently used research tools for DID have been indicated: dissociative experience scale (DES) and somatoform dissociation questionnaire (SDQ-20). Based upon the known literature, the authors have presented treatment methods such as hypnotherapy and recorded therapy sessions. It is the view of the authors that the switching in dissociative identity disorder is of adaptive character (it occurrs depending upon adaptive needs).

  9. Rapidly evolving hypopituitarism in a boy with multiple autoimmune disorders.

    Science.gov (United States)

    Jevalikar, Ganesh; Wong, Sze Choong; Zacharin, Margaret

    2013-09-01

    A 10-year-old boy with acute onset cranial diabetes insipidus and multiple autoimmune disorders had evolving panhypopituitarism, thought to be due to autoimmune hypophysitis. Over 18 months, a dramatic clinical course with progressive hypopituitarism and development of type 1 diabetes mellitus was evident. Serial brain imaging showed changes suggestive of germinoma.

  10. A More Unified View of the Multiple Personality Disorder.

    Science.gov (United States)

    Kelley, Ronald L.; Kodman, Frank

    1987-01-01

    Offers perspective of Multiple Personality Disorder (MPD) phenomenon based on current clinical experience. Asserts that the Jmind is polypsychic with multitude of psychological systems and processes existing in conjunction with one another, that MPD individuals have fragmented or dissociated ego states due to stress on unity of sense of self, and…

  11. Indicators of Multiple Personality Disorder for the Clinician.

    Science.gov (United States)

    Dalton, Thomas W.

    Multiple personality disorder (MPD) is now recognized as a valid diagnostic category. Occurrence may be higher than previously suspected. While physiological testing of MPD has shown significant differences between the various personalities of individuals in terms of galvanic skin response, electroencephalogram recordings, electrodermal response…

  12. A More Unified View of the Multiple Personality Disorder.

    Science.gov (United States)

    Kelley, Ronald L.; Kodman, Frank

    1987-01-01

    Offers perspective of Multiple Personality Disorder (MPD) phenomenon based on current clinical experience. Asserts that the Jmind is polypsychic with multitude of psychological systems and processes existing in conjunction with one another, that MPD individuals have fragmented or dissociated ego states due to stress on unity of sense of self, and…

  13. Indicators of Multiple Personality Disorder for the Clinician.

    Science.gov (United States)

    Dalton, Thomas W.

    Multiple personality disorder (MPD) is now recognized as a valid diagnostic category. Occurrence may be higher than previously suspected. While physiological testing of MPD has shown significant differences between the various personalities of individuals in terms of galvanic skin response, electroencephalogram recordings, electrodermal response…

  14. Tumefactive Demyelinating Lesions in Multiple Sclerosis and Associated Disorders.

    Science.gov (United States)

    Frederick, Meredith C; Cameron, Michelle H

    2016-03-01

    Tumefactive demyelinating lesions are rare consequences of central nervous system (CNS) idiopathic inflammatory demyelinating diseases. Tumefactive demyelinating lesions pose a diagnostic challenge because they can mimic tumors and abscesses and because they can be caused by a heterogeneous range of disorders. This article reviews the recent literature on the clinical presentation; radiographic features; prognosis; and management of tumefactive demyelinating lesions in multiple sclerosis, acute demyelinating encephalomyelitis, neuromyelitis optica, and the rare variants of multiple sclerosis including Schilder's disease, Marburg acute multiple sclerosis, and Balo's concentric sclerosis.

  15. Treatment for multiple personality disorder: at what cost?

    Science.gov (United States)

    Piper, A

    1994-01-01

    The material presented in this paper suggests that before mental health practitioners ask of society the resources to treat those thousands of patients diagnosed with MPD in the past few years, a critical attempt should be made to evaluate the efficacy of the type of treatment currently recommended for the condition. Proponents of the disorder claim its treatment is cost-effective, but this article's analysis indicates that it is simply premature to make claims about the treatability or prognosis of multiple personality disorder.

  16. Adolescent multiple personality disorder: a preliminary study of eleven cases.

    Science.gov (United States)

    Dell, P F; Eisenhower, J W

    1990-05-01

    The diagnostic features and treatment histories of 11 adolescents with multiple personality disorder (MPD) are presented. Clinical evaluation revealed that the majority of these adolescents manifested extremely variable school performance, disruptive behavior, trances, amnesias, mood swings, sharp changes in personality, apparent lying, voices heard in the head, and depression. All had a history of childhood trauma: Sexual abuse (73%), physical abuse (73%), and emotional abuse (82%). Seventy-three percent had a parent with a diagnosable dissociative disorder; 36% of the mothers had MPD. These adolescents had a mean number of 24.1 alter personalities and appear to have become multiple at a mean age of 3 years, 1 month. All patients had angry protector alters, depressed alters, scared alters, and child alters. Fifty-four percent of these cases have integrated during treatment or are progressing toward integration. The remaining cases dropped out of therapy.

  17. Toward a psychoanalytic understanding of multiple personality disorder.

    Science.gov (United States)

    Reis, B E

    1993-01-01

    The author suggests a developmental psychoanalytic frame from which to understand the clinical phenomenology of multiple personality disorder (MPD). Annihilation anxiety and fears of nonbeing are understood as central; they are seen as resulting from actual early traumatic impingements at key developmental periods. Alter "personalities" are conceptualized as functional delusional processes that serve to maintain self-cohesion. The alters are brought about through the subject's lack of capacity for illusion. Some therapeutic implications regarding a psychoanalytic stance are discussed.

  18. Multiple personality disorder manifesting itself under the mask of transsexualism.

    Science.gov (United States)

    Modestin, J; Ebner, G

    1995-01-01

    The case of a young female patient is described who presented symptoms of transsexualism; surgical intervention was considered. Admitted to the hospital after having become depressed and suicidal, a thorough examination and observation revealed the presence of multiple personality disorder (MPD). Even though transsexualism and MPD represent two different conditions, there are many similarities between them. The possibility of MPD should be considered in every case of transsexualism.

  19. 对立违抗性障碍、注意缺陷多动障碍儿童的冲动行为及社会心理因素%Impulsive behaviors and psychosocial factors in children with oppositional defiant disorder and attention-deficit/hyperactivity disorder

    Institute of Scientific and Technical Information of China (English)

    王长虹; 苏林雁; 李晏; 耿耀国; 徐该玲; 从恩朝; 聂慧瑶

    2012-01-01

    relationship between impulsive behaviors and psychosocial factors in children with oppositional defiant disorder (ODD) and attention-deficit/hyperactivity disorder (ADHD). Methods: Totally 152 normal children and 157 impulsive children who were diagnosed as ODD and ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and whose average (Barratt Impulsiveness Scale, BIS) score was 3 1.5 times the standard deviation of the normal group' mean value. They were assessed with the Egm Minnen av Bardnosnauppforstran (EMBU), Family Assessment Device (FAD), Behavioral Style Questionnaire (BSQ), Middle Childhood Temperament Questionnaire (MCTQ), Piers- Harris Children's Self-concept Scale (PHCSS),Self-esteem Inventory (SEI) and Teacher Rating Scale (TRS). Results: The EMBU "affect warmth of father and mother " factor scores were lower in the case group than in the control group (Ps <0. 05). The EMBU "punishment and refusal of father and mother "factor scores were higher in the case group than in the control group (Ps <0.05). The FAD "affective involvement", "behavior control" and "general functioning" scores were higher in the case group than in the control group (Ps <0. 05). The temperament questionnaire "activity level", "rhythmicity", "intensity of reaction", "feature of mood", "persistency", and "attention-dispersal" scores were higher in the case group than in the control group (Ps <0.05). Most children's temperament in case group were difficulty (D) and intermediate-difficulty (I-D) type, and there were significant differences between case group and control group (Ps <0.01). The SEI total scores were significantly lower in the case group than in the control group (P<0.05). The scores of TRS "conduct","hyperactivity","impaired concentration" and "passive", and "hyperactivity index" were higher in the case group than in the control group (Ps <0.05). Regression a-nalysis showed that disappointing relationship between husband and wife (OR

  20. Psychiatric disorders revealing multiple sclerosis after 20 years of evolvement

    Directory of Open Access Journals (Sweden)

    Aicha Slassi Sennou

    2014-01-01

    Full Text Available Previous research indicates that the onset of psychiatric disorders is sometimes associated with multiple sclerosis (MS evolving several years later. However, information on why this might occur, and on the outcomes of such patients, is still lacking. We aim to discuss these limitations with the current paper. We describe a 51-year-old female who demonstrated severe anxiety disorder and depression years before developing MS neurological symptoms. The patient was treated for these psychiatric disorders over 20 years. In the last 3 years of her treatment, the patient demonstrated a choreic-type of movement disorder in all her limbs. This disorder is consistent with relapsing-remitting MS. Clinical and magnetic resonance imaging (MRI examinations demonstrated aspects of MS, without MS being diagnosed conclusively. The visual evoked potential indicated a diagnosis of conduction abnormalities. The established diagnosis was slow relapsing MS. The patient underwent methylprednisolone bolus (1 g/day. This case-study suggests that health professionals should conduct a full neurological assessment when they find atypical psychiatric symptoms in a patient. This would make sure that patients receive a better standard of care, and thus experience a better quality of life.

  1. Anxiety Symptoms in Boys with Autism Spectrum Disorder, Attention-Deficit Hyperactivity Disorder, or Chronic Multiple Tic Disorder and Community Controls

    Science.gov (United States)

    Guttmann-Steinmetz, Sarit; Gadow, Kenneth D.; DeVincent, Carla J.; Crowell, Judy

    2010-01-01

    We compared symptoms of generalized anxiety disorder (GAD) and separation anxiety disorder (SAD) in 5 groups of boys with neurobehavioral syndromes: attention-deficit/hyperactivity disorder (ADHD) plus autism spectrum disorder (ASD), ADHD plus chronic multiple tic disorder (CMTD), ASD only, ADHD only, and community Controls. Anxiety symptoms were…

  2. Anxiety Symptoms in Boys with Autism Spectrum Disorder, Attention-Deficit Hyperactivity Disorder, or Chronic Multiple Tic Disorder and Community Controls

    Science.gov (United States)

    Guttmann-Steinmetz, Sarit; Gadow, Kenneth D.; DeVincent, Carla J.; Crowell, Judy

    2010-01-01

    We compared symptoms of generalized anxiety disorder (GAD) and separation anxiety disorder (SAD) in 5 groups of boys with neurobehavioral syndromes: attention-deficit/hyperactivity disorder (ADHD) plus autism spectrum disorder (ASD), ADHD plus chronic multiple tic disorder (CMTD), ASD only, ADHD only, and community Controls. Anxiety symptoms were…

  3. Bloom syndrome: multiple retinopathies in a chromosome breakage disorder.

    Science.gov (United States)

    Bhisitkul, R B; Rizen, M

    2004-03-01

    To describe multiple retinal abnormalities in a patient with Bloom syndrome, including early macular drusen, diabetic retinopathy, and the onset of leukaemic retinopathy. Clinical data were collected over 1 year of follow up, and ocular abnormalities in Bloom syndrome were reviewed from the literature. A 39 year old man with a rare autosomal recessive "chromosome breakage" syndrome was followed. A variety of ocular findings have been reported in Bloom syndrome; this patient had hard drusen in both maculae, non-proliferative diabetic retinopathy, and haemorrhagic retinopathy as a herald of acute lymphocytic leukaemia. Bloom syndrome is a rare disorder of genomic instability, in which a variety of ocular abnormalities have been found. Described here are multiple retinal manifestations arising from characteristic systemic associations of diabetes mellitus and leukaemia, as well as macular hard drusen.

  4. Prevalence of temporomandibular disorders symptoms in patients with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Lucas S. C. Carvalho

    2014-06-01

    Full Text Available The aim of the present study was to assess the prevalence of symptoms of temporomandibular disorders (TMD in patients with the relapsing-remitting form of multiple sclerosis (MS, the relationship between TMD and the severity of MS, and the presence of TMD symptoms in the evaluated groups. Sixty individuals were evaluated: 30 patients diagnosed with relapsing-remitting MS and 30 control individuals matched for gender and age range with no neurologic pathology. In order to investigate the TMD symptoms, the questionnaires of the EACD (European Academy of Craniomandibular Disorders and the RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorders, both validated for TMD research, were administered. To assess the extent of disability produced by MS, the Expanded Disability Status Scale (EDSS was used. The prevalence of TMD symptoms in patients with MS was 56.7% versus 16.7% for the control group, with a statistically significant difference between the groups (p=0.0016. No correlation was found between the severity of MS and the prevalence of TMD symptoms (Fisher's test, p=1.0.

  5. Differential diagnosis of Mendelian and mitochondrial disorders in patients with suspected multiple sclerosis.

    Science.gov (United States)

    Weisfeld-Adams, James D; Katz Sand, Ilana B; Honce, Justin M; Lublin, Fred D

    2015-03-01

    Several single gene disorders share clinical and radiologic characteristics with multiple sclerosis and have the potential to be overlooked in the differential diagnostic evaluation of both adult and paediatric patients with multiple sclerosis. This group includes lysosomal storage disorders, various mitochondrial diseases, other neurometabolic disorders, and several other miscellaneous disorders. Recognition of a single-gene disorder as causal for a patient's 'multiple sclerosis-like' phenotype is critically important for accurate direction of patient management, and evokes broader genetic counselling implications for affected families. Here we review single gene disorders that have the potential to mimic multiple sclerosis, provide an overview of clinical and investigational characteristics of each disorder, and present guidelines for when clinicians should suspect an underlying heritable disorder that requires diagnostic confirmation in a patient with a definite or probable diagnosis of multiple sclerosis.

  6. Can Multiple Sclerosis as a Cognitive Disorder Influence Patients’ Dreams?

    Directory of Open Access Journals (Sweden)

    Abdorreza Naser Moghadasi

    2013-04-01

    Full Text Available Dream should be considered as a kind of cognitive ability that is formed parallel to other cognitive capabilities like language. On the other hand, multiple sclerosis (MS is a complex disease that can involve different aspects of our cognition. Therefore, MS may influence patients’ dreams. In fact, we do not know what the importance of dream is in MS, but further studies may introduce dream and dreaming as a sign of improvement or progression in MS disease.Multiple sclerosis (MS is a disease that involves different areas of the brain and is accompanied by several disorders of the central nervous system. The topology of the disease and different areas of the brain that are involved during the disease may cause various changes in dreams, because dreaming has a close relation with the human brain physiology. The destruction of this physiology by a disease like MS with the ability of involving different areas of brain, may probably lead to changes in dreaming.This topic can also lead to a discussion from another point of view that is a different interpretation of these findings. By analyzing contents of hundreds of dreams, Domhoff concluded that the content of a dream is the continuance of our daily activities.1 In other words, the constitutive elements of our dreams are the ones that we think about and experience during a day. Strange and fantasy dreams constitute a very low percentage of the dreams and more than 70% of them are nothing but our daily activities in wakefulness.2Domhoff represents a kind of cognitive approach in the field of dream according to this considerable fact and also the evolution of dream’s content in children in accordance with their growth and changes of dream due to brain lesions. According to this approach, dream is also a kind of cognitive activity that is formed parallel to other cognitive capabilities like language. Moreover, whatever brings us various cognitive understandings such as hearing and seeing during

  7. Some aspects of balance disorder in patients with multiple sclerosis.

    Science.gov (United States)

    Burina, Adnan; Sinanović, Osman; Smajlović, Dzevdet; Vidović, Mirjana; Brkić, Fuad

    2008-02-01

    The aim of this study was to analyze: frequency of balance disorder (vertigo and disequilibrium), frequency of abnormalities in auditory evoked potentials (AEP) and magnetic resonance imaging (MRI) changes of the brain in multiple sclerosis (MS) patients with balance disorder, relation of patient's disability status to balance disorder and relation of the changes in MRI of the brainstem to AEP abnormalities. It was analyzed 60 patients with relapsing-remitting form of MS. Two groups of patients were made consecutively under Expanded Disability Status Scale score (EDSS): A (EDSS or =5,0). The study was retrospective-prospective. After the neurological exam AEP and MRI of the brain have been done. Balance disorder has been verified as initial symptom in 29 (48,4%) and out of them disequilibrium experienced 24 (83,4%) patients. During the relapses balance disorder experienced 48 (80%) patients and in 37 (77,1%) it was disequilibrium. Among them 33 (68,7%) were with lower EDSS ( or =5). There is no correlation between disability status and vertigo which means that vertigo is not more frequent in more disabled patients and vice-versa. The AEP were pathological in 57 (95%) patients. Of all 29 patients with vertigo AEP were pathological in 28 (96,5%) while in 31 patients without vertigo pathological AEP were in 29 (93,5%) but it is not statistical significant. The most frequent characteristic of AEP changes were prolonged inter-peak latency III-V waves (48 patients or 80%). The plaque in brainstem visualized by MRI was found in 41 (71,8%) of patients (38 or 92,6% of them had pathological AEP and in three patients AEP were normal). In group of patients with pathological AEP, 38 (66,6%) of them had plaque in brainstem. In other three patients with normal AEP it was visualized plaque in brainstem. In the group of 29 patients with balance disorder, 20 (68,9%) had plaque in brainstem as well as 21 (67,7%) out of 31 patients without balance disorder had plaque in the brainstem

  8. Case report of a person with Down's syndrome and multiple personality disorder.

    Science.gov (United States)

    Fotheringham, J B; Thompson, F

    1994-03-01

    A case is presented of an individual with Down's syndrome and multiple personality disorder. No such cases were found in a review of the literature. Three other individuals with Down's syndrome are also discussed whose symptoms range from experiencing imaginary friends to experiencing borderline multiple personality disorder. In all these cases the imaginary friends became more evident and resistive of diversion as the levels of stress increased. We speculate that experiencing imaginary friends progresses to experiencing multiple personality disorder in some individuals as personal stress increases. These cases also indicate that limited cognitive development does not preclude individuals from presenting with imaginary friends or multiple personality disorder.

  9. Bipolar Disorder and Multiple Sclerosis: A Case Series

    Directory of Open Access Journals (Sweden)

    Youssef Sidhom

    2014-01-01

    Full Text Available Background. The prevalence of psychiatric disturbance for patients with multiple sclerosis (MS is higher than that observed in other chronic health conditions. We report three cases of MS and bipolar disorder and we discuss the possible etiological hypothesis and treatment options. Observations. All patients fulfilled the McDonald criteria for MS. Two patients were followed up in psychiatry for manic or depressive symptoms before developing MS. A third patient was diagnosed with MS and developed deferred psychotic symptoms. Some clinical and radiological features are highlighted in our patients: one manic episode induced by high dose corticosteroids and one case of a new orbitofrontal MRI lesion concomitant with the emergence of psychiatric symptoms. All patients needed antipsychotic treatment with almost good tolerance for high dose corticosteroids and interferon beta treatment. Conclusions. MRI lesions suggest the possible implication of local MS-related brain damage in development of pure “psychiatric fits” in MS. Genetic susceptibility is another hypothesis for this association. We have noticed that interferon beta treatments were well tolerated while high dose corticosteroids may induce manic fits.

  10. Bedside Tested Ocular Motor Disorders in Multiple Sclerosis Patients

    Directory of Open Access Journals (Sweden)

    G. Servillo

    2014-01-01

    Full Text Available Background/Aims. Ocular motor disorders (OMDs are a common feature of multiple sclerosis (MS. In clinical practice, if not reported by patients, OMDs are often underdiagnosed and their prevalence is underestimated. Methods. We studied 163 patients (125 women, 76.7%, 38 men, 23.3%; median age 45.0 years; median disease duration 10 years; median EDSS 3.5 with definite MS (n=150, 92% or clinically isolated syndrome (n=13, 8% who underwent a thorough clinical examination of eye movements. Data on localization of previous relapses, MS subtype, and MRI findings were collected and analyzed. Results. Overall, 111/163 (68.1% patients showed at least one abnormality of eye movement. Most frequent OMDs were impaired smooth pursuit (42.3%, saccadic dysmetria (41.7%, unilateral internuclear ophthalmoplegia (14.7%, slowing of saccades (14.7%, skew deviation (13.5%, and gaze evoked nystagmus (13.5%. Patients with OMDs had more severe disability (P=0.0005 and showed more frequently infratentorial MRI lesions (P=0.004. Localization of previous relapses was not associated with presence of OMDs. Conclusion. OMDs are frequent in patients with stable (no relapses MS. A precise bedside examination of eye motility can disclose abnormalities that imply the presence of subclinical MS lesions and may have a substantial impact on definition of the diagnosis and on management of MS patients.

  11. Satanism, ritual abuse, and multiple personality disorder: a sociohistorical perspective.

    Science.gov (United States)

    Mulhern, S

    1994-10-01

    During the past decade in North America, a growing number of mental health professionals have reported that between 25% and 50% of their patients in treatment for multiple personality disorder (MPD) have recovered early childhood traumatic memories of ritual torture, incestuous rape, sexual debauchery, sacrificial murder, infanticide, and cannibalism perpetrated by members of clandestine satanic cults. Although hundreds of local and federal police investigations have failed to corroborate patients' therapeutically constructed accounts, because the satanic etiology of MPD is logically coherent with the neodissociative, traumatic theory of psychopathology, conspiracy theory has emerged as the nucleus of a consistent pattern of contemporary clinical interpretation. Resolutely logical and thoroughly operational, ultrascientific psychodemonology remains paradoxically oblivious to its own irrational premises. When the hermetic logic of conspiracy theory is stripped away by historical and socio/psychological analysis, however, the hypothetical perpetrators of satanic ritual abuse simply disappear, leaving in their wake the very real human suffering of all those who have been caught up in the social delusion.

  12. Four cases of supposed multiple personality disorder: evidence of unjustified diagnoses.

    Science.gov (United States)

    Freeland, A; Manchanda, R; Chiu, S; Sharma, V; Merskey, H

    1993-05-01

    Four cases are presented in which an unjustified diagnosis of multiple personality disorder was made. These cases are used to illustrate the concern that some cases of multiple personality disorder may be the result of misdiagnosis by both patients and clinicians.

  13. Comparative Study of Children with ADHD Only, Autism Spectrum Disorder + ADHD, and Chronic Multiple Tic Disorder + ADHD

    Science.gov (United States)

    Gadow, Kenneth D.; DeVincent, Carla J.; Schneider, Jayne

    2009-01-01

    Objective: Identification of differences among children with ADHD only, autism spectrum disorder (ASD)+ADHD, and chronic multiple tic disorder (CMTD)+ADHD may lead to better understanding of clinical phenotypes. Method: Children were evaluated using the parent- and teacher-completed questionnaires. Results: All three groups were highly similar in…

  14. Longitudinal associations of multiple physical symptoms with recurrence of depressive and anxiety disorders

    NARCIS (Netherlands)

    Dijkstra-Kersten, Sandra M. A.; Sitnikova, Kate; Terluin, Berend; Penninx, Brenda W. J. H.; Twisk, Jos W. R.; van Marwijk, Harm W. J.; van der Horst, Henriette E.; van der Wouden, Johannes C.

    Objective: To examine longitudinal associations of multiple physical symptoms with recurrence of depressive and anxiety disorders. Methods: Follow-up data of 584 participants with remitted depressive or anxiety disorders were used from the Netherlands Study of Depressive and Anxiety disorders.

  15. A systematic review of the incidence and prevalence of sleep disorders and seizure disorders in multiple sclerosis

    DEFF Research Database (Denmark)

    Marrie, Ruth Ann; Reider, Nadia; Cohen, Jeffrey

    2015-01-01

    BACKGROUND: Several studies have suggested that comorbid neurologic disorders are more common than expected in multiple sclerosis (MS). OBJECTIVE: To estimate the incidence and prevalence of comorbid seizure disorders and sleep disorders in persons with MS and to evaluate the quality of studies...... included studies qualitatively and quantitatively (I² statistic), and conducted meta-analyses among population-based studies. RESULTS: We reviewed 32 studies regarding seizure disorders. Among population-based studies the incidence of seizure disorders was 2.28% (95% CI: 1.11-3.44%), while the prevalence...... was 3.09% (95% CI: 2.01-4.16%). For sleep disorders we evaluated 18 studies; none were population-based. The prevalence ranged from 0-1.6% for narcolepsy, 14.4-57.5% for restless legs syndrome, 2.22-3.2% for REM behavior disorder, and 7.14-58.1% for obstructive sleep apnea. CONCLUSION: This review...

  16. Child Abuse and Multiple Personality Disorders: Review of the Literature and Suggestions for Treatment.

    Science.gov (United States)

    Coons, Philip M.

    1986-01-01

    Multiple personality disorder is associated with a high incidence of physical and sexual abuse during childhood. While difficult to diagnose, multiple personality is easier to treat if diagnosed early in childhood or adolescence. Treatment for multiple personality focuses on establishing trust and communicating with and integrating the…

  17. Child Abuse and Multiple Personality Disorders: Review of the Literature and Suggestions for Treatment.

    Science.gov (United States)

    Coons, Philip M.

    1986-01-01

    Multiple personality disorder is associated with a high incidence of physical and sexual abuse during childhood. While difficult to diagnose, multiple personality is easier to treat if diagnosed early in childhood or adolescence. Treatment for multiple personality focuses on establishing trust and communicating with and integrating the…

  18. Sensory and sensorimotor gating in children with multiple complex developmental disorders (MCDD) and autism

    DEFF Research Database (Denmark)

    Oranje, Bob; Lahuis, Bertine; van Engeland, Herman

    2013-01-01

    Multiple Complex Developmental Disorder (MCDD) is a well-defined and validated behavioral subtype of autism with a proposed elevated risk of developing a schizophrenic spectrum disorder. The current study investigated whether children with MCDD show the same deficits in sensory gating that are co......Multiple Complex Developmental Disorder (MCDD) is a well-defined and validated behavioral subtype of autism with a proposed elevated risk of developing a schizophrenic spectrum disorder. The current study investigated whether children with MCDD show the same deficits in sensory gating...

  19. Increasing infection rate in multiple implanted pulse generator changes in movement disorder patients treated with deep brain stimulation

    DEFF Research Database (Denmark)

    Thrane, Jens F; Sunde, Niels A; Bergholt, Bo

    2014-01-01

    Increasing infection rate in multiple implanted pulse generator changes in movement disorder patients treated with deep brain stimulation......Increasing infection rate in multiple implanted pulse generator changes in movement disorder patients treated with deep brain stimulation...

  20. The Parental Fitness of Mothers with Multiple Personality Disorder: A Preliminary Study.

    Science.gov (United States)

    Kluft, Richard P.

    1987-01-01

    A review of the parenting patterns of 75 mothers with multiple personality disorders indicated 38.7% were competent or exceptional mothers, 16% were grossly abusive, and 45.3% were compromised or impaired as parents. (DB)

  1. The Parental Fitness of Mothers with Multiple Personality Disorder: A Preliminary Study.

    Science.gov (United States)

    Kluft, Richard P.

    1987-01-01

    A review of the parenting patterns of 75 mothers with multiple personality disorders indicated 38.7% were competent or exceptional mothers, 16% were grossly abusive, and 45.3% were compromised or impaired as parents. (DB)

  2. ECI-4 screening of attention deficit-hyperactivity disorder and co-morbidity in Mexican preschool children: preliminary results Tamizaje del trastorno por déficit de atención-hiperactividad y su co-morbilidad en preescolares mexicanos por el ECI-4: resultados preliminares

    OpenAIRE

    2006-01-01

    OBJECTIVE: To examine prospectively usefulness of Early Childhood Inventory-4 (ECI-4) in identifying attention deficit-hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). METHOD: A sample of children

  3. From Single to Multiple Deficit Models of Developmental Disorders

    Science.gov (United States)

    Pennington, Bruce F.

    2006-01-01

    The emerging etiological model for developmental disorders, like dyslexia, is probabilistic and multifactorial while the prevailing cognitive model has been deterministic and often focused on a single cognitive cause, such as a phonological deficit as the cause of dyslexia. So there is a potential contradiction in our explanatory frameworks for…

  4. Cataplexy and the switch process of multiple personality disorder.

    Science.gov (United States)

    La Via, M C; Brewerton, T D

    1996-07-31

    A case history is presented of an 18-year-old male with dissociative disorder and polysubstance abuse. The patient was observed to switch between three personalities, and the personality changes were often associated with symptoms of cataplexy. Both dissociative episodes and cataplexy are associated with strong affective stimuli. Similar reports in the literature are briefly reviewed.

  5. Preschool Attention-Deficit/Hyperactivity and Oppositional Defiant Problems as Antecedents of School Bullying.

    Science.gov (United States)

    Verlinden, Marina; Jansen, Pauline W; Veenstra, René; Jaddoe, Vincent W V; Hofman, Albert; Verhulst, Frank C; Shaw, Philip; Tiemeier, Henning

    2015-07-01

    To examine whether early manifestations of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) increase children's later risk of bullying or victimization. Using a population-based, prospective cohort, our multi-informant approach comprised reports of parents, teachers, and peers. ADHD and ODD behavioral problems at ages 1.5, 3, and 5 years were determined from parental reports on the Child Behavior Checklist. Later bullying behavior at school was reported by teachers using a questionnaire (n = 3,192, mean age 6.6 years), and by peer/self-reports using peer nominations (n = 1,098, mean age 7.6 years). We examined the following: whether problem behavior scores at age 1.5, 3, or 5 years predicted a risk of bullying involvement; and whether high or increasing behavioral problems throughout ages 1.5 to 5 years were associated with bullying involvement at school. Analyses were adjusted for a range of child and maternal covariates. Behavioral problems at a young age each predicted later bullying involvement at school. For example, higher ADHD problem scores at age 3 years were associated with the risks of becoming a bully or a bully-victim (ORBULLY = 1.20, 95% CI = 1.07-1.35 [teacher report], ORBULLY-VICTIM = 1.28, 95% CI = 1.14-1.43 [teacher report], and ORBULLY-VICTIM = 1.35, 95% CI = 1.03-1.78 [peer/self-report]). Children whose behavioral problem scores were high or increased over time consistently had elevated risks of becoming a bully or a bully-victim. Behavioral problems at a young age may predispose children to bullying involvement in early elementary school. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  6. Multiple personality disorder in an intellectually disabled man: a case report.

    Science.gov (United States)

    Fairley, M; Jones, R C; McGuire, B E; Stevenson, J

    1995-03-01

    The case of a young man with the dual diagnoses of severe intellectual handicap (IQ 30 and mental age 4 years) and Multiple Personality Disorder is presented. The intellectual handicap is probably due to hypoxia in infancy and the Multiple Personality Disorder follows prolonged physical and sexual abuse. The patient frequently switches between any of nine discrete but incompletely formed identities. Although some personalities seem more capable than others, all have similar levels of disability on testing. The diagnosis of psychiatric disorders coexistent with the intellectual handicap is hindered by the difficulty in separating psychiatric phenomena from the behavioural disturbances associated with the disability. Differential diagnosis and management are discussed.

  7. Longitudinal prediction of disruptive behavior disorders in adolescent males from multiple risk domains.

    Science.gov (United States)

    Trentacosta, Christopher J; Hyde, Luke W; Goodlett, Benjamin D; Shaw, Daniel S

    2013-08-01

    The disruptive behavior disorders are among the most prevalent youth psychiatric disorders, and they predict numerous problematic outcomes in adulthood. This study examined multiple domains of risk during early childhood and early adolescence as longitudinal predictors of disruptive behavior disorder diagnoses among adolescent males. Early adolescent risks in the domains of sociodemographic factors, the caregiving context, and youth attributes were examined as mediators of associations between early childhood risks and disruptive behavior disorder diagnoses. Participants were 309 males from a longitudinal study of low-income mothers and their sons. Caregiving and youth risk during early adolescence each predicted the likelihood of receiving a disruptive behavior disorder diagnosis. Furthermore, sociodemographic and caregiving risk during early childhood were indirectly associated with disruptive behavior disorder diagnoses via their association with early adolescent risk. The findings suggest that preventive interventions targeting risk across domains may reduce the prevalence of disruptive behavior disorders.

  8. The incidence and prevalence of psychiatric disorders in multiple sclerosis

    DEFF Research Database (Denmark)

    Marrie, Ruth Ann; Reingold, Stephen; Cohen, Jeffrey

    2015-01-01

    -based studies, the prevalence of anxiety was 21.9% (95% CI: 8.76%-35.0%), while it was 14.8% for alcohol abuse, 5.83% for bipolar disorder, 23.7% (95% CI: 17.4%-30.0%) for depression, 2.5% for substance abuse, and 4.3% (95% CI: 0%-10.3%) for psychosis. CONCLUSION: This review confirms that psychiatric...... disorders in MS and evaluate the quality of included studies. METHODS: We searched the PubMed, PsychInfo, SCOPUS, and Web of Knowledge databases and reference lists of retrieved articles. Abstracts were screened for relevance by two independent reviewers, followed by full-text review. Data were abstracted...... comorbidity, particularly depression and anxiety, is common in MS. However, the incidence of psychiatric comorbidity remains understudied. Future comparisons across studies would be enhanced by developing a consistent approach to measuring psychiatric comorbidity, and reporting of age-, sex-, and ethnicity...

  9. An Alternative Approach to the Effects of Multiple Traumas: Complex Post-Traumatic Stress Disorder.

    Science.gov (United States)

    Taycan, Okan; Yildirim, Ahmet

    2015-09-01

    Exposure to multiple traumatic events, particularly in childhood, has been shown to result in more complex symptoms than those seen after exposure to a single traumatic event. In case of overlooking the link between trauma and psychopathology, patients with multiple traumatic experiences receive a variety of different diagnoses that are unable to completely cover the clinical picture. Misdiagnoses of genuine cases inevitably lead to mistreatment. A diagnosis of complex post-traumatic stress disorder has been proposed to cover the emerging psychopathology in survivors of multiple traumas. This present report aimed to discuss the construct and to increase the awareness of complex post-traumatic stress disorder diagnosis among mental health professionals.

  10. Multiple immune disorders in unrecognized celiac disease: a case report

    Institute of Scientific and Technical Information of China (English)

    Giorgio La Villa; Peietro Pantaleo; Roberto Tarquini; Lino Cirami; Federico Perfetto; Francesco Mancuso; Giacomo Laffi

    2003-01-01

    We reported a female patient with unrecognized celiac disease and multiple extra intestinal manifestations, mainly related to a deranged immune function, including macroamilasemia, macrolipasemia, IgA nephropathy,thyroiditis, and anti-b2-glicoprotein-1 antibodies, that disappeared or improved after the implementation of a gluten-free diet.

  11. Multiple DSM-5 substance use disorders: A national study of US adults.

    Science.gov (United States)

    McCabe, Sean Esteban; West, Brady T; Jutkiewicz, Emily M; Boyd, Carol J

    2017-09-01

    Our aim is to determine the lifetime and past-year prevalence estimates of multiple Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) substance use disorders (SUDs) among U.S. adults. The 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions featured in-person interviews with a nationally representative sample of adults aged 18 and older. The majority of past-year nonalcohol DSM-5 SUDs had at least 1 other co-occurring past-year SUD, ranging from 56.8% (SE = 3.4) for past-year prescription opioid use disorder to 97.5% (SE = 2.7) for past-year hallucinogen use disorder. In contrast, only 15.0% (SE = 0.6) of past-year alcohol use disorders had a co-occurring past-year SUD. The odds of past-year multiple SUDs were greater among males, younger adults, African-Americans, and those with mood, personality, posttraumatic stress, or multiple psychiatric disorders. Assessment, diagnosis, and treatment often focus on individual substance-specific SUDs rather than multiple SUDs, despite evidence for substantial rates of polysubstance use in clinical and epidemiological studies. There are notable differences in the prevalence of multiple SUDs between alcohol use disorders and other nonalcohol SUDs that have important clinical implications; for example, multiple SUDs are more persistent than individual SUDs. These findings suggest that clinical assessment and diagnosis should screen for multiple SUDs, especially among adults with nonalcohol DSM-5 SUDs. Copyright © 2017 John Wiley & Sons, Ltd.

  12. Mindfulness training for adolescents with externalizing disorders and their parents

    NARCIS (Netherlands)

    Bögels, S.M.; Hoogstad, B.; van Dun, L.; de Schutter, S.E.R.; Restifo, K.

    2008-01-01

    Mindfulness training was evaluated as a new treatment for attention and impulsivity problems in adolescents with a variety of different externalizing disorders: attention deficithyperactivity disorder, oppositional-defiant and/or conduct disorder, and autism spectrum disorder if characterized by ext

  13. Mindfulness training for adolescents with externalizing disorders and their parents

    NARCIS (Netherlands)

    Bögels, S.M.; Hoogstad, B.; van Dun, L.; de Schutter, S.E.R.; Restifo, K.

    2008-01-01

    Mindfulness training was evaluated as a new treatment for attention and impulsivity problems in adolescents with a variety of different externalizing disorders: attention deficithyperactivity disorder, oppositional-defiant and/or conduct disorder, and autism spectrum disorder if characterized by ext

  14. Obsessive Compulsive Disorder: What an Educator Needs to Know

    Science.gov (United States)

    Chaturvedi, Amrita; Murdick, Nikki L.; Gartin, Barbara C.

    2014-01-01

    The presence of obsessive compulsive disorder (OCD) impairs social, emotional and academic functioning. Individuals with OCD may have co-morbid disorders including attention deficit hyperactivity disorder, depression, oppositional defiant disorder, or Tourette syndrome. Challenges occur when students with OCD become a part of the general education…

  15. Delusional disorder and schizophrenia: a comparative study across multiple domains.

    Science.gov (United States)

    Peralta, V; Cuesta, M J

    2016-10-01

    Delusional disorder (DD) is an under-researched condition and its relationship to schizophrenia (SZ) controversial. This study aimed to further characterize DD and to examine multi-domain evidence for the distinction between DD and SZ. Using univariate analyses we examined 146 subjects with DD, 114 subjects with paranoid SZ and 244 subjects with non-paranoid SZ on 52 characteristics from several domains including demographics, risk factors, premorbid features, illness characteristics, index episode features, delusional-related features, response to treatment and outcome. In a further step, we searched for independent associations of the examined characteristics with DD v. SZ. Univariate analyses showed that DD differed from either form of SZ in 40 characteristics, the pattern of findings indicated that paranoid SZ was much more similar to non-paranoid SZ than DD. Relative to subjects with SZ, those with DD were more likely to have drug abuse before illness onset, better premorbid sexual adjustment, later age at illness onset, higher levels of affective symptoms and lack of insight, poorer response to antipsychotic medication, better functioning in the domains of personal care, paid work and social functioning; last, subjects with DD had fewer but more severe delusions and higher ratings of conviction of delusional experience than those with SZ. Predominance of jealousy and somatic delusions was confined to subjects with DD. DD and SZ represent two distinct classes of disorders, the differential features of DD being of nosological, aetiological and therapeutic relevance.

  16. A controlled study of formal thought disorder in children with autism and multiple complex developmental disorders.

    NARCIS (Netherlands)

    Gaag, R.J. van der; Caplan, R.; Engeland, H. van; Loman, F.

    2005-01-01

    Along with well-defined categories in classification systems (e.g., autistic disorders and attention-deficit/hyperactivity disorder (ADHD)), practitioners are confronted with many children showing mixed forms of developmental psychopathology. These clusters of symptoms are on the borderlines of more

  17. Multiple personality disorder and iatrogenesis: the cautionary tale of Anna O.

    Science.gov (United States)

    Weissberg, M

    1993-01-01

    An examination of Breuer's treatment of Anna O. illustrates some of the controversies surrounding the recent rise of case reports of multiple personality disorder. Anna O., the first patient of the cathartic method, psychoanalysis, and dynamic psychiatry, fits current criteria for multiple personality disorder. Breuer's treatment, however, may have contributed to her states of absence; the timing, type, and intensity of Breuer's interventions make it possible that he unwittingly encouraged and amplified Anna's dissociations, reified her ego fragments, and then explained Anna's symptoms with the pseudomemories and confabulations recovered from Anna while she was hypnotized. A review of Breuer's treatment highlights some of the controversial aspects of multiple personality disorder, specifically its possible vulnerability to iatrogenesis via suggestion and unconscious collusion and other factors. The current stance of some multiple personality disorder enthusiasts, opaque to their participation in interactions that may lead to certain patient productions, resembles the older psychoanalytic stance exemplified by the early Breuer and Freud. The dialectic of the therapist as a neutral observer versus as an influential participant continues to be a focus of controversy, both within psychoanalysis and psychotherapy and in the understandings of the etiology and treatment of multiple personality disorder.

  18. Nature and Specificity of Gestural Disorder in Children with Developmental Coordination Disorder: A Multiple Case Study

    Directory of Open Access Journals (Sweden)

    Orianne Costini

    2017-07-01

    Full Text Available Aim: Praxis assessment in children with developmental coordination disorder (DCD is usually based on tests of adult apraxia, by comparing across types of gestures and input modalities. However, the cognitive models of adult praxis processing are rarely used in a comprehensive and critical interpretation. These models generally involve two systems: a conceptual system and a production system. Heterogeneity of deficits is consistently reported in DCD, involving other cognitive skills such as executive or visual-perceptual and visuospatial functions. Surprisingly, few researches examined the impact of these functions in gestural production. Our study aimed at discussing the nature and specificity of the gestural deficit in DCD using a multiple case study approach.Method: Tasks were selected and adapted from protocols proposed in adult apraxia, in order to enable a comprehensive assessment of gestures. This included conceptual tasks (knowledge about tool functions and actions; recognition of gestures, representational (transitive, intransitive, and non-representational gestures (imitation of meaningless postures. We realized an additional assessment of constructional abilities and other cognitive domains (executive functions, visual-perceptual and visuospatial functions. Data from 27 patients diagnosed with DCD were collected. Neuropsychological profiles were classified using an inferential clinical analysis based on the modified t-test, by comparison with 100 typically developing children divided into five age groups (from 7 to 13 years old.Results: Among the 27 DCD patients, we first classified profiles that are characterized by impairment in tasks assessing perceptual visual or visuospatial skills (n = 8. Patients with a weakness in executive functions (n = 6 were then identified, followed by those with an impaired performance in conceptual knowledge tasks (n = 4. Among the nine remaining patients, six could be classified as having a visual

  19. Laminopathies: Multiple disorders arising from defects in nuclear architecture

    Indian Academy of Sciences (India)

    Veena K Parnaik; Kaliyaperumal Manju

    2006-09-01

    Lamins are the major structural proteins of the nucleus in an animal cell. In addition to being essential for nuclear integrity and assembly, lamins are involved in the organization of nuclear processes such as DNA replication, transcription and repair. Mutations in the human lamin A gene lead to highly debilitating genetic disorders that primarily affect muscle, adipose, bone or neuronal tissues and also cause premature ageing syndromes. Mutant lamins alter nuclear integrity and hinder signalling pathways involved in muscle differentiation and adipocyte differentiation, suggesting tissue-specific roles for lamins. Furthermore, cells expressing mutant lamins are impaired in their response to DNA damaging agents. Recent reports indicate that certain lamin mutations act in a dominant negative manner to cause nuclear defects and cellular toxicity, and suggest a possible role for aberrant lamins in normal ageing processes.

  20. Ethnopharmacological evaluation of Cenchrus ciliaris for multiple gastrointestinal disorders

    Directory of Open Access Journals (Sweden)

    Ambreen Aleem

    2017-06-01

    Full Text Available This study was conducted to rationalize the traditional uses of Cenchrus ciliaris in gastrointestinal disorders using in vivo and ex vivo assays. The antidiarrheal effect was evaluated in rats by the castor oil-induced diarrheal model. C. ciliaris (100, 300 and 500 mg/kg reduced the castor oil-induced diarrhea significantly. Another study carried out in mice to determine the intestinal transit rate showed that C. ciliaris (100 and 200 mg/kg inhibited the transit rate significantly. Ex vivo assay demonstrated that C. ciliaris (0.01–1 mg/mL relaxed the spontaneous and K+ (80 mM-induced contractions, like verapamil. The crude extract (75, 100 and 150 mg/kg also exhibited significant anti-emetic activity in chicks. These results indicate the presence of antispasmodic, antidiarrheal and antiemetic activities in C. ciliaris, thus providing the scientific basis for its traditional uses.

  1. Distinguishing between multiple personality disorder (dissociative identity disorder) and schizophrenia using the Structured Clinical Interview for DSM-IV Dissociative Disorders.

    Science.gov (United States)

    Steinberg, M; Cicchetti, D; Buchanan, J; Rakfeldt, J; Rounsaville, B

    1994-09-01

    The authors describe the systematic assessment of dissociative symptoms using the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D) in 50 psychiatric outpatients with a referring DSM-III-R diagnosis of either schizophrenia or schizoaffective disorder (N = 31) and subjects with multiple personality disorder (MPD [DSM-IV name change: dissociative identity disorder]; N = 19). Results indicate that patients with MPD experience significantly higher scores for five specific dissociative symptoms than patients with schizophrenia or schizoaffective disorder. The range, severity, and nature of the five dissociative symptom areas evaluated by the SCID-D distinguish MPD from the occasional occurrence of dissociative symptoms which may be seen in schizophrenia. Systematic assessment of dissociative symptoms using the SCID-D can assist in accurate differential diagnosis of MPD and schizophrenia.

  2. Learning from extremism in the history of mental health. The example of multiple personality disorder.

    Science.gov (United States)

    Mohr, Wanda K

    2002-05-01

    This article reviews some of the history of the cultural forces that shaped the diagnosis of multiple personality disorder/dissociative identity disorder and the subsequent abuses that occurred at the time of its popularization. Some of the implications that can be drawn from these kinds of historical excesses in the field of mental health will be discussed. The article concludes by underscoring the ethical obligation inherent in maintaining healthy professional skepticism toward ideas driven by ideology and fad, rather than scientific empiricism.

  3. The effects of a multiple family therapy on adolescents with eating disorders: an outcome study.

    Science.gov (United States)

    Gelin, Zoé; Fuso, Silvana; Hendrick, Stephan; Cook-Darzens, Solange; Simon, Yves

    2015-03-01

    Multiple Family Therapy (MFT) has gained increasing popularity in the treatment of eating disorders and many programs have been developed over the past decade. Still, there is little evidence in the literature on the effectiveness on MFT for treating eating disorders. The present study examines the effects of a particular model of Multiple Family Therapy on eating disorder symptoms, quality of life, and percentage of Expected Body Weight (%EBW) in adolescents with eating disorders (ED). Eighty-two adolescents with ED, aged between 11 and 19 years, were assessed before and after treatment using the Eating Disorders Inventory 2 (EDI-2), the Outcome Questionnaire 45 (OQ-45) and %EBW. Results showed a significant increase in %EBW between the beginning and end of treatment, with a large effect size. 52.4% of patients achieved an EBW above 85%. Symptoms relative to all EDI dimensions (except for bulimia) significantly decreased during treatment. The three dimensions related to quality of life assessment also improved over the course of MFT. At the end of treatment, 70.7% of patients had a total OQ-45 score below clinical significance. This study suggests that Multiple Family Therapy may benefit adolescents with eating disorders, with improvement on several outcome measures (%EBW, ED symptoms, and quality of life). However, the lack of a comparison group entails caution when drawing conclusions. © 2014 Family Process Institute.

  4. Disorder chaos and multiple valleys in spin glasses

    CERN Document Server

    Chatterjee, Sourav

    2009-01-01

    We prove that the Sherrington-Kirkpatrick model of spin glasses is chaotic under small perturbations of the couplings at any temperature in the absence of an external field. The result is proved for two kinds of perturbations: (a) distorting the couplings via Ornstein-Uhlenbeck flows, and (b) replacing a small fraction of the couplings by independent copies. We further prove that the S-K model exhibits multiple valleys in its energy landscape, i.e. there are many states with near-minimal energy that are mutually nearly orthogonal. We show that the variance of the free energy of the S-K model is unusually small at any temperature. (By `unusually small' we mean that it is much smaller than the number of sites; in other words, it beats the classical Gaussian concentration inequality, a phenomenon that we call `superconcentration'.) We prove that the bond overlap in the Edwards-Anderson model of spin glasses is not chaotic under perturbations of the couplings, even large perturbations. Lastly, we obtain sharp low...

  5. Case Study: Camptocormia, a Rare Conversion Disorder.

    Science.gov (United States)

    Rajmohan, Velayudhan; Thomas, Biju; Sreekumar, Kumaran

    2004-01-01

    Camptocormia is a condition characterized by severe frontal flexion of the spinal cord and knees, with passive drooping of both arms. It occurs as a form of conversion disorder. Some cases are associated with behavioral problems. A case of camptocormia of 2-year duration in a south Indian adolescent girl with oppositional defiant disorder and…

  6. The epigenetics of multiple sclerosis and other related disorders.

    Science.gov (United States)

    van den Elsen, Peter J; van Eggermond, Marja C J A; Puentes, Fabiola; van der Valk, Paul; Baker, David; Amor, Sandra

    2014-03-01

    Multiple Sclerosis (MS) is a demyelinating disease characterized by chronic inflammation of the central nervous system (CNS) gray and white matter. Although the cause of MS is unknown, it is widely appreciated that innate and adaptive immune processes contribute to its pathogenesis. These include microglia/macrophage activation, pro-inflammatory T-cell (Th1) responses and humoral responses. Additionally, there is evidence indicating that MS has a neurodegenerative component since neuronal and axonal loss occurs even in the absence of overt inflammation. These aspects also form the rationale for clinical management of the disease. However, the currently available therapies to control the disease are only partially effective at best indicating that more effective therapeutic solutions are urgently needed. It is appreciated that in the immune-driven and neurodegenerative processes MS-specific deregulation of gene expressions and resulting protein dysfunction are thought to play a central role. These deviations in gene expression patterns contribute to the inflammatory response in the CNS, and to neuronal or axonal loss. Epigenetic mechanisms control transcription of most, if not all genes, in nucleated cells including cells of the CNS and in haematopoietic cells. MS-specific alterations in epigenetic regulation of gene expression may therefore lie at the heart of the deregulation of gene expression in MS. As such, epigenetic mechanisms most likely play an important role in disease pathogenesis. In this review we discuss a role for MS-specific deregulation of epigenetic features that control gene expression in the CNS and in the periphery. Furthermore, we discuss the application of small molecule inhibitors that target the epigenetic machinery to ameliorate disease in experimental animal models, indicating that such approaches may be applicable to MS patients.

  7. Conformity in the Asch Experiment: Inner-Other Directedness and the "Defiant Subject".

    Science.gov (United States)

    Lamb, Theodore A.; Alsikafi, Majeed

    1980-01-01

    The more other-directed, the more subjects tended to conform. These conformity rates were higher than previous studies. When replications of well-known experiments are conducted, there is increased need for debriefing because of the apparent defiant subject effect. (Author/JAC)

  8. Enjoyment and Consumption of Defiant Rock Music as a Function of Adolescent Rebelliousness.

    Science.gov (United States)

    Bleich, Susan; And Others

    1991-01-01

    Discussion of adolescent rebelliousness highlights a study of high school students that explored the relationship between rebelliousness as a personality trait and the enjoyment of defiant rock music. Hypotheses tested are discussed, the use of MTV concept music videos is explained, gender differences are considered, and further research is…

  9. Fifty Strategies for Counseling Defiant, Aggressive Adolescents: Reaching, Accepting, and Relating.

    Science.gov (United States)

    Hanna, Fred J.; Hanna, Constance A.; Keys, Susan G.

    1999-01-01

    Takes a transtheoretical approach using ideas from cognitive behavioral, existential, Gestalt, psychodynamic, and multicultural therapies to describe both new and established strategies for relationships building with defiant youth. Arranges strategies in three categories: reaching, accepting, and relating. Suggestions for counselors when working…

  10. Marital and Family Therapy in the Treatment of Multiple Personality Disorder.

    Science.gov (United States)

    Sachs, Roberta G.; And Others

    1988-01-01

    Explores marital and family therapy in treatment of Multiple Personality Disorder (MPD), discussing role of family of origin in MPD development and role of nuclear family in its perpetuation. Suggests family and marital interventions, illustrating them with case examples. Proposes involving MPD client in marital or family therapy, in addition to…

  11. Outpatient Art Therapy with Multiple Personality Disorder: A Survey of Current Practice.

    Science.gov (United States)

    Mills, Anne

    1995-01-01

    Reports findings of a 1993 questionnaire completed by 46 North American art therapists that focuses on the outpatient treatment of multiple personality disorder. Includes information on role in diagnosing, fees and third-party payment, and therapeutic activities. Treatment issues include pacing and containment, and managing the client's chronic…

  12. Childhood Trauma and Multiple Personality Disorder: The Case of a 9-Year-Old Girl.

    Science.gov (United States)

    LaPorta, Lauren D.

    1992-01-01

    This paper reports the case of a nine-year-old female victim of sexual abuse, evaluated and diagnosed with multiple personality disorder over a six-month period. Included is a description of the child's presentation with historical and developmental data. A discussion of the dynamic and predisposing features of the case follows, along with…

  13. Hitting Closer to Home: A Multiple Family Prevention Group for Adolescent Disordered Eating

    Science.gov (United States)

    Clemency, Colleen E.; Rayle, Andrea Dixon

    2006-01-01

    This article presents an innovative multiple family psychoeducational group for the prevention of disordered eating among adolescent females. An overview of the concerns facing adolescents today is presented, including sociocultural norms, body dissatisfaction associated with pubertal changes, teasing regarding weight and shape, and family…

  14. Childhood Trauma and Multiple Personality Disorder: The Case of a 9-Year-Old Girl.

    Science.gov (United States)

    LaPorta, Lauren D.

    1992-01-01

    This paper reports the case of a nine-year-old female victim of sexual abuse, evaluated and diagnosed with multiple personality disorder over a six-month period. Included is a description of the child's presentation with historical and developmental data. A discussion of the dynamic and predisposing features of the case follows, along with…

  15. Outpatient Art Therapy with Multiple Personality Disorder: A Survey of Current Practice.

    Science.gov (United States)

    Mills, Anne

    1995-01-01

    Reports findings of a 1993 questionnaire completed by 46 North American art therapists that focuses on the outpatient treatment of multiple personality disorder. Includes information on role in diagnosing, fees and third-party payment, and therapeutic activities. Treatment issues include pacing and containment, and managing the client's chronic…

  16. Marital and Family Therapy in the Treatment of Multiple Personality Disorder.

    Science.gov (United States)

    Sachs, Roberta G.; And Others

    1988-01-01

    Explores marital and family therapy in treatment of Multiple Personality Disorder (MPD), discussing role of family of origin in MPD development and role of nuclear family in its perpetuation. Suggests family and marital interventions, illustrating them with case examples. Proposes involving MPD client in marital or family therapy, in addition to…

  17. Prevalence and classification of hallucinations in multiple sensory modalities in schizophrenia spectrum disorders

    NARCIS (Netherlands)

    Lim, Anastasia; Hoek, Hans W.; Deen, Mathijs L.; Blom, Jan Dirk

    2016-01-01

    Background: Auditory hallucinations are experienced by 60-80% of all patients diagnosed with a schizophrenia spectrum disorder. However, in this patient group, the prevalence of hallucinations in multiple sensory modalities, i.e. multimodal hallucinations (MMHs), is unknown. Aims: To assess the

  18. Prevalence and classification of hallucinations in multiple sensory modalities in schizophrenia spectrum disorders

    NARCIS (Netherlands)

    Lim, Anastasia; Hoek, Hans W.; Deen, Mathijs L.; Blom, Jan Dirk; Bruggeman, Richard; Cahn, Wiepke; de Haan, Lieuwe; Kahn, René S.; Meijer, Carin J.; Myin-Germeys, Inez; van Os, Jim; Wiersma, Durk

    2016-01-01

    Background Auditory hallucinations are experienced by 60–80% of all patients diagnosed with a schizophrenia spectrum disorder. However, in this patient group, the prevalence of hallucinations in multiple sensory modalities, i.e. multimodal hallucinations (MMHs), is unknown. Aims To assess the

  19. Soliton pulse propagation in the presence of disorder-induced multiple scattering in photonic crystal waveguides

    CERN Document Server

    Mann, Nishan

    2016-01-01

    We introduce a new coupled mode theory to model nonlinear Schr\\"{o}dinger equations for contra-propagating Bloch modes that include disorder-induced multiple scattering effects on nonlinear soliton propagation in photonic crystal waveguides. We also derive sub unit-cell coupling coefficients and use these to introduce a generalized length scale associated with each coupling effect. In particular, we define a multiple-scattering length scale that quantifies the spatial extent of a disorder-induced cavity mode. Our numerical simulations of nonlinear pulse propagation are in excellent qualitative agreement with recent experiments and provide insight into how disorder inhibits soliton propagation and other nonlinear propagation effects in photonic crystal waveguides.

  20. School Counselors Serving Students with Disruptive Behavior Disorders

    Science.gov (United States)

    Grothaus, Tim

    2013-01-01

    School counselors are in a prime position to collaborate with school and community stakeholders to both prevent and respond to the challenges experienced and exhibited by students with one or more disruptive behavior disorders (DBD). In this article, the DBDs discussed include conduct disorder, oppositional defiant disorder, intermittent explosive…

  1. Rethinking the comparison of borderline personality disorder and multiple personality disorder.

    Science.gov (United States)

    Marmer, S S; Fink, D

    1994-12-01

    This article has made a number of points that assert what is today a minority position within the fields of MPD/DID and BPD. We hope our views will stimulate attempts by others to rethink their positions and test our assertions, so that issues surrounding these two disorders can be sharpened. For the sake of the clarity of future work, we summarize in outline form the essence of our viewpoint. 1. BPD and MPD/DID have similar appearing symptoms, such as identity problems, unstable affect modulation, self-destructive behaviors, chaotic impulse control, and troubled interpersonal relationships, but they have decisive differences in underlying dynamics, process, and structure. 2. DSM tends to blur these two disorders by its emphasis on phenomenology over inner structure, thus fostering misleading conclusions when DSM criteria are used to test for comorbidity or overlap between BPD and MPD/DID. 3. BPD and MPD/DID are both described dynamically as using the defense of splitting, but we contend that the splitting in each disorder is fundamentally different from the splitting in the other. BPD uses a polarization form of splitting, whereas MPD/DID uses ego splitting or identity division. 4. Both disorders partake in the process of dissociation, but the quality of dissociation in BPD is a "low-tech" spaced out type, whereas that of MPD/DID is a "high-tech" waking dream. 5. BPD structure is also "low tech," with polarization of self, object, and relationship. MPD/DID structure is "high tech," with heavily symbolic, highly nuanced variations of self, object, and relationship. 6. Although both conditions have etiologic elements of trauma, BPD has a larger degree of developmental deficiency, with a failure to complete the task of entering a repression hierarchy of defenses. MPD/DID, by use of primary process-linked symbolic dissociation, is able to continue development to the repression hierarchy, although at a profound cost of simultaneous suspension of reality testing. BPD

  2. Confirmation of childhood abuse in child and adolescent cases of multiple personality disorder and dissociative disorder not otherwise specified.

    Science.gov (United States)

    Coons, P M

    1994-08-01

    The diagnostic validity of multiple personality disorder (MPD) and its association to trauma have been questioned because corroboration of child abuse in studies of patients with MPD is scant. The purpose of this study was to determine on a retrospective basis whether external corroboration of child abuse could be found in a group of patients with MPD and dissociative disorder not otherwise specified. A group of child and adolescent psychiatric inpatients and outpatients was chosen because of the extensive number of collateral records collected on them in a tertiary care setting. This group was also chosen because of the intense interest paid by child protective services and courts to child abuse during the past 15 years. This retrospective chart review confirmed child abuse in eight of nine patients with MPD and in all 12 cases of dissociative disorder not otherwise specified. This study provides further evidence of the association of severe dissociative disorders with trauma, particularly child abuse. Future studies should be prospective and blinded to avoid the possibility of investigator bias, and should include a control group for comparison of base rate of child abuse.

  3. Schema therapy for personality disorders in older adults: a multiple-baseline study.

    Science.gov (United States)

    Videler, Arjan C; van Alphen, Sebastiaan P J; van Royen, Rita J J; van der Feltz-Cornelis, Christina M; Rossi, Gina; Arntz, Arnoud

    2017-04-21

    No studies have been conducted yet into the effectiveness of treatment of personality disorders in later life. This study is a first test of the effectiveness of schema therapy for personality disorders in older adults. Multiple-baseline design with eight cluster C personality disorder patients, with a mean age of   69. After a baseline phase with random length, schema therapy was given during the first year, followed by follow-up sessions during six months. Participants weekly rated the credibility of dysfunctional core beliefs. Symptomatic distress, early maladaptive schemas, quality of life and target complaints were assessed every six months and personality disorder diagnosis was assessed before baseline and after follow-up. Data were analyzed with mixed regression analyses. Results revealed significant linear trends during treatment phases, but not during baseline and follow-up. The scores during follow-up remained stable and were significantly lower compared to baseline, with high effect sizes. Seven participants remitted from their personality disorder diagnosis. Schema therapy appears an effective treatment for cluster C personality disorders in older adults. This finding is highly innovative as this is the first study exploring the effectiveness of psychotherapy, in this case schema therapy, for personality disorders in older adults.

  4. Do childhood externalizing disorders predict adult depression? A meta-analysis.

    Science.gov (United States)

    Loth, Annemarie K; Drabick, Deborah A G; Leibenluft, Ellen; Hulvershorn, Leslie A

    2014-10-01

    Childhood externalizing disorders have been linked to adult affective disorders, although some studies fail to substantiate this finding. Multiple longitudinal cohort studies identifying childhood psychopathology and their association with adult psychiatric illness have been published. To examine the association between childhood externalizing symptoms or disorders and the development of adult depression across cohorts, a meta-analysis was performed. Potential studies were identified using a PubMed search through November 2013. All published, prospective, longitudinal, community-sampled cohort studies of children (≤ 13 years) with externalizing symptoms or disorders (aggression, conduct problems, oppositional defiant disorder, conduct disorder), reassessed in adulthood (≥ 18 years) for depressive disorders (major depressive disorder, depressive disorder NOS, or dysthymic disorder) were included. A random effects model was used to summarize the pooled effect sizes. Ancillary analyses considered covariates that could account for variance among studies. Ten studies representing eight cohorts of children initially assessed at age 13 or younger (N = 17,712) were included in the meta-analysis. Childhood externalizing behavior was associated with adult depressive disorders (OR = 1.52, 95% confidence interval = 1.27-1.80, p < 0.0001). Utilizing Orwin's Fail-safe N approach, 263 studies with a mean odds ratio of 1.0 would have to be added to the analysis before the cumulative effect would become trivial. Externalizing psychopathology in childhood is associated with the development of unipolar depressive disorders in adulthood.

  5. Systems of Selves: the Construction of Meaning in Multiple Personality Disorder

    Science.gov (United States)

    Hughes, Dureen Jean

    Current models for understanding both Multiple Personality Disorder and human mentation in general are both linear in nature and self-perpetuating insofar as most research in this area has been informed and shaped by extant psychological concepts, paradigms and methods. The research for this dissertation made use of anthropological concepts and methods in an attempt to gain a richer understanding of both multiple personality and fundamental universal processes of the mind. Intensive fieldwork using in-depth, open-ended interviewing techniques was conducted with people diagnosed with Multiple Personality Disorder with the purpose of mapping their personality systems in order to discover the nature of the relationships between the various alternate personalities and subsystems comprising the overall personality systems. These data were then analyzed in terms of dynamical systems theory ("Chaos Theory") as a way of understanding various phenomena of multiple personality disorder as well as the overall structure of each system. It was found that the application of the formal characteristics of nonlinear models and equations to multiple personality systems provided a number of new perspectives on mental phenomena. The underlying organizational structure of multiple personality systems can be understood as a phenomenon of spontaneous self-organization in far-from -equilibrium states which characterizes dissipative structures. Chaos Theory allows the perspective that the nature of the process of the self and the nature of relationship are one and the same, and that both can be conceived as ideas in struggle at a fractal boundary. Further, such application makes it possible to postulate an iterative process which would have as one of its consequences the formation of a processural self who is conscious of self as separate self. Finally, given that the iterative application of a few simple rules (or instructions) can result in complex systems, an attempt was made to discern

  6. [Multiple personality disorder. Presentation of 2 cases and a model of the etiology].

    Science.gov (United States)

    Pfeifer, S; Brenner, L; Spengler, W

    1994-09-01

    Although the syndrome of Multiple Personality Disorder (MPD) has received much interest in the international literature, there have been virtually no professional articles on the topic in German over the last 70 years. This is a report on two cases with nine and 70 persons respectively. Both had undergone severe and prolonged sexual abuse in childhood. Compared with DSM-III-R, the ICD-10 criteria seem to reflect historic reports on alternating personalities rather than recent empirical research on multiple personality. The proposed etiological model postulates that extreme trauma in childhood can result in dissociative vulnerability persisting into adulthood.

  7. Experience of gratitude, awe and beauty in life among patients with multiple sclerosis and psychiatric disorders

    DEFF Research Database (Denmark)

    Büssing, Arndt; Wirth, Anne Gritli; Reiser, Franz

    2014-01-01

    in life among patients with multiple sclerosis and psychiatric disorders, particularly with respect to their engagement in specific spiritual/religious practices and their life satisfaction. Methods: We conducted a cross-sectional survey with standardized questionnaires to measure engagement in various...... spiritual practices (SpREUK-P) and their relation to experiences of Gratitude, Awe and Beauty in Life and life satisfaction (BMLSS-10). In total, 461 individuals (41 +/- 13 years; 68% women) with multiple sclerosis (46%) and depressive (22%) or other psychiatric disorders (32%) participated. Results: Among......Background: Feelings of gratitude and awe facilitate perceptions and cognitions that go beyond the focus of illness and include positive aspects of one's personal and interpersonal reality, even in the face of disease. We intended to measure feelings of gratitude, awe, and experiences of beauty...

  8. BIOFEEDBACK: A NEW METHOD FOR CORRECTION OF MOTOR DISORDERS IN PATIENTS WITH MULTIPLE SCLEROSIS

    Directory of Open Access Journals (Sweden)

    Ya. S. Pekker

    2014-01-01

    Full Text Available Major disabling factors in multiple sclerosis is motor disorders. Rehabilitation of such violations is one of the most important medical and social problems. Currently, most of the role given to the development of methods for correction of motor disorders based on accessing natural resources of the human body. One of these methods is the adaptive control with biofeedback (BFB. The aim of our study was the correction of motor disorders in multiple sclerosis patients using biofeedback training. In the study, we have developed scenarios for training rehabilitation program computer EMG biofeedback aimed at correction of motor disorders in patients with multiple sclerosis (MS. The method was tested in the neurological clinic of SSMU. The study included 9 patients with definite diagnosis of MS with the presence of the clinical picture of combined pyramidal and cerebellar symptoms. Assessed the effectiveness of rehabilitation procedures biofeedback training using specialized scales (rating scale functional systems Kurtzke; questionnaire research quality of life – SF-36, evaluation of disease impact Profile – SIP and score on a scale fatigue – FSS. In the studied group of patients decreased score on a scale of fatigue (FSS, increased motor control (SIP2, the physical and mental components of health (SF-36. The tendency to reduce the amount of neurological deficit by reducing the points on the pyramidal Kurtske violations. Analysis of the exchange rate dynamics of biofeedback training on EMG for trained muscles indicates an increase in the recorded signal OEMG from session to session. Proved a tendency to increase strength and coordination trained muscles of patients studied.Positive results of biofeedback therapy in patients with MS can be recommended to use this method in the complex rehabilitation measures to correct motor and psycho-emotional disorders.

  9. On a Diagnosed Case of Multiple Personality Disorder -A Supplementary Report with Special Reference to Psychotherapy-

    OpenAIRE

    藤田, 裕司

    2000-01-01

    As a supplement of the study on a dignosed case of MPD (Multiple Personality Disorder), the effect of the psychotherapy was discussed. The patient was a twenty-four-year-old woman suspected of an attempted murder. In this article, continued from the previous one reporting the process of a series of ten psychotherapeutic interviews with her, the general comment on that was made, and the merits and demerits of the psychotherapy were clarified.

  10. Th17 Cells Pathways in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders: Pathophysiological and Therapeutic Implications

    OpenAIRE

    Giordani Rodrigues Dos Passos; Douglas Kazutoshi Sato; Jefferson Becker; Kazuo Fujihara

    2016-01-01

    Several animal and human studies have implicated CD4+ T helper 17 (Th17) cells and their downstream pathways in the pathogenesis of central nervous system (CNS) autoimmunity in multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD), challenging the traditional Th1-Th2 paradigm. Th17 cells can efficiently cross the blood-brain barrier using alternate ways from Th1 cells, promote its disruption, and induce the activation of other inflammatory cells in the CNS. A number of e...

  11. Assessing the criminal responsibility of individuals with multiple personality disorder: legal cases, legal theory.

    Science.gov (United States)

    Behnke, S H

    1997-01-01

    This article discusses the criminal responsibility of individuals diagnosed with multiple personality disorder (MPD). First, it reviews how courts understand and assess criminal responsibility. Second, it gives an overview of how courts have applied the doctrine of criminal responsibility to individuals with MPD. Third, it explains what legal theorists say about this question. Finally, it uses a case example to illustrate how various theorists would assess the responsibility of a criminal defendant with MPD.

  12. Three dimensions of oppositionality in autism spectrum disorder.

    Science.gov (United States)

    Mandy, William; Roughan, Laura; Skuse, David

    2014-02-01

    In autism spectrum disorder (ASD), symptoms of oppositional defiant disorder (ODD) are common but poorly understood. DSM-5 has adopted a tripartite model of ODD, parsing its features into 'angry and irritable symptoms' (AIS), 'argumentative and defiant behavior' (ADB) and 'vindictiveness'. This was based on findings in non-autistic populations that each of these dimensions of oppositionality has a distinct constellation of associations with internalising and externalising psychopathology. We applied the tripartite DSM-5 ODD model to ASD to test its generalisability beyond non-ASD populations; and to elucidate the nature of ODD symptoms in ASD. Participants were 216 verbally-fluent young people (mean age = 9.6 years, range 3.0 to 16.2 years, 82 % male) with ASD. Cross-sectional parent-and teacher-report data were analysed using bootstrap multiple regression to test the following predictions, derived from studies of non-ASD young people: (1) AIS will be the main predictor of internalising problems; (2) ADB will be the main predictor of ADHD symptoms; (3) all ODD traits will independently predict conduct disorder symptoms; (4) vindictiveness will be the main predictor of aggressive conduct problems. Our findings using both parent and teacher data were consistent with the non-ASD ODD literature. AIS were associated with internalising but not externalising problems; ADB and vindictiveness were associated with externalising but not internalising problems; and vindictiveness was the main predictor of aggression. The DSM-5 tripartite model of ODD appears to be generalisable to ASD: for people with an autistic disorder, AIS, ADB and vindictive dimensions of oppositionality have distinct associations with concurrent psychopathology, suggesting the need to assess them as separate constructs.

  13. Effect of Attachment-Based Therapy on Behavioral Disorders in Girls with Attachment Problems

    Directory of Open Access Journals (Sweden)

    Marzieh Jahanbakhsh

    2014-09-01

    Full Text Available Background: Multidimensional and complex nature of children`s behavioral disorders requires assessment and usage of modern treatments. The present study investigated the effects of attachment-based therapy on behavioral disorders (depression, over anxiety and oppositional defiant in girl students of primary school who had attachment problems. Materials and Methods: This study is an empirical plan with pretest-posttest and control group. The target samples were 34 individuals of 388 second and fourth grade students of primary school that had highest scores on attachment problems and behavioral disorders (depression, over anxiety and oppositional defiant. Evaluation implemented using Randolph attachment disorder questionnaire (RADQ and Ontario mental health test. Mothers were presented in 10 group sessions of attachment-based intervention and its effects investigated in their girl`s behavioral disorders (depression, over anxiety and oppositional defiant. Results: Reduction rate of behavioral disorders general scores (depression, over anxiety and oppositional defiant of experimental group compared with control group showed significant decreases in posttest and three months follow up. Conclusion: The attachment based therapy offered for mothers of the girls with attachment problems was effective to reduction of behavioral disorders (depression, over anxiety and oppositional defiant symptoms in their children and the mother`s continues attention to interventional methods showed more improvement in follow up evaluation.

  14. Assessing Eating Disorder Symptoms in Adolescence: Is There a Role for Multiple Informants?

    Science.gov (United States)

    Swanson, SA; Aloisio, KM; Horton, NJ; Sonneville, KR; Crosby, RD; Eddy, KT; Field, AE; Micali, N

    2014-01-01

    disorder presentations may be improved by using multiple sources of information. PMID:24436213

  15. An uncommon disorder with multiple skeletal anomalies: Gorlin-Goltz syndrome.

    Science.gov (United States)

    Keçeli, Onur; Coskun-Benlidayı, İlke; Benlidayı, M Emre; Erdoğan, Özgür

    2014-01-01

    Gorlin-Goltz syndrome is an uncommon disorder transmitted through autosomal dominant inheritance. This syndrome is characterized by multiple odontogenic keratocysts, along with congenital skeletal anomalies and basal cell carcinomas. A 16-year-old girl was admitted with a complaint of swelling on the lower jaw. She had multiple basal cell nevi on both hands. Multiple lytic bone lesions on radiographs were defined as odontogenic keratocysts following the biopsy. The patient was referred to the Department of Physical Medicine and Rehabilitation for detailed musculoskeletal evaluation. Adam's forward bend test revealed a hump on the right side representing right thoracic scoliosis. Cervical kyphosis, thoracic lordosis and scoliosis, bifid rib and sacral and lumbar spina bifida on plain radiographs led to the diagnosis of Gorlin-Goltz syndrome. Since early diagnosis may provide optimum surveillance for related neoplasms, it is of paramount importance for pediatricians as well as physicians dealing with the musculoskeletal system to be aware of this rare condition.

  16. The Relationship Between Multiple Sex Partners and Anxiety, Depression, and Substance Dependence Disorders: A Cohort Study

    Science.gov (United States)

    Paul, Charlotte; Bell, Melanie L.; Dickson, Nigel; Moffitt, Terrie E.; Caspi, Avshalom

    2013-01-01

    Changes in sexual behavior have resulted in longer periods of multiple serial or concurrent relationships. This study investigated the effects of multiple heterosexual partners on mental health, specifically, whether higher numbers of partners were linked to later anxiety, depression, and substance dependency. Data from the Dunedin Multidisciplinary Health and Development Study, a prospective, longitudinal study of a birth cohort born in 1972–1973 in Dunedin, New Zealand were used. The relationship between numbers of sex partners over three age periods (18–20, 21–25, and 26–32 years) and diagnoses of anxiety, depression, and substance dependence disorder at 21, 26, and 32 years were examined, using logistic regression. Interaction by gender was examined. Adjustment was made for prior mental health status. There was no significant association between number of sex partners and later anxiety and depression. Increasing numbers of sex partners were associated with increasing risk of substance dependence disorder at all three ages. The association was stronger for women and remained after adjusting for prior disorder. For women reporting 2.5 or more partners per year, compared to 0–1 partners, the adjusted odd ratios (and 95 % CIs) were 9.6 (4.4–20.9), 7.3 (2.5–21.3), and 17.5 (3.5–88.1) at 21, 26, and 32 years, respectively. Analyses using new cases of these disorders showed similar patterns. This study established a strong association between number of sex partners and later substance disorder, especially for women, which persisted beyond prior substance use and mental health problems more generally. The reasons for this association deserve investigation. PMID:23400516

  17. The relationship between multiple sex partners and anxiety, depression, and substance dependence disorders: a cohort study.

    Science.gov (United States)

    Ramrakha, Sandhya; Paul, Charlotte; Bell, Melanie L; Dickson, Nigel; Moffitt, Terrie E; Caspi, Avshalom

    2013-07-01

    Changes in sexual behavior have resulted in longer periods of multiple serial or concurrent relationships. This study investigated the effects of multiple heterosexual partners on mental health, specifically, whether higher numbers of partners were linked to later anxiety, depression, and substance dependency. Data from the Dunedin Multidisciplinary Health and Development Study, a prospective, longitudinal study of a birth cohort born in 1972-1973 in Dunedin, New Zealand were used. The relationship between numbers of sex partners over three age periods (18-20, 21-25, and 26-32 years) and diagnoses of anxiety, depression, and substance dependence disorder at 21, 26, and 32 years were examined, using logistic regression. Interaction by gender was examined. Adjustment was made for prior mental health status. There was no significant association between number of sex partners and later anxiety and depression. Increasing numbers of sex partners were associated with increasing risk of substance dependence disorder at all three ages. The association was stronger for women and remained after adjusting for prior disorder. For women reporting 2.5 or more partners per year, compared to 0-1 partners, the adjusted odd ratios (and 95 % CIs) were 9.6 (4.4-20.9), 7.3 (2.5-21.3), and 17.5 (3.5-88.1) at 21, 26, and 32 years, respectively. Analyses using new cases of these disorders showed similar patterns. This study established a strong association between number of sex partners and later substance disorder, especially for women, which persisted beyond prior substance use and mental health problems more generally. The reasons for this association deserve investigation.

  18. Estimated Risk of Developing Selected DSM-IV Disorders among 5-Year-Old Children with Prenatal Cocaine Exposure

    Science.gov (United States)

    Morrow, Connie E.; Accornero, Veronica H.; Xue, Lihua; Manjunath, Sudha; Culbertson, Jan L.; Anthony, James C.; Bandstra, Emmalee S.

    2009-01-01

    We estimated childhood risk of developing selected DSM-IV Disorders, including Attention-Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), and Separation Anxiety Disorder (SAD), in children with prenatal cocaine exposure (PCE). Children were enrolled prospectively at birth (n = 476) with prenatal drug exposures documented…

  19. Has multiple personality disorder remained consistent over time? A comparison of past and recent cases.

    Science.gov (United States)

    Goff, D C; Simms, C A

    1993-10-01

    The purpose of this study was to determine whether recent descriptions of multiple personality disorder are consistent with descriptions from the past. Clinical presentations and childhood histories obtained from early case reports of multiple personality disorder published between 1800 and 1965 (N = 52) were compared with recent case reports published in the 1980s (N = 54). Recent and past cases did not differ in age at diagnosis, length of treatment, duration of follow-up, presence of child and opposite gender personalities, and exposure to hypnosis. Recent cases differed significantly from past cases in mean number of personalities (12 vs. 3), age of onset (11 vs. 20 years), proportion of males (24% vs. 44%), and in prevalence of childhood abuse histories (81% vs. 29%). The authors discuss clinical and cultural factors that may have contributed to the change over time in the number of reported cases, complexity of personality structure, and description of etiological childhood trauma. Although a core set of symptoms has consistently been associated with this disorder over time, other important aspects have not been stable.

  20. The neuropsychiatry of multiple sclerosis: focus on disorders of mood, affect and behaviour.

    Science.gov (United States)

    Paparrigopoulos, Thomas; Ferentinos, Panagiotis; Kouzoupis, Anastasios; Koutsis, George; Papadimitriou, George N

    2010-01-01

    Neuropsychiatric symptoms are common in multiple sclerosis (MS). They include two broad categories of disturbances: abnormalities in cognition, and abnormalities of mood, affect and behaviour. The present review deals with the epidemiology, clinical features, etiology and treatment of disturbances included in the second category, i.e., major depression, fatigue and sleep disorders, bipolar disorder, euphoria, pathological laughing and crying, anxiety, psychosis and personality changes. Major depression is one of the most common neuropsychiatric disorders in MS with an approximate 50% lifetime prevalence rate. Early recognition and management of depression in MS is of major importance because it is a key predictor of morbidity, mortality, quality of life, possibly physical outcome and disease exacerbations, adherence to immunomodulatory treatments and suicide risk in MS patients, as well as of the caregiver's distress and quality of life. The etiopathogenesis of neuropsychiatric disorders in MS has been incompletely investigated. It is postulated that a complex interplay of biological, disease-related, behavioural and psychosocial factors contribute to the pathophysiology of most of them. Management of neuropsychiatric symptoms in MS is often effective, although commonly based on evidence provided by case studies and uncontrolled trials. A comprehensive biopsychosocial neuropsychiatric approach is essential for the optimal care of patients with MS.

  1. Multiple scattering of polarized light in disordered media exhibiting short-range structural correlations

    Science.gov (United States)

    Vynck, Kevin; Pierrat, Romain; Carminati, Rémi

    2016-09-01

    We develop a model based on a multiple scattering theory to describe the diffusion of polarized light in disordered media exhibiting short-range structural correlations. Starting from exact expressions of the average field and the field spatial correlation function, we derive a radiative transfer equation for the polarization-resolved specific intensity that is valid for weak disorder and we solve it analytically in the diffusion limit. A decomposition of the specific intensity in terms of polarization eigenmodes reveals how structural correlations, represented via the standard anisotropic scattering parameter g , affect the diffusion of polarized light. More specifically, we find that propagation through each polarization eigenchannel is described by its own transport mean free path that depends on g in a specific and nontrivial way.

  2. Multiple scattering of polarized light in disordered media exhibiting short-range structural correlations

    CERN Document Server

    Vynck, Kevin; Carminati, Rémi

    2016-01-01

    We develop a model based on a multiple scattering theory to describe the diffusion of polarized light in disordered media exhibiting short-range structural correlations. Starting from exact expressions of the average field and the field spatial correlation function, we derive a radiative transfer equation for the polarization-resolved specific intensity that is valid for weak disorder and we solve it analytically in the diffusion limit. A decomposition of the specific intensity in terms of polarization eigenmodes reveals how structural correlations, represented via the standard anisotropic scattering parameter $g$, affect the diffusion of polarized light. More specifically, we find that propagation through each polarization eigenchannel is described by its own transport mean free path that depends on $g$ in a specific and non-trivial way.

  3. Personality characteristics and disorders in multiple sclerosis patients: assessment and treatment.

    Science.gov (United States)

    Stathopoulou, Anastasia; Christopoulos, Platon; Soubasi, Evanthia; Gourzis, Philippos

    2010-01-01

    Multiple sclerosis (MS) is a major inflammatory and demyelinating disease of the central nervous system. Although a significant incidence and prevalence of psychological disorders in MS has been reported there is limited data on the prevalence of personality disorders (PD) in these patients. Recent findings indicate the need for early diagnosis and treatment of PD in MS patients in the interests of prognosis, conformity to treatment and patient's quality of life improvement. This article summarizes existing evidence on prevalence, types and diagnostic criteria of PD in MS, clinical manifestations of personality pathology or changes in MS patients, and instruments currently used for diagnosis and assessment of PD in this group of patients. Underlying mechanisms suggested as causes of personality changes in MS patients are also discussed. The article reviews therapeutic strategies, including pharmacotherapy and psychotherapy interventions and emphasizes the need for a multidisciplinary approach to patient's treatment.

  4. Mortality in individuals with disruptive behavior disorders diagnosed by specialist services - A nationwide cohort study

    DEFF Research Database (Denmark)

    Scott, James G; Giørtz Pedersen, Marianne; Erskine, Holly E

    2017-01-01

    Disruptive behavior disorders (DBDs), inclusive of oppositional defiant disorder (ODD) and conduct disorder (CD), are associated with outcomes likely to increase risk of mortality. Using Danish National Registers, a total of 1.92 million individuals including 9495 individuals with DBDs diagnosed ...

  5. Child and Adolescent Behaviorally Based Disorders: A Critical Review of Reliability and Validity

    Science.gov (United States)

    Mallett, Christopher A.

    2014-01-01

    Objectives: The purpose of this study was to investigate the historical construction and empirical support of two child and adolescent behaviorally based mental health disorders: oppositional defiant and conduct disorders. Method: The study utilized a historiography methodology to review, from 1880 to 2012, these disorders' inclusion in…

  6. Treatment of Comorbid Attention-Deficit/Hyperactivity Disorder and Anxiety in Children : A Multiple Baseline Design Analysis

    Science.gov (United States)

    Jarrett, Matthew A.; Ollendick, Thomas H.

    2012-01-01

    Objective: The present study evaluated a 10-week psychosocial treatment designed specifically for children with attention-deficit/hyperactivity disorder (ADHD) and a comorbid anxiety disorder. Method: Using a nonconcurrent multiple baseline design, the authors treated 8 children ages 8-12 with ADHD, combined type, and at least 1 of 3 major anxiety…

  7. Treatment of Comorbid Attention-Deficit/Hyperactivity Disorder and Anxiety in Children : A Multiple Baseline Design Analysis

    Science.gov (United States)

    Jarrett, Matthew A.; Ollendick, Thomas H.

    2012-01-01

    Objective: The present study evaluated a 10-week psychosocial treatment designed specifically for children with attention-deficit/hyperactivity disorder (ADHD) and a comorbid anxiety disorder. Method: Using a nonconcurrent multiple baseline design, the authors treated 8 children ages 8-12 with ADHD, combined type, and at least 1 of 3 major anxiety…

  8. The 7-Item Generalized Anxiety Disorder Scale as a Tool for Measuring Generalized Anxiety in Multiple Sclerosis

    OpenAIRE

    Terrill, Alexandra L.; Hartoonian, Narineh; Beier, Meghan; Salem, Rana; Alschuler, Kevin

    2015-01-01

    Background: Generalized anxiety disorder (GAD) is common in multiple sclerosis (MS) but understudied. Reliable and valid measures are needed to advance clinical care and expand research in this area. The objectives of this study were to examine the psychometric properties of the 7-item Generalized Anxiety Disorder Scale (GAD-7) in individuals with MS and to analyze correlates of GAD.

  9. [Monomorphic post-transplant T-lymphoproliferative disorder after autologous stem cell transplantation for multiple myeloma].

    Science.gov (United States)

    Ishikawa, Tetsuya; Shimizu, Hiroaki; Takei, Toshifumi; Koya, Hiroko; Iriuchishima, Hirono; Hosiho, Takumi; Hirato, Junko; Kojima, Masaru; Handa, Hiroshi; Nojima, Yoshihisa; Murakami, Hirokazu

    2016-01-01

    We report a rare case of T cell type monomorphic post-transplant lymphoproliferative disorders (PTLD) after autologous stem cell transplantation. A 53-year-old man with multiple myeloma received autologous stem cell transplantation and achieved a very good partial response. Nine months later, he developed a high fever and consciousness disturbance, and had multiple swollen lymph nodes and a high titer of Epstein-Barr (EB) virus DNA in his peripheral blood. Neither CT nor MRI of the brain revealed any abnormalities. Cerebrospinal fluid contained no malignant cells, but the EB virus DNA titer was high. Lymph node biopsy revealed T cell type monomorphic PTLD. Soon after high-dose treatment with methotrexate and cytosine arabinoside, the high fever and consciousness disturbance subsided, and the lymph node swelling and EB virus DNA disappeared. Given the efficacy of chemotherapy in this case, we concluded that the consciousness disturbance had been induced by central nervous system involvement of monomorphic PTLD.

  10. Neuromyelitis Optica Spectrum Disorder with Tumefactive Demyelination mimicking Multiple Sclerosis: a rare case

    Directory of Open Access Journals (Sweden)

    UJJAWAL eROY

    2016-05-01

    Full Text Available Neuromyelitis optica spectrum disorder (NMOSD is a diverse condition which not only encompasses isolated longitudinally extensive transverse myelitis and optic neuritis but also includes area postrema syndrome, acute brainstem syndrome, symptomatic narcolepsy or acute diencephalic clinical syndrome, and symptomatic cerebral syndrome. Imaging may reveal periependymal lesions surrounding the ventricular system or involvement of corticospinal tracts, area postrema, diencephalon and corpus callosum. Rarely there may be hemispheric tumefactive lesions which enhance in a Cloud-like fashion on gadolinium injection unlike in tumefactive multiple sclerosis where there is incomplete ring enhancement. Here, we present a case of aquaporin-4 positive relapsing NMOSD who presented to us with recurrent episodes of paraperesis with longitudinally extensive transverse myelitis and tumefactive lesions of brain on imaging which enhanced in an incomplete ring like pattern resembling multiple sclerosis.

  11. A Multiple Deficit Model of Reading Disability and Attention-Deficit/Hyperactivity Disorder: Searching for Shared Cognitive Deficits

    Science.gov (United States)

    McGrath, Lauren M.; Pennington, Bruce F.; Shanahan, Michelle A.; Santerre-Lemmon, Laura E.; Barnard, Holly D.; Willcutt, Erik G.; DeFries, John C.; Olson, Richard K.

    2011-01-01

    Background: This study tests a multiple cognitive deficit model of reading disability (RD), attention-deficit/hyperactivity disorder (ADHD), and their comorbidity. Methods: A structural equation model (SEM) of multiple cognitive risk factors and symptom outcome variables was constructed. The model included phonological awareness as a unique…

  12. Morphostructural MRI Abnormalities Related to Neuropsychiatric Disorders Associated to Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Simona Bonavita

    2013-01-01

    Full Text Available Multiple Sclerosis associated neuropsychiatric disorders include major depression (MD, obsessive-compulsive disorder (OCD, bipolar affective disorder, euphoria, pseudobulbar affect, psychosis, and personality change. Magnetic Resonance Imaging (MRI studies focused mainly on identifying morphostructural correlates of MD; only a few anecdotal cases on OCD associated to MS (OCD-MS, euphoria, pseudobulbar affect, psychosis, personality change, and one research article on MRI abnormalities in OCD-MS have been published. Therefore, in the present review we will report mainly on neuroimaging abnormalities found in MS patients with MD and OCD. All together, the studies on MD associated to MS suggest that, in this disease, depression is linked to a damage involving mainly frontotemporal regions either with discrete lesions (with those visible in T1 weighted images playing a more significant role or subtle normal appearing white matter abnormalities. Hippocampal atrophy, as well, seems to be involved in MS related depression. It is conceivable that grey matter pathology (i.e., global and regional atrophy, cortical lesions, which occurs early in the course of disease, may involve several areas including the dorsolateral prefrontal cortex, the orbitofrontal cortex, and the anterior cingulate cortex whose disruption is currently thought to explain late-life depression. Further MRI studies are necessary to better elucidate OCD pathogenesis in MS.

  13. Time course of changes in the development of gait disorders in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    A. M. Petrov

    2015-01-01

    Full Text Available Objective: to estimate the time course of changes in foot biomechanical function as multiple sclerosis (MS progresses in patients with different degrees of disability compared to a control group. Patients and methods. To estimate the time course of changes in gait disorders in MS, changes in foot biomechanical function were explored in 30 patients with relapsing-remitting MS. Their neurological status was evaluated using the expanded disability status scale (EDSS; pedographic examination was made applying a plantar pressure distribution system; all the patients were examined twice. During the first examination, the patients were divided into two groups: 1 minimal neurological disorders (EDSS scores of < 3.0 and 2 moderate ones (EDSS scores of ≥3.0. Results and discussion. The patients with a mild neurological deficit showed increases in foot load and its lateralization by elevating pressure on the heads of the fourth and fifth metatarsal bones, as evidenced by a significant rise in mean pressure, maximum force, and force-time integral. These changes occurred in the absence of the patients’ complaints of changes in movements. Pedographic examination revealed the changes indicating an enlarged anterior transverse arch and the lower role of the hallux in body weight transfer in the patients with a moderate neurological deficit despite the fact that there were no further visible negative changes in a motor process or progression in neurological deficit. The pedographic examination makes it possible to estimate the degree of gait disorders caused by pyramidal and/or cerebellar lesions and to identify a leading role of this or that functional system in their genesis. Pyramidal dysfunction has impact on the pressurization of the heads of the second and third metatarsal bones. Computed pedography can identify clinically subtle movement changes and estimate the time course of changes in movement disorders in MS patients, including those to evaluate

  14. Multiple sclerosis and bipolar disorders: the burden of comorbidity and its consequences on quality of life.

    Science.gov (United States)

    Carta, M G; Moro, M F; Lorefice, L; Picardi, A; Trincas, G; Fenu, G; Cocco, E; Floris, F; Bessonov, D; Akiskal, H S; Marrosu, M G

    2014-01-01

    The purpose is to measure the worsening of the Quality of Life (QoL) in people with Multiple Sclerosis (MS) and the concomitant role of co-morbid Major Depressive Disorder (MDD) and Bipolar Disorder (BD), the latter not yet studied even though it was found strictly associated with MS. 201 consecutive-MS-patients. 804 sex-and-age-matched subjects without MS, randomly selected from an epidemiological database study. Psychiatric diagnoses according to DSM-IV were determined by physicians using structured interview tools (ANTAS-SCID). Bipolar Spectrum Disorders were identified by Mood Disorders Questionnaire (MDQ). QoL was measured by SF-12. MS was the strongest determinant in worsening the QoL in the overall sample. Both MDD and BD type-II lifetime diagnoses were significantly associated with a poorer quality of life in the total sample as in cases of MS. In MS the impairment of the QoL attributable to BD type-II was even greater than that in MDD. The MS diagnosis was made differently in cases and controls. Although this may have produced false negatives in controls, it would have reinforced the null hypothesis (no role of MS in worsening the QoL); therefore, it does not invalidate the study. MDD as well BD type-II are co-determinants in worsening QoL in MS. Clinicians should consider depressive symptoms as well as the hypomanic and mixed components in MS. Additional research is required to confirm our results and further clarify the manner in which BD and the mixed symptoms of BD type-II may affect awareness of both the underlying disease and psychiatric component and finally to what extent they impact treatment adherence with the available therapies for MS. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. The 3-Year Course of Multiple Substance Use Disorders in the United States: A National Longitudinal Study.

    Science.gov (United States)

    McCabe, Sean Esteban; West, Brady T

    2017-05-01

    To examine the 3-year course of multiple co-occurring substance use disorders (SUDs) based on longitudinal survey data from a large, nationally representative sample. National estimates of the prevalence of DSM-IV SUDs were derived by analyzing data from structured, face-to-face diagnostic interviews as part of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), which collected data from a large, nationally representative sample of noninstitutionalized US adults at 2 waves (2001-2002 and 2004-2005; N = 34,653). US adults with multiple past-year SUDs at Wave 1 were substantially more likely than those with an individual past-year SUD or no SUD at Wave 1 to report at least 1 past-year SUD at Wave 2 (66.3% vs 46.0% vs 6.9%, respectively). There were several sociodemographic characteristics and psychiatric disorders (ie, male, younger age, never married, sexual minority identity, nicotine dependence, mood disorder, and personality disorder) associated with increased odds of developing multiple SUDs and having 3-year persistence of multiple SUDs. The majority of adults with multiple past-year SUDs had a lifetime personality disorder and did not utilize substance abuse treatment or other help-seeking. Multiple SUDs are associated with a more persistent 3-year course of disease over time relative to individual SUDs. Despite a more severe 3-year course and higher rates of comorbidity with other psychiatric disorders, the majority of US adults with multiple SUDs do not utilize substance abuse treatment or other help-seeking. Clinical assessments and the substance abuse literature tend to focus on drug-specific individual SUDs rather than considering the more complex multiple SUDs, which can be more challenging to treat.

  16. Annual research review: The neurobehavioral development of multiple memory systems--implications for childhood and adolescent psychiatric disorders.

    Science.gov (United States)

    Goodman, Jarid; Marsh, Rachel; Peterson, Bradley S; Packard, Mark G

    2014-06-01

    Extensive evidence indicates that mammalian memory is organized into multiple brains systems, including a 'cognitive' memory system that depends on the hippocampus and a stimulus-response 'habit' memory system that depends on the dorsolateral striatum. Dorsal striatal-dependent habit memory may in part influence the development and expression of some human psychopathologies, particularly those characterized by strong habit-like behavioral features. The present review considers this hypothesis as it pertains to psychopathologies that typically emerge during childhood and adolescence. These disorders include Tourette syndrome, attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, eating disorders, and autism spectrum disorders. Human and nonhuman animal research shows that the typical development of memory systems comprises the early maturation of striatal-dependent habit memory and the relatively late maturation of hippocampal-dependent cognitive memory. We speculate that the differing rates of development of these memory systems may in part contribute to the early emergence of habit-like symptoms in childhood and adolescence. In addition, abnormalities in hippocampal and striatal brain regions have been observed consistently in youth with these disorders, suggesting that the aberrant development of memory systems may also contribute to the emergence of habit-like symptoms as core pathological features of these illnesses. Considering these disorders within the context of multiple memory systems may help elucidate the pathogenesis of habit-like symptoms in childhood and adolescence, and lead to novel treatments that lessen the habit-like behavioral features of these disorders.

  17. Genetic pleiotropy between multiple sclerosis and schizophrenia but not bipolar disorder

    DEFF Research Database (Denmark)

    Andreassen, O A; Harbo, H F; Wang, Y

    2014-01-01

    in SNPs associated with SCZ (n=21 856) and multiple sclerosis (MS) (n=43 879), an inflammatory, demyelinating disease of the central nervous system. Because SCZ and bipolar disorder (BD) show substantial clinical and genetic overlap, we also investigated pleiotropy between BD (n=16 731) and MS. We found...... significant genetic overlap between SCZ and MS and identified 21 independent loci associated with SCZ, conditioned on association with MS. This enrichment was driven by the major histocompatibility complex (MHC). Importantly, we detected the involvement of the same human leukocyte antigen (HLA) alleles...... in both SCZ and MS, but with an opposite directionality of effect of associated HLA alleles (that is, MS risk alleles were associated with decreased SCZ risk). In contrast, we found no genetic overlap between BD and MS. Considered together, our findings demonstrate genetic pleiotropy between SCZ and MS...

  18. Joint source based analysis of multiple brain structures in studying major depressive disorder

    Science.gov (United States)

    Ramezani, Mahdi; Rasoulian, Abtin; Hollenstein, Tom; Harkness, Kate; Johnsrude, Ingrid; Abolmaesumi, Purang

    2014-03-01

    We propose a joint Source-Based Analysis (jSBA) framework to identify brain structural variations in patients with Major Depressive Disorder (MDD). In this framework, features representing position, orientation and size (i.e. pose), shape, and local tissue composition are extracted. Subsequently, simultaneous analysis of these features within a joint analysis method is performed to generate the basis sources that show signi cant di erences between subjects with MDD and those in healthy control. Moreover, in a cross-validation leave- one-out experiment, we use a Fisher Linear Discriminant (FLD) classi er to identify individuals within the MDD group. Results show that we can classify the MDD subjects with an accuracy of 76% solely based on the information gathered from the joint analysis of pose, shape, and tissue composition in multiple brain structures.

  19. Treatment Efficacy of Multiple Family Therapy for Chinese Families of Children with Attention Deficit Hyperactivity Disorder.

    Science.gov (United States)

    Ma, Joyce L C; Lai, Kelly Y C; Xia, Lily Li Li

    2017-05-30

    The treatment efficacy of multiple family therapy (MFT) for Chinese families of children with attention deficit hyperactivity disorder (ADHD) has not been studied in the past. In this paper, the effect of MFT on different aspects of the lives of the parents in the experimental group (n = 61) was compared with the effect of only the psychoeducational talks on parents in the control group (n = 53). The results of a MANOVA have shown that by the time they reached the posttreatment phase, the parents who had completed the full 42 hours of the MFT program perceived their children's ADHD symptoms as being less serious and less pathological than they had originally thought compared to the parents in the control group. The effect of MFT on parent-child relationships, parenting stress, parental efficacy, hope, and perceived social support was statistically insignificant. Contributions and limitations of our study are discussed. © 2017 Family Process Institute.

  20. A trans-diagnostic review of anxiety disorder comorbidity and the impact of multiple exclusion criteria on studying clinical outcomes in anxiety disorders.

    Science.gov (United States)

    Goldstein-Piekarski, A N; Williams, L M; Humphreys, K

    2016-06-28

    Anxiety disorders are highly comorbid with each other and with other serious mental disorders. As our field progresses, we have the opportunity to pursue treatment study designs that consider these comorbidities. In this perspective review, we first characterized the prevalence of multiple anxiety disorder comorbidity by reanalyzing national survey data, then conducted an English-language PubMed search of studies analyzing the impact of exclusion criteria on treatment outcome data. In the prevalence data, 60% of people with an anxiety disorder had one or more additional anxiety or depression diagnosis. Because our commonly applied exclusion criteria focus on a single diagnosis and do not consider a multiple comorbidity profile, the impact of the criteria may be to exclude up to 92% of anxiety disorder treatment seekers. Moreover, the findings do not suggest a consistent relationship between the number of exclusion criteria and the effect size of treatment outcomes. Thus, future studies might consider a more trans-diagnostic rationale for determining exclusion criteria, one that is generalizable to real-world settings in which multiple diagnoses commonly co-occur. The findings also encourage a more systematic reporting of rationales for the choice of-and the implications of-each exclusion criterion.

  1. Multiple dimensions of familial psychopathology affect risk of mood disorder in children of bipolar parents

    NARCIS (Netherlands)

    Wals, M; van Os, J; Reichart, CG; Hillegers, MHJ; Ormel, J; Verhulst, FC; Nolen, WA

    2004-01-01

    The aim of our study was to determine whether familial loading of unipolar disorder, bipolar disorder, and substance use disorder are associated with DSM-IV mood disorders in adolescents at risk for bipolar disorder. One hundred and forty adolescents aged 12-21 years of 86 bipolar parents participat

  2. Th17 Cells Pathways in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders: Pathophysiological and Therapeutic Implications.

    Science.gov (United States)

    Dos Passos, Giordani Rodrigues; Sato, Douglas Kazutoshi; Becker, Jefferson; Fujihara, Kazuo

    2016-01-01

    Several animal and human studies have implicated CD4+ T helper 17 (Th17) cells and their downstream pathways in the pathogenesis of central nervous system (CNS) autoimmunity in multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD), challenging the traditional Th1-Th2 paradigm. Th17 cells can efficiently cross the blood-brain barrier using alternate ways from Th1 cells, promote its disruption, and induce the activation of other inflammatory cells in the CNS. A number of environmental factors modulate the activity of Th17 pathways, so changes in the diet, exposure to infections, and other environmental factors can potentially change the risk of development of autoimmunity. Currently, new drugs targeting specific points of the Th17 pathways are already being tested in clinical trials and provide basis for the development of biomarkers to monitor disease activity. Herein, we review the key findings supporting the relevance of the Th17 pathways in the pathogenesis of MS and NMOSD, as well as their potential role as therapeutic targets in the treatment of immune-mediated CNS disorders.

  3. Th17 Cells Pathways in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders: Pathophysiological and Therapeutic Implications

    Directory of Open Access Journals (Sweden)

    Giordani Rodrigues Dos Passos

    2016-01-01

    Full Text Available Several animal and human studies have implicated CD4+ T helper 17 (Th17 cells and their downstream pathways in the pathogenesis of central nervous system (CNS autoimmunity in multiple sclerosis (MS and neuromyelitis optica spectrum disorders (NMOSD, challenging the traditional Th1-Th2 paradigm. Th17 cells can efficiently cross the blood-brain barrier using alternate ways from Th1 cells, promote its disruption, and induce the activation of other inflammatory cells in the CNS. A number of environmental factors modulate the activity of Th17 pathways, so changes in the diet, exposure to infections, and other environmental factors can potentially change the risk of development of autoimmunity. Currently, new drugs targeting specific points of the Th17 pathways are already being tested in clinical trials and provide basis for the development of biomarkers to monitor disease activity. Herein, we review the key findings supporting the relevance of the Th17 pathways in the pathogenesis of MS and NMOSD, as well as their potential role as therapeutic targets in the treatment of immune-mediated CNS disorders.

  4. Multiple sclerosis and alcohol use disorders: In-hospital mortality, extended hospital stays, and overexpenditures.

    Science.gov (United States)

    Gili-Miner, M; López-Méndez, J; Vilches-Arenas, A; Ramírez-Ramírez, G; Franco-Fernández, D; Sala-Turrens, J; Béjar-Prado, L

    2016-10-22

    The objective of this study was to analyse the impact of alcohol use disorders (AUD) in patients with multiple sclerosis (MS) in terms of in-hospital mortality, extended hospital stays, and overexpenditures. We conducted a retrospective observational study in a sample of MS patients obtained from minimal basic data sets from 87 Spanish hospitals recorded between 2008 and 2010. Mortality, length of hospital stays, and overexpenditures attributable to AUD were calculated. We used a multivariate analysis of covariance to control for such variables as age and sex, type of hospital, type of admission, other addictions, and comorbidities. The 10,249 patients admitted for MS and aged 18-74 years included 215 patients with AUD. Patients with both MS and AUD were predominantly male, with more emergency admissions, a higher prevalence of tobacco or substance use disorders, and higher scores on the Charlson comorbidity index. Patients with MS and AUD had a very high in-hospital mortality rate (94.1%) and unusually lengthy stays (2.4 days), and they generated overexpenditures (1,116.9euros per patient). According to the results of this study, AUD in patients with MS results in significant increases in-hospital mortality and the length of the hospital stay and results in overexpenditures. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Obsessive compulsive personality disorder in Progressive Supranuclear Palsy, Multiple System Atrophy and Essential Tremor.

    Science.gov (United States)

    Nicoletti, A; Luca, A; Luca, M; Donzuso, G; Mostile, G; Raciti, L; Contrafatto, D; Dibilio, V; Sciacca, G; Cicero, C E; Vasta, R; Petralia, A; Zappia, M

    2016-09-01

    aim of the study was to evaluate the presence of the Obsessive Compulsive Personality Disorder (OCPeD) in Multiple System Atrophy (MSA), Progressive Supranuclear Palsy (PSP) and Essential Tremor (ET) and in a group of healthy subjects. patients affected by MSA, PSP and ET diagnosed according to currently accepted diagnostic criteria and a group of healthy controls were enrolled in the study. Patients with cognitive impairment were excluded from the study. The Structured Clinical Interview for Personality Disorders-II (SCID-II) has been performed to evaluate the presence of personality disorders (PeDs). The diagnosis of OCPeD was confirmed by a psychiatric interview. fifteen MSA patients (8 men and 7 women; aged 62.9 ± 7.6 years), 14 PSP patients (8 men and 6 women; aged 69.8 ± 4.4 years), 16 ET patients (10 men and 6 women; aged 70.4 ± 6.4 years) and 20 healthy subjects (10 men and 10 women; aged 65.5 ± 6.0 years) were enrolled. OCPeD was recorded in 5 (35.7%) PSP patients, 2 (13.3%) MSA patients, 2 (12.5%) ET patient and 2 (10%) controls. a low frequency of OCPeD, close to those recorded in healthy subjects, was recorded in both MSA and ET patients. Conversely an higher frequency of OCPeD, similar to PD was found among PSP patients, supporting the possibility of an impairment of common basal ganglia network possibly involving the orbito-frontal circuits. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Psychiatric disorders in multiple sclerosis patients Transtornos psiquiátricos em pacientes com esclerose múltipla

    OpenAIRE

    Mirella Martins Fazzito; Sérgio Semeraro Jordy; Charles Peter Tilbery

    2009-01-01

    Multiple sclerosis (MS) is a demyelinating disease showing variable clinical presentation. Optic neuritis is the most common symptom, followed by motor and sensitive manifestations. It is known that this disease may be related to several psychiatric disorders, especially depression. In this study we will discribe 5 cases of MS patients harboring psychiatric disorder related or unchained by the disease itself.Esclerose múltipla é uma doença desmielinizante com variadas apresentações clínicas. ...

  7. Does the mind fall apart in multiple personality disorder? Some proposals based on a psychoanalytic case.

    Science.gov (United States)

    Gottlieb, R M

    1997-01-01

    A psychoanalytic study of some of the phenomena of multiple personality disorder (MPD), this paper takes issue with the view that a falling apart, fragmentation, or disaggregation of the mind is at the bottom of MPD's characteristic symptoms. Since first proposed by Janet in 1889, the view that ordinarily integrated parts of the mind separate from the center, accounting for the appearance of separate "selves," has prevailed among workers in this field. The close psychoanalytic study of a case of MPD suggests that, to the contrary, the appearance of multiplicity may derive from an essentially unitary but nonetheless powerful set of organizing fantasies centering on the idea that one's body and mind can be taken over and controlled by persons other than oneself. The data of the case under study suggest, further, that certain of the details of these patients' histories of childhood sexual and physical abuse may be of great importance in explaining the extraordinary organizing power of their fantasies of being occupied and controlled. In this connection, special attention is directed to the very commonly reported experiences of forced violation and the involuntary filling and emptying of their bodies during childhood.

  8. Clinical Reasoning in the Assessment and Planning for Intervention for Oppositional Defiant Disorder

    Science.gov (United States)

    Wilcox, Gabrielle; Heudes, Alethea

    2017-01-01

    Clinical reasoning requires thoughtful consideration of a variety of factors that contribute to the conceptualization of a case such as the reason for referral, school information, home environment, assessment outcomes, and behavioural observations made during assessments. The purpose of this article is to provide the reader with insight into the…

  9. The Reciprocal Influence of Callous-Unemotional Traits, Oppositional Defiant Disorder and Parenting Practices in Preschoolers.

    Science.gov (United States)

    Brown, Caitlin A; Granero, Roser; Ezpeleta, Lourdes

    2017-04-01

    The present study investigates reciprocal associations between positive parenting, parental monitoring, CU traits, and ODD in children assessed at age 3 and again at age 6. Data were collected from a sample of preschoolers (N = 419; 51.58 % female) through diagnostic interviews and questionnaires answered by parents and teachers. Structural equation modeling revealed a bidirectional relationship between poor monitoring and ODD, with poor monitoring at age 3 predicting ODD at age 6 (β = 0.11, p < 0.05), and ODD at age 3 predicting poor monitoring at age 6 (β = 0.10, p < 0.05). While poor monitoring at age 3 predicted CU traits at age 6 (β = 0.11, p < 0.05), CU traits at age 3 predicted positive parenting (β = 0.09, p < 0.05) and ODD (β = 0.13, p < 0.05) at age 6. Results have important implications for early targeted parenting interventions for CU traits and ODD.

  10. Behavior of conduct disordered children in interaction with each other and with normal peers

    NARCIS (Netherlands)

    MATTHYS, W; VANLOO, P; PACHEN, [No Value; de Vries, Han; VANHOOFF, JARAM; VANENGELAND, H

    1995-01-01

    This study investigated the behavior of children with conduct disorder or oppositional defiant disorder (CD/ODD) in interaction with each other and with normal control (NC) children in a semi-standardized setting over a period of 25 minutes. This short time turned out to be sufficient to demonstrate

  11. Trajectories of Symptom Reduction and Engagement during Treatment for Childhood Behavior Disorders: Differences across Settings

    Science.gov (United States)

    Lindhiem, Oliver; Kolko, David J.

    2010-01-01

    In this study, we examined trajectories of symptom reduction and family engagement during the modular treatment phase of a clinical trial for early-onset disruptive behavior disorders that was applied either in community settings or a clinic. Participants (N = 139) were 6-11 year-old children with diagnoses of Oppositional Defiant Disorder (ODD)…

  12. Motor Profile of Children with Attention Deficit Hyperactivity Disorder, Combined Type

    Science.gov (United States)

    Goulardins, Juliana B.; Marques, Juliana C. Bilhar; Casella, Erasmo B.; Nascimento, Roseane O.; Oliveira, Jorge A.

    2013-01-01

    Objectives: The aim of this study was to assess the motor profile of children with attention deficit hyperactivity disorder (ADHD), combined type. Method: The case group consisted of 34 treatment-naive, male patients, aged 7-11 years, who had been diagnosed with ADHD, combined type, without comorbidities (except oppositional defiant disorder). The…

  13. Behavior of conduct disordered children in interaction with each other and with normal peers

    NARCIS (Netherlands)

    MATTHYS, W; VANLOO, P; PACHEN, [No Value; de Vries, Han; VANHOOFF, JARAM; VANENGELAND, H

    1995-01-01

    This study investigated the behavior of children with conduct disorder or oppositional defiant disorder (CD/ODD) in interaction with each other and with normal control (NC) children in a semi-standardized setting over a period of 25 minutes. This short time turned out to be sufficient to demonstrate

  14. [Treatment manual for psychotherapy of acute and posttraumatic stress disorders after multiple ICD shocks].

    Science.gov (United States)

    Jordan, J; Titscher, G; Kirsch, H

    2011-09-01

    In view of the inceasing number of implanted defibrillators in all industrial nations, the number of people who have suffered so-called multiple shocks (electrical storm, ES) also increases. Common complaints are severe and continuously recurrent massive anxiety, panic attacks, fear of death, helplessness and hopelessness, depression, nervosity and irritability as well as reclusive and uncontrollable avoidance behaviour, intrusions, nightmares, flashbacks, sleeplessness and the inability to show feelings and limitation of future perspectives. Because people with an ICD are often physically (very) ill and after multiple ICD shocks are additionally very insecure, it would seem logical if the inpatient treatment would be carried out in an institution which has close connections and is also spatially close to a cardiology department. The basis of the diagnostics is the clinical anamnesis and a systematic exploration of the trauma situation and the resulting complaints. As an additional diagnostic element psychological test procedures should be implemented to determine the core symptomatic (anxiety, depression, trauma symptoms). Psychological test procedures should be included in the diagnostics so that at the end of treatment it is obvious even to the patient which alterations have occurred. The core element of inpatient treatment is daily intensive psychotherapy and includes deep psychologically well-founded psychotherapy and behavioral therapeutic-oriented anxiety therapy as well as cognitive restructuring and elements of eye movement desensitization and reprocessing (EMDR). A follow-up examination within 4 months of the multiple shocks episode is recommended because symptoms of posttraumatic stress disorder often occur after a long latent time period.

  15. Sleep Disorders Reduce Health-Related Quality of Life in Multiple Sclerosis (Nottingham Health Profile Data in Patients with Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Christian Veauthier

    2015-07-01

    Full Text Available Quality of Life (QoL is decreased in multiple sclerosis (MS, but studies about the impact of sleep disorders (SD on health-related quality of Life (HRQoL are lacking. From our original cohort, a cross-sectional polysomnographic (PSG study in consecutive MS patients, we retrospectively analysed the previously unpublished data of the Nottingham Health Profile (NHP. Those MS patients suffering from sleep disorders (n = 49 showed significantly lower HRQoL compared to MS patients without sleep disorders (n = 17. Subsequently, we classified the patients into four subgroups: insomnia (n = 17, restless-legs syndrome, periodic limb movement disorder and SD due to leg pain (n = 24, obstructive sleep apnea (n = 8 and patients without sleep disorder (n = 17. OSA and insomnia patients showed significantly higher NHP values and decreased HRQoL not only for the sleep subscale but also for the “energy” and “emotional” area of the NHP. In addition, OSA patients also showed increased NHP values in the “physical abilities” area. Interestingly, we did not find a correlation between the objective PSG parameters and the subjective sleep items of the NHP. However, this study demonstrates that sleep disorders can reduce HRQoL in MS patients and should be considered as an important confounder in all studies investigating HRQoL in MS.

  16. Influence of Disruptive Behavior Disorders on Academic Performance and School Functions of Youths with Attention-Deficit/Hyperactivity Disorder.

    Science.gov (United States)

    Liu, Chao-Yu; Huang, Wei-Lieh; Kao, Wei-Chih; Gau, Susan Shur-Fen

    2017-02-06

    Childhood attention-deficit/hyperactivity disorder (ADHD) and comorbid oppositional defiant disorder/conduct disorder (ODD/CD) are associated with negative school outcomes. The study aimed to examine the impact of ADHD and ODD/CD on various school functions. 395 youths with ADHD (244 with ADHD + ODD/CD and 151 with ADHD only) and 156 controls received semi-structured psychiatric interviews. School functions were assessed and compared between each group with a multiple-level model. The results showed that youths with ADHD had poorer performance across different domains of school functioning. Youths with ADHD + ODD/CD had more behavioral problems but similar academic performance than those with ADHD only. The multiple linear regression models revealed that ADHD impaired academic performance while ODD/CD aggravated behavioral problems. Our findings imply that comorbid ODD/CD may specifically contribute to social difficulties in youths with ADHD. Measures of early detection and intervention for ODD/CD should be conducted to prevent adverse outcomes.

  17. White matter changes in paediatric multiple sclerosis and monophasic demyelinating disorders.

    Science.gov (United States)

    Longoni, Giulia; Brown, Robert A; MomayyezSiahkal, Parya; Elliott, Colm; Narayanan, Sridar; Bar-Or, Amit; Ann Marrie, Ruth; Ann Yeh, E; Filippi, Massimo; Banwell, Brenda; Arnold, Douglas L

    2017-03-14

    Most children who experience an acquired demyelinating syndrome of the central nervous system will have a monophasic disease course, with no further clinical or radiological symptoms. A subset will be diagnosed with multiple sclerosis, a life-long disorder. Using linear mixed effects models we examined longitudinal diffusion properties of normal-appearing white matter in 505 serial scans of 132 paediatric participants with acquired demyelinating syndromes followed for a median of 4.4 years, many from first clinical presentation, and 106 scans of 80 healthy paediatric participants. Fifty-three participants with demyelinating syndromes eventually received a diagnosis of paediatric-onset multiple sclerosis. Diffusion tensor imaging measures properties of water diffusion through tissue, which normally becomes increasingly restricted and anisotropic in the brain during childhood and adolescence, as fibre bundles develop and myelinate. In the healthy paediatric participants, our data demonstrate the expected trajectory of more restricted and anisotropic white matter diffusivity with increasing age. However, in participants with multiple sclerosis, fractional anisotropy decreased and mean diffusivity of non-lesional, normal-appearing white matter progressively increased after clinical presentation, suggesting not only a failure of age-expected white matter development but also a progressive loss of tissue integrity. Surprisingly, patients with monophasic disease failed to show age-expected changes in diffusion parameters in normal-appearing white matter, although they did not show progressive loss of integrity over time. Further analysis demonstrated that participants with monophasic disease experienced different post-onset trajectories in normal-appearing white matter depending on their presenting phenotype: those with acute disseminated encephalomyelitis demonstrated abnormal trajectories of diffusion parameters compared to healthy paediatric participants, as did

  18. Association of Fluid Intelligence and Psychiatric Disorders in a Population-Representative Sample of US Adolescents.

    Science.gov (United States)

    Keyes, Katherine M; Platt, Jonathan; Kaufman, Alan S; McLaughlin, Katie A

    2017-02-01

    Despite long-standing interest in the association of psychiatric disorders with intelligence, few population-based studies of psychiatric disorders have assessed intelligence. To investigate the association of fluid intelligence with past-year and lifetime psychiatric disorders, disorder age at onset, and disorder severity in a nationally representative sample of US adolescents. National sample of adolescents ascertained from schools and households from the National Comorbidity Survey Replication-Adolescent Supplement, collected 2001 through 2004. Face-to-face household interviews with adolescents and questionnaires from parents were obtained. The data were analyzed from February to December 2016. DSM-IV mental disorders were assessed with the World Health Organization Composite International Diagnostic Interview, and included a broad range of fear, distress, behavior, substance use, and other disorders. Disorder severity was measured with the Sheehan Disability Scale. Fluid IQ measured with the Kaufman Brief Intelligence Test, normed within the sample by 6-month age groups. The sample included 10 073 adolescents (mean [SD] age, 15.2 [1.50] years; 49.0% female) with valid data on fluid intelligence. Lower mean (SE) IQ was observed among adolescents with past-year bipolar disorder (94.2 [1.69]; P = .004), attention-deficit/hyperactivity disorder (96.3 [0.91]; P = .002), oppositional defiant disorder (97.3 [0.66]; P = .007), conduct disorder (97.1 [0.82]; P = .02), substance use disorders (alcohol abuse, 96.5 [0.67]; P Intelligence was not associated with posttraumatic stress disorder, eating disorders, and anxiety disorders other than specific phobia, and was positively associated with past-year major depression (mean [SE], 100 [0.5]; P = .01). Associations of fluid intelligence with lifetime disorders that had remitted were attenuated compared with past-year disorders, with the exception of separation anxiety disorder. Multiple past

  19. Multiple Channel Exposure Therapy: Combining Cognitive-Behavioral Therapies for the Treatment of Posttraumatic Stress Disorder with Panic Attacks

    Science.gov (United States)

    Falsetti, Sherry A.; Resnick, Heidi S.; Davis, Joanne

    2005-01-01

    A large proportion of patients who present for treatment of posttraumatic stress disorder (PTSD) experience comorbid panic attacks, yet it is unclear to what extent currently available PTSD treatment programs address this problem. Here we describe a newly developed treatment, multiple-channel exposure therapy (M-CET), for comorbid PTSD and panic…

  20. An Overview of Multiple Sclerosis: Medical, Psychosocial, and Vocational Aspects of a Chronic and Unpredictable Neurological Disorder

    Science.gov (United States)

    Rumrill, Phillip D., Jr.; Roessler, Richard T.

    2015-01-01

    This article presents an overview of multiple sclerosis (MS), one of the most common neurological disorders in the western hemisphere. Medical and psychosocial aspects of the disease such as causes and risk factors, diagnosis, incidence and prevalence, symptoms, courses, and treatment are described. Existing research regarding the employment…

  1. Dubowitz syndrome is a complex comprised of multiple, genetically distinct and phenotypically overlapping disorders.

    Directory of Open Access Journals (Sweden)

    Douglas R Stewart

    Full Text Available Dubowitz syndrome is a rare disorder characterized by multiple congenital anomalies, cognitive delay, growth failure, an immune defect, and an increased risk of blood dyscrasia and malignancy. There is considerable phenotypic variability, suggesting genetic heterogeneity. We clinically characterized and performed exome sequencing and high-density array SNP genotyping on three individuals with Dubowitz syndrome, including a pair of previously-described siblings (Patients 1 and 2, brother and sister and an unpublished patient (Patient 3. Given the siblings' history of bone marrow abnormalities, we also evaluated telomere length and performed radiosensitivity assays. In the siblings, exome sequencing identified compound heterozygosity for a known rare nonsense substitution in the nuclear ligase gene LIG4 (rs104894419, NM_002312.3:c.2440C>T that predicts p.Arg814X (MAF:0.0002 and an NM_002312.3:c.613delT variant that predicts a p.Ser205Leufs*29 frameshift. The frameshift mutation has not been reported in 1000 Genomes, ESP, or ClinSeq. These LIG4 mutations were previously reported in the sibling sister; her brother had not been previously tested. Western blotting showed an absence of a ligase IV band in both siblings. In the third patient, array SNP genotyping revealed a de novo ∼ 3.89 Mb interstitial deletion at chromosome 17q24.2 (chr 17:62,068,463-65,963,102, hg18, which spanned the known Carney complex gene PRKAR1A. In all three patients, a median lymphocyte telomere length of ≤ 1st centile was observed and radiosensitivity assays showed increased sensitivity to ionizing radiation. Our work suggests that, in addition to dyskeratosis congenita, LIG4 and 17q24.2 syndromes also feature shortened telomeres; to confirm this, telomere length testing should be considered in both disorders. Taken together, our work and other reports on Dubowitz syndrome, as currently recognized, suggest that it is not a unitary entity but instead a collection of

  2. Pica in an eating disordered woman with multiple sclerosis: impulse dys-control, compulsive symptom or self-medication attempt?

    Science.gov (United States)

    Ceschin, L; Giannunzio, V; Favaro, A; Santonastaso, P

    2010-01-01

    We report about a complex case of pica in comorbidity with multiple sclerosis and binge eating disorder. Pica is classified among the feeding and eating disorders of infancy and early childhood, but there is a debate in the literature about the psychopathology and classification of this behavior. Some authors emphasize the similarities with the obsessive-compulsive spectrum disorders, whereas others propose an interpretation of pica as an addiction or as an impulsive behavior. The clinical case that we describe provides a picture of impulsive and compulsive features that are very difficult to disentangle. It is noteworthy that hypercalcemia is reported to have a protective/therapeutic effect against multiple sclerosis and seems to increase the plasmatic levels of beta-endorphins. The nature, diagnostic classification, and functions of pica are a topic worthy of future investigation.

  3. Association of oxytocin receptor (OXTR) gene variants with multiple phenotype domains of autism spectrum disorder.

    Science.gov (United States)

    Campbell, Daniel B; Datta, Dibyadeep; Jones, Shaine T; Batey Lee, Evon; Sutcliffe, James S; Hammock, Elizabeth A D; Levitt, Pat

    2011-06-01

    Autism spectrum disorder (ASD) is characterized by core deficits in social behavior, communication, and behavioral flexibility. Several lines of evidence indicate that oxytocin, signaling through its receptor (OXTR), is important in a wide range of social behaviors. In attempts to determine whether genetic variations in the oxytocin signaling system contribute to ASD susceptibility, seven recent reports indicated association of common genetic polymorphisms in the OXTR gene with ASD. Each involved relatively small sample sizes (57 to 436 families) and, where it was examined, failed to identify association of OXTR polymorphisms with measures of social behavior in individuals with ASD. We report genetic association analysis of 25 markers spanning the OXTR locus in 1,238 pedigrees including 2,333 individuals with ASD. Association of three markers previously implicated in ASD susceptibility, rs2268493 (P = 0.043), rs1042778 (P = 0.037), and rs7632287 (P = 0.016), was observed. Further, these genetic markers were associated with multiple core ASD phenotypes, including social domain dysfunction, measured by standardized instruments used to diagnose and describe ASD. The data suggest association of OXTR genetic polymorphisms with ASD, although the results should be interpreted with caution because none of the significant associations would survive appropriate correction for multiple comparisons. However, the current findings of association in a large independent cohort are consistent with previous results, and the biological plausibility of participation of the oxytocin signaling system in modulating social disruptions characteristic of ASD, suggest that functional polymorphisms of OXTR may contribute to ASD risk in a subset of families.

  4. Managing disruptive behaviour disorders in children.

    Science.gov (United States)

    Stephen, Scott; Bailey, Clare

    2013-05-01

    The age at which individuals are most physically aggressive is 22 months. However, some children fail to inhibit this normal aggression and by the time they are three or four are showing signs of oppositional defiant disorder. In older children persistent antisocial behaviour is classified as conduct disorder. At any age, antisocial behaviour is on a continuum, and while the most severe 5% or so will meet diagnostic criteria, those falling short are often described as having conduct problems. Epidemiological follow-up surveys show that the risk of poor outcomes in antisocial children is very high. The causes are multiple but two sets of factors stand out. First, genetic predisposition. Even children adopted away from violent or criminal parents have three or four times the rate of antisocial behaviour and second, poor parenting. Watching and waiting is a reasonable strategy if the antisocial behaviour is not very severe. It is important to be vigilant for severe tantrums or aggression occurring almost every day, harsh, rough, or inconsistent parenting and coexistent ADHD. If severity is moderate, referral to an evidence-based parenting group would be a good first move. If this fails to make things better, or if the child or parent has a comorbid condition, referral to CAMHS is indicated. For older children, aged 10 to 17, there are effective interventions such as anger management CBT and parenting groups for adolescents.

  5. A multiple case study comparison of normal private preparatory school and substance abusing/mood disordered adolescents and their families.

    Science.gov (United States)

    Yeh, L S; Hedgespeth, J

    1995-01-01

    This multiple case study of ten families of normal private preparatory school adolescents and five families of substance abusing/mood disordered adolescents was an effort to identify factors that may suggest a relationship between the abuse of substances in adolescents who also have mood disorders and the following family factors: parental marital discord, degree of family satisfaction, and family problem-solving styles. The fifteen families completed four assessment instruments and participated in a videotaped problem-solving exercise. The results of this study showed that all members of the substance abusing/mood disordered adolescents' families rated themselves as dysfunctional in all major areas of family life. In contrast, the normal private preparatory school families reported satisfaction with most areas of family functioning. Communication styles also differed considerably between the two small groups of families. These results appear to support the importance of family evaluation and treatment when addressing the issue of adolescent substance abusers with mood disorders.

  6. Speech disorders reflect differing pathophysiology in Parkinson's disease, progressive supranuclear palsy and multiple system atrophy.

    Science.gov (United States)

    Rusz, Jan; Bonnet, Cecilia; Klempíř, Jiří; Tykalová, Tereza; Baborová, Eva; Novotný, Michal; Rulseh, Aaron; Růžička, Evžen

    2015-01-01

    Although speech disorder is frequently an early and prominent clinical feature of Parkinson's disease (PD) as well as atypical parkinsonian syndromes (APS) such as progressive supranuclear palsy (PSP) and multiple system atrophy (MSA), there is a lack of objective and quantitative evidence to verify whether any specific speech characteristics allow differentiation between PD, PSP and MSA. Speech samples were acquired from 77 subjects including 15 PD, 12 PSP, 13 MSA and 37 healthy controls. The accurate differential diagnosis of dysarthria subtypes was based on the quantitative acoustic analysis of 16 speech dimensions. Dysarthria was uniformly present in all parkinsonian patients but was more severe in PSP and MSA than in PD. Whilst PD speakers manifested pure hypokinetic dysarthria, ataxic components were more affected in MSA whilst PSP subjects demonstrated severe deficits in hypokinetic and spastic elements of dysarthria. Dysarthria in PSP was dominated by increased dysfluency, decreased slow rate, inappropriate silences, deficits in vowel articulation and harsh voice quality whereas MSA by pitch fluctuations, excess intensity variations, prolonged phonemes, vocal tremor and strained-strangled voice quality. Objective speech measurements were able to discriminate between APS and PD with 95% accuracy and between PSP and MSA with 75% accuracy. Dysarthria severity in APS was related to overall disease severity (r = 0.54, p = 0.006). Dysarthria with various combinations of hypokinetic, spastic and ataxic components reflects differing pathophysiology in PD, PSP and MSA. Thus, motor speech examination may provide useful information in the evaluation of these diseases with similar manifestations.

  7. Fatigue and Sleep-Disordered Breathing in Multiple Sclerosis: A Clinically Relevant Association?

    Directory of Open Access Journals (Sweden)

    Ulf Kallweit

    2013-01-01

    Full Text Available Background. Fatigue in patients with multiple sclerosis (MS is highly prevalent and severely impacts quality of life. Recent studies suggested that sleep-disordered breathing (SDB significantly contributes to fatigue in MS. Study Objective. To evaluate the importance of routine respirography in MS patients with severe fatigue and to explore the effects of treatment with continuous positive airway pressure (CPAP. Patients and Methods. We prospectively assessed the presence of severe fatigue, as defined by a score of ≥5.0 on the Fatigue Severity Scale (FSS, in 258 consecutive MS patients. Ninety-seven patients (38% suffered from severe fatigue, whereof 69 underwent overnight respirography. Results. We diagnosed SDB in 28 patients (41%. Male sex was the only independent associate of SDB severity (P=0.003. CPAP therapy in 6 patients was associated with a significant reduction of FSS scores (5.8±0.5 versus 4.8±0.6, P=0.04, but the scores remained pathological (≥4.0 in all patients. Conclusion. Respirography in MS patients with severe fatigue should be considered in daily medical practice, because SDB frequency is high and CPAP therapy reduces fatigue severity. However, future work is needed to understand the real impact of CPAP therapy on quality of life in this patient group.

  8. Disordered and Multiple Destinations Path Planning Methods for Mobile Robot in Dynamic Environment

    Directory of Open Access Journals (Sweden)

    Yong-feng Dong

    2016-01-01

    Full Text Available In the smart home environment, aiming at the disordered and multiple destinations path planning, the sequencing rule is proposed to determine the order of destinations. Within each branching process, the initial feasible path set is generated according to the law of attractive destination. A sinusoidal adaptive genetic algorithm is adopted. It can calculate the crossover probability and mutation probability adaptively changing with environment at any time. According to the cultural-genetic algorithm, it introduces the concept of reducing turns by parallelogram and reducing length by triangle in the belief space, which can improve the quality of population. And the fallback strategy can help to jump out of the “U” trap effectively. The algorithm analyses the virtual collision in dynamic environment with obstacles. According to the different collision types, different strategies are executed to avoid obstacles. The experimental results show that cultural-genetic algorithm can overcome the problems of premature and convergence of original algorithm effectively. It can avoid getting into the local optimum. And it is more effective for mobile robot path planning. Even in complex environment with static and dynamic obstacles, it can avoid collision safely and plan an optimal path rapidly at the same time.

  9. Imagery Rescripting for Body Dysmorphic Disorder: A Multiple-Baseline Single-Case Experimental Design.

    Science.gov (United States)

    Willson, Rob; Veale, David; Freeston, Mark

    2016-03-01

    Individuals with body dysmorphic disorder (BDD) often experience negative distorted images of their appearance, and research suggests these may be linked to memories of adverse events such as bullying or teasing. This study evaluates imagery rescripting (ImR) as an intervention for BDD. In this article, we present a multiple-baseline single-case experimental design testing imagery rescripting as a brief, stand-alone intervention, with six individuals with BDD that related to aversive memories. The impact of the intervention was assessed by self-reported daily measures of symptom severity (preoccupation with appearance, appearance-related checking behaviors, appearance-related distress, and strength of belief that their main problem is their appearance) and standardized clinician ratings of BDD severity (Yale-Brown Obsessive Compulsive Scale modified for BDD). Four out of six of the participants responded positively to the intervention, with clinically meaningful improvement in symptomatology. Overall response was rapid; improvements began within the first week post-ImR intervention. From a small sample it is cautiously concluded that imagery rescripting may show promise as a module in cognitive-behavioral therapy for BDD, and is worthy of further investigation.

  10. Periventricular Lesions Help Differentiate Neuromyelitis Optica Spectrum Disorders from Multiple Sclerosis

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    Eytan Raz

    2014-01-01

    Full Text Available Objective. To compare periventricular lesions in multiple sclerosis (MS and neuromyelitis optica spectrum disorders (NMOsd. Materials and Methods. Sagittal and axial fluid attenuated inversion recovery (FLAIR sequences of 20 NMOsd and 40 group frequency-matched MS patients were evaluated by two neuroradiologists. On axial FLAIR, periventricular area was characterized as free of lesions/smooth-bordered (“type A” or jagged-bordered (“type B” pattern. On sagittal FLAIR, the images were evaluated for presence of “Dawson’s fingers.” Results. Type A pattern was observed in 80% of NMOsd patients by Reader 1 and 85% by Reader 2 but only in 5% MS patients by either Reader. Type B was seen in 15% NMOsd patients by Reader 1 and 20% by Reader 2 and in 95% MS patients by either Reader. Dawson’s fingers were observed in no NMOsd patients by Reader 1 and 5% by Reader 2. In MS, Dawson’s fingers were seen in 92.5% patients by Reader 1 and 77.5% by Reader 2. The differences in periventricular patterns and Dawson’s finger detection between NMOsd and MS were highly significant (P<0.001. Conclusions. Dawson’s fingers and “jagged-bordered” periventricular hyperintensities are typical of MS and almost never seen in NMOsd, which suggests a practical method for differentiating the two diseases.

  11. Optical Coherence Tomography and Magnetic Resonance Imaging in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder.

    Science.gov (United States)

    Manogaran, Praveena; Hanson, James V M; Olbert, Elisabeth D; Egger, Christine; Wicki, Carla; Gerth-Kahlert, Christina; Landau, Klara; Schippling, Sven

    2016-11-15

    Irreversible disability in multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) is largely attributed to neuronal and axonal degeneration, which, along with inflammation, is one of the major pathological hallmarks of these diseases. Optical coherence tomography (OCT) is a non-invasive imaging tool that has been used in MS, NMOSD, and other diseases to quantify damage to the retina, including the ganglion cells and their axons. The fact that these are the only unmyelinated axons within the central nervous system (CNS) renders the afferent visual pathway an ideal model for studying axonal and neuronal degeneration in neurodegenerative diseases. Structural magnetic resonance imaging (MRI) can be used to obtain anatomical information about the CNS and to quantify evolving pathology in MS and NMOSD, both globally and in specific regions of the visual pathway including the optic nerve, optic radiations and visual cortex. Therefore, correlations between brain or optic nerve abnormalities on MRI, and retinal pathology using OCT, may shed light on how damage to one part of the CNS can affect others. In addition, these imaging techniques can help identify important differences between MS and NMOSD such as disease-specific damage to the visual pathway, trans-synaptic degeneration, or pathological changes independent of the underlying disease process. This review focuses on the current knowledge of the role of the visual pathway using OCT and MRI in patients with MS and NMOSD. Emphasis is placed on studies that employ both MRI and OCT to investigate damage to the visual system in these diseases.

  12. Neuromyelitis optica spectrum disorder and multiple sclerosis: Differentiation by a multimodal approach.

    Science.gov (United States)

    Ota, Miho; Sato, Noriko; Okamoto, Tomoko; Noda, Takamasa; Araki, Manabu; Yamamura, Takashi; Kunugi, Hiroshi

    2015-11-01

    Neuromyelitis optica spectrum disorder (NMOSD) differs from multiple sclerosis (MS) by prognosis and approach to treatment, and it is thus important to distinguish NMOSD from MS. We evaluated the structural brain abnormalities in patients with NMOSD and with relapsing-remitting MS (RRMS) using with MRI. Twenty-one NMOSD patients with antibodies against aquaporin 4, 32 patients with RRMS, and current age- and sex- matched 39 healthy subjects underwent 3-T MRI. The differences in gray matter volume and fractional anisotropy (FA) value among the three groups were evaluated. There were significant global gray matter volume reductions of NMOSD and RRMS groups, compared to the healthy subjects. Significant and diffuse decreases in FA values were observed in both the NMOSD and RRMS patients. Significant gray matter volume and FA value reductions of the RRMS patients in the bilateral thalami and some regions were observed compared to the NMOSD patients. Larger brain structural changes were seen in the RRMS group compared to the NMOSD group, and among them, the thalamus was revealed as the important region for the discrimination of these two diseases. MRI analyses of the brain may be helpful in differentiating NMOSD from RRMS patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Ecosystemic needs assessment for children with developmental coordination disorder in elementary school: multiple case studies.

    Science.gov (United States)

    Jasmin, Emmanuelle; Tétreault, Sylvie; Joly, Jacques

    2014-11-01

    This study explored the needs of children with developmental coordination disorder (DCD) from an ecosystemic viewpoint as part of a theory-driven program evaluation process. A multiple case study needs assessment was conducted. Participants included ten children with DCD, their parents (n = 12), teachers (n = 9), and service providers (n = 6). Data collection involved semi-structured interviews, validated questionnaires, and a review of the children's records. The results support the relevance of using an ecosystemic model to assess the needs of children with DCD in their life and social contexts. More specifically, the results highlight the need to provide additional services at school, such as occupational therapy and special education, as well as information and training regarding DCD for parents and teachers. The results also point to the relevant variables to consider in an intervention program based on theory-driven evaluations. This study shows how employing an ecosystemic frame of reference provides a better understanding of the needs of children with DCD. Future research should document the ecosystemic profiles and evolution of the needs of children with DCD with a larger sample from diverse socioeconomic backgrounds using a longitudinal study design.

  14. Service utilization by children with conduct disorders: findings from the 2004 Great Britain child mental health survey.

    Science.gov (United States)

    Shivram, Raghuram; Bankart, John; Meltzer, Howard; Ford, Tamsin; Vostanis, Panos; Goodman, Robert

    2009-09-01

    Children with conduct disorders (CD) and their families are in contact with multiple agencies, but there is limited evidence on their patterns of service utilization. The aim of this study was to establish the patterns, barriers and correlates of service use by analysing the cohort of the 2004 Great Britain child mental health survey (N = 7,977). Use of social services was significantly higher by children with CD than emotional disorders (ED) in the absence of co-morbidity, while use of specialist child mental health and paediatric was significantly higher by children with hyperkinetic disorders (HD) than CD. Children who had comorbid physical disorders used more primary healthcare services compared to those without physical disorders. Utilization of specialist child mental heath and social services was significantly higher among children with unsocialized CD than socialized CD and oppositional defiant disorders. Services utilization and its correlates varied with the type of service. Overall, specialist services use was associated with co-morbidity with learning disabilities, physical and psychiatric disorders. Several correlates of services use in CD appeared non-specific, i.e. associated with use of different services indicating the possibility of indiscriminate use of different types of services. The findings led to the conclusion that there is the need for effective organization and co-ordination of services, and clear care pathways. Involvement of specialist child mental health services should be requested in the presence of mental health co-morbidity.

  15. Multiple clinical presentations of lymphoproliferative disorders in pediatric liver transplant recipients: a single-center experience.

    Science.gov (United States)

    Pinho-Apezzato, M L; Tannuri, U; Tannuri, A C A; Mello, E S; Lima, F; Gibelli, N E; Santos, M M; Ayoub, A A; Maksoud-Filho, J G; Velhote, M C; Silva, M M; Andrade, W C; Miyatani, H T

    2010-06-01

    Posttransplantation lymphoproliferative disorder (PTLD) is a serious complication following solid organ transplantation that has been linked to Epstein-Barr virus (EBV) infection. The aim of this article was to describe a single-center experience with the multiplicity of clinical presentations of PTLD. Among 350 liver transplantations performed in 303 children, 13 survivor children displayed a histological diagnosis of PTLD (13/242 survivors; 5.4%). The age at diagnosis ranged from 12 to 258 months (median, 47), and the time from transplantation ranged from 1 to 84 months (median, 13). Ten of these children (76.9%) were EBV-naïve prior to transplantation. Fever was present in all cases. The clinical signs at presentation were anemia (92.3%), diarrhea and vomiting (69.2%), recurrent upper airway infections (38.4%), Waldeyer ring lymphoid tissue hypertrophy (23.0%), abdominal mass lesions (30.7%), massive cervical and mediastinal adenopathy (15.3%), or gastrointestinal and respiratory symptoms (30.7%). One child developed fulminant hepatic allograft failure secondary to graft involvement by PTLD. Polymorphic PTLD was diagnosed in 6 patients; 7 had the diagnosis of lymphoma. Treatment consisted of stopping immunosuppression as well as starting intravenous gancyclovir and anti-CD20 monoclonal antibody therapy. The mortality rate was 53.8%. The clinical presentation of PTLD varied from fever of unknown origin to fulminant hepatic failure. The other symptoms that may be linked to the diagnosis of PTLD are pancytopenia, tonsil and adenoid hypertrophy, cervical or mediastinal lymph node enlargement, as well as abdominal masses. Despite numerous advances, the optimal treatment approach for PTLD is not completely known and the mortality rate is still high.

  16. Clinical Features of Patients with Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders

    Science.gov (United States)

    Chen, Hai; Liu, Shi-Meng; Zhang, Xu-Xiang; Liu, Ya-Ou; Li, Si-Zhao; Liu, Zheng; Dong, Hui-Qing

    2016-01-01

    Background: Neuromyelitis optica spectrum disorder (NMOSD) was long believed to be an aggressive form of multiple sclerosis (MS). This study aimed to describe the clinical features of patients with MS and NMOSD to assist in differential diagnoses in clinical practice. Methods: Data including the patients’ serum and cerebrospinal fluid (CSF) tests, image findings, and clinical information from 175 patients with MS or NMOSD at Xuanwu Hospital, Capital Medical University from November 2012 to May 2014 were collected and analyzed retrospectively. An enzyme-linked immunosorbent assay was performed to detect the myelin oligodendrocyte glycoprotein (MOG) autoantibodies in CSF and serum. Cell-based assays were used to detect aquaporin-4-antibody (AQP4-Ab). The Chi-square test was used to compare the categorical variables. Wilcoxon rank sum test was performed to analyze the continuous variables. Results: Totally 85 MS patients (49%) and 90 NMOSD patients (51%) were enrolled, including 124 (71%) women and 51 (29%) men. Fewer MS patients (6%) had autoimmune diseases compared to NMOSD (19%) (χ2 = 6.9, P < 0.01). Patients with NMOSD had higher Expanded Disability Status Scale scores (3.5 [3]) than MS group (2 [2]) (Z = −3.69, P < 0.01). The CSF levels of white cell count and protein in both two groups were slightly elevated than the normal range, without significant difference between each other. Positivity of serum AQP4-Ab in NMOSD patients was higher than that in MS patients (MS: 0, NMOSD: 67%; χ2 = 63.9, P < 0.01). Oligoclonal bands in CSF among NMOSD patients were remarkably lower than that among MS (MS: 59%, NMOSD: 20%; χ2 = 25.7, P < 0.01). No significant difference of MOG autoantibodies was found between the two groups. Conclusion: The different CSF features combined with clinical, magnetic resonance imaging, and serum characteristics between Chinese patients with MS and NMOSD could assist in the differential diagnosis. PMID:27569235

  17. Optical Coherence Tomography and Magnetic Resonance Imaging in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder

    Science.gov (United States)

    Manogaran, Praveena; Hanson, James V. M.; Olbert, Elisabeth D.; Egger, Christine; Wicki, Carla; Gerth-Kahlert, Christina; Landau, Klara; Schippling, Sven

    2016-01-01

    Irreversible disability in multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) is largely attributed to neuronal and axonal degeneration, which, along with inflammation, is one of the major pathological hallmarks of these diseases. Optical coherence tomography (OCT) is a non-invasive imaging tool that has been used in MS, NMOSD, and other diseases to quantify damage to the retina, including the ganglion cells and their axons. The fact that these are the only unmyelinated axons within the central nervous system (CNS) renders the afferent visual pathway an ideal model for studying axonal and neuronal degeneration in neurodegenerative diseases. Structural magnetic resonance imaging (MRI) can be used to obtain anatomical information about the CNS and to quantify evolving pathology in MS and NMOSD, both globally and in specific regions of the visual pathway including the optic nerve, optic radiations and visual cortex. Therefore, correlations between brain or optic nerve abnormalities on MRI, and retinal pathology using OCT, may shed light on how damage to one part of the CNS can affect others. In addition, these imaging techniques can help identify important differences between MS and NMOSD such as disease-specific damage to the visual pathway, trans-synaptic degeneration, or pathological changes independent of the underlying disease process. This review focuses on the current knowledge of the role of the visual pathway using OCT and MRI in patients with MS and NMOSD. Emphasis is placed on studies that employ both MRI and OCT to investigate damage to the visual system in these diseases. PMID:27854301

  18. Optical Coherence Tomography and Magnetic Resonance Imaging in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Praveena Manogaran

    2016-11-01

    Full Text Available Irreversible disability in multiple sclerosis (MS and neuromyelitis optica spectrum disorder (NMOSD is largely attributed to neuronal and axonal degeneration, which, along with inflammation, is one of the major pathological hallmarks of these diseases. Optical coherence tomography (OCT is a non-invasive imaging tool that has been used in MS, NMOSD, and other diseases to quantify damage to the retina, including the ganglion cells and their axons. The fact that these are the only unmyelinated axons within the central nervous system (CNS renders the afferent visual pathway an ideal model for studying axonal and neuronal degeneration in neurodegenerative diseases. Structural magnetic resonance imaging (MRI can be used to obtain anatomical information about the CNS and to quantify evolving pathology in MS and NMOSD, both globally and in specific regions of the visual pathway including the optic nerve, optic radiations and visual cortex. Therefore, correlations between brain or optic nerve abnormalities on MRI, and retinal pathology using OCT, may shed light on how damage to one part of the CNS can affect others. In addition, these imaging techniques can help identify important differences between MS and NMOSD such as disease-specific damage to the visual pathway, trans-synaptic degeneration, or pathological changes independent of the underlying disease process. This review focuses on the current knowledge of the role of the visual pathway using OCT and MRI in patients with MS and NMOSD. Emphasis is placed on studies that employ both MRI and OCT to investigate damage to the visual system in these diseases.

  19. Attention deficit hyperactivity disorder.

    Science.gov (United States)

    Kulkarni, Madhuri

    2015-03-01

    Attention Deficit Hyperactivity Disorder (ADHD) is a common behavioral disorder in children. It is characterized by motor hyperactivity, impulsivity and inattention inappropriate for the age. Approximately 5-10 % of school age children are diagnosed to have ADHD. The affected children show significant impairment in social behavior and academic performance. The DSM-5 criteria are useful in diagnosing three subtypes of ADHD based on presence of symptoms described in 3 domains viz ., inattention, hyperactivity and impulsivity. Co-morbidities like specific learning disability, anxiety disorder, oppositional defiant disorder are commonly associated with ADHD.Education of parents and teachers, behavioral therapy and medication are main components of management. Methylphenidate and Atomoxetine are effective in controlling symptoms of ADHD in most children. Research studies estimated that 30-60 % of children continue to show symptoms of ADHD in adulthood. The general practitioner can play an important role in early diagnosis, appropriate assessment and guiding parents for management of children with ADHD.

  20. Commentary: Differentiated Measures of Temperament and Multiple Pathways to Childhood Disorders

    Science.gov (United States)

    Rothbart, Mary K.

    2004-01-01

    Provided is a commentary on articles written for a special section on temperament and childhood disorders. Temperament's contributions to the development of childhood disorders are considered both generally and specifically. Questions are raised about the use of terminology in the field, particularly the term difficult. Differentiation of outcomes…

  1. Immediate-Release Methylphenidate for ADHD in Children with Comorbid Chronic Multiple Tic Disorder

    Science.gov (United States)

    Gadow, Kenneth D.; Sverd, Jeffrey; Nolan, Edith E.; Sprafkin, Joyce; Schneider, Jayne

    2007-01-01

    Objective: To examine the safety and efficacy of immediate-release methylphenidate (MPH-IR) for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children (ages 6-12 years) with Tourette's syndrome (96%) or chronic motor tic disorder (4%). Method: Two cohorts of prepubertal children (N = 71) received placebo and three doses of…

  2. Commentary: Differentiated Measures of Temperament and Multiple Pathways to Childhood Disorders

    Science.gov (United States)

    Rothbart, Mary K.

    2004-01-01

    Provided is a commentary on articles written for a special section on temperament and childhood disorders. Temperament's contributions to the development of childhood disorders are considered both generally and specifically. Questions are raised about the use of terminology in the field, particularly the term difficult. Differentiation of outcomes…

  3. Association between infection early in life and mental disorders among youth in the community: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Goodwin Renee D

    2011-11-01

    Full Text Available Abstract Background The objective of this study was to examine the association between infection early in life and mental disorders among youth in the community. Methods Data were drawn from the MECA (Methods in Epidemiology of Child and Adolescent psychopathology, a community-based study of 1,285 youth in the United States conducted in 1992. Multiple logistic regression analyses were used to investigate the association between parent/caregiver-reported infection early in life and DSM/DISC diagnoses of mental disorders at ages 9-17. Results Infection early in life was associated with a significantly increased odds of major depression (OR = 3.9, social phobia (OR = 5.8, overanxious disorder (OR = 6.1, panic disorder (OR = 12.1, and oppositional defiant disorder (OR = 3.7. Conclusions These findings are consistent with and extend previous results by providing new evidence suggesting a link between infection early in life and increased risk of depression and anxiety disorders among youth. These results should be considered preliminary. Replication of these findings with longitudinal epidemiologic data is needed. Possible mechanisms are discussed.

  4. Clinical Features of Patients with Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders

    Institute of Scientific and Technical Information of China (English)

    Hai Chen; Shi-Meng Liu; Xu-Xiang Zhang; Ya-Ou Liu; Si-Zhao Li; Zheng Liu; Hui-Qing Dong

    2016-01-01

    Background:Neuromyelitis optica spectrum disorder (NMOSD) was long believed to be an aggressive form of multiple sclerosis (MS).This study aimed to describe the clinical features of patients with MS and NMOSD to assist in differential diagnoses in clinical practice.Methods:Data including the patients' serum and cerebrospinal fluid (CSF) tests,image findings,and clinical information from 175 patients with MS or NMOSD at Xuanwu Hospital,Capital Medical University from November 2012 to May 2014 were collected and analyzed retrospectively.An enzyme-linked immunosorbent assay was performed to detect the myelin oligodendrocyte glycoprotein (MOG)autoantibodies in CSF and serum.Cell-based assays were used to detect aquaporin-4-antibody (AQP4-Ab).The Chi-square test was used to compare the categorical variables.Wilcoxon rank sum test was performed to analyze the continuous variables.Results:Totally 85 MS patients (49%) and 90 NMOSD patients (51%) were enrolled,including 124 (71%) women and 51 (29%) men.Fewer MS patients (6%) had autoimmune diseases compared to NMOSD (19%) (22 =6.9,P < 0.01).Patients with NMOSD had higher Expanded Disability Status Scale scores (3.5 [3]) than MS group (2 [2]) (Z =-3.69,P < 0.01).The CSF levels of white cell count and protein in both two groups were slightly elevated than the normal range,without significant difference between each other.Positivity of serum AQP4-Ab in NMOSD patients was higher than that in MS patients (MS:0,NMOSD:67%;x2 =63.9,P < 0.01).Oligoclonal bands in CSF among NMOSD patients were remarkably lower than that among MS (MS:59%,NMOSD:20%;x2 =25.7,P < 0.01).No significant difference of MOG autoantibodies was found between the two groups.Conclusion:The different CSF features combined with clinical,magnetic resonance imaging,and serum characteristics between Chinese patients with MS and NMOSD could assist in the differential diagnosis.

  5. The role of anxiety in cortisol stress response and cortisol recovery in boys with oppositional defiant disorder/conduct disorder

    NARCIS (Netherlands)

    Schoorl, Jantiene; van Rijn, S.; de Wied, M.; van Goozen, S.H.M.; Swaab, Hanna

    2016-01-01

    Children with antisocial and aggressive behaviors have been found to show abnormal neurobiological responses to stress, specifically impaired cortisol stress reactivity. The role of individual characteristics, such as comorbid anxiety, in the stress response is far less studied. Furthermore, this st

  6. Is ADHD a Risk Factor Independent of Conduct Disorder for Illicit Substance Use? A Meta-Analysis and Meta-Regression Investigation

    Science.gov (United States)

    Serra-Pinheiro, Maria Antonia; Coutinho, Evandro S. F.; Souza, Isabella S.; Pinna, Camilla; Fortes, Didia; Araujo, Catia; Szobot, Claudia M.; Rohde, Luis A.; Mattos, Paulo

    2013-01-01

    Objective: To investigate meta-analytically if the association between ADHD and illicit substance use (ISU) is maintained when controlling for conduct disorder/oppositional-defiant disorder (CD/ODD). Method: A systematic literature review was conducted through Medline from 1980 to 2008. Data extracted and selections made by one author were…

  7. Is ADHD a Risk Factor Independent of Conduct Disorder for Illicit Substance Use? A Meta-Analysis and Meta-Regression Investigation

    Science.gov (United States)

    Serra-Pinheiro, Maria Antonia; Coutinho, Evandro S. F.; Souza, Isabella S.; Pinna, Camilla; Fortes, Didia; Araujo, Catia; Szobot, Claudia M.; Rohde, Luis A.; Mattos, Paulo

    2013-01-01

    Objective: To investigate meta-analytically if the association between ADHD and illicit substance use (ISU) is maintained when controlling for conduct disorder/oppositional-defiant disorder (CD/ODD). Method: A systematic literature review was conducted through Medline from 1980 to 2008. Data extracted and selections made by one author were…

  8. Startle potentiation to uncertain threat as a psychophysiological indicator of fear-based psychopathology: An examination across multiple internalizing disorders.

    Science.gov (United States)

    Gorka, Stephanie M; Lieberman, Lynne; Shankman, Stewart A; Phan, K Luan

    2017-01-01

    Heightened reactivity to uncertain threat (U-threat) is an important individual difference factor that may characterize fear-based internalizing psychopathologies (IPs) and distinguish them from distress/misery IPs. To date, however, the majority of existing research examining reactivity to U-threat has been within individuals with panic disorder and major depressive disorder (MDD) and no prior study has directly tested this hypothesis across multiple IPs. The current study therefore explored whether heightened reactivity to U-threat is a psychophysiological indicator of fear-based psychopathology across 5 groups: current (a) social anxiety disorder (SAD); (b) specific phobia (SP); (c) generalized anxiety disorder (GAD); (d) MDD; and (c) individuals with no history of psychopathology (controls). All 160 adults completed a well-validated threat-of-shock task designed to probe responses to predictable (P-) and U-threat. Startle eyeblink potentiation was recorded as an index of aversive arousal. Results indicated that individuals with SAD and SP evidenced greater startle potentiation to U-threat, but not P-threat, relative to individuals with GAD, MDD, and controls (who did not differ). The current findings, along with the prior panic disorder and MDD literature, suggest that heightened reactivity to U-threat is a psychophysiological indicator of fear-based disorders and could represent a neurobiological organizing principle for internalizing psychopathology. The findings also suggest that individuals with fear disorders generally display a hypersensitivity to uncertain aversive events, which could contribute to their psychopathology. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  9. Multiple cluster axis II comorbidity and functional outcome in severe patients with borderline personality disorder.

    Science.gov (United States)

    Palomares, Nerea; McMaster, Antonia; Díaz-Marsá, Marina; de la Vega, Irene; Montes, Ana; Carrasco, José Luis

    2016-11-01

    Current literature suggests that personality disorder comorbidity negatively contributes to both the severity and prognosis of other disorders; however, little literature has been devoted to its influence on borderline personality disorder (BPD). The objective of the present work is to study comorbidity with other personality disorders in a severe clinical sample of patients with BPD, and its relationship with global functionality. A sample of 65 patients with severe borderline personality disorder was included in the study. Clinical and functionality measures were applied in order to study comorbidity of BPD with other disorders and its relationship with functionality. Associations with other comorbid PDs were analyzed with t-tests and linear correlations. Most patients (87%) presented comorbidity with other PDs. Almost half of the sample (42%) presented more than two PDs, and cluster A (paranoid) and C (obsessive and avoidant) PD were more frequent than cluster B (histrionic and antisocial). Only the presence of avoidant PD predicted a worse functional outcome in the long term (U Mann Withney ppersonality disorder might negatively predict for prognosis.

  10. The figure with recurrent presence: the defiant hero in Nigerian narratives

    Directory of Open Access Journals (Sweden)

    Ignatius Chukwumah

    2014-03-01

    Full Text Available Nigerian narratives always reveal corruption, disillusionment, mythological entities, political instability, cultural backgrounds and traditions of the tribes and nations used as context. Textual resources advertise literary works as realistic. In general, the recurring presence of the characters in these narratives is almost ignored. Unlike earlier interpretations of the Nigerian narratives, this essay is based on the theory of Frye’s five mimetic modes or categories. Based on the analysis of The Interpreters (SOYINKA, 1972 and The Famished Road (OKRI, 1992, this article examines the defiant hero as a recurring presence in Nigerian narratives. In fact, the hero is a character of resistance, which, in many ways, is in conflict with the laws made unbearable for others. The article also shows how the character, revealed by the constant manifestations of the structure of the primary activities of the hero of narratives such as myths, gradually and systematically hides in later narratives of mimetic modes through the emergence and influence of realist art. Similar processes in which the hero is involved are abundant in many Nigerian narratives. The insights revealed by these discussions serve to rethink previous critical views on these texts.

  11. The multiple dimensions of the social anxiety spectrum in mood disorders.

    Science.gov (United States)

    Fournier, Jay C; Cyranowski, Jill M; Rucci, Paola; Cassano, Giovanni B; Frank, Ellen

    2012-09-01

    Major depressive disorder and bipolar spectrum disorders are debilitating conditions associated with severe impairment. The presence of co-occurring social phobia can make the clinical course of these disorders even more challenging. To better understand the nature of social anxiety in the context of ongoing mood disorders, we report the results of exploratory factor analyses of the Social Phobia Spectrum Self-Report Instrument (SHY), a 162-item measure designed to capture the full spectrum of manifestations and features associated with social anxiety experienced across the lifespan. We examined data from 359 adult outpatients diagnosed with major depressive disorder and 403 outpatients diagnosed with a bipolar spectrum disorder. The measure was divided into its two components: the SHY-General (SHY-G), reflecting general social anxiety features, and the SHY-Specific (SHY-S), reflecting anxiety in specific situations. Exploratory factor analyses were conducted for each using tetrachoric correlation matrices and an unweighted least squares estimator. Item invariance was evaluated for important patient subgroups. Five factors were identified for the SHY-G, representing general features of social anxiety: Fear of Social Disapproval, Childhood Social Anxiety, Somatic Social Anxiety, Excessive Agreeableness, and Behavioral Submission. Seven specific-situation factors were identified from the SHY-S: Writing in Public, Dating, Public Speaking, Eating in Public, Shopping Fears, Using Public Restrooms, and Unstructured Social Interactions. The identified dimensions provide clinically valuable information about the nature of the social fears experienced by individuals diagnosed with mood disorders and could help guide the development of tailored treatment strategies for individuals with co-occurring mood disorders and social anxiety.

  12. Circadian rhythm sleep disorders in patients with multiple sclerosis and its association with fatigue: A case-control study

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Najafi

    2013-01-01

    Full Text Available Background: Circadian rhythm sleep disorders are a presentation of sleep disorders in patients with multiple sclerosis (MS. This study aims to compare this problem in MS patients with healthy people and to determine its association with chronic fatigue in MS patients. Materials and Methods: A case-control study was performed on 120 MS patients and 60 healthy subjects matched for age and sex, in 2009 in MS Clinic Alzahra Hospital. Sleep quality, rhythm and fatigue severity were assessed using PSQI (Pittsburgh sleep quality index and FSS (Fatigue severity Scale questionnaires, respectively. Its reliability and validity has been confirmed in several studies (Cronbach′s alpha = 0.83. This index has seven sections including patient′s assessment of his/her sleep, sleep duration, efficacy of routine sleep, sleep disorders, use of hypnotic medication, and dysfunction in daily activities. Results: Circadian rhythm sleep disorder was more frequent in MS patients relative to healthy subjects (P: 0.002. It was higher in MS patients with severe fatigue relative to MS patients with mild fatigue (P: 0.05. Fatigue severity was 49.9 ± 8.2 and 22.5 ± 7.4 in the first and second group, respectively. PSQI index was 7.9 ± 4.5 in patients with severe fatigue and 5.9 ± 4.5 in patients with mild fatigue and 4.5 ± 2.4 in the control group (P: 0.0001. Conclusion: Circadian rhythm sleep disorders are more frequent in MS patients and those with fatigue. Recognition and management of circadian rhythm sleep disorders in MS patients, especially those with fatigue may be helpful in improving care of these patients.

  13. Functional MRI studies in disruptive behaviour disorders.

    Science.gov (United States)

    Bellani, M; Garzitto, M; Brambilla, P

    2012-03-01

    Aggressive or antisocial behaviours with violations of social rules are the main features of disruptive behaviour disorders (DBDs), which are developmental diseases and include conduct disorder and oppositional defiant disorder. In the last decade, several efforts have been made to shed light on the biological underpinnings of DBDs. In this context, the main findings of functional magnetic resonance imaging studies in DBD are reported here. There are indications of neural dysfunctions in response to affective stimuli, especially regarding medial and orbitofrontal prefrontal cortex and connected subcortical structures.

  14. [Multiple system atrophy and Alzheimer's disease: a case report of a rare association of two neuro-degenerative disorders].

    Science.gov (United States)

    Rusina, R; Bourdain, F; Matej, R

    2007-12-01

    Multiple system atrophy (MSA) is a neurodegenerative disorder typically characterised by cerebellar dysfunction, parkinsonism, pyramidal signs and dysautonomy. Cognitive impairement is usually limited to a moderate subcortical dysexecutive syndrom. We report the case of a 62-year-old woman suffering from MSA who progressively developed severe dementia. Neuropathological examination confirmed the diagnosis of definite MSA and also showed histopathological hallmarks of Alzheimer's disease. This association is extremely rare in the literature. Our observation confirmes that franc dementia in MSA should prompt a search for another associated cause and underlines the usefulness of neuropathological verifications in atypical clinical pictures.

  15. 76 FR 66006 - Revised Medical Criteria for Evaluating Congenital Disorders That Affect Multiple Body Systems

    Science.gov (United States)

    2011-10-25

    ... trisomy (Edwards' syndrome or trisomy E) are usually expected to result in early death. Others such as cri... methods for establishing the existence of non-mosaic Down syndrome and other congenital disorders that... (section 110.00); Revise adult listing 10.06 and childhood listing 110.06 for non-mosaic Down syndrome;...

  16. Temperament and Attention Deficit Hyperactivity Disorder: The Development of a Multiple Pathway Model

    Science.gov (United States)

    Nigg, Joel T.; Goldsmith, H. Hill; Sachek, Jennifer

    2004-01-01

    This article outlines the parallels between major theories of attention deficit hyperactivity disorder (ADHD) and relevant temperament domains, summarizing recent research from our laboratories on (a) child temperament and (b) adult personality traits related to ADHD symptoms. These data are convergent in suggesting a role of effortful control and…

  17. Restraint and Cancellation: Multiple Inhibition Deficits in Attention Deficit Hyperactivity Disorder

    Science.gov (United States)

    Schachar, Russell; Logan, Gordon D.; Robaey, Philippe; Chen, Shirley; Ickowicz, Abel; Barr, Cathy

    2007-01-01

    We used variations of the stop signal task to study two components of motor response inhibition--the ability to withhold a strong response tendency (restraint) and the ability to cancel an ongoing action (cancellation)--in children with a diagnosis of attention deficit hyperactivity disorder (ADHD) and in non-ADHD controls of similar age (ages…

  18. Facebook Role Play Addiction - A Comorbidity with Multiple Compulsive-Impulsive Spectrum Disorders.

    Science.gov (United States)

    Nathan, Deeepa; Shukla, Lekhansh; Kandasamy, Arun; Benegal, Vivek

    2016-06-01

    Background Problematic Internet use (PIU) is an emerging entity with varied contents. Behavioral addictions have high comorbidity of attention deficit hyperactivity disorder and obsessive-compulsive spectrum disorders. Social networking site (SNS) addiction and role playing game (RPG) addiction are traditionally studied as separate entities. We present a case with excessive Internet use, with a particular focus on phenomenology and psychiatric comorbidities. Case presentation Fifteen-year-old girl with childhood onset attention deficit disorder, obsessive-compulsive disorder, adolescent onset trichotillomania, and disturbed family environment presented with excessive Facebook use. Main online activity was creating profiles in names of mainstream fictional characters and assuming their identity (background, linguistic attributes, etc.). This was a group activity with significant socialization in the virtual world. Craving, salience, withdrawal, mood modification, and conflict were clearly elucidated and significant social and occupational dysfunction was evident. Discussion This case highlights various vulnerability and sociofamilial factors contributing to behavioral addiction. It also highlights the presence of untreated comorbidities in such cases. The difference from contemporary RPGs and uniqueness of role playing on SNS is discussed. SNS role playing as a separate genre of PIU and its potential to reach epidemic proportions are discussed. Conclusions Individuals with temperamental vulnerability are likely to develop behavioral addictions. Identification and management of comorbid conditions are important. The content of PIU continues to evolve and needs further study.

  19. Inattention, hyperactivity, oppositional-defiant symptoms and school failure Desatenção, hiperatividade, sintomas de oposição e desafio e fracasso escolar

    Directory of Open Access Journals (Sweden)

    Maria Antonia Serra-Pinheiro

    2008-12-01

    Full Text Available BACKGROUND: Attention-deficit hyperactivity disorder (ADHD is associated with school failure. Inattention has been mainly implicated for this association. Oppositional-defiant disorder's (ODD impact on academic performance remains controversial, because of the high comorbidity between ODD and ADHD. OBJECTIVE: To understand the role of inattention (IN, hyperactivity (H/I and ODD in school failure. METHOD: Parents and teachers filled out SNAP-IV questionnaires for 241 / 6th grade students. The associations of the scores of oppositional-defiant (OP, H/I and IN symptoms with school year failure were calculated. RESULTS: IN was strongly correlated with school failure. H/I and OP were not associated with school failure, when controlled for IN. CONCLUSION: OP and H/I symptoms do not play an important role in school failure, when controlled for IN symptoms. Our study supports the cross-cultural role of IN as a major predictor of school failure.Transtorno do déficit de atenção e hiperatividade (TDAH está fortemente correlacionado a fracasso escolar. Desatenção (DA parece ser primordialmente responsável por essa associação. A influência de transtorno desafiador de oposicão (TDO sobre o desempenho acadêmico continua a ser controversa, principalmente devido à alta comorbidade entre TDO e TDAH. OBJETIVO: Entender melhor o papel da DA, hiperatividade/impulsividade (H/I e sintomas opositivo-desafiadores (OP no fracasso escolar. MÉTODO: Duzentos e quarenta e um estudantes da 6ª série foram avaliados com os questionários de Swanson, Nolan e Pelham (SNAP-IV, preenchidos pelos pais e professores. As associações entre as sub-escalas de OP, H/I e DA, com o número de notas "I" ("insuficiente" e com reprovação escolar foram calculadas. RESULTADOS: Sintomas OP não foram correlacionados com o número de notas "I", após o controle para a sua associação com H/I e DA. DA se associou com fracasso escolar. H/I não se correlacionou com fracasso

  20. Mother-Son Interactions in Families of Boys with Attention-Deficit/hyperactivity Disorder with and without Oppositional Behavior.

    Science.gov (United States)

    Seipp, Carla M.; Johnston, Charlotte

    2005-01-01

    Parenting responsiveness and over-reactivity were assessed among 25 mothers of 7-9-year-old sons with Attention-Deficit/Hyperactivity Disorder (ADHD) and oppositional behavior (Oppositional Defiant, OD), 24 mothers of sons with ADHD only, and 38 mothers of nonproblem sons. Responsiveness was observed during mother-son play and clean-up…

  1. The persistence of folly: critical examination of dissociative identity disorder. Part II. The defence and decline of multiple personality or dissociative identity disorder.

    Science.gov (United States)

    Piper, August; Merskey, Harold

    2004-10-01

    In this second part of our review, we continue to explore the illogical nature of the arguments offered to support the concept of dissociative identity disorder (DID). We also examine the harm done to patients by DID proponents' diagnostic and treatment methods. It is shown that these practices reify the alters and thereby iatrogenically encourage patients to behave as if they have multiple selves. We next examine the factors that make impossible a reliable diagnosis of DID--for example, the unsatisfactory, vague, and elastic definition of "alter personality." Because the diagnosis is unreliable, we believe that US and Canadian courts cannot responsibly accept testimony in favour of DID. Finally, we conclude with a guess about the condition's status over the next 10 years.

  2. Multiple epigenetic factors predict the attention deficit/hyperactivity disorder among the Chinese Han children.

    Science.gov (United States)

    Xu, Yi; Chen, Xiang-Tao; Luo, Man; Tang, Yuqing; Zhang, Guangxiang; Wu, De; Yang, Bin; Ruan, Di-Yun; Wang, Hui-Li

    2015-05-01

    Attention deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders of childhood. Despite its prevalence, the critical factors involved in its development remain to be identified. It was recently suggested that epigenetic mechanisms probably contribute to the etiology of ADHD. The present study was designed to examine the associations of epigenetic markers with ADHD among Chinese Han children, aiming to establish the prediction model for this syndrome from the epigenetic perspective. We conducted a pair-matching case-control study, and the ADHD children were systematically evaluated via structured diagnostic interviews, including caregiver interviews, based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, revised criteria (DSM-IV-R). The expression levels of risk genes DAT1, DRD4, DRD5, as well as their promoter methylation, were determined respectively, followed by the expression profiles of histone-modifying genes p300, MYST4, HDAC1, MeCP2. The multivariate logistic regressions were performed to establish ADHD prediction models. All of the seven genes tested were identified as risk factors for ADHD. The methylation of one critical CpG site located upstream of DRD4 was shown to affect its transcription, suggesting a role in ADHD's development. Aberrant DNA methylation and histone acetylation were indicated in ADHD patients. In addition, a prediction model was established using the combination of p300, MYST4 and HDAC1, with the accuracy of 0.9338. This is, to our knowledge, the first study to clearly demonstrate the associations between epigenetic markers and ADHD, shedding light on the preliminary diagnosis and etiological studies of this widespread disorder.

  3. Predicting quality of life in multiple sclerosis: accounting for physical disability, fatigue, cognition, mood disorder, personality, and behavior change.

    Science.gov (United States)

    Benedict, Ralph H B; Wahlig, Elizabeth; Bakshi, Rohit; Fishman, Inna; Munschauer, Frederick; Zivadinov, Robert; Weinstock-Guttman, Bianca

    2005-04-15

    Health-related quality of life (HQOL) is poor in multiple sclerosis (MS) but the clinical precipitants of the problem are not well understood. Previous correlative studies demonstrated relationships between various clinical parameters and diminished HQOL in MS. Unfortunately, these studies failed to account for multiple predictors in the same analysis. We endeavored to determine what clinical parameters account for most variance in predicting HQOL, and employability, while accounting for disease course, physical disability, fatigue, cognition, mood disorder, personality, and behavior disorder. In 120 MS patients, we measured HQOL (MS Quality of Life-54) and vocational status (employed vs. disabled) and then conducted detailed clinical testing. Data were analyzed by linear and logistic regression methods. MS patients reported lower HQOL (pPhysical HQOL was predicted by fatigue, depression, and physical disability. Mental HQOL was associated with only depression and fatigue. In contrast, vocational status was predicted by three cognitive tests, conscientiousness, and disease duration (p<0.05). Thus, for the first time, we predicted HQOL in MS while accounting for measures from these many clinical domains. We conclude that self-report HQOL indices are most strongly predicted by measures of depression, whereas vocational status is predicted primarily by objective measures of cognitive function. The findings highlight core clinical problems that merit early identification and further research regarding the development of effective treatment.

  4. Multiple self-healing squamous epithelioma in different ethnic groups: more than a founder mutation disorder?

    DEFF Research Database (Denmark)

    D'Alessandro, Mariella; Coats, Stephanie E; Morley, Susan M

    2007-01-01

    Multiple self-healing squamous epithelioma (MSSE), also known as Ferguson-Smith Disease, is a rare cancer-associated genodermatosis with an autosomal dominant inheritance. Affected patients suffer from recurrent skin lesions, which clinically and histologically resemble keratoacanthomas or well-d...

  5. Report from the european myeloma network on interphase FISHin multiple myeloma and related disorders

    DEFF Research Database (Denmark)

    Ross, Fiona; Avet-Loiseau, Herve; Ameye, Genevieve;

    2012-01-01

    The European Myeloma Network has organized two workshops on fluorescence in situ hybridization in multiple myeloma. The first aimed to identify specific indications and consensus technical approaches of current practice. A second workshop followed a quality control exercise in which 21 laboratori...

  6. Multiple Ocular and Systemic Disorders in Association with Bilateral Duane's Retraction Syndrome

    Science.gov (United States)

    Zare, Mohammad Ali; Akbari, Mohammad Reza; Kiarudi, Mohammad Yaser; Mehrjardi, Hadi Zare

    2016-01-01

    Duane's retraction syndrome (DRS) is characterized by limitations in horizontal eye movements, globe retraction, and palpebral fissure narrowing on attempted adduction. This disorder is caused by a disturbance in innervation originating in the brain stem and represents <1% of all cases of strabismus. It is postulated that this syndrome is due to an insult during the early weeks (8–10 weeks) of pregnancy and is 10–20 times more frequently associated with other systemic congenital anomalies. This case report of bilateral DRS included bilateral iris-retinal coloboma and congenital heart disease, sensory hearing loss, and inguinal hernia. PMID:27555711

  7. The efficacy and safety of multiple doses of vortioxetine for generalized anxiety disorder: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Fu J

    2016-04-01

    Full Text Available Jie Fu,1 Lilei Peng,2 Xiaogang Li1 1Department of Neurology, 2Department of Neurosurgery, The Affiliated Hospital of Luzhou Medical College, Luzhou, People’s Republic of China Objective: Vortioxetine is a novel antidepressant approved for the treatment of major depressive disorder by the US Food and Drug Administration in September 2013. This meta-analysis assessed the efficacy and safety of different doses of vortioxetine for generalized anxiety disorder of adults.Methods: PubMed, Cochrane Library, PsycINFO, and Clinical Trials databases were searched from 2000 through 2015. The abstracts of the annual meetings of the American Psychiatric Association and previous reviews were searched to identify additional studies. The search was limited to individual randomized controlled trials (RCTs, and there was no language restriction. Four RCTs met the selection criteria. These studies included 1,843 adult patients. Results were expressed as odds ratios (ORs and 95% confidence intervals (CIs. The data were pooled with a random-effects or fixed-effects model.Results: The results showed that multiple doses (2.5, 5, and 10 mg/d of vortioxetine did not significantly improve the generalized anxiety disorder symptoms compared to placebo (OR=1.16, 95% CI=0.84–1.60, Z=0.89, P=0.38; OR=1.41, 95% CI=0.82–2.41, Z=1.25, P=0.21; OR=1.05, 95% CI=0.76–1.46, Z=0.32, P=0.75, respectively. We measured the efficacy of 2.5 mg/d vortioxetine compared to 10 mg/d, and no significant differences were observed. The common adverse effects included nausea and headache. With increased dose, nausea was found to be more frequent in the vortioxetine (5 and 10 mg/d group (OR=2.99, 95% CI=1.31–6.84, Z=2.60, P=0.009; OR=2.80, 95% CI=1.85–4.25, Z=4.85, P<0.00001, respectively, but no significant differences were observed for headache.Conclusion: The results showed no significant improvement in the treatment of generalized anxiety disorder for vortioxetine compared to placebo

  8. Capturing domain knowledge from multiple sources: the rare bone disorders use case

    OpenAIRE

    Groza, Tudor; Tudorache, Tania; Peter N Robinson; Zankl, Andreas

    2015-01-01

    Background Lately, ontologies have become a fundamental building block in the process of formalising and storing complex biomedical information. The community-driven ontology curation process, however, ignores the possibility of multiple communities building, in parallel, conceptualisations of the same domain, and thus providing slightly different perspectives on the same knowledge. The individual nature of this effort leads to the need of a mechanism to enable us to create an overarching and...

  9. Effects of Psychiatric Disorders on Labor Market Outcomes: A Latent Variable Approach Using Multiple Clinical Indicators.

    Science.gov (United States)

    Banerjee, Souvik; Chatterji, Pinka; Lahiri, Kajal

    2017-02-01

    In this paper, we estimate the effect of psychiatric disorders on labor market outcomes using a structural equation model with a latent index for mental illness, an approach that acknowledges the continuous nature of psychiatric disability. We also address the potential endogeneity of mental illness using an approach proposed by Lewbel (2012) that relies on heteroscedastic covariance restrictions rather than questionable exclusion restrictions for identification. Data come from the US National Comorbidity Survey - Replication and the National Latino and Asian American Study. We find that mental illness adversely affects employment and labor force participation and also reduces the number of weeks worked and increases work absenteeism. To assist in the interpretation of findings, we simulate the labor market outcomes of individuals meeting diagnostic criteria for mental disorder if they had the same mental health symptom profile as individuals not meeting diagnostic criteria. We estimate potential gains in employment for 3.5 million individuals, and reduction in workplace costs of absenteeism of $21.6 billion due to the resultant improvement in mental health. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  10. Multiple episodes in children and adolescents with bipolar disorder: comorbidity, hospitalization, and treatment (data from a cohort of 8,129 patients of a national managed care database).

    Science.gov (United States)

    Castilla-Puentes, Ruby

    2008-01-01

    The purpose of this study was to delineate the prevalence, demographic characteristics, comorbidity, hospitalization, and medication use of a large cohort of patients with and without multiple episodes per year. We hypothesized that children and adolescents with multiple episodes per year would have a higher comorbidity and require more hospitalizations and pharmacological treatment than their counterparts without multiple episodes. Analysis was conducted on a cohort of 8,129 children and adolescents patients (bipolar disorders (BD), from the Integrated Healthcare Information Services (IHCIS) identified from June 30, 2000 to July 1, 2003. Demographics variables, type of hospitalization, and psychotropic medication used in the year of follow-up were compared between children and adolescents with multiple and those without multiple episodes per year. Included were 58 patients with multiple episodes (defined as: > or = 4 or more reports of inpatient treatment for any affective disorders per year) and 8,071 without multiple episodes. Children and adolescents with multiple episodes versus those without multiple episodes were differentiated as follows: more comorbid attention deficit disorder (ADD) (80.9% versus 29.4%) (chi2 = 70.61, df = 1, p children and adolescents with multiple episodes per year present a higher comorbidity and require more hospitalizations and pharmacological treatment than those without multiple episodes. The diagnosis and treatment of children and adolescents with BD will have to take into account the high comorbidity of ADD mainly in children and adolescents with multiple episodes. Future prospective studies will help to better characterize the impact of multiple episodes in the course of pediatric BD and facilitate appropriate treatment strategies.

  11. Multiple benefits of personal FM system use by children with auditory processing disorder (APD).

    Science.gov (United States)

    Johnston, Kristin N; John, Andrew B; Kreisman, Nicole V; Hall, James W; Crandell, Carl C

    2009-01-01

    Children with auditory processing disorders (APD) were fitted with Phonak EduLink FM devices for home and classroom use. Baseline measures of the children with APD, prior to FM use, documented significantly lower speech-perception scores, evidence of decreased academic performance, and psychosocial problems in comparison to an age- and gender-matched control group. Repeated measures during the school year demonstrated speech-perception improvement in noisy classroom environments as well as significant academic and psychosocial benefits. Compared with the control group, the children with APD showed greater speech-perception advantage with FM technology. Notably, after prolonged FM use, even unaided (no FM device) speech-perception performance was improved in the children with APD, suggesting the possibility of fundamentally enhanced auditory system function.

  12. Getting the Balance Right: The Challenge of Balancing Praise and Correction for Early School Years Children Who Exhibit Oppositional and Defiant Behaviour

    Science.gov (United States)

    Fields, Barry

    2012-01-01

    Increasingly, early childhood practitioners are faced with children who present with significant levels of oppositional and defiant behaviour. The management of this behaviour is often difficult and stressful. Efforts to minimise disruptive behaviour and to encourage more prosocial behaviour have very much revolved around the teaching of…

  13. Disorder, fluctuations and electron interactions in doped semiconductors: A multiple-scattering approach

    Science.gov (United States)

    Ghazali, A.; Serre, J.

    1985-02-01

    Using a multiple-scattering method, we estimate the relative importance of both scattering and concentration-fluctuation effects on the band tailing and on interband optical absorption spectra. In addition, we show that as the impurity concentration decreases, the band tail gradually splits off from the main band, forming an impurity band. Spectral-density analysis allows one to distinguish between quasi-atomic and extended states. It is found that even when no gap appears, a significant part of electrons in the tail has a quasi-atomic character. Compensation effects have also been analyzed. Finally, our results are discussed and compared with various experiments.

  14. Multiple-trait estimates of genetic parameters for metabolic disease traits, fertility disorders, and their predictors in Canadian Holsteins.

    Science.gov (United States)

    Jamrozik, J; Koeck, A; Kistemaker, G J; Miglior, F

    2016-03-01

    Producer-recorded health data for metabolic disease traits and fertility disorders on 35,575 Canadian Holstein cows were jointly analyzed with selected indicator traits. Metabolic diseases included clinical ketosis (KET) and displaced abomasum (DA); fertility disorders were metritis (MET) and retained placenta (RP); and disease indicators were fat-to-protein ratio, milk β-hydroxybutyrate, and body condition score (BCS) in the first lactation. Traits in first and later (up to fifth) lactations were treated as correlated in the multiple-trait (13 traits in total) animal linear model. Bayesian methods with Gibbs sampling were implemented for the analysis. Estimates of heritability for disease incidence were low, up to 0.06 for DA in first lactation. Among disease traits, the environmental herd-year variance constituted 4% of the total variance for KET and less for other traits. First- and later-lactation disease traits were genetically correlated (from 0.66 to 0.72) across all traits, indicating different genetic backgrounds for first and later lactations. Genetic correlations between KET and DA were relatively strong and positive (up to 0.79) in both first- and later-lactation cows. Genetic correlations between fertility disorders were slightly lower. Metritis was strongly genetically correlated with both metabolic disease traits in the first lactation only. All other genetic correlations between metabolic and fertility diseases were statistically nonsignificant. First-lactation KET and MET were strongly positively correlated with later-lactation performance for these traits due to the environmental herd-year effect. Indicator traits were moderately genetically correlated (from 0.30 to 0.63 in absolute values) with both metabolic disease traits in the first lactation. Smaller and mostly nonsignificant genetic correlations were among indicators and metabolic diseases in later lactations. The only significant genetic correlations between indicators and fertility

  15. [Conduction disorders at multiple levels during the acute phase of a myocardial infarct: an electrophysiological study].

    Science.gov (United States)

    García Burgos, A; Rangel Abundis, A; Castaño, R; Ramos, M A; Badui, E

    1993-01-01

    Forty patients with a diagnosis of acute myocardial infarction (anterior 24, and inferior 16) were studied. Of these patients, 37.5% manifested second and third degree atrioventricular (AV) block as a complication; another 30% showed complete right bundle branch and left anterior hemiblock. Right bundle branch and left posterior hemiblock were evidenced in 12.5% of the subjects. There was 20% with complete left bundle branch block. Electrophysiologic studies were performed in all patients to assess the site of block. A direct relation was found between the surface ECG and the His bundle electrogram studies in patients with an inferior myocardial infarction and AV block, both procedures located the conduction disturbances at the AV node (suprahisian block), in contrast to patients with anteroseptal myocardial infarction whose surface ECG only showed bundle branch block or fascicular block. The His bundle electrogram registered multiple levels of AV block, 70% with troncular and infrahisian block that gave way to sudden AV block. The mechanism responsible for this block was considered to be a functional longitudinal dissociation of conduction system due to an acute ischemic injury of the His bundle, more than a sudden and simultaneous failure of all the bundle branch of His. We conclude that electrophysiologic studies are a useful procedure for identification of a group of patients with multiple AV conduction disturbances that have a less favorable prognosis than those with only suprahisian level of block.

  16. Similar or disparate brain patterns? The intra-personal EEG variability of three women with multiple personality disorder.

    Science.gov (United States)

    Lapointe, A R; Crayton, J W; DeVito, R; Fichtner, C G; Konopka, L M

    2006-07-01

    Quantitative EEG was used to assess the intra-personal variability of brain electrical activity for 3 women diagnosed with Multiple Personality Disorder (MPD). Two separate control groups (within-subject and between-subject) were used to test the hypothesis that the intra-personal EEG variability between 2 alters would be less than the interpersonal EEG variability between 2 controls, and similar to the intra-personal EEG variability of a single personality. This hypothesis was partially supported. In general, the 2 EEG records of a MPD subject (alter 1 vs. alter 2) were more different from one another than the 2 EEG records of a single control, but less different from one another than the EEG records of 2 separate controls. Most of the EEG variability between alters involved beta activity in the frontal and temporal lobes.

  17. A comparison of three Rorschach diagnostic systems and use of the Hand Test for detecting multiple personality disorder in outpatients.

    Science.gov (United States)

    Young, G R; Wagner, E E; Finn, R F

    1994-06-01

    Eleven individuals diagnosed with multiple personality disorder (MPD) on the basis of clinical observation by experienced therapists plus elevated scores on the Dissociative Experiences Scale (DES; Bernstein & Putnam, 1986) were administered the Rorschach Inkblot Test and the Hand Test. Results from the sample (n = 11) and a matched control group (N = 22) were analyzed and discussed in accordance with previous Rorschach diagnostic systems. The Wagner Signs diagnosed 91% (n = 10) of the MPD cases in this outpatient sample, with no false positives. The Labott Signs were found to have no utility, and the Barach Signs, when they occurred, seemed to be diagnostic of MPD but yielded a high rate of false negatives. Hand Test results were analyzed and found to be possibly diagnostic of MPD. Tentative criteria were proposed for its use as an additional tool for diagnosing MPD.

  18. Disorder-induced incoherent scattering losses in photonic crystal waveguides: Bloch mode reshaping, multiple scattering, and breakdown of the Beer-Lambert law

    Science.gov (United States)

    Patterson, M.; Hughes, S.; Schulz, S.; Beggs, D. M.; White, T. P.; O'Faolain, L.; Krauss, T. F.

    2009-11-01

    Through a combined theoretical and experimental study of disorder-induced incoherent scattering losses in slow-light photonic crystal slab waveguides, we show the importance of Bloch mode reshaping and multiple scattering. We describe a convenient and fully three-dimensional theoretical treatment of disorder-induced extrinsic scattering, including the calculation of backscatter and out-of-plane losses per unit cell, and the extrapolation of the unit-cell loss to the loss for an entire disordered waveguide. The theoretical predictions, which are also compared with recent measurements on dispersion engineered silicon waveguides, demonstrate the failure of the Beer-Lambert law due to multiple scattering. We also explain why the previously assumed group velocity scalings of disorder-induced loss break down in general.

  19. Characteristics of multiple sclerosis patient stance control disorders, measured by means of posturography and related to brainstem lesions

    Directory of Open Access Journals (Sweden)

    Dario Alpini

    2012-01-01

    Full Text Available Balance disorders are commonly observed during the course of multiple sclerosis (MS. The aim of this study is to report characteristics of MS patient stance control disorders, measured by means of posturography and related to the brainstem lesions. Thirty-eight patients affected by MS, mildly to moderately disable according to Kurtzke’s Expanded Disability Status Scale, underwent a complete clinical neurological and vestibular evaluation and brain MRI scanning. All patients were then tested on a static posturography platform (Tetrax, Israel in four conditions: eyes open and eyes closed standing on a firm surface and on a foam pad. Clinical and/or magnetic resonance imaging evidence of brainstem involvement was observed in 55.3% of patients. When brainstem lesion was detected, Fourier analysis showed a typical pattern characterized by inversion of the 0- 0.1 Hz and 0.1-0.25 Hz frequency bands. In conclusion, MS leads to pervasive postural disturbances in the majority of subjects, including the visuo-vestibular loops and proprioception involving vestibulospinal pathways in at least 55.3% of patients. Our results may also suggest the presence of Fourier inversion in patients with brainstem lesions.

  20. Genetic and functional analyses of SHANK2 mutations suggest a multiple hit model of autism spectrum disorders.

    Directory of Open Access Journals (Sweden)

    Claire S Leblond

    2012-02-01

    Full Text Available Autism spectrum disorders (ASD are a heterogeneous group of neurodevelopmental disorders with a complex inheritance pattern. While many rare variants in synaptic proteins have been identified in patients with ASD, little is known about their effects at the synapse and their interactions with other genetic variations. Here, following the discovery of two de novo SHANK2 deletions by the Autism Genome Project, we identified a novel 421 kb de novo SHANK2 deletion in a patient with autism. We then sequenced SHANK2 in 455 patients with ASD and 431 controls and integrated these results with those reported by Berkel et al. 2010 (n = 396 patients and n = 659 controls. We observed a significant enrichment of variants affecting conserved amino acids in 29 of 851 (3.4% patients and in 16 of 1,090 (1.5% controls (P = 0.004, OR = 2.37, 95% CI = 1.23-4.70. In neuronal cell cultures, the variants identified in patients were associated with a reduced synaptic density at dendrites compared to the variants only detected in controls (P = 0.0013. Interestingly, the three patients with de novo SHANK2 deletions also carried inherited CNVs at 15q11-q13 previously associated with neuropsychiatric disorders. In two cases, the nicotinic receptor CHRNA7 was duplicated and in one case the synaptic translation repressor CYFIP1 was deleted. These results strengthen the role of synaptic gene dysfunction in ASD but also highlight the presence of putative modifier genes, which is in keeping with the "multiple hit model" for ASD. A better knowledge of these genetic interactions will be necessary to understand the complex inheritance pattern of ASD.

  1. Genetic and Functional Analyses of SHANK2 Mutations Suggest a Multiple Hit Model of Autism Spectrum Disorders

    Science.gov (United States)

    Leblond, Claire S.; Heinrich, Jutta; Delorme, Richard; Proepper, Christian; Betancur, Catalina; Huguet, Guillaume; Konyukh, Marina; Chaste, Pauline; Ey, Elodie; Rastam, Maria; Anckarsäter, Henrik; Nygren, Gudrun; Gillberg, I. Carina; Melke, Jonas; Toro, Roberto; Regnault, Beatrice; Fauchereau, Fabien; Mercati, Oriane; Lemière, Nathalie; Skuse, David; Poot, Martin; Holt, Richard; Monaco, Anthony P.; Järvelä, Irma; Kantojärvi, Katri; Vanhala, Raija; Curran, Sarah; Collier, David A.; Bolton, Patrick; Chiocchetti, Andreas; Klauck, Sabine M.; Poustka, Fritz; Freitag, Christine M.; Waltes, Regina; Kopp, Marnie; Duketis, Eftichia; Bacchelli, Elena; Minopoli, Fiorella; Ruta, Liliana; Battaglia, Agatino; Mazzone, Luigi; Maestrini, Elena; Sequeira, Ana F.; Oliveira, Barbara; Vicente, Astrid; Oliveira, Guiomar; Pinto, Dalila; Scherer, Stephen W.; Zelenika, Diana; Delepine, Marc; Lathrop, Mark; Bonneau, Dominique; Guinchat, Vincent; Devillard, Françoise; Assouline, Brigitte; Mouren, Marie-Christine; Leboyer, Marion; Gillberg, Christopher; Boeckers, Tobias M.; Bourgeron, Thomas

    2012-01-01

    Autism spectrum disorders (ASD) are a heterogeneous group of neurodevelopmental disorders with a complex inheritance pattern. While many rare variants in synaptic proteins have been identified in patients with ASD, little is known about their effects at the synapse and their interactions with other genetic variations. Here, following the discovery of two de novo SHANK2 deletions by the Autism Genome Project, we identified a novel 421 kb de novo SHANK2 deletion in a patient with autism. We then sequenced SHANK2 in 455 patients with ASD and 431 controls and integrated these results with those reported by Berkel et al. 2010 (n = 396 patients and n = 659 controls). We observed a significant enrichment of variants affecting conserved amino acids in 29 of 851 (3.4%) patients and in 16 of 1,090 (1.5%) controls (P = 0.004, OR = 2.37, 95% CI = 1.23–4.70). In neuronal cell cultures, the variants identified in patients were associated with a reduced synaptic density at dendrites compared to the variants only detected in controls (P = 0.0013). Interestingly, the three patients with de novo SHANK2 deletions also carried inherited CNVs at 15q11–q13 previously associated with neuropsychiatric disorders. In two cases, the nicotinic receptor CHRNA7 was duplicated and in one case the synaptic translation repressor CYFIP1 was deleted. These results strengthen the role of synaptic gene dysfunction in ASD but also highlight the presence of putative modifier genes, which is in keeping with the “multiple hit model” for ASD. A better knowledge of these genetic interactions will be necessary to understand the complex inheritance pattern of ASD. PMID:22346768

  2. Sudden hearing loss as the initial symptom in Japanese patients with multiple sclerosis and seropositive neuromyelitis optica spectrum disorders.

    Science.gov (United States)

    Tanaka, Masami; Tanaka, Keiko

    2016-09-15

    Sudden hearing loss may occur in rare cases of relapsing-remitting multiple sclerosis (RRMS). There have also been reports of idiopathic sudden sensorineural hearing loss (SNHL) in patients with neuromyelitis optica spectrum disorders (NMOSD), but the frequency of such cases is unclear. We conducted a retrospective analysis of the medical records of 173 consecutive patients with multiple sclerosis (MS) and 101 consecutive patients with NMOSD who tested positive for anti-aquaporin-4 antibodies in addition to 37 consecutive patients with clinically isolated syndromes (CIS) to investigate the frequency and onset timing of SNHL. SNHL was observed in six (3.5%) of the RRMS cases, one (1.0%) of the seropositive NMOSD cases, and three (8.1%) of the CIS cases. SNHL occurred ahead of onset in 4/6 MS patients and in all of 3 CIS patients. Patient with NMOSD exhibited SNHL 6years after the onset of NMOSD. Although SNHL is rare, these results suggest the risk of developing demyelinating lesions in the central nervous system and further conversion to MS in the future. Copyright © 2016. Published by Elsevier B.V.

  3. Multiple patterns of writing disorders in dementia of the Alzheimer type and their evolution.

    Science.gov (United States)

    Luzzatti, Claudio; Laiacona, Marcella; Agazzi, Daniela

    2003-01-01

    This paper reports the results obtained from a writing task given to 23 Italian patients suffering from mild to moderate dementia of the Alzheimer's type (DAT). Spelling performance was tested with a task that taps the sub-word-level (spelling of regular words and nonwords), and the lexical route (spelling of regular and irregular words), in line with contemporary models of writing. Each patient's performance was classified according to the emergence of dissociated patterns of damage between regular words and nonwords and between regular and irregular words. The 23 DAT patients span the whole spectrum of dysgraphic taxonomy; five showed the characteristic pattern of impairment of surface dysgraphia, two showed the characteristics of phonological dysgraphia, while a mixed pattern (i.e. better performance on regular words compared to irregular words and regular nonwords) emerged in seven cases. Three patients presented undifferentiated writing disorders, two were completely agraphic, while four patients showed only minimal or no writing defects. The rate of dissociated impairments in the lexical and the sub-word-level routine is very similar to that observed after acute focal brain damage, which contradicts the hypothesis that degenerative brain damage selectively impairs writing performance along the lexical-semantic route. To test the hypothesis that surface sub-word-level processing abilities are affected only during the evolution of the disease, nine patients were tested longitudinally after an interval of 6-12 months. Once again, the data showed high variability across subjects, and do not seem to support involvement of the sub-word-level spelling routine only at a late stage in the development of the disease.

  4. Hypogelsolinemia, a disorder of the extracellular actin scavenger system, in patients with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Janmey Paul A

    2010-11-01

    Full Text Available Abstract Background Extracellular gelsolin (GSN and GC-globulin/Vitamin D-binding protein (DBP appear to play an important role in clearing the actin from extracellular fluids and in modulating cellular responses to anionic bioactive lipids. In this study we hypothesized that cellular actin release and/or increase in bioactive lipids associated with multiple sclerosis (MS development will translate into alteration of the actin scavenger system protein concentrations in blood and cerebrospinal fluid (CSF of patients with MS. Methods We measured GSN and DBP concentrations in blood and CSF obtained from patients diagnosed with MS (n = 56 in comparison to a control group (n = 20 that includes patients diagnosed with conditions such as idiopathic cephalgia (n = 11, idiopathic (Bell's facial nerve palsy (n = 7 and ischialgia due to discopathy (n = 2. GSN and DBP levels were measured by Western blot and ELISA, respectively. Results We found that the GSN concentration in the blood of the MS group (115 ± 78 μg/ml was significantly lower (p Conclusions The decrease of GSN concentration in blood and CSF of MS subjects suggests that this protein may be involved in chronic inflammation associated with neurodegeneration. Additionally, the results presented here suggest the possible utility of GSN evaluation for diagnostic purposes. Reversing plasma GSN deficiency might represent a new strategy in MS treatment.

  5. Multiple traumatisation as a risk factor of post-traumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Savjak Nadežda

    2003-01-01

    Full Text Available Paper presents a part of results obtained in 1998 within action study of the psychological effects of war traumatisation in Republika Srpska. Special attention is paid to the additional impact of multiple exposure to war sufferings regarding the degree of the traumatisation (the loss of loved ones, direct life threat, the participation in combats, and the testimony of the death of other people. 229 persons were assessed in 8 towns of Republika Srpska. The comparison of the results of refugees and domicile persons at the Reaction Index - Revised speaks in favour of their significantly higher vulnerability even after three years after the end of war. Total degree of the traumatisation, as well as the symptoms of intrusion, avoidance, and hyper-arousal are significantly more frequent. In 42.5% of refugees (in relation to 26.7% of domicile persons there is PTSP risk. The intensification of criteria proves that 17% of refugees are at high risk (in relation to 5.2% of the domiciled. It is obvious, that refuge presents traumatic event for many people, and not only chronic burden. The results suggest that the effect of direct jeopardy, combat stress, and the testimony of somebody else’s death are fading in time, but that the culmination of tangible, social, and human losses in refuge is serious risk factor for mental health.

  6. Personality Disorder in Adult Attention-Deficit/Hyperactivity Disorder: Attrition and Change During Long-term Treatment.

    Science.gov (United States)

    Gift, Thomas E; Reimherr, Frederick W; Marchant, Barrie K; Steans, Tammy A; Wender, Paul H

    2016-05-01

    Personality disorders (PDs) are commonly found in adults with attention-deficit/hyperactivity disorder (ADHD) and are associated with increased ADHD symptoms and psychosocial impairment. To assess the impact of PDs or personality traits on retention rates in ADHD trials and whether treating ADHD affects the expression of PD, data were analyzed from 2 methylphenidate trials. Assessment of PDs and personality traits included using the Wisconsin Personality Disorders Inventory IV and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Personality Disorders. Attention-deficit/hyperactivity disorder symptoms were evaluated using the Wender-Reimherr Adult Attention Deficit Disorder Scale. Major findings were that subjects with cluster A, cluster B, passive-aggressive, or more than 1 PD showed more attrition. Subjects dropping out also had more schizoid and narcissistic traits. Attention-deficit/hyperactivity disorder symptoms (p Disorders Inventory IV items that improved most, 8 resembled ADHD or oppositional defiant disorder symptoms.

  7. [Contribution of cognitive evoked potentials for detecting early cognitive disorders in multiple sclerosis].

    Science.gov (United States)

    Magnié, M N; Bensa, C; Laloux, L; Bertogliati, C; Faure, S; Lebrun, C

    2007-11-01

    In Multiple Sclerosis (MS), one of the most frequent neurological diseases in young adults, cognitive dysfunctions have been under considered whereas their evolution may produce a fronto-sous-cortical deterioration and more than half of the MS patients present such dysfunctions. Nevertheless sensory evoked-potentials are classically used in this disease, event-related potentials (ERP) are not included in the clinical exploration of MS. Two studies are presented aimed at further tracking the usefulness of ERP for detecting early cognitive dysfunctions in MS. All of the patients presented a relapsing remitting MS for less than 5 years with a moderate physical handicap and complained from their memory. They performed a neuropsychological set and ERP were elicited using the oddball paradigm in both modalities, visual and auditory. In the first study, 10 patients without cognitive dysfunction at the neuropsychological evaluation and 10 patients with an attention deficit participated with 10 age-matched controls. In the second study, 10 patients with memory impairment at the neuropsychological evaluation and 10 age-matched controls were included. Our data argue for an earlier modification of ERP parameters in the visual modality than in the auditory one, even before the modification of cognitive scores. In both studies, P300 parameters were correlated to neuropsychological performances (and especially to the attention examination in the first study and to memory tests in the second study) in both modalities. Taking into account the clinical usefulness of ERPs, it is nowadays important to include this electrophysiological method in evaluation and follow-up of MS, and not only using the auditory modality but also the visual presentation in order to detect earlier cognitive dysfunctions even before modification of neuropsychological performances.

  8. Possibilities of pharmacologic correction of cognitive disorders in conditions of experimental equivalent of multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Nefyodov A.A.

    2015-06-01

    Full Text Available A comparative analysis of the impact of citicoline, ±-lipoic acid, nicergoline, donepezil and colloidal solution of nano-silver (CSNS on the processes of learning and consolidation of memorable track in the test of the conditional reaction of passive avoidance (CRPA in conditions of experimental allergic encephalomyelitis (EAE was conducted. Testing of passive defensive skill was performed on days 12 and 20 after the induction of EAE. To assess the impact of drugs on the inputted information processes the investigated substances were administered intragastrically (CSNS - intraperitoneally once daily in the definite dose from the second to the day 10 after the induction of EAE (latent phase of the disease, and assessing processes of conditional skill preserving, further administration of drugs by the day 20 of the experiment (average duration of EAE was used. A positive effect of citicoline, ±-lipoic acid, nicergoline and donepezil on the input information processes and the ability to prevent accelerated extinction of acquired contingent skill in the conditions of experimental pathology was established. Drugs statistically significantly increased duration of the latent period of CRPA in comparison with a group of active control by 49%, 43%, 39% and 34%, respectively. Here with preparations were characterized by a high coefficient of antiamnesic activity, by the end of the experiment it was recorded at the level of 95% (citicoline, 81% (±-lipoic acid, 76% (nicergoline and 53% (donepezil. It is shown that the ability to prevent development of cognitive impairment in conditions of experimental equivalent of multiple sclerosis decreases in the number of citicoline (500 mg/kg > ±-lipoic acid (50 mg/kg H nicergoline (10 mg/kg > donepezil (10 mg/kg.

  9. Karyotypic abnormalities and clinical aspects of patients with multiple myeloma and related paraproteinemic disorders

    Energy Technology Data Exchange (ETDEWEB)

    Liang, W.; Hopper, J.E.; Rowley, J.D.

    1979-08-01

    Karyotypic abnormalities were detected in the malignant cells of 6 of 18 patients with multiple myeloma (MM). Six patients with benign monoclonal gammopathy, one with amyloidosis of immunoglobulin origin, and two with Waldenstroem's macroglobulinemia had normal karyotypes. All six MM patients with aneuploidy were in a group of 10 patients in an accelerated or relapse phase of their disease and four had high serum paraprotein levels when their abnormal karyotypes were detected. Five of the 6 MM patients with aneuploidy had received prior chemotherapy. Aneuploidy was not observed in 8 stable MM patients. Abnormalities of chromosome 14 were present in all 6 patients. A translocation between Nos. 11 and 14 was found in aneuploid cells of 2 patients who had plasma cell leukemia (PCL). A deletion of chromosome 6 was detected in 2 MM patients and a pericentric inversion of No. 6 was seen in the patient with PCL. Three of 4 MM patients had a nonrandom loss of one chromosome 8. Two other MM patients developed acute nonlymphocytic leukemia (ANLL) after the diagnosis of MM. Marrow cells of one patient showed a 5q- chromosome and a constitutional translocation involving Nos. 13 and 14 during the preleukemic stage; during the leukemic phase, the karyotype evolved to 50 chromosomes including extra chromosomes 1, 6, 8, 10, and 21 and a missing 7, in addition to the originally detected 5q- and the 13/14 translocation.The peripheral blood from the other patient was hypodiploid, with a missing chromosome 7 and a translocation between 3q and 9p. These patterns of chromosome change resemble those of ANLL rather than MM and are similar to the changes seen in ANLL after treated malignant lymphoma.

  10. Actigraphic and parental reports of sleep difficulties in children with attention-deficit/hyperactivity disorder

    DEFF Research Database (Denmark)

    Hvolby, Allan; Jørgensen, Jan; Bilenberg, Niels

    2008-01-01

    (Fourth Edition) criteria. MAIN OUTCOME MEASURES: Actigraphically measured sleep variables and parent-estimated sleep by diary. RESULTS: We found that children with ADHD have significantly longer sleep onset latency and a more irregular sleep pattern than the psychiatric control or healthy reference...... the objectively measured sleep variables and those reported by parents, who overestimated sleep onset latency. CONCLUSIONS: The results of this study allow us to conclude that some children with ADHD have impaired sleep that cannot be referred to comorbid oppositional defiant disorder. However, it is important......OBJECTIVES: To describe actigraphically detected and parent-reported sleep problems in nonmedicated children with attention-deficit/hyperactivity disorder (ADHD); to clarify whether or not comorbid oppositional defiant disorder contributes to sleep difficulties; and to compare objectively measured...

  11. A Systematic Review and Meta-Analysis of Multiple Airborne Pollutants and Autism Spectrum Disorder

    Science.gov (United States)

    Lam, Juleen; Sutton, Patrice; Kalkbrenner, Amy; Windham, Gayle; Halladay, Alycia; Koustas, Erica; Lawler, Cindy; Davidson, Lisette; Daniels, Natalyn; Newschaffer, Craig; Woodruff, Tracey

    2016-01-01

    Background Exposure to ambient air pollution is widespread and may be detrimental to human brain development and a potential risk factor for Autism Spectrum Disorder (ASD). We conducted a systematic review of the human evidence on the relationship between ASD and exposure to all airborne pollutants, including particulate matter air pollutants and others (e.g. pesticides and metals). Objective To answer the question: “is developmental exposure to air pollution associated with ASD?” Methods We conducted a comprehensive search of the literature, identified relevant studies using inclusion/exclusion criteria pre-specified in our protocol (registered in PROSPERO, CRD # 42015017890), evaluated the potential risk of bias for each included study and identified an appropriate subset of studies to combine in a meta-analysis. We then rated the overall quality and strength of the evidence collectively across all air pollutants. Results Of 1,158 total references identified, 23 human studies met our inclusion criteria (17 case-control, 4 ecological, 2 cohort). Risk of bias was generally low across studies for most domains; study limitations were related to potential confounding and accuracy of exposure assessment methods. We rated the quality of the body of evidence across all air pollutants as “moderate.” From our meta-analysis, we found statistically significant summary odds ratios (ORs) of 1.07 (95% CI: 1.06, 1.08) per 10-μg/m3 increase in PM10 exposure (n = 6 studies) and 2.32 (95% CI: 2.15, 2.51) per 10-μg/m3 increase in PM2.5 exposure (n = 3 studies). For pollutants not included in a meta-analysis, we collectively evaluated evidence from each study in rating the strength and quality of overall evidence considering factors such as inconsistency, imprecision, and evidence of dose-response. All included studies generally showed increased risk of ASD with increasing exposure to air pollution, although not consistently across all chemical components. Conclusion After

  12. Short-term effect of American summer treatment program for Japanese children with attention deficit hyperactivity disorder.

    Science.gov (United States)

    Yamashita, Yushiro; Mukasa, Akiko; Honda, Yuko; Anai, Chizuru; Kunisaki, Chie; Koutaki, Jun-ichi; Motoyama, Satoko; Miura, Naoki; Sugimoto, Ami; Ohya, Takashi; Nakashima, Masayuki; Nagamitsu, Shin-ichiro; Gnagy, Elizabeth M; Greiner, Andrew R; Pelham, William E; Matsuishi, Toyojiro

    2010-02-01

    We reported the results of the 3-week summer treatment program (STP) for children with attention deficit hyperactivity disorder (ADHD) in 2006. The STP was based on methods established by Professor Pelham in Buffalo, NY and has been used in a number of studies and at a number of sites in the U.S. This is the first STP outside North America. Thirty-six children age 6-12 years with ADHD participated. The collection of evidence-based behavioral modification techniques that comprises the STP's behavioral program (e.g., point system, daily report card, positive reinforcement, time out) was used. Most children showed positive behavioral changes in multiple domains of functioning, demonstrated by significant improvement in points earned daily, which reflect behavior frequencies. Only one child with ADHD co-morbid with pervasive developmental disorder required an individualized program for excessive time outs. The ADHD rating scale, symptoms of oppositional defiant disorder, and hyperactivity/inattention in Strength and Difficulties Questionnaires evaluated by parents significantly improved after STP. Although the 3-week STP was much shorter than most STPs run in the U.S., the program is more intensive than typical outpatient treatment, providing 105h of intervenion in 3 weeks. The short-term effect of the STP was demonstrated for Japanese children with ADHD.

  13. Multiple comorbidities of 21 psychological disorders and relationships with psychosocial variables: a study of the online assessment and diagnostic system within a web-based population.

    Science.gov (United States)

    Al-Asadi, Ali M; Klein, Britt; Meyer, Denny

    2015-02-26

    While research in the area of e-mental health has received considerable attention over the last decade, there are still many areas that have not been addressed. One such area is the comorbidity of psychological disorders in a Web-based sample using online assessment and diagnostic tools, and the relationships between comorbidities and psychosocial variables. We aimed to identify comorbidities of psychological disorders of an online sample using an online diagnostic tool. Based on diagnoses made by an automated online assessment and diagnostic system administered to a large group of online participants, multiple comorbidities (co-occurrences) of 21 psychological disorders for males and females were identified. We examined the relationships between dyadic comorbidities of anxiety and depressive disorders and the psychosocial variables sex, age, suicidal ideation, social support, and quality of life. An online complex algorithm based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision, was used to assign primary and secondary diagnoses of 21 psychological disorders to 12,665 online participants. The frequency of co-occurrences of psychological disorders for males and females were calculated for all disorders. A series of hierarchical loglinear analyses were performed to examine the relationships between the dyadic comorbidities of depression and various anxiety disorders and the variables suicidal ideation, social support, quality of life, sex, and age. A 21-by-21 frequency of co-occurrences of psychological disorders matrix revealed the presence of multiple significant dyadic comorbidities for males and females. Also, for those with some of the dyadic depression and the anxiety disorders, the odds for having suicidal ideation, reporting inadequate social support, and poorer quality of life increased for those with two-disorder comorbidity than for those with only one of the same two disorders. Comorbidities of

  14. Multiple Comorbidities of 21 Psychological Disorders and Relationships With Psychosocial Variables: A Study of the Online Assessment and Diagnostic System Within a Web-Based Population

    Science.gov (United States)

    Klein, Britt; Meyer, Denny

    2015-01-01

    Background While research in the area of e-mental health has received considerable attention over the last decade, there are still many areas that have not been addressed. One such area is the comorbidity of psychological disorders in a Web-based sample using online assessment and diagnostic tools, and the relationships between comorbidities and psychosocial variables. Objective We aimed to identify comorbidities of psychological disorders of an online sample using an online diagnostic tool. Based on diagnoses made by an automated online assessment and diagnostic system administered to a large group of online participants, multiple comorbidities (co-occurrences) of 21 psychological disorders for males and females were identified. We examined the relationships between dyadic comorbidities of anxiety and depressive disorders and the psychosocial variables sex, age, suicidal ideation, social support, and quality of life. Methods An online complex algorithm based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision, was used to assign primary and secondary diagnoses of 21 psychological disorders to 12,665 online participants. The frequency of co-occurrences of psychological disorders for males and females were calculated for all disorders. A series of hierarchical loglinear analyses were performed to examine the relationships between the dyadic comorbidities of depression and various anxiety disorders and the variables suicidal ideation, social support, quality of life, sex, and age. Results A 21-by-21 frequency of co-occurrences of psychological disorders matrix revealed the presence of multiple significant dyadic comorbidities for males and females. Also, for those with some of the dyadic depression and the anxiety disorders, the odds for having suicidal ideation, reporting inadequate social support, and poorer quality of life increased for those with two-disorder comorbidity than for those with only one of the same

  15. Family history of education predicts eating disorders across multiple generations among 2 million Swedish males and females.

    Directory of Open Access Journals (Sweden)

    Anna Goodman

    Full Text Available To investigate which facets of parent and grandparent socio-economic position (SEP are associated with eating disorders (ED, and how this varies by ED subtype and over time.Total-population cohort study of 1,040,165 females and 1,098,188 males born 1973-1998 in Sweden, and followed for inpatient or outpatient ED diagnoses until 2010. Proportional hazards models estimated associations with parental education, income and social class, and with grandparental education and income.15,747 females and 1051 males in our sample received an ED diagnosis, with rates increasing in both sexes over time. ED incidence in females was independently predicted by greater educational level among the father, mother and maternal grandparents, but parent social class and parental income showed little or no independent effect. The associations with education were equally strong for anorexia nervosa, bulimia nervosa and ED not-otherwise-specified, and had increased over time. Among males, an apparently similar pattern was seen with respect to anorexia nervosa, but non-anorexia ED showed no association with parental education and an inverse association with parental income.Family history of education predicts ED in gender- and disorder-specific ways, and in females the effect is observed across multiple generations. Particularly given that these effects may have grown stronger in more recent cohorts, these findings highlight the need for further research to clarify the underlying mechanisms and identify promising targets for prevention. Speculatively, one such mechanism may involve greater internal and external demands for academic success in highly educated families.

  16. Impact of childhood exposure to psychological trauma on the risk of psychiatric disorders and somatic discomfort: single vs. multiple types of psychological trauma.

    Science.gov (United States)

    Park, Subin; Hong, Jin Pyo; Bae, Jae Nam; Cho, Seong-Jin; Lee, Dong-Woo; Lee, Jun-Young; Chang, Sung Man; Jeon, Hong Jin; Hahm, Bong-Jin; Lee, Young Moon; Seong, Sujeong; Cho, Maeng Je

    2014-11-30

    We examined whether childhood exposure to multiple types of potentially traumatic events (PTEs) relative to a single type of PTE is associated with a higher prevalence of psychiatric disorders and greater somatic discomfort in Korean adults. The Composite International Diagnostic Interview 2.1 (K-CIDI 2.1) was administered to 6027 subjects aged 18-74 years. Subjects who experienced a traumatic event before the age of 18 years, the childhood trauma exposure group, were compared with controls without childhood exposure to PTEs. In the childhood trauma exposure group, subjects who experienced only a single type of PTE and subjects who experienced two or more types of PTEs were compared further. Childhood exposure to PTEs was linked to a wide range of psychiatric comorbidities, with a higher risk for exposure to multiple types of PTEs than for exposure to a single type of PTE. Obsessive-compulsive disorder, generalized anxiety disorder, and somatoform disorder were significantly associated with exposure to multiple types of PTEs but not with exposure to a single type of PTE. Exposure to multiple types of PTEs was associated with reports of marked fatigue and pain. Future research should examine the psychiatric sequelae associated with various types of childhood PTEs. Copyright © 2014. Published by Elsevier Ireland Ltd.

  17. The Diagnostic Drawing Series and the Tree Rating Scale: An Isomorphic Representation of Multiple Personality Disorder, Major Depression, and Schizophrenic Populations.

    Science.gov (United States)

    Morris, Maureen Batza

    1995-01-01

    The tree drawings of 80 subjects, who were diagnosed with either multiple personality disorder, schizophrenia, or major depression, and a control group, were rated. Patterns were examined and graphs were used to depict results. Certain features were found to distinguish each category. The descriptive statistical findings were both consistent and…

  18. Predicting Social and Communicative Ability in School-Age Children with Autism Spectrum Disorder: A Pilot Study of the Social Attribution Task, Multiple Choice

    Science.gov (United States)

    Burger-Caplan, Rebecca; Saulnier, Celine; Jones, Warren; Klin, Ami

    2016-01-01

    The Social Attribution Task, Multiple Choice is introduced as a measure of implicit social cognitive ability in children, addressing a key challenge in quantification of social cognitive function in autism spectrum disorder, whereby individuals can often be successful in explicit social scenarios, despite marked social adaptive deficits. The…

  19. The Diagnostic Drawing Series and the Tree Rating Scale: An Isomorphic Representation of Multiple Personality Disorder, Major Depression, and Schizophrenic Populations.

    Science.gov (United States)

    Morris, Maureen Batza

    1995-01-01

    The tree drawings of 80 subjects, who were diagnosed with either multiple personality disorder, schizophrenia, or major depression, and a control group, were rated. Patterns were examined and graphs were used to depict results. Certain features were found to distinguish each category. The descriptive statistical findings were both consistent and…

  20. Patients with schizophrenia or schizoaffective disorder who receive multiple electroconvulsive therapy sessions: characteristics, indications, and results

    Directory of Open Access Journals (Sweden)

    Iancu I

    2015-03-01

    Full Text Available Iulian Iancu,* Nimrod Pick,* Orit Seener-Lorsh, Pinhas Dannon Be’er Ya’akov Mental Health Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel *These authors share first authorship of this paper Background: While electroconvulsive therapy (ECT has been used for many years, there is insufficient research regarding the indications for continuation/maintenance (C/M-ECT, its safety and efficacy, and the characteristics of patients with schizophrenia or schizoaffective disorder who receive multiple ECT sessions. The aims of this study were to characterize a series of patients who received 30 ECT sessions or more, to describe treatment regimens in actual practice, and to examine the results of C/M-ECT in terms of safety and efficacy, especially the effect on aggression and functioning.Methods: We performed a retrospective chart review of 20 consecutive patients (mean age 64.6 years with schizophrenia (n=16 or schizoaffective disorder (n=4 who received at least 30 ECT sessions at our ECT unit, and also interviewed the treating physician and filled out the Clinical Global Impression-Severity, Global Assessment of Functioning, and the Staff Observation Aggression Scale-Revised.Results: Patients received a mean of 91.3 ECT sessions at a mean interval of 2.6 weeks. All had been hospitalized for most or all of the previous 3 years. There were no major adverse effects, and cognitive side effects were relatively minimal (cognitive deficit present for several hours after treatment. We found that ECT significantly reduced scores on the Staff Observation Aggression Scale-Revised subscales for verbal aggression and self-harm, and improved Global Assessment of Functioning scores. There were reductions in total aggression scores, subscale scores for harm to objects and to others, and Clinical Global Impression-Severity scores, these were not statistically significant.Conclusion: C/M-ECT is safe and effective for

  1. Collaborative Care for patients with severe borderline and NOS personality disorders: A comparative multiple case study on processes and outcomes

    Directory of Open Access Journals (Sweden)

    Koekkoek Bauke

    2011-06-01

    Full Text Available Abstract Background Structured psychotherapy is recommended as the preferred treatment of personality disorders. A substantial group of patients, however, has no access to these therapies or does not benefit. For those patients who have no (longer access to psychotherapy a Collaborative Care Program (CCP is developed. Collaborative Care originated in somatic health care to increase shared decision making and to enhance self management skills of chronic patients. Nurses have a prominent position in CCP's as they are responsible for optimal continuity and coordination of care. The aim of the CCP is to improve quality of life and self management skills, and reduce destructive behaviour and other manifestations of the personality disorder. Methods/design Quantitative and qualitative data are combined in a comparative multiple case study. This makes it possible to test the feasibility of the CCP, and also provides insight into the preliminary outcomes of CCP. Two treatment conditions will be compared, one in which the CCP is provided, the other in which Care as Usual is offered. In both conditions 16 patients will be included. The perspectives of patients, their informal carers and nurses are integrated in this study. Data (questionnaires, documents, and interviews will be collected among these three groups of participants. The process of treatment and care within both research conditions is described with qualitative research methods. Additional quantitative data provide insight in the preliminary results of the CCP compared to CAU. With a stepped analysis plan the 'black box' of the application of the program will be revealed in order to understand which characteristics and influencing factors are indicative for positive or negative outcomes. Discussion The present study is, as to the best of our knowledge, the first to examine Collaborative Care for patients with severe personality disorders receiving outpatient mental health care. With the chosen

  2. Predictors and Correlates of Completing Behavioral Parent Training for the Treatment of Oppositional Defiant Disorder in Pediatric Primary Care

    Science.gov (United States)

    Lavigne, John V.; LeBailly, Susan A.; Gouze, Karen R.; Binns, Helen J.; Keller, Jennifer; Pate, Lindsay

    2010-01-01

    This study examined the role of pretreatment demographic and clinical predictors of attendance as well as barriers to treatment and consumer satisfaction on attendance at therapist-led parent training with 86 families of children ages 3 to 6 years conducted in pediatric primary care settings. Only socioeconomic status (SES) and minority group…

  3. The potential use of adult stem cells for the treatment of multiple sclerosis and other neurodegenerative disorders.

    Science.gov (United States)

    Slavin, Shimon; Kurkalli, Basan G S; Karussis, Dimitrios

    2008-11-01

    No specific treatment exists for patients with multiple sclerosis (MS) who fail to respond to conventional immunosuppressive and immunomodulating modalities. Furthermore, no method is available for regeneration of existing defect in the central nervous system (CNS). The ultimate goals of MS treatment, similarly to other autoimmune diseases, are twofold: first, to eliminate self-reactive lymphocytes and to prevent de novo development of self-reactivity by induction of self-tolerance. Second, attempting regeneration and repair of existing damage. In the case of MS, there is a need to stop the ongoing process of inflammation against the CNS by self-reactive lymphocytes thus facilitating spontaneous re-myelinization while in parallel attempt to recover existing neurological deficits caused by the autoimmune process resulting in demyelinization. Cell therapy stands out as the most rationale approach for neurological regeneration. In the absence of clinically applicable approaches involving the use of embryonic stem cells, we are investigating the feasibility and efficacy of enriched autologous mesenchymal stromal cells (MSC) injected intrathecally and intravenously to induce in situ immunomodulation and neuroprotection and possibly facilitate repair of the CNS in patients with MS and other neurodegenerative disorders. Our preclinical results suggest that bone marrow cells may provide a source of stem cells with a potential for migration into inflamed CNS and differentiate into cells expressing neuronal and glial cell markers. Based on the preclinical data, we are currently evaluating the safety of a similar therapeutic approach in a small group of patients with MS and other neurodegenerative diseases.

  4. Prevalence and significant determinants of post-traumatic stress disorder in a large sample of patients with multiple sclerosis.

    Science.gov (United States)

    Ostacoli, Luca; Carletto, Sara; Borghi, Martina; Cavallo, Marco; Rocci, Emanuela; Zuffranieri, Marco; Malucchi, Simona; Bertolotto, Antonio; Zennaro, Alessandro; Furlan, Pier Maria; Picci, Rocco Luigi

    2013-06-01

    Chronic and life-threatening neurodegenerative diseases may be associated with post-traumatic stress disorder (PTSD). Therefore, the current study was an investigation of the prevalence of PTSD in multiple sclerosis (MS) patients, and identification of significant determinants of PTSD. Two hundred thirty-two MS patients were consecutively recruited and screened for the presence of PTSD with the Impact of Event Scale-Revised, corroborated by the Structured Clinical Interview for DSM-IV. Furthermore, participants were administered the Hospital Anxiety and Depression Scale and the Fatigue Severity Scale. Twelve patients (12/232, i.e. 5.17 %) were diagnosed as suffering from PTSD. Levels of education, anxiety and depression were significant determinants of the presence of PTSD. The role played by the levels of education, anxiety and depression in determining the presence of PTSD has been discussed. Further research on the psychological features of neurodegenerative diseases is urgently needed in order to plan appropriate treatments and improve patients' quality of life.

  5. Anger in psychological disorders: Prevalence, presentation, etiology and prognostic implications.

    Science.gov (United States)

    Fernandez, Ephrem; Johnson, Sheri L

    2016-06-01

    Anger is present as a key criterion in five diagnoses within DSM-5: Intermittent Explosive Disorder, Oppositional Defiant Disorder, Disruptive Mood Dysregulation Disorder, Borderline Personality Disorder and Bipolar Disorder. This review amasses scientific literature demonstrating that within each of these disorders, anger is a central clinical feature that is highly prevalent and predictive of important outcomes. For each disorder, we also discuss the phenomenology and etiology of anger. Although models of anger have been quite distinct across these disorders, few empirical studies have truly tested whether anger stems from different etiological factors across these different conditions. We end with a discussion of transdiagnostic research that draws from cognitive psychology, affective science, and the neuroscience of anger, and that also fits with integrative approaches to treatment.

  6. Increases in multiple psychiatric disorders in parents and grandparents of patients with bipolar disorder from the USA compared with The Netherlands and Germany

    NARCIS (Netherlands)

    Post, Robert M.; Leverich, Gabriele S.; Kupka, Ralph; Keck, Paul E.; McElroy, Susan L.; Altshuler, Lori L.; Frye, Mark A.; Rowe, Michael; Grunze, Heinz; Suppes, Trisha; Nolen, Willem A.

    2015-01-01

    ObjectiveWe previously found that compared with Europe more parents of the USA patients were positive for a mood disorder, and that this was associated with early onset bipolar disorder. Here we examine family history of psychiatric illness in more detail across several generations.MethodsA total of

  7. Against All Odds—“Sam Hall” and “The Man in Black”: From British Social Disparagement to American Defiant Individualism

    Directory of Open Access Journals (Sweden)

    Eva-Sabine Zehelein

    2007-12-01

    Full Text Available This article traces the development of the “Sam Hall” topos from its 18th or 17th century British origins to William Blake, to the Dubliners’ version of a Celtic traditional, to Hayes’ Harvard version, and finally to Johnny Cash. As an expression of socio-cultural criticism, the outlaw Sam Hall has been formed into a prototype of American defiant individualism “against all odds.”

  8. [Attention deficit - hyperactivity disorder and enuresis in children and adolescents].

    Science.gov (United States)

    Zavadenko, N N; Kolobova, N M; Suvorinova, N Iu

    2010-01-01

    Frequency of comorbid disorders and neuropsychological state, executive functions (EF), were studied in two groups of patients aged from 5 to 14 years: 53 patients with attention-deficit hyperactivity disorder (ADHD) in the association with enuresis and 71 patients with ADHD without enuresis. The most cases of enuresis (50 out of 53 patients) were represented by primary nocturnal enuresis. The significant increase of total number of ADHD cases with comorbidity for oppositional-defiant disorder, anxiety disorder, tics or encopresis (77.7%) was found in the first group compared to the second one (60.6%). The presence of enuresis in ADHD was associated with the significant increase of frequency of anxiety disorders (54.7% versus 39.4%). Moreover, in the group of patients with ADHD and enuresis, the frequency of oppositional-defiant disorder and encopresis was higher in the age of 5-9 years while the frequency of obsessive-compulsive disorder and tics increased in the period of 10-14 years as compared to patients without enuresis. The assessment of executive functions with the Wisconsin Card Sorting Test did not reveal any differences between patients of two groups.

  9. Responses to panic induction procedures in subjects with multiple chemical sensitivity/idiopathic environmental intolerance: understanding the relationship with panic disorder.

    Science.gov (United States)

    Tarlo, Susan M; Poonai, Naveen; Binkley, Karen; Antony, Martin M; Swinson, Richard P

    2002-08-01

    Idiopathic environmental intolerance (IEI), also known as multiple chemical sensitivity, is a clinical description for a cluster of symptoms of unknown etiology that have been attributed by patients to multiple environmental exposures when other medical explanations have been excluded. Because allergy has not been clearly demonstrated and current toxicological paradigms for exposure-symptom relationships do not readily accommodate IEI, psychogenic theories have been the focus of a number of investigations. A significantly higher lifetime prevalence of major depression, mood disorders, anxiety disorders, and somatization disorder has been reported among patients with environmental illness compared with that in controls. Symptoms often include anxiety, lightheadedness, impaired mentation, poor coordination, breathlessness (without wheezing), tremor, and abdominal discomfort. Responses to intravenous sodium lactate challenge or single-breath inhalation of 35% carbon dioxide versus a similar breath inhalation of clean air have shown a greater frequency of panic responses in subjects with IEI than in control subjects, although such responses did not occur in all subjects. Preliminary genetic findings suggest an increased frequency of a common genotype with panic disorder patients. The panic responses in a significant proportion of IEI patients opens a therapeutic window of opportunity. Patients in whom panic responses may at least be a contributing factor to their symptoms might be responsive to intervention with psychotherapy to enable their desensitization or deconditioning of responses to odors and other triggers, and/or may be helped by anxiolytic medications, relaxation training, and counseling for stress management.

  10. Application of the 2012 revised diagnostic definitions for paediatric multiple sclerosis and immune-mediated central nervous system demyelination disorders

    NARCIS (Netherlands)

    van Pelt, E. Danielle; Neuteboom, Rinze F.; Ketelslegers, Immy A.; Boon, Maartje; Catsman-Berrevoets, Coriene E.; Hintzen, Rogier Q.

    2014-01-01

    Background Recently, the International Paediatric Multiple Sclerosis Study Group (IPMSSG) definitions for the diagnosis of immune-mediated acquired demyelinating syndromes (ADS) of the central nervous system, including paediatric multiple sclerosis (MS), have been revised. Objective To evaluate the

  11. Subthreshold Conditions as Precursors for Full Syndrome Disorders: A 15-Year Longitudinal Study of Multiple Diagnostic Classes

    Science.gov (United States)

    Shankman, Stewart A.; Lewinsohn, Peter M.; Klein, Daniel N.; Small, Jason W.; Seeley, John R.; Altman, Sarah E.

    2009-01-01

    Background: There has been increasing interest in the distinction between subthreshold and full syndrome disorders and specifically whether subthreshold conditions escalate or predict the onset of full syndrome disorders over time. Most of these studies, however, examined whether a single subthreshold condition escalates into the full syndrome…

  12. Reliability and Diagnostic Efficiency of the Diagnostic Inventory for Disharmony (DID) in Youths with Pervasive Developmental Disorder and Multiple Complex Developmental Disorder

    Science.gov (United States)

    Xavier, Jean; Vannetzel, Leonard; Viaux, Sylvie; Leroy, Arthur; Plaza, Monique; Tordjman, Sylvie; Mille, Christian; Bursztejn, Claude; Cohen, David; Guile, Jean-Marc

    2011-01-01

    The Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) category is a psychopathological entity few have described and is poorly, and mainly negatively, defined by autism exclusion. In order to limit PDD-NOS heterogeneity, alternative clinical constructs have been developed. This study explored the reliability and the diagnostic…

  13. PROBLEM OF FORMATION OF EMOTIONAL REACTION IN PRE-SCHOOL CHILDREN WITH MULTIPLE DEVELOPMENTAL DISORDERS IN SUBJECT-COMMUNICATIVE ACTIVITY IN THE CONDITIONS OF KINDERGARTEN

    Directory of Open Access Journals (Sweden)

    Ольга Валентиновна Шохова

    2013-11-01

    Full Text Available The article is devoted to the problem of emotional response in children with developmental disorders in subject-communicative activity . The characteristic of the particularities of emotional reaction in children with divelopmental disorders is given. The author proves that it is necessary to develop emotional response as the base for further social adaptation of children with multiple disorders in development; mechanisms of formation of emotional reaction in communicative activity are described: contents, methods used for multiple diorders. Experimental data has proved the effectiveness of pedagogical thechnology on forming of emotional reaction in subject-communicative activity. Corrective and development work used in this technology is based on principles of integrity, complexness; the interralated series of thematical studies is organized intended for develoment of motor, sensor, communicative and emotional sphere in different activities of children. All this facilitate gradual interiorization of emotional reactions, their automatization in communicative activity.DOI: http://dx.doi.org/10.12731/2218-7405-2013-10-7

  14. Association between internalizing disorders and day-to-day activities of low energetic expenditure.

    Science.gov (United States)

    Gosmann, Natan Pereira; Salum, Giovanni Abrahão; Schuch, Felipe; Silveira, Patrícia Pelufo; Bosa, Vera Lucia; Goldani, Marcelo Zubaran; Manfro, Gisele Gus

    2015-02-01

    The objective of this study is to compare energetic expenditure in day-to-day activities among subjects with internalizing disorders (depression and anxiety), externalizing disorders (attention deficit/hyperactivity disorder and oppositional defiant disorder) and healthy children and adolescents without any psychiatric diagnosis. One hundred and five (n = 105) students from a community sample were evaluated throughout a structured psychiatric interview and categorized into three groups: internalizing (n = 54), externalizing (n = 12) and typically developing controls (TDC, n = 39). Energetic expenditure was evaluated using 3-day physical activity record. Subjects with internalizing disorders performed activities with lower energetic expenditure as compared to those with externalizing disorders and TDC. Participants with externalizing disorders had more energetic expenditure variability. Our study suggests that internalizing disorders are associated with activities of low energetic expenditure in day-to-day activities, extending previous findings with physical exercise. These findings may further contribute to the understanding of the associated morbidity previously described in patients with internalizing disorders.

  15. Cognitive and affective empathy in children with conduct problems: additive and interactive effects of callous-unemotional traits and autism spectrum disorders symptoms.

    Science.gov (United States)

    Pasalich, Dave S; Dadds, Mark R; Hawes, David J

    2014-11-30

    Callous-unemotional (CU) traits and autism spectrum disorders (ASD) symptoms are characterized by problems in empathy; however, these behavioral features are rarely examined together in children with conduct problems. This study investigated additive and interactive effects of CU traits and ASD symptoms in relation to cognitive and affective empathy in a non-ASD clinic-referred sample. Participants were 134 children aged 3 to 9 years (M=5.60; 79% boys) with oppositional defiant/conduct disorder, and their parents. Clinicians, teachers, and parents reported on dimensions of child behavior, and parental reports of family dysfunction and direct observations of parental warmth/responsiveness assessed quality of family relationships. Results from multiple regression analysis showed that, over and above the effects of child conduct problem severity and quality of family relationships, both ASD symptoms and CU traits were uniquely associated with deficits in cognitive empathy. Moreover, CU traits demonstrated an independent association with affective empathy, and this relationship was moderated by ASD symptoms. That is, there was a stronger negative association between CU traits and affective empathy at higher versus lower levels of ASD symptoms. These findings suggest including both CU traits and ASD-related social impairments in models delineating the atypical development of empathy in children with conduct problems.

  16. Prevalence of Comorbid Psychiatric Disorders in Children and Adolescents With Attention Deficit Hyperactivity Disorder

    Directory of Open Access Journals (Sweden)

    Riahi

    2015-08-01

    Full Text Available Background Attention deficit hyperactivity disorder (ADHD is often associated with other psychological problems. Objectives The present study aimed to study the prevalence of comorbid psychiatric disorders in children and adolescents with ADHD who admitted to Golestan Hospital in Ahvaz. Patients and Methods This was a descriptive/analytic cross-sectional study carried out on 118 outpatient children and adolescents who were selected by convenient sampling. The data were collected using the questionnaire, designed by authors, and were analyzed through descriptive statistics and chi-square test. Results The prevalence of comorbid disorders were as follows: anxiety disorders (48.3%; depression (20.33%; bipolar disorder (17.79%; obsessive-compulsive (47.45%; tic and tourette (35.59%, oppositional defiant disorder (43.22%; conduct disorder (11.01%; urinary incontinence (58.47%; communication disorder (9.32%; and learning disorder (21.18%. There was no significant difference between females and males with respect to the prevalence of comorbid disorders. Conclusions Similar to previous studies, we found some comorbid psychiatric disorders with ADHD. The treatment of the disorder can be improved, by more attention to comorbid psychiatric disorders, early diagnosis of them, and using distinct and specific treatment for everyone.

  17. Collaborative Care for patients with severe borderline and NOS personality disorders: A comparative multiple case study on processes and outcomes

    NARCIS (Netherlands)

    dr Barbara Stringer; Ad Kerkhof; Aartjan Beekman; prof Berno van Meijel

    2011-01-01

    Background: Structured psychotherapy is recommended as the preferred treatment of personality disorders. A substantial group of patients, however, has no access to these therapies or does not benefit. For those patients who have no (longer) access to psychotherapy a Collaborative Care Program (CCP)

  18. Behavioral interventions in Attention-Deficit/ Hyperactivity Disorder: a meta-analysis of randomized controlled trials across multiple outcome domains

    NARCIS (Netherlands)

    D. Daley; S. van der Oord; M. Ferrin; M. Danckaerts; M. Doepfner; S. Cortese; E.J.S. Sonuga-Barke

    2014-01-01

    OBJECTIVE: Behavioral interventions are recommended as attention-deficit/hyperactivity disorder (ADHD) treatments. However, a recent meta-analysis found no effects on core ADHD symptoms when raters were probably blind to treatment allocation. The present analysis is extended to a broader range of ch

  19. Attention deficit hyperactivity disorder and the behavior of "Che" Guevara.

    Science.gov (United States)

    Teive, Hélio A G; Zavala, Jorge A; Munhoz, Renato P; Lara, Diogo R; Lima, Pedro; Palmini, André

    2009-09-01

    Attention deficit hyperactivity disorder (ADHD) is a childhood onset neuropsychiatric disorder characterized by inattention, hyperactivity and impulsivity. ADHD is related to several co-morbidities, such as opposition defiant disorder, conduct disorder, mood and anxiety disturbances, as well as tics and Tourette's syndrome. The objective of this report is to shed an alternative light on the personality of Ernesto "Che" Guevara, discussing whether he might have had ADHD. Several published biographies of Che Guevara were reviewed. Established ADHD criteria (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), were used as a framework to evaluate Che's behaviour. In addition, we compared the main features of Che's reported behaviour to the set of abnormalities leading to the diagnosis of ADHD in adults proposed by Wender and colleagues and known as the UTAH ADHD criteria. Analysis of the most renowned biographies of Ernesto "Che" Guevara suggests that he may have had ADHD.

  20. Single versus multiple impulse control disorders in Parkinson's disease: an ¹¹C-raclopride positron emission tomography study of reward cue-evoked striatal dopamine release.

    Science.gov (United States)

    Wu, Kit; Politis, Marios; O'Sullivan, Sean S; Lawrence, Andrew D; Warsi, Sarah; Bose, Subrata; Lees, Andrew J; Piccini, Paola

    2015-06-01

    Impulse control disorders (ICDs) are reported in Parkinson's disease (PD) in association with dopaminergic treatment. Approximately 25 % of patients with ICDs have multiple co-occurring ICDs (i.e. more than one diagnosed ICD). The extent to which dopaminergic neurotransmission in PD patients with multiple ICDs differs from those with only one diagnosed ICD is unknown. The aims of this study are: (1) to investigate dopamine neurotransmission in PD patients diagnosed with multiple ICDs, single ICDs and non-ICD controls in response to reward-related visual cues using positron emission tomography with (11)C-raclopride. (2) to compare clinical features of the above three groups. PD individuals with mulitple ICDs (n = 10), single ICD (n = 7) and no ICDs (n = 9) were recruited and underwent two positron emission tomography (PET) scans with (11)C-raclopride: one where they viewed neutral visual cues and the other where they viewed a range of visual cues related to different rewards. Individuals with both multiple ICDs and single ICDs showed significantly greater ventral striatal dopamine release compared to non-ICD PD individuals in response to reward cues, but the two ICD groups did not differ from each other in the extent of dopamine release. Subjects with multiple ICDs were, however, significantly more depressed, and had higher levels of impulsive sensation-seeking compared to subjects with single ICDs and without ICDs. This is the first study to compare dopamine neurotransmission using PET neuroimaging in PD subjects with multiple vs. single ICDs. Our results suggest that striatal dopamine neurotransmission is not directly related to the co-occurrence of ICDs in PD, potentially implicating non-dopaminergic mechanisms linked to depression; and suggest that physicians should be vigilant in managing depression in PD patients with ICDs.

  1. Trastorno oposicional desafiante: enfoques diagnóstico y terapéutico y trastornos asociados Oppositional defiant disorder: Diagnostic and therapeutic approaches, and associated disorders

    OpenAIRE

    Juan David Palacio Ortiz; Carlos Alberto Giraldo Giraldo; Blair Ortiz Giraldo

    2008-01-01

    Se define el trastorno oposicional desafiante (TOD) como un patrón recurrente de conducta negativista, desafiante, desobediente y hostil, dirigido a los padres y a las figuras de autoridad. Los estudios en países desarrollados han identificado factores cognitivos y conductuales errados, como los principales determinantes de una actitud negativa, opuesta y contraria a las normas establecidas; mientras que en países en vías de desarrollo, como Colombia, se destacan los factores ambientales como...

  2. Renal complications in multiple myeloma and related disorders: Survivorship care plan of the IMF Nurse Leadership Board

    Science.gov (United States)

    Faiman, Beth; Tariman, Joseph D.; Mangan, Patricia A.; Spong, Jacy

    2012-01-01

    Kidney dysfunction is a common clinical feature of symptomatic multiple myeloma. Some degree of renal insufficiency or renal failure is present at diagnosis or will occur during the course of the disease, and which, if not reversed, will adversely effect overall survival and quality of life. Chronic insults to the kidneys from other illnesses, treatment, or multiple myeloma itself can further damage renal function and increase the risk for additional complications, such as anemia. Patients with multiple myeloma who have light chain (Bence Jones protein) proteinuria may experience renal failure or progress to end-stage renal disease (ESRD) and require dialysis due to light chain cast nephropathy. Kidney failure in patients with presumed multiple myeloma may also result from amyloidosis, light chain deposition disease, or acute tubular necrosis caused by nephrotoxic agents; therefore identification of patients at risk for kidney damage is essential. The International Myeloma Foundation’s Nurse Leadership Board have developed these practice recommendations for screening for renal function, identifying positive and negative contributing risk and environmental factors, selecting appropriate therapies and supportive care measures to decrease progression to ESRD and dialysis, and reducing and managing renal complications in patients with multiple myeloma. PMID:21816711

  3. Renal complications in multiple myeloma and related disorders: survivorship care plan of the International Myeloma Foundation Nurse Leadership Board.

    Science.gov (United States)

    Faiman, Beth M; Mangan, Patricia; Spong, Jacy; Tariman, Joseph D

    2011-08-01

    Kidney dysfunction is a common clinical feature of symptomatic multiple myeloma. Some degree of renal insufficiency or renal failure is present at diagnosis or will occur during the course of the disease and, if not reversed, will adversely affect overall survival and quality of life. Chronic insults to the kidneys from other illnesses, treatment, or multiple myeloma itself can further damage renal function and increase the risk for additional complications, such as anemia. Patients with multiple myeloma who have light chain (Bence Jones protein) proteinuria may experience renal failure or progress to end-stage renal disease (ESRD) and require dialysis because of light chain cast nephropathy. Kidney failure in patients with presumed multiple myeloma also may result from amyloidosis, light chain deposition disease, or acute tubular necrosis caused by nephrotoxic agents; therefore, identification of patients at risk for kidney damage is essential. The International Myeloma Foundation's Nurse Leadership Board has developed practice recommendations for screening renal function, identifying positive and negative contributing risk and environmental factors, selecting appropriate therapies and supportive care measures to decrease progression to ESRD, and enacting dialysis to reduce and manage renal complications in patients with multiple myeloma.

  4. Therapeutic Horseback Riding Outcomes of Parent-Identified Goals for Children with Autism Spectrum Disorder: An ABA' Multiple Case Design Examining Dosing and Generalization to the Home and Community

    Science.gov (United States)

    Holm, Margo B.; Baird, Joanne M.; Kim, Young Joo; Rajora, Kuwar B.; D'Silva, Delma; Podolinsky, Lin; Mazefsky, Carla; Minshew, Nancy

    2014-01-01

    We examined whether different doses of therapeutic riding influenced parent-nominated target behaviors of children with autism spectrum disorder (ASD) (a) during the session (b) at home, and (c) in the community. We used a single subject multiple Baseline, multiple case design, with dosing of 1, 3, and 5 times/week. Three boys with ASD, 6-8 years…

  5. Multiple lattice instabilities resolved by magnetic-field and disorder sensitivities in MgV2O4

    Science.gov (United States)

    Watanabe, Tadataka; Ishikawa, Takashi; Hara, Shigeo; Islam, A. T. M. Nazmul; Wheeler, Elisa M.; Lake, Bella

    2014-09-01

    Ultrasound velocity measurements of the orbitally degenerate frustrated spinel MgV2O4 are performed in a high-purity single crystal which exhibits successive structural and antiferromagnetic phase transitions, and in the disorder-introduced single crystal which exhibits spin-glass-like behavior. The measurements reveal that two types of unusual temperature dependence of the elastic moduli coexist in the cubic paramagnetic phase, which are resolved by magnetic-field and disorder sensitivities: huge Curie-type softening with decreasing temperature (convex temperature dependence), and concave temperature dependence with a characteristic minimum. These elastic anomalies suggest the coupling of the lattice to coexisting orbital fluctuations and spin-cluster excitations.

  6. Peptide Regulation of Cofilin Activity in the CNS: A Novel Therapeutic Approach for Treatment of Multiple Neurological Disorders.

    Science.gov (United States)

    Shaw, Alisa E; Bamburg, James R

    2017-02-19

    Cofilin is a ubiquitous protein which cooperates with many other actin-binding proteins in regulating actin dynamics. Cofilin has essential functions in nervous system development including neuritogenesis, neurite elongation, growth cone pathfinding, dendritic spine formation, and the regulation of neurotransmission and spine function, components of synaptic plasticity essential for learning and memory. Cofilin's phosphoregulation is a downstream target of many transmembrane signaling processes, and its misregulation in neurons has been linked in rodent models to many different neurodegenerative and neurological disorders including Alzheimer disease (AD), aggression due to neonatal isolation, autism, manic/bipolar disorder, and sleep deprivation. Cognitive and behavioral deficits of these rodent models have been largely abrogated by modulation of cofilin activity using viral-mediated, genetic, and/or small molecule or peptide therapeutic approaches. Neuropathic pain in rats from sciatic nerve compression has also been reduced by modulating the cofilin pathway within neurons of the dorsal root ganglia. Neuroinflammation, which occurs following cerebral ischemia/reperfusion, but which also accompanies many other neurodegenerative syndromes, is markedly reduced by peptides targeting specific chemokine receptors, which also modulate cofilin activity. Thus, peptide therapeutics offer potential for cost-effective treatment of a wide variety of neurological disorders. Here we discuss some recent results from rodent models using therapeutic peptides with a surprising ability to cross the rodent blood brain barrier and alter cofilin activity in brain. We also offer suggestions as to how neuronal-specific cofilin regulation might be achieved.

  7. "Nothing like Pretend": Difference, Disorder, and Dystopia in the Multiple World Spaces of Philip Pullman's "His Dark Materials"

    Science.gov (United States)

    Cantrell, Sarah K.

    2010-01-01

    This article examines the multiple worlds in Philip Pullman's "His Dark Materials" trilogy in light Pierre Bourdieu's "space of possibles" and the combination of chance and choice that impact Lyra and Will's decisions. Rather than viewing chance or destiny as disempowering, this article considers how the protagonists' choices also encourage…

  8. Anxiety disorders moderate the association between externalizing problems and substance use disorders: data from the National Comorbidity Survey-Revised.

    Science.gov (United States)

    Hofmann, Stefan G; Richey, J Anthony; Kashdan, Todd B; McKnight, Patrick E

    2009-05-01

    Anxiety disorders and externalizing problems are both associated with substance use disorders. However, the nature of this relationship remains unclear. To examine whether presence of an anxiety disorder changes the association between externalizing problems (conduct disorder, oppositional defiant disorder, and attention deficit hyperactivity disorder) and substance use disorders, we analyzed data from the National Comorbidity Survey-Replication, which is based on a nationally representative sample of 9282 English-speaking adults. Presence of externalizing problems was associated with an increased odds for alcohol abuse (OR: 6.7, CI: 5.6-8.1), alcohol dependence (OR: 7.6, CI: 5.9-9.6), substance abuse (OR: 9.9, CI: 8.1-12.2), and substance dependence (OR: 13.1, CI: 9.6-17.8). Similarly, anxiety disorders were associated with increased odds for substance use disorders. The highest association was found between post-traumatic stress disorder and substance use disorder (OR: 9.2, CI: 5.4-15.5). Individuals who met diagnostic criteria for an anxiety disorder and externalizing problems showed consistently and significantly lower odds for substance use problems than subjects with externalizing problems without a comorbid anxiety disorder. The results suggest that presence of any anxiety disorder reduces the association between externalizing problems and substance use disorders, possibly because the fear of bodily symptoms prevents individuals with externalizing problems from engaging in drug-seeking behaviors.

  9. Posttraumatic stress disorder in adult attention-deficit/hyperactivity disorder: clinical features and familial transmission.

    Science.gov (United States)

    Antshel, Kevin M; Kaul, Prashant; Biederman, Joseph; Spencer, Thomas J; Hier, Bridget O; Hendricks, Kaitlin; Faraone, Stephen V

    2013-03-01

    Attention-deficit/hyperactivity disorder (ADHD) is characterized by clinically significant functional impairment due to symptoms of inattention and/or hyperactivity and impulsivity. Previous research suggests a link, in child samples, between ADHD and posttraumatic stress disorder (PTSD), which is characterized by (1) chronically reexperiencing a traumatic event, (2) hyperarousal, and (3) avoiding stimuli associated with the trauma while exhibiting numbed responsiveness. This study sought to address the link between ADHD and PTSD in adults by providing a comprehensive comparison of ADHD patients with and without PTSD across multiple variables including demographics, patterns of psychiatric comorbidities, functional impairments, quality of life, social adjustment, and familial transmission. Participants in our controlled family study conducted between 1998 and 2003 were 190 adults with DSM-IV ADHD who were attending an outpatient mental health clinic in Boston, Massachusetts; 16 adults with DSM-IV ADHD who were recruited by advertisement from the greater Boston area; and 123 adult controls without ADHD who were recruited by advertisement from the greater Boston area. All available first-degree relatives also participated. Subjects completed a large battery of self-report measures (the Quality of Life Enjoyment and Satisfaction Questionnaire, items from the Current Behavior Scale, the Social Adjustment Scale Self-Report, and the Four Factor Index of Social Status) designed to assess various psychiatric and functional parameters. Diagnoses were made using data obtained from structured psychiatric interviews (Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version, and the Schedule for Affective Disorders and Schizophrenia for School-Aged Children-Epidemiologic Version). The lifetime prevalence of PTSD was significantly higher among adults with ADHD compared with controls (10.0% vs 1.6%; P = .004). Participants with ADHD and those with ADHD + PTSD

  10. Genome-wide scan in Portuguese Island families implicates multiple loci in bipolar disorder: fine mapping adds support on chromosomes 6 and 11.

    Science.gov (United States)

    Pato, Carlos N; Pato, M T; Kirby, A; Petryshen, T L; Medeiros, H; Carvalho, C; Macedo, A; Dourado, A; Coelho, I; Valente, J; Soares, M J; Ferreira, C P; Lei, M; Verner, A; Hudson, T J; Morley, C P; Kennedy, J L; Azevedo, M H; Daly, M J; Sklar, P

    2004-05-15

    As part of an extensive study in the Portuguese Island population of families with multiple patients suffering from bipolar disorder and schizophrenia, we performed an initial genome-wide scan of 16 extended families with bipolar disorder that identified three regions on chromosomes 2, 11, and 19 with genome-wide suggestive linkage and several other regions, including chromosome 6q, also approached suggestive levels of significance. Dick et al. [2003: Am J Hum Genet 73:107-114] recently reported in a study of 250 families with bipolar disorder a maxLOD score of 3.61 near marker D6S1021 on chromosome 6q. This study replicates this finding having detected a peak NPL = 2.02 (P = 0.025) with the same marker D6S1021(104.7 Mb). Higher-density mapping provided additional support for loci on chromosome 6 including marker D6S1021 with an NPL = 2.59 (P = 0.0068) and peaking at marker D6S1639 (125 Mb) with an NPL = 3.06 (P = 0.0019). A similar pattern was detected with higher-density mapping of chromosome 11 with an NPL = 3.15 (P = 0.0014) at marker D11S1883 (63.1 Mb). Simulations at the density of our fine mapping data indicate that less than 1 scan out of 10 would find two such scores genome-wide in the same scan by chance. Our findings provide additional support for a susceptibility locus for bipolar disorder on 6q, as well as, suggesting the importance of denser scans. Published 2004 Wiley-Liss, Inc.

  11. Relationship between anxiety, anxiety sensitivity and conduct disorder symptoms in children and adolescents with attention-deficit/hyperactivity disorder (ADHD).

    Science.gov (United States)

    Bilgiç, Ayhan; Türkoğlu, Serhat; Ozcan, Ozlem; Tufan, Ali Evren; Yılmaz, Savaş; Yüksel, Tuğba

    2013-09-01

    Attention-deficit hyperactivity disorder (ADHD) is often comorbid with anxiety disorders and previous studies observed that anxiety could have an impact on the clinical course of ADHD and comorbid disruptive behavioral disorders (conduct disorders and oppositional-defiant disorders). Anxiety sensitivity (AS) is a different concept from anxiety per se and it is believed to represent the constitutionally based sensitivity of individuals to anxiety and anxiety symptoms. We aimed to assess the associations between anxiety, AS and symptoms of disruptive behavioral disorders (DBD) in a clinical sample of children and adolescents with ADHD. The sample consisted of 274 treatment naive children with ADHD aged 8-17 years. The severity of ADHD symptoms and comorbid DBD were assessed via parent rated Turgay DSM-IV-Based Child and Adolescent Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S), Conners' Parent Rating Scale (CPRS), and Conners' Teacher Rating Scale (CTRS). AS and severity of anxiety symptoms of children were evaluated by self-report inventories. The association between anxiety, AS, and DBD was evaluated using structural equation modeling. Analyses revealed that AS social subscale scores negatively predicted symptoms of conduct disorder (CD) reported in T-DSM-IV-S. On the other hand, CD symptoms positively predicted severity of anxiety. No direct relationships were detected between anxiety, AS and oppositional-defiant behavior scores in any scales. These results may suggest a protective effect of AS social area on the development of conduct disorder in the presence of a diagnosis of ADHD, while the presence of symptoms of CD may be a vulnerability factor for the development of anxiety symptoms in children and adolescents with ADHD.

  12. Annual Research Review: The neurobehavioral development of multiple memory systems: implications for childhood and adolescent psychiatric disorders

    OpenAIRE

    Goodman, Jarid; Marsh, Rachel; Peterson, Bradley S.; Packard, Mark G.

    2013-01-01

    Extensive evidence indicates that mammalian memory is organized into multiple brains systems, including a “cognitive” memory system that depends upon the hippocampus and a stimulus-response “habit” memory system that depends upon the dorsolateral striatum. Dorsal striatal-dependent habit memory may in part influence the development and expression of some human psychopathologies, particularly those characterized by strong habit-like behavioral features. The present review considers this hypoth...

  13. Intricate Crystal Structure of Dihydrolipoamide Dehydrogenase (E3) with its Binding Protein: Multiple Copies, Dynamic and Static Disorders

    Science.gov (United States)

    Makal, A.; Hong, Y. S.; Potter, R.; Vettaikkorumakankauv, A. K.; Korotchkina, L. G.; Patel, M. S.; Ciszak, E.

    2004-01-01

    Human E3 and binding protein E3BP are two components of the pyruvate dehydrogenase complex. Crystallization of E3 with 221-amino acid fragment of E3BP (E3BPdd) led to crystals that diffracted to a resolution of 2.6 Angstroms. Structure determination involved molecular replacement using a dimer of E3 homolog as a search model and de novo building of the E3BPdd peptide. Solution was achieved by inclusion of one E3 dimer at a time, followed by refinement until five E3 dimers were located. This complete content of E3 provided electron density maps suitable for tracing nine peptide chains of E3BPdd, eight of them being identified with partial occupancies. Final content of the asymmetric unit consists of five E3 dimers, each binding one E3BPdd molecule. In four of these molecular complexes, E3BPdd is in static disorder resulting in E3BPdd binding to either one or the other monomer of the E3 dimer. However, E3BPdd of the fifth E3 dimer forms specific contacts that lock it at one monomer. In addition to this static disorder, E3BPdd reveals high mobility in the limited space of the crystal lattice. Support from NIH and NASA.

  14. Phenotypic and Causal Structure of Conduct Disorder in the Broader Context of Prevalent Forms of Psychopathology

    Science.gov (United States)

    Lahey, Benjamin B.; Waldman, Irwin D.

    2011-01-01

    Background A better understanding of the nature and etiology of conduct disorder (CD) can inform nosology and vice-versa. We posit that any prevalent form of psychopathology, including CD, can be best understood if it is studied in the context of other correlated forms of child and adolescent psychopathology using formal models to guide inquiry. Methods Review of both cross-sectional and longitudinal studies of the place of CD in the phenotypic and causal structure of prevalent psychopathology, with an emphasis on similarities and differences between CD and oppositional defiant disorder (ODD). Papers were located using Web of Science by topic searches with no restriction on year of publication. Results Although some important nosologic questions remain unanswered, the dimensional phenotype of CD is well defined. CD differs from other disorders in its correlates, associated impairment, and course. Nonetheless, it is robustly correlated with many other prevalent dimensions of psychopathology both concurrently and predictively, including both other “externalizing” disorders and some “internalizing” disorders. Based on emerging evidence, we hypothesize that these concurrent and predictive correlations result primarily from widespread genetic pleiotropy, with some genetic factors nonspecifically influencing risk for multiple correlated dimensions of psychopathology. In contrast, environmental influences mostly act to differentiate dimensions of psychopathology from one another both concurrently and over time. CD and ODD share half of their genetic influences, but their genetic etiologies are distinct in other ways. Unlike most other dimensions of psychopathology, half of the genetic influences on CD appear to be unique to CD. In contrast, ODD broadly shares nearly all of its genetic influences with other disorders and has little unique genetic variance. Conclusions CD is a relatively distinct syndrome at both phenotypic and etiologic levels, but much is revealed

  15. Stress and psychosocial adaptation in mothers of children with attention deficit hyperactivity disorder / Estresse e adaptação psicossocial em mães de crianças com transtorno de déficit de atenção/hiperatividade

    OpenAIRE

    2009-01-01

    The present study has investigated the parental stress in mothers of children with Attention Deficit Hyperactivity Disorder (ADHD) (n=30), in mothers of children with co-morbidity with the Oppositional Defiant Disorder (ODD) (n=30), and in mothers of children with typical development (n=30). In addition, possible correlations of parental stress with coping strategies, social support and ADHD severity have been investigated. The mothers have been evaluated using the following instruments: (a) ...

  16. Hezbollah Leader Defiant

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    As clashes between Lebanese paramilitary group Hezbollah and Israeli forces threaten to drag the two sides into open war, Hezbollah leader Sheikh Hassan Nasrallah made an appearance in a televised statement, saying his forces have "complete strength and power" and "yearn for a ground conflict" with Israelis.

  17. Multiple System Atrophy (MSA)

    Science.gov (United States)

    Diseases and Conditions Multiple system atrophy (MSA) By Mayo Clinic Staff Multiple system atrophy (MSA) is a rare neurological disorder that impairs your body's involuntary (autonomic) functions, including blood ...

  18. Soluble CD40 ligand contributes to blood-brain barrier breakdown and central nervous system inflammation in multiple sclerosis and neuromyelitis optica spectrum disorder.

    Science.gov (United States)

    Masuda, Hiroki; Mori, Masahiro; Uchida, Tomohiko; Uzawa, Akiyuki; Ohtani, Ryohei; Kuwabara, Satoshi

    2017-04-15

    Soluble CD40 ligand (sCD40L) is reported to disrupt the blood-brain barrier (BBB). Cerebrospinal fluid (CSF) and serum sCD40L levels were measured in 29 multiple sclerosis (MS), 29 neuromyelitis optica spectrum disorder (NMOSD), and 27 disease control (DC) patients. In MS, serum sCD40L levels were higher than in DCs and positively correlated with the CSF/serum albumin ratio (Qalb). In NMOSD, CSF sCD40L levels were significantly increased compared to DCs, and were correlated to Qalb, CSF cell counts, protein concentrations, and interleukin-6 levels. sCD40L could be involved in BBB disruption in MS, whereas it may contribute to CNS inflammation in NMOSD. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Treating Post-traumatic Stress Disorder in patients with Multiple Sclerosis: a randomized controlled trial comparing the efficacy of Eye Movement Desensitization and Reprocessing and Relaxation Therapy.

    Directory of Open Access Journals (Sweden)

    Sara eCarletto

    2016-04-01

    Full Text Available Objective: Multiple Sclerosis (MS is a demyelinating autoimmune disease that imposes a significant emotional burden with heavy psychosocial consequences. Several studies have investigated the association between MS and mental disorders such as depression and anxiety, and recently researchers have focused also on Post-traumatic Stress Disorder (PTSD. This is the first study that investigates the usefulness of proposing a treatment for PTSD to patients with MS. Methods: A randomized controlled trial with patients with MS diagnosed with PTSD comparing Eye Movement Desensitization and Reprocessing (EMDR; n = 20 and Relaxation Therapy (RT; n = 22. The primary outcome measure was the proportion of participants that no longer meet PTSD diagnosis as measured with Clinician Administered PTSD Scale six-months after the treatment.Results: The majority of patients were able to overcome their PTSD diagnosis after only 10 therapy sessions. EMDR treatment appears to be more effective than RT in reducing the proportion of patients with MS suffering from PTSD. Both treatments are effective in reducing PTSD severity, anxiety symptoms and to improve Quality of Life (QoL. Conclusions: Although our results can only be considered preliminary, this study suggests that it is essential that PTSD symptoms are detected and that brief and cost-effective interventions to reduce PTSD and associated psychological symptoms are offered to patients, in order to help them to reduce the psychological burden associated with their neurological condition.Trail registration: NCT01743664, https://clinicaltrials.gov/ct2/show/NCT01743664

  20. InMS: Chronic insomnia disorder in multiple sclerosis - a Portuguese multicentre study on prevalence, subtypes, associated factors and impact on quality of life.

    Science.gov (United States)

    Viana, Pedro; Rodrigues, Elisabete; Fernandes, Carina; Matas, Andreia; Barreto, Rui; Mendonça, Marcelo; Peralta, Rita; Geraldes, Ruth

    2015-09-01

    Sleep may be disrupted in Multiple Sclerosis (MS), but the prevalence of chronic insomnia disorder (CID) using standard diagnostic criteria is unknown. To determine the prevalence of CID in an MS population, the frequency of CID subtypes, associated factors and impact on quality of life (QoL). Multicentre, hospital-based cross-sectional study. An adapted version of the Brief Insomnia Questionnaire was applied to a consecutively recruited MS population. The influence of demographic, MS-related features, fatigue, medical and psychiatric comorbidities, nocturnal symptoms, other sleep disorders, dysfunctional beliefs about sleep in CID was evaluated. The relation between CID and QoL was analysed. Of 206 MS patients, 22.3% fulfilled criteria for CID, with initial insomnia in 11.7%, maintenance insomnia in 11.2% and terminal insomnia in 10.2% of patients. CID was more frequent in female patients, those with nocturnal symptoms, medical comorbidities, higher levels of anxiety, depression and fatigue. Multivariable analysis identified female sex, medical comorbidities, anxiety and fatigue as independent factors for CID. CID patients had a significantly lower self-reported QoL. CID is prevalent in MS patients and associated with psychiatric and medical comorbidities, as well as fatigue. It has a negative impact on QoL. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Affective disorders and Health-Related Quality of Life (HRQoL) in adolescents and young adults with Multiple Sclerosis (MS): the moderating role of resilience.

    Science.gov (United States)

    Rainone, Nunzia; Chiodi, Alessandro; Lanzillo, Roberta; Magri, Valeria; Napolitano, Anna; Morra, Vincenzo Brescia; Valerio, Paolo; Freda, Maria Francesca

    2017-03-01

    To investigate the moderating role of resilience in the relationship between affective disorders and Health-Related Quality of Life (HRQoL) for adolescents and young adults with multiple sclerosis (MS). A quantitative methodology was adopted. Fifty-three adolescents and young adults were interviewed to assess resilience as a personality trait (Ego-Resiliency Scale) and resilience as an interactive competence (CYRM-28), Health-Related Quality of Life (PedsQL 4.0), depression and anxiety (BDI-II and STAI-Y). Affective disorders, both depression (β = -.38, p resilience competencies using Individual (β = .22, p resilience competence using individual resources on the relationship between the Depression Cognitive Factor and Emotional Functioning. Data show that in step 2 of the regression analysis, we obtained a variation of β = -.45 (p resilience was significant regarding the increase in R(2) (p Resilience competence using individual resources moderates the relationship between the Depression Cognitive Factor and Emotional Functioning in adolescents with MS. Our study suggests that to improve well-being for adolescents with MS resilience could play a key role.

  2. Are there any associations between single and/or multiple social roles and self-rated physical health, psychiatric disorder and long-term sickness absence in women?

    Directory of Open Access Journals (Sweden)

    Carin Staland Nyman

    2012-03-01

    Full Text Available

    Abstract:
    Background: the relationship between single and/or multiple social roles that women hold (occupa- tional, partner, and parent and health and sickness absence is an important public health issue. Few studies on the social roles held by women have been performed in the Swedish context of gender equality. The aim of this study was to analyse associations between occupational, partner and parent roles (and combinations of these roles and their relation to self-rated physical health, psychiatric disorders and long-term sickness absence in a population based sample of women in Sweden.
    Methods: women born in 1935, 1945, 1955, 1965, 1970 or 1975 (n=600 were interviewed at baseline and five years later. cross-sectional data were analysed with multivariate logistic regression analysis adjusted for age, socio-economic position, alcohol dependence and abuse.
    Results: an occupational role was associated with lower odds for poor self-rated physical health, 0.28 (0.10-0.82, and sickness absence, 0.25 (0.10-0.86. a partner role was associated with lower odds for psy- chiatric disorder, 0.58 (0.35-0.98 while a parental role (children < 14 years was associated with higher odds for sickness absence, 4.17 (1.86-9.38. The combination of holding an occupational and partner role was associated with lower odds for health outcomes compared with having three roles. Conclusion: holding an occupational and partner role was related to lower odds for poor self-rated physical health, psychiatric disorder and long-term sickness absence, while having a parental role was adversely related to sickness absence. results are important in the light of discussions on reconciliation of work and family, and are of interest in countries with high or increasing female labour force participation.

  3. Mosaicism for genome-wide paternal uniparental disomy with features of multiple imprinting disorders: diagnostic and management issues.

    Science.gov (United States)

    Inbar-Feigenberg, Michal; Choufani, Sanaa; Cytrynbaum, Cheryl; Chen, Yi-An; Steele, Leslie; Shuman, Cheryl; Ray, Peter N; Weksberg, Rosanna

    2013-01-01

    Mosaicism for genome-wide paternal uniparental disomy (UPD) has been reported in only seven live born individuals to date. Clinical presentation includes manifestations of multiple paternal UPD syndromes with high variability, likely due to the variable levels of mosaicism in different somatic tissues. We report an eighth case in a female patient with mosaicism for genome-wide paternal UPD which highlights the complex clinical presentation. Our patient had features of Beckwith-Wiedemann syndrome (BWS), Angelman syndrome, and congenital hyperinsulinism. The clinical findings included prematurity, organomegaly, hemihyperplasia, developmental delay, benign tumors, and cystic lesions. The diagnosis in our patient was established utilizing microarray-based genome-wide DNA methylation analysis performed on leukocyte DNA. Targeted multiplex ligation-dependent probe amplification (MLPA) analysis of chromosome regions 11p15 and 15q13 confirmed mosaicism for paternal UPD at these genomic regions. This case represents the first report of microarray-based genome-wide DNA methylation analysis in the diagnosis of genome-wide paternal UPD. The application of microarray-based genome-wide DNA methylation analysis on selected individuals with complex clinical presentations could be a valuable diagnostic tool to improve the detection rate of mosaic genome-wide paternal UPD. This approach, which screens many loci simultaneously, is more cost-effective and less labor-intensive than performing multiple targeted DNA methylation-based assays. Identification of individuals with mosaicism for genome-wide paternal UPD is an important goal as it confers a low recurrence risk for the family and identifies individuals who require surveillance due to increased tumor risk.

  4. Anchoring Intrinsically Disordered Proteins to Multiple Targets: Lessons from N-Terminus of the p53 Protein

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    Yongqi Huang

    2011-02-01

    Full Text Available Anchor residues, which are deeply buried upon binding, play an important role in protein–protein interactions by providing recognition specificity and facilitating the binding kinetics. Up to now, studies on anchor residues have been focused mainly on ordered proteins. In this study, we investigated anchor residues in intrinsically disordered proteins (IDPs which are flexible in the free state. We identified the anchor residues of the N-terminus of the p53 protein (Glu17–Asn29, abbreviated as p53N which are involved in binding with two different targets (MDM2 and Taz2, and analyzed their side chain conformations in the unbound states. The anchor residues in the unbound p53N were found to frequently sample conformations similar to those observed in the bound complexes (i.e., Phe19, Trp23, and Leu26 in the p53N-MDM2 complex, and Leu22 in the p53N-Taz2 complex. We argue that the bound-like conformations of the anchor residues in the unbound state are important for controlling the specific interactions between IDPs and their targets. Further, we propose a mechanism to account for the binding promiscuity of IDPs in terms of anchor residues and molecular recognition features (MoRFs.

  5. Multiple Family Groups to reduce child disruptive behavior difficulties: moderating effects of child welfare status on child outcomes.

    Science.gov (United States)

    Gopalan, Geetha; Small, Latoya; Fuss, Ashley; Bowman, Melissa; Jackson, Jerrold; Marcus, Sue; Chacko, Anil

    2015-08-01

    Children who remain at home with their permanent caregivers following a child welfare (CW) involvement (e.g., investigation, out-of-home placement) manifest high rates of behavioral difficulties, which is a risk factor for further maltreatment and out-of-home placement if not treated effectively. A recently tested Multiple Family Group (MFG) service delivery model to treat youth Disruptive Behavior Disorders (DBDs) has demonstrated effectiveness in improving child behavior difficulties among hard-to-engage, socioeconomically disadvantaged families by addressing parenting skills, parent-child relationships, family communication and organization, social support, and stress. This exploratory study examines whether child behavioral outcomes for MFG differ for families with self-reported lifetime involvement in CW services compared to other families, as families with CW involvement struggle with additional stressors that can diminish treatment success. Youth (aged 7-11) and their families were assigned to MFG or services as usual (SAU) using a block comparison design. Caregivers reported on child behavior, social skills, and functional impairment. Mixed effects regression modeled multilevel outcomes across 4 assessment points (i.e., baseline, mid-test, post-test, 6-month follow-up). Among CW-involved families, MFG participants reported significantly reduced child oppositional defiant disorder symptoms at 6-month follow-up compared with SAU participants. No other differences were found in the effect of MFG treatment between CW and non-CW involved families. Findings suggest that MFG may be as effective in reducing child behavior difficulties for both CW and non-CW involved families. As a short-term, engaging, and efficient intervention, MFG may be a particularly salient service offering for families involved in the CW system.

  6. Comorbid Psychiatric Disorders in Children and Adolescents with Nocturnal Enuresis.

    Science.gov (United States)

    Amiri, Shahrokh; Shafiee-Kandjani, Ali Reza; Naghinezhad, Roghayeh; Farhang, Sara; Abdi, Salman

    2017-01-18

    The present study was conducted with the aim of identifying the frequency of comorbid psychiatricdisorders in children and adolescents with nocturnal enuresis (NE). In this descriptive-analytical study, 183 children and adolescents aged 5-18 years withNE referred to psychiatric clinics at Tabriz University of Medical Sciences were selected in 2015. A structuredclinical diagnostic interview, the kiddie-schedule for affective disorders and schizophrenia (K-SADS), was employedbased on the diagnostic and statistical manual of mental disorders (DSM-IV-TR) for the diagnosis of NEand comorbid psychiatric disorders. In this study, 39 participants (21.3%) were female and 144 (78.7%) were male. The mean age of participantswas 8.69 ± 2.34 years. The lifelong incidence of mental disorders among enuretic children and adolescentswas 79.23%. The highest incidence belonged to attention deficit/hyperactivity disorder (ADHD) with 74.9%, oppositional-defiant disorder (ODD) with 53%, and tic disorders with 12% (motor tics together with a single caseof vocal tic). The lowest incidence was for conduct disorder, bipolar affective disorder, and post-traumatic stressdisorder (PTSD) with 5%. Based on the Fisher exact test, there was no significant difference between girls andboys in terms of psychiatric disorders incidence (P > .05). Comorbid psychiatric disorders with NE are common among children and adolescents. Therefore,in-depth examination of other psychiatric disorders needs to be carried out in enuretic children and adolescents,which will affect the treatment and prognosis of NE.

  7. Population pharmacokinetics of methylphenidate hydrochloride extended-release multiple-layer beads in pediatric subjects with attention deficit hyperactivity disorder

    Directory of Open Access Journals (Sweden)

    Teuscher NS

    2015-05-01

    Full Text Available Nathan S Teuscher,1 Akwete Adjei,2 Robert L Findling,3,4 Laurence L Greenhill,5 Robert J Kupper,2 Sharon Wigal6 1PK/PD Associates, Trophy Club, TX, 2Rhodes Pharmaceuticals L.P., Coventry, RI, 3Department of Psychiatric Services and Research, Kennedy Krieger Institute, Baltimore, MD, 4Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, 5Department of Psychiatry, Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, 6AVIDA Inc., Newport Beach, CA, USA Abstract: A new multilayer-bead formulation of extended-release methylphenidate hydrochloride (MPH-MLR has been evaluated in pharmacokinetic studies in healthy adults and in Phase III efficacy/safety studies in children and adolescents with attention deficit hyperactivity disorder (ADHD. Using available data in healthy adults, a two-input, one-compartment, first-order elimination population pharmacokinetic model was developed using nonlinear mixed-effect modeling. The model was then extended to pediatric subjects, and was found to adequately describe plasma concentration–time data for this population. A pharmacokinetic/pharmacodynamic model was also developed using change from baseline in the ADHD Rating Scale (ADHD-RS-IV total scores from a pediatric Phase III trial and simulated plasma concentration–time data. During simulations for each MPH-MLR dose level (10–80 mg, increased body weight resulted in decreased maximum concentration. Additionally, as maximum concentration increased, ADHD-RS-IV total score improved (decreased. Knowledge of the relationship between dose, body weight, and clinical response following the administration of MPH-MLR in children and adolescents may be useful for clinicians selecting initial dosing of MPH-MLR. Additional study is needed to confirm these results. Keywords: population pharmacokinetics, Aptensio XR™, MPH-MLR, methylphenidate

  8. Comparison Study of Polysomnographic Features in Multiple System Atrophy-cerebellar Types Combined with and without Rapid Eye Movement Sleep Behavior Disorder

    Institute of Scientific and Technical Information of China (English)

    Yan Ding; Yue-Qing Hu; Shu-Qin Zhan; Cun-Jiang Li; Hong-Xing Wang; Yu-Ping Wang

    2016-01-01

    Background:The brain stem is found to be impaired in multiple system atrophy-cerebellar types (MSA-C).Rapid eye movement (REM) sleep behavior disorder (RBD) is reported as a marker of progressive brain stem dysfunction.Few systematic studies about the sleep disturbances in MSA-C patients combined with or without RBD were reported.This study aimed to explore the polysomnographic (PSG) features of sleep disturbances between MSA-C patients with and without RBD.Methods:Totally,46 MSA-C patients (23 with RBD,and 23 without RBD) were enrolled in this study.All patients underwent a structured interview for their demographic data,history of sleep pattern,and movement disorders;and then,overnight video-PSG was performed in each patient.All the records were evaluated by specialists at the Sleep Medicine Clinic for RBD and the Movement Disorder Clinic for MSA-C.The Student's t-test,Mann-Whitney U-test for continuous variables,and the Chi-square test for categorical variables were used in this study.Results:MSA-C patients with RBD had younger visiting age (52.6 ± 7.4 vs.56.7 ± 6.0 years,P =0.046) and shorter duration of the disease (12.0 [12.0,24.0] vs.24.0 [14.0,36.0] months,P =0.009) than MSA-C patients without RBD.MSA-C with RBD had shorter REM sleep latency (111.7 ± 48.2 vs.157.0 ± 68.8 min,P =0.042),higher percentage of REM sleep (14.9% ±4.0% vs.10.0% ± 3.2%,P =0.019),and lower Stage Ⅰ (9.5% ±7.2% vs.15.9% ±8.0%,P =0.027) than MSA-C without RBD.Moreover,MSA-C patients with RBD had more decreased sleep efficiency (52.4% ±12.6% vs.65.8% ±15.9%,P =0.029) than that without RBD.Conclusions:In addition to the RBD,MSA-C patients with RBD had other more severe sleep disturbances than those without RBD.The sleep disorders of MSA patients might be associated with the progress of the disease.

  9. Comparison Study of Polysomnographic Features in Multiple System Atrophy-cerebellar Types Combined with and without Rapid Eye Movement Sleep Behavior Disorder

    Science.gov (United States)

    Ding, Yan; Hu, Yue-Qing; Zhan, Shu-Qin; Li, Cun-Jiang; Wang, Hong-Xing; Wang, Yu-Ping

    2016-01-01

    Background: The brain stem is found to be impaired in multiple system atrophy-cerebellar types (MSA-C). Rapid eye movement (REM) sleep behavior disorder (RBD) is reported as a marker of progressive brain stem dysfunction. Few systematic studies about the sleep disturbances in MSA-C patients combined with or without RBD were reported. This study aimed to explore the polysomnographic (PSG) features of sleep disturbances between MSA-C patients with and without RBD. Methods: Totally, 46 MSA-C patients (23 with RBD, and 23 without RBD) were enrolled in this study. All patients underwent a structured interview for their demographic data, history of sleep pattern, and movement disorders; and then, overnight video-PSG was performed in each patient. All the records were evaluated by specialists at the Sleep Medicine Clinic for RBD and the Movement Disorder Clinic for MSA-C. The Student's t-test, Mann-Whitney U-test for continuous variables, and the Chi-square test for categorical variables were used in this study. Results: MSA-C patients with RBD had younger visiting age (52.6 ± 7.4 vs. 56.7 ± 6.0 years, P = 0.046) and shorter duration of the disease (12.0 [12.0, 24.0] vs. 24.0 [14.0, 36.0] months, P = 0.009) than MSA-C patients without RBD. MSA-C with RBD had shorter REM sleep latency (111.7 ± 48.2 vs. 157.0 ± 68.8 min, P = 0.042), higher percentage of REM sleep (14.9% ±4.0% vs. 10.0% ± 3.2%, P = 0.019), and lower Stage I (9.5% ±7.2% vs. 15.9% ±8.0%, P = 0.027) than MSA-C without RBD. Moreover, MSA-C patients with RBD had more decreased sleep efficiency (52.4% ±12.6% vs. 65.8% ±15.9%, P = 0.029) than that without RBD. Conclusions: In addition to the RBD, MSA-C patients with RBD had other more severe sleep disturbances than those without RBD. The sleep disorders of MSA patients might be associated with the progress of the disease. PMID:27625088

  10. Clinico-MRI study of hemispheric disorder in long-term follow-up cases of multiple system atrophy

    Energy Technology Data Exchange (ETDEWEB)

    Konagaya, Masaaki; Miwa, Shigeru; Matsuoka, Yukihiko [Suzuka National Hospital, Mie (Japan); Konagaya, Yoko

    1998-12-01

    Twelve cases of multiple system atrophy (MSA) were studied for clinical and MRI findings of the cerebral hemispheric involvement. The subjects consisted of five olivopontocerebellar atrophy (OPCA) type and seven striatonigral degeneration (SND) type. The age at onset was 56.7{+-}8.0 (M{+-}SD) years, duration of illness at the first MRI study 3.2{+-}1.1 years, duration of illness at the last study 8.1{+-}2.2 years, and the following up duration 4.9{+-}2.0 years. The grasping phenomenon was observed in 70% of the cases examined, snout reflex in 80%, slowness of verbal response in 88%, and decrease of spontaneous speech in 100%. Three cases finally fell into the state of mutism. Three out of ten cases were categorized as dementia by HDS-R (Hasegawa Dementia Scale-Revised) test. Besides the progression of the pontocerebellar atrophy and putaminal changes, MRI study revealed progressive frontal lobe atrophy in most cases. At six years after the onset, SND type showed significantly higher incidence of conspicuous frontal lobe atrophy and dilatation of the Sylvian fissure than OPCA type. Cerebral ventricular dilatation was common feature, and atrophy of the temporal and occipital lobes were observed in several cases. We indicated the possible involvement of the cerebral hemisphere, especially the frontal lobe, and higher nervous function in MSA. (author)

  11. A Randomized Placebo-Controlled Trial of D-Cycloserine for the Enhancement of Social Skills Training in Pervasive Development Disorders

    Science.gov (United States)

    2015-03-01

    hyperactivity disorder, oppositional defiant disorder, schizophrenia, ASD, social anxiety disorder, and major depression ). The child’s appropriateness for...Psychotherapy Physical Therapy Social Skills Training Music Therapy Other Treatments 12 (35.29) 9 (26.47) 1 (2.94) 0 (0.00) 3...Training Music Therapy Other Treatments 6 (40.00) 6 (40.00) 2 (13.33) 0 (0.00) 1 (6.67) 1 (6.67) 1 (6.67) 1 (6.67) 30 (57.69) 21

  12. Genome-wide identification of transcriptional targets of RORA reveals direct regulation of multiple genes associated with autism spectrum disorder.

    Science.gov (United States)

    Sarachana, Tewarit; Hu, Valerie W

    2013-05-22

    We have recently identified the nuclear hormone receptor RORA (retinoic acid-related orphan receptor-alpha) as a novel candidate gene for autism spectrum disorder (ASD). Our independent cohort studies have consistently demonstrated the reduction of RORA transcript and/or protein levels in blood-derived lymphoblasts as well as in the postmortem prefrontal cortex and cerebellum of individuals with ASD. Moreover, we have also shown that RORA has the potential to be under negative and positive regulation by androgen and estrogen, respectively, suggesting the possibility that RORA may contribute to the male bias of ASD. However, little is known about transcriptional targets of this nuclear receptor, particularly in humans. Here we identify transcriptional targets of RORA in human neuronal cells on a genome-wide level using chromatin immunoprecipitation (ChIP) with an anti-RORA antibody followed by whole-genome promoter array (chip) analysis. Selected potential targets of RORA were then validated by an independent ChIP followed by quantitative PCR analysis. To further demonstrate that reduced RORA expression results in reduced transcription of RORA targets, we determined the expression levels of the selected transcriptional targets in RORA-deficient human neuronal cells, as well as in postmortem brain tissues from individuals with ASD who exhibit reduced RORA expression. The ChIP-on-chip analysis reveals that RORA1, a major isoform of RORA protein in human brain, can be recruited to as many as 2,764 genomic locations corresponding to promoter regions of 2,544 genes across the human genome. Gene ontology analysis of this dataset of genes that are potentially directly regulated by RORA1 reveals statistically significant enrichment in biological functions negatively impacted in individuals with ASD, including neuronal differentiation, adhesion and survival, synaptogenesis, synaptic transmission and plasticity, and axonogenesis, as well as higher level functions such as

  13. Barriers to effective diagnosis and management of a bleeding patient with undiagnosed bleeding disorder across multiple specialties: results of a quantitative case-based survey

    Directory of Open Access Journals (Sweden)

    Reding MT

    2012-10-01

    Full Text Available Mark T Reding,1 David L Cooper21Center for Bleeding and Clotting Disorders, University of Minnesota Medical Center, Minneapolis, MN, 2Medical Affairs, Novo Nordisk Inc, Princeton, NJ, USABackground: Bleeding symptoms commonly seen by multiple physician specialties may belie undiagnosed congenital or acquired bleeding disorders. Acquired hemophilia is a potentially life-threatening cause of unexplained acute bleeding manifested by an abnormal activated partial thromboplastin time (aPTT that does not correct with 1:1 mixing with normal plasma.Methods: Practicing physicians (hematology/oncology, emergency medicine, geriatrics, internal medicine, rheumatology, obstetrics and gynecology, critical care medicine, and general surgery completed an online survey based on a hypothetical case scenario.Results: Excluding surgeons and obstetrician/gynecologist respondents, 302 physicians (about 50 per specialty were presented with an older adult woman complaining of recurrent epistaxis. Nearly 90% ordered a complete blood count and coagulation studies (aPTT, prothrombin time [PT]/international normalized ratio [INR]. Despite a prolonged aPTT of 42 seconds, <50% of nonhematologists would repeat the aPTT, and <45% would consult a hematologist; emergency medicine physicians were least likely (10% and rheumatologists were most likely (43% to consult. After presentation weeks later with bruising and abdominal/back pain, ≥90% of physicians within each specialty ordered a complete blood count or PT/INR/aPTT. Despite an aPTT of 63 seconds, the majority did not repeat the aPTT. At this point, approximately 75% of internal medicine and geriatric physicians indicated they would consult a hematologist, versus 47% in emergency medicine and 50% in critical care. All participants preferred abdominal computed tomography (80%–84%. After 12 hours of additional observation, 73% to 94% of respondents consulted a hematologist. Complete blood count revealed anemia and an a

  14. Adolescent substance use disorders and comorbidity.

    Science.gov (United States)

    Simkin, Deborah R

    2002-04-01

    -scale IQ to detect learning problems. For instance, if a student has an IQ of 115, the standard nationally recommended deviation from this IQ to detect a learning disorder is 15. Therefore, any child who scores 100 or less on an achievement test should be considered to have a learning disorder. Some schools prefer to use a deviation of up to 23 so that learning disorders are not detected. Few schools screen for processing problems, including auditory and visual motor processing problems, processing speed, comprehension, and short-term and long-term memory problems. This is extremely important because ADHD can be confused with an auditory processing problem. Stimulants may help this condition, but accommodations must be made to ensure continued success. Early-intervention programs, such as Drug Abuse Resistance Education (DARE), proved to be ineffective because the programs did not target components that have been shown to predict future drug use [54]. One program that has targeted these components, normative beliefs, lifestyle-behavior incongruence, and commitment is the All Stars program [39,40]. A strong initial dosage with booster interventions for at least 2 years is also important [10]. Before a child is diagnosed with oppositional defiant disorder or conduct disorder, every effort should be made to detect any underlying psychiatric disorder that has not been treated and therefore may look like a conduct disorder (e.g., bipolar disorder). Proper psychopharmacologic interventions should be made for psychiatric disorders. If one drug has been ineffective, another untreated psychiatric disorder may be present, and it is always important to tease out what remaining symptoms are present after a therapeutic trial has been tried. It is important to form a team approach so that all risk factors can be approached. Members of the team often include a primary care physician, a child psychologist, the parents, the patient, a teacher, a school counselor, a child psychiatrist, and

  15. Quetiapine monotherapy in adolescents with bipolar disorder comorbid with conduct disorder.

    Science.gov (United States)

    Masi, Gabriele; Pisano, Simone; Pfanner, Chiara; Milone, Annarita; Manfredi, Azzurra

    2013-10-01

    Bipolar Disorders (BD) are often comorbid with disruptive behaviour disorders (DBDs) (oppositional-defiant disorder or conduct disorder), with negative implications on treatment strategy and outcome. The aim of this study was to assess the efficacy of quetiapine monotherapy in adolescents with BD comorbid with conduct disorder (CD). A consecutive series of 40 adolescents (24 males and 16 females, age range 12-18 years, mean age 14.9 ± 2.0 years), diagnosed with a clinical interview (Kiddie Schedule for Affective Disorders and Schizophrenia for School-Aged Children-Present and Lifetime Version [K-SADS-PL]) according to American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision (DSM-IV-TR) criteria were included. All the patients were treated with quetiapine monotherapy (mean final dose 258 ± 124 mg/day, range 100-600 mg/day). At the end-point (3 months), 22 patients (55.0%) were responders (Clinical Global Impressions-Improvement [CGI-I] score of 1 or 2 and CGI-Severity [CGI-S] ≤ 3 and improvement of at least 30% Children's Global Assessment Scale [C-GAS] during 3 consecutive months). Both CGI-S and C-GAS significantly improved (pdisorder (ADHD) comorbidity. Eight patients (20.0%) experienced moderate to severe sedation and eight (20.0%) experienced increased appetite and weight gain. In these severely impaired adolescents, quetiapine monotherapy was well tolerated and effective in>50% of the patients.

  16. Attention and Executive Function in Children Diagnosed with Attention Deficit Hyperactivity Disorder and Comorbid Disorders

    Science.gov (United States)

    Ter-Stepanian, Mariam; Grizenko, Natalie; Cornish, Kim; Talwar, Victoria; Mbekou, Valentin; Schmitz, Norbert; Joober, Ridha

    2017-01-01

    Objective The goal of this study was to examine the relationship between comorbid disorders and executive function (EF) in children diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD). Methods Three hundred and fifty-five, 6–12 year old children clinically diagnosed with ADHD were included in the study. Comorbid anxiety disorders, Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) were examined. The EF domains were assessed using the Conners’ Continuous Performance Test (CPT), Wisconsin Card Sorting Test (WCST), Tower of London (ToL), Finger Windows (FW) and Self Ordered Pointing Test (SOPT). Results The findings indicate that children with comorbid anxiety disorders performed worse in domains measured by CPT and prior to controlling for age and sex, by FW. However, once sex was controlled for the results for FW were no longer significant. Children with CD obtained lower scores on WCST. Furthermore, a significant sex by CD interaction was observed. Conclusion These results indicate that comorbid disorders should be carefully examined as they play a significant role in EF performance and subsequently in day-to-day functioning of children with ADHD.

  17. Prevalence of Psychiatric Disorders amongst Adolescents in Tehran

    Directory of Open Access Journals (Sweden)

    Zahra Shahrivar

    2008-08-01

    Full Text Available "n Objective: "n The aim of the present study was to determine the prevalence of different psychiatric disorders among 12 to 17 years old adolescents in urban areas of Tehran. "nMethod: In this study, 1105 adolescents (12 -17 years old were selected from 250 clusters of the entire 22 municipality areas of Tehran using a multistage sampling method. After responding to the Farsi version of the Strengths and Difficulties Questionnaire self-report version, the Farsi version of the Kiddie Schedule for Affective Disorders and Schizophrenia - Present and Lifetime version (K-SADS-PL was administered to 273 adolescents and their families. The prevalence of adolescent psychiatric disorders was determined using the results of K-SADS-PL. "nResults: There were not any statistically significant differences between the sexes in the frequency of psychiatric disorders except for ADHD which was observed more frequently in boys. The most prevalent psychiatric disorders were attention-deficit/hyperactivity disorder (ADHD, oppositional defiant disorder, depressive disorders and separation anxiety disorder. "nConclusion: The frequency of psychiatric disorders among the adolescents in Tehran's urban areas was comparable to the reports from other countries. However, using methods to deal with missing data makes these prevalence rates somehow higher.

  18. High-Density Single-Layer Coating of Gold Nanoparticles onto Multiple Substrates by Using an Intrinsically Disordered Protein of α-Synuclein for Nanoapplications.

    Science.gov (United States)

    Bhak, Ghibom; Lee, Junghee; Kim, Chang-Hyun; Chung, Dong Young; Kang, Jin Hyoun; Oh, Soojung; Lee, Jungsup; Kang, Jin Soo; Yoo, Ji Mun; Yang, Jee Eun; Rhoo, Kun Yil; Park, Sunghak; Lee, Somin; Nam, Ki Tae; Jeon, Noo Li; Jang, Jyongsik; Hong, Byung Hee; Sung, Yung-Eun; Yoon, Myung-Han; Paik, Seung R

    2017-03-15

    Functional graffiti of nanoparticles onto target surface is an important issue in the development of nanodevices. A general strategy has been introduced here to decorate chemically diverse substrates with gold nanoparticles (AuNPs) in the form of a close-packed single layer by using an omni-adhesive protein of α-synuclein (αS) as conjugated with the particles. Since the adsorption was highly sensitive to pH, the amino acid sequence of αS exposed from the conjugates and its conformationally disordered state capable of exhibiting structural plasticity are considered to be responsible for the single-layer coating over diverse surfaces. Merited by the simple solution-based adsorption procedure, the particles have been imprinted to various geometric shapes in 2-D and physically inaccessible surfaces of 3-D objects. The αS-encapsulated AuNPs to form a high-density single-layer coat has been employed in the development of nonvolatile memory, fule-cell, solar-cell, and cell-culture platform, where the outlying αS has played versatile roles such as a dielectric layer for charge retention, a sacrificial layer to expose AuNPs for chemical catalysis, a reaction center for silicification, and biointerface for cell attachment, respectively. Multiple utilizations of the αS-based hybrid NPs, therefore, could offer great versatility to fabricate a variety of NP-integrated advanced materials which would serve as an indispensable component for widespread applications of high-performance nanodevices.

  19. What is a Visual Object? Evidence from the Reduced Interference of Grouping in Multiple Object Tracking for Children with Autism Spectrum Disorders

    Directory of Open Access Journals (Sweden)

    Lee de-Wit

    2012-05-01

    Full Text Available Objects offer a critical unit with which we can organise our experience of the world. However, whilst their influence on perception and cognition may be fundamental, understanding how objects are constructed from sensory input remains a key challenge for vision research and psychology in general. A potential window into the means by which objects are constructed in the visual system is offered by the influence that they have on the allocation of attention. In Multiple Object Tracking (MOT, for example, attention is automatically allocated to whole objects, even when this interferes with the tracking of the parts of these objects. In this study we demonstrate that this default tendency to track whole objects is reduced in children with Autisim Spectrum Disorders (ASD. This result both validates the use of MOT as a window into how objects are generated in the visual system and highlights how the reduced bias towards more global processing in ASD could influence further stages of cognition by altering the way in which attention selects information for further processing.

  20. Correlates of incident bipolar disorder in children and adolescents diagnosed with attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Jerrell, Jeanette M; McIntyre, Roger S; Park, Yong-Moon Mark

    2014-11-01

    The greater severity and chronicity of illness in youths with co-occurring attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder deserve further investigation as to the risk imparted by comorbid conditions and the pharmacotherapies employed. A retrospective cohort design was employed, using South Carolina's Medicaid claims dataset covering outpatient and inpatient medical and psychiatric service claims with International Classification of Diseases, Ninth Revision, Clinical Modification diagnoses and medication prescriptions between January 1996 and December 2006 for patients ≤ 17 years of age. The cohort included 22,797 cases diagnosed with ADHD at a mean age of 7.8 years; 1,604 (7.0%) were diagnosed with bipolar disorder at a mean age of 12.2 years. The bipolar disorder group developed conduct disorder (CD)/oppositional defiant disorder (ODD), anxiety disorder, and a substance use disorder later than the ADHD-only group. The odds of a child with ADHD developing bipolar disorder were significantly and positively associated with a comorbid diagnosis of CD/ODD (adjusted odds ratio [aOR] = 4.01), anxiety disorder (aOR = 2.39), or substance use disorder (aOR = 1.88); longer treatment with methylphenidate, mixed amphetamine salts, or atomoxetine (aOR = 1.01); not being African American (aOR = 1.61); and being treated with certain antidepressant medications, most notably fluoxetine (aOR = 2.00), sertraline (aOR = 2.29), bupropion (aOR = 2.22), trazodone (aOR = 2.15), or venlafaxine (aOR = 2.37) prior to the first diagnosis of mania. Controlling for pharmacotherapy differences, incident bipolar disorder was more likely in individuals clustering specific patterns of comorbid psychiatric disorders, suggesting that there are different pathways to bipolarity and providing a clinical impetus for prioritizing prevention and preemptive strategies to reduce their hazardous influence. © Copyright 2014 Physicians Postgraduate Press, Inc.

  1. Prenatal Testosterone and Preschool Disruptive Behavior Disorders.

    Science.gov (United States)

    Roberts, Bethan A; Martel, Michelle M

    2013-11-01

    Disruptive Behaviors Disorders (DBD), including Oppositional-Defiant Disorder (ODD) and Attention-Deficit/Hyperactivity Disorder (ADHD), are fairly common and highly impairing childhood behavior disorders that can be diagnosed as early as preschool. Prenatal exposure to testosterone may be particularly relevant to these early-emerging DBDs that exhibit a sex-biased prevalence rate favoring males. The current study examined associations between preschool DBD symptom domains and prenatal exposure to testosterone measured indirectly via right 2D:4D finger-length ratios. The study sample consisted of 109 preschool-age children between ages 3 and 6 (64% males;72% with DBD) and their primary caregivers. Primary caregivers completed a semi-structured interview (i.e., Kiddie Disruptive Behavior Disorder Schedule), as well as symptom questionnaires (i.e., Disruptive Behavior Rating Scale, Peer Conflict Scale); teachers and/or daycare providers completed symptom questionnaires and children provided measures of prenatal testosterone exposure, measured indirectly via finger-length ratios (i.e., right 2D:4D). Study results indicated a significant association of high prenatal testosterone (i.e., smaller right 2D:4D) with high hyperactive-impulsive ADHD symptoms in girls but not boys, suggesting that the effect may be driven by, or might only exist in, girls. The present study suggests that prenatal exposure to testosterone may increase risk for early ADHD, particularly hyperactivity-impulsivity, in preschool girls.

  2. Mental Disorders, Comorbidity, and Pre-enlistment Suicidal Behavior Among New Soldiers in the U.S. Army: Results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).

    Science.gov (United States)

    Nock, Matthew K; Ursano, Robert J; Heeringa, Steven G; Stein, Murray B; Jain, Sonia; Raman, Rema; Sun, Xiaoying; Chiu, Wai Tat; Colpe, Lisa J; Fullerton, Carol S; Gilman, Stephen E; Hwang, Irving; Naifeh, James A; Rosellini, Anthony J; Sampson, Nancy A; Schoenbaum, Michael; Zaslavsky, Alan M; Kessler, Ronald C

    2015-01-26

    We examined the associations between mental disorders and suicidal behavior (ideation, plans, and attempts) among new soldiers using data from the New Soldier Study (NSS) component of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS; N = 38,507). Most new soldiers with a pre-enlistment history of suicide attempt reported a prior mental disorder (59.0%). Each disorder examined was associated with increased odds of suicidal behavior (ORs = 2.6-8.6). Only PTSD and disorders characterized by irritability and impulsive/aggressive behavior (i.e., bipolar disorder, conduct disorder, oppositional defiant disorder, and attention-deficit/hyperactivity disorder) predicted unplanned attempts among ideators. Mental disorders are important predictors of pre-enlistment suicidal behavior among new soldiers and should figure prominently in suicide screening and prevention efforts.

  3. Multiple structural states exist throughout the helical nucleation sequence of the intrinsically disordered protein stathmin, as reported by electron paramagnetic resonance spectroscopy.

    Science.gov (United States)

    Chui, Ashley J; López, Carlos J; Brooks, Evan K; Chua, Katherina C; Doupey, Tonia G; Foltz, Gretchen N; Kamel, Joseph G; Larrosa, Estefania; Sadiki, Amissi; Bridges, Michael D

    2015-03-10

    The intrinsically disordered protein (IDP) stathmin plays an important regulatory role in cytoskeletal maintenance through its helical binding to tubulin and microtubules. However, it lacks a stable fold in the absence of its binding partner. Although stathmin has been a focus of research over the past two decades, the solution-phase conformational dynamics of this IDP are poorly understood. It has been reported that stathmin is purely monomeric in solution and that it bears a short helical region of persistent foldedness, which may act to nucleate helical folding in the C-terminal direction. Here we report a comprehensive study of the structural equilibria local to this region in stathmin that contradicts these two claims. Using the technique of electron paramagnetic resonance (EPR) spectroscopy on spin-labeled stathmin mutants in the solution-phase and when immobilized on Sepharose solid support, we show that all sites in the helical nucleation region of stathmin exhibit multiple spectral components that correspond to dynamic states of differing mobilities and stabilities. Importantly, a state with relatively low mobility dominates each spectrum with an average population greater than 50%, which we suggest corresponds to an oligomerized state of the protein. This is in contrast to a less populated, more mobile state, which likely represents a helically folded monomeric state of stathmin, and a highly mobile state, which we propose is the random coil conformer of the protein. Our interpretation of the EPR data is confirmed by further characterization of the protein using the techniques of native and SDS PAGE, gel filtration chromatography, and multiangle and dynamic light scattering, all of which show the presence of oligomeric stathmin in solution. Collectively, these data suggest that stathmin exists in a diverse equilibrium of states throughout the purported helical nucleation region and that this IDP exhibits a propensity toward oligomerization.

  4. Executive function profile of Chinese boys with attention-deficit hyperactivity disorder: different subtypes and comorbidity.

    Science.gov (United States)

    Shuai, Lan; Chan, Raymond C K; Wang, Yufeng

    2011-03-01

    This study examined the executive function (EF) profile of Chinese boys with attention-deficit hyperactivity disorder (ADHD) using a large sample. Executive function performance within the ADHD subtypes and the effects of comorbidity were also investigated. Five hundred Chinese boys (375 with ADHD and 125 controls) aged 6-15 completed a battery of EF tests. Boys with all types of ADHD performed worse in all of the EF tests than age- and intelligence quotient-matched healthy controls. The boys with the inattention ADHD subtype and the combined subtype showed similar impairments across different EF tasks, whereas the boys with the hyperactive-impulsive ADHD subtype primarily displayed deficits in theory of mind and visual memory. Comorbid oppositional defiant disorder/conduct disorder had no additional influence on the EF characteristics of the boys with ADHD only, whereas comorbid learning disorder increased the severity of inhibition and shifting impairments.

  5. Disruptive Behavior Disorders and Marijuana Use: The Role of Depressive Symptoms

    Science.gov (United States)

    Morse, Melanie C.; Benson, Kari; Flory, Kate

    2015-01-01

    OBJECTIVE The present study sought to examine the relations among disruptive behavior disorders (DBDs; ie, attention-deficit/hyperactivity disorder [ADHD], conduct disorder [CD], oppositional defiant disorder [ODD]), depressive symptoms, and marijuana use among a sample of late adolescents and emerging adults. METHOD A total of 900 students (75.8% female, 80.3% Caucasian, Mage = 20) from a large public university completed an online survey. RESULTS Findings indicated that depressive symptoms mediated the relation between the marijuana use and past symptoms of ADHD, past diagnosis of ADHD, CD symptoms, CD diagnosis, and ODD diagnosis. CONCLUSION Depressive symptoms represent a link between DBDs and marijuana use that is suggested, but not well documented in the existing literature. The current findings add to this evidence and suggest a need to assess individuals presenting with symptoms of DBDs for depressive symptoms, as this symptom pattern may result in a greater likelihood of marijuana use. PMID:27594786

  6. 多系统萎缩患者的主客观睡眠障碍%Subjective and objective features of sleep disorders in multiple system atrophy

    Institute of Scientific and Technical Information of China (English)

    赵馨; 张玉虎; 冯淑君; 聂坤; 王丽敏; 张又文; 谢泗芬; 李彦; 周晓红

    2016-01-01

    目的 研究多系统萎缩(MSA)患者的主客观睡眠障碍.方法 选取2013年6月至2015年8月广东省人民医院神经内科住院的MSA患者30例,对照组25例,采用非运动症状量表睡眠分项、匹兹堡睡眠质量指数(PSQI)及帕金森病睡眠量表-2(PDSS-2)评价其主观睡眠障碍,同时行多导睡眠图(PSG)评价其客观睡眠障碍.结果 30例MSA患者中有29例(96.7%)至少存在1项睡眠障碍主诉.MSA组的PSQI总分(分)、PDSS-2总分(分)较对照组显著增高(PSQI:9.37±4.60和5.36±2.86,t=-3.934,P<0.01;PDSS-2:15.60±10.02和5.48±2.74,t=-5.300,P <0.01),MSA组睡眠量表的部分因子分与增龄、运动症状相关.PSG示MSA组患者总睡眠时间减少,睡眠效率减低,各期睡眠比例未见差异;确诊快速动眼睡眠行为障碍(RBD)者24例(80.0%),其中仅2例表现为暴力动作;MSA组周期性肢体运动(PLMS)指数增高.以帕金森症候群为主的MSA (MSA-P)组PDSS-2总分较以共济失调为主的MSA (MSA-C)组增高(17.79±10.01和6.83±2.40,t=4.834,P<0.01).结论 MSA患者存在多种睡眠障碍;其睡眠结构改变以睡眠时长减少、睡眠效率减低为主,各期睡眠比例变化不明显;RBD发生率高而症状轻;PLMS在MSA患者多见且程度较重;MSA-P患者的睡眠主观体验与运动症状相关,且较MSA-C患者更差.%Objective To investigate the subjective and objective sleep disorders in patients with multiple system atrophy (MSA).Methods Thirty MSA patients and 25 age-and-sex matched controls were enrolled.Sleep disorders were assessed by Pittsburgh Sleep Quality Index (PSQI),Parkinson's Disease Sleep Scale-2 (PDSS-2),and polysomnography (PSG).Results Twenty-nine (96.7%) patients complained of sleep disorders.The PSQI and PDSS-2 scores were significantly higher in MSA group than those in control group (PSQI:9.37 ±4.60 vs 5.36 ±2.86,t =-3.934,P <0.01 ;PDSS-2:15.60 ± 10.02 vs 5.48 ±2.74,t =-5.300,P < 0.01).Some parameters of sleep scales were

  7. Attention deficit hyperactivity disorder: A review for family physicians

    Directory of Open Access Journals (Sweden)

    Karande Sunil

    2005-12-01

    Full Text Available Attention deficit hyperactivity disorder (ADHD is a chronic behavioral disorder characterized by persistent hyperactivity, impulsivity, and inattention that impairs educational achievement and/or social functioning. Its diagnosis is made by ascertaining whether the child′s specific behaviors meet the diagnostic and statistical manual of mental disorders-IV-revised criteria. Its etiology is still unclear but recent studies suggest that genetics plays a major role in conferring susceptibility. Comorbidity with psychiatric disorders such as anxiety disorder, depression, oppositional defiant disorder and conduct disorder; and with specific learning disability is not uncommon. Although medication works well in most cases of ADHD, optimal treatment requires integrated medical and behavioral treatment. Methylphenidate (MPH and atomoxetine are the two drugs being currently prescribed and their efficacy in decreasing the symptoms of ADHD is well documented. Pyschoeducational interventions in school can help increase the successful functioning of affected children and improve their academic performance. Almost half of affected children continue to show significant symptoms of the disorder into adolescence and young adulthood. The family physician can play an important role in detecting this condition early, coordinating its assessment and treatment, counseling the parents and classroom teacher, and monitoring the child′s academic and psychosocial progress on a long-term basis.

  8. Quantum Interference of Multiple Beams Induced by Multiple Scattering

    DEFF Research Database (Denmark)

    Ott, Johan Raunkjær; Mortensen, N. Asger; Lodahl, Peter

    2011-01-01

    We report on quantum interference induced by the transmission of quantized light through a multiple-scattering medium. We show that entangled states can be created by multiple-scattering and that quantum interference survives disorder averaging.......We report on quantum interference induced by the transmission of quantized light through a multiple-scattering medium. We show that entangled states can be created by multiple-scattering and that quantum interference survives disorder averaging....

  9. Dissociative Identity Disorder

    Science.gov (United States)

    Schmidt, Tom

    2007-01-01

    Few psychological disorders in the Diagnostic Statistical Manual have generated as much controversy as Dissociative Identity Disorder (DID). For the past 35 years diagnoses of DID, previously referred to as Multiple Personality Disorder (MPD), have increased exponentially, causing various psychological researchers and clinicians to question the…

  10. Psychiatric disorders in preschoolers: the structure of DSM-IV symptoms and profiles of comorbidity.

    Science.gov (United States)

    Wichstrøm, Lars; Berg-Nielsen, Turid Suzanne

    2014-07-01

    Psychiatric disorders have been increasingly recognized in preschool children; at present, however, we know comparatively less about how well current diagnostic manuals capture the symptoms described in this age group and how comorbidity is patterned. Therefore, this study aimed to investigate whether the symptoms defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) load on their respective disorders, examine whether individual symptoms exist that load particularly high or low on the disorder they allegedly define, and analyze how comorbidity clusters in individual children. Parents of a community sample of Norwegian 4-year-olds (N = 995) were interviewed using the Preschool Age Psychiatric Assessment. A confirmatory factor analysis (CFA) and a latent profile analysis (LPA) were performed on the symptoms of seven DSM disorders: attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder, conduct disorder, major depressive disorder (MDD), generalized anxiety disorder (GAD), social phobia, and separation anxiety disorder. The results showed that the CFA solution that closely resembled the disorders delineated in the DSM-IV fitted the data best. However, vegetative symptoms did not define preschool depression. The LPA identified nine symptom profiles among preschoolers, of which four showed evidence of psychopathology: comorbid MDD/GAD ? ADHD combined type, comorbid MDD/GAD ? ADHD hyperactive/impulsive type, separation anxiety only, and social phobia only. In conclusion, the symptoms observed in preschoolers fit the DSM-IV well, and comorbidity followed specific patterns.

  11. Differences in finger length ratio between males with autism, pervasive developmental disorder-not otherwise specified, ADHD, and anxiety disorders.

    Science.gov (United States)

    de Bruin, Esther I; Verheij, Fop; Wiegman, T; Ferdinand, Robert F

    2006-12-01

    Children with autism have a relatively shorter index finger (2D) compared with their ring finger (4D). It is often presumed that the 2D:4D ratio is associated with fetal testosterone levels and that high fetal testosterone levels could play a role in the aetiology of autism. It is unknown whether this effect is specific to autism. In this study, 2D:4D ratios of 144 males aged 6 to 14 years (mean age 9y 1 mo [SD 1y 11 mo]) with psychiatric disorders were compared with those of 96 males aged 6 to 13 years from the general population (mean age 9y 1 mo [SD 1y 10 mo]). Psychiatric disorders were divided into autism/Asperger syndrome (n=24), pervasive developmental disorder-not otherwise specified (PDD-NOS; n=26), attention-deficit-hyperactivity disorder (ADHD)/oppositional defiant disorder (ODD; n=68), and anxiety disorders (n=26). Males with autism/Asperger syndrome (pADHD/ODD (pAsperger syndrome had lower ratios than those in the comparison group. These results indicated that higher fetal testosterone levels may play a role, not only in the origin of autism, but also in the aetiology of PDD-NOS and of ADHD/ODD. Males with anxiety disorders might have been exposed to lower prenatal testosterone levels.

  12. Attention deficit disorders--drugs or nutrition?

    Science.gov (United States)

    Matsudaira, Toshiko

    2007-01-01

    3-9% of schoolchildren in the U.K. suffer Attention Deficit and Hyperactivity Disorder (ADHD). Since the 1950s stimulants have been used. particularly methylphenidate and dextroamphetamine, with some 75% response rate. The first non-stimulant medication--atmoxetine hydrochloride, has also been used. However, side effects have included: growth retardation; appetite loss: headache: stomachache: heart problem: insomnia: seizure; change of character: addiction or even suicidal thoughts. Alternative treatments have been used including omega-3s, yet the way they benefit in ADHD is uncertain. They may be important in remodelling dendrites and synapses, and/or sustaining: blood brain barrier, neuronal membrane. neurotransmitter channel, receptors and ion channel. Stevens in 2003 found long-chain polyunsaturated fatty acids (LCPUFAs) effective for oppositional defiant disorder, whereas Eicosapentaenoic acid (EPA) specifically was helpful with disruptive behaviour. Docosahexaenoic acid (DHA) is important during gestation and early infancy, particularly for neurodevelopment. The Durham Trial by Richardson published in 2005, tested omega-3s with omega-6s on schoolchildren with developmental coordination disorder (many of them had ADHD symptoms), improving scores in co-ordination and short term memory.

  13. Prosocial skills may be necessary for better peer functioning in children with symptoms of disruptive behavior disorders

    Science.gov (United States)

    Browne, Dillon T.; Tannock, Rosemary

    2014-01-01

    Children with disruptive behavior disorders experience substantial social challenges; however, the factors that account for (i.e., mediate), or influence (i.e., moderate), peer problems are not well understood. This study tested whether symptoms of Oppositional Defiant Disorder and Conduct Disorder were associated with peer impairment and whether prosocial skills mediated or moderated these associations. Teacher ratings were gathered for 149 children (Mage = 9.09, SD = 1.71, 26% female) referred for behavioral concerns to an urban child psychiatry clinic. Path-analytic linear regressions testing mediation and moderation effects showed that prosocial skills significantly moderated the negative effects of symptoms of Conduct Disorder on peer impairment. Children showed less peer impairment only when they had relatively few conduct symptoms and high prosocial skills. Measurement of prosocial skills, in addition to conduct problems, may best capture factors which contribute to peer problems of children with disruptive behaviors. PMID:25083349

  14. Genetics Home Reference: multiple system atrophy

    Science.gov (United States)

    ... Home Health Conditions multiple system atrophy multiple system atrophy Enable Javascript to view the expand/collapse boxes. ... PDF Open All Close All Description Multiple system atrophy is a progressive brain disorder that affects movement ...

  15. Attention-deficit/hyperactivity disorder in adolescence predicts onset of major depressive disorder through early adulthood.

    Science.gov (United States)

    Meinzer, Michael C; Lewinsohn, Peter M; Pettit, Jeremy W; Seeley, John R; Gau, Jeff M; Chronis-Tuscano, Andrea; Waxmonsky, James G

    2013-06-01

    The aim of this study was to examine the prospective relationship between a history of attention-deficit/hyperactivity disorder (ADHD) assessed in mid-adolescence and the onset of major depressive disorder (MDD) through early adulthood in a large school-based sample. A secondary aim was to examine whether this relationship was robust after accounting for comorbid psychopathology and psychosocial impairment. One thousand five hundred seven participants from the Oregon Adolescent Depression Project completed rating scales in adolescence and structured diagnostic interviews up to four times from adolescence to age 30. Adolescents with a lifetime history of ADHD were at significantly higher risk of MDD through early adulthood relative to those with no history of ADHD. ADHD remained a significant predictor of MDD after controlling for gender, lifetime history of other psychiatric disorders in adolescence, social and academic impairment in adolescence, stress and coping in adolescence, and new onset of other psychiatric disorders through early adulthood (hazard ratio, 1.81; 95% confidence interval, 1.04, 3.06). Additional significant, robust predictors of MDD included female gender, a lifetime history of an anxiety disorder, and poor coping skills in mid-adolescence, as well as the onset of anxiety, oppositional defiant disorder, and substance-use disorder after mid-adolescence. A history of ADHD in adolescence was associated with elevated risk of MDD through early adulthood and this relationship remained significant after controlling for psychosocial impairment in adolescence and co-occurring psychiatric disorders. Additional work is needed to identify the mechanisms of risk and to inform depression prevention programs for adolescents with ADHD. © 2013 Wiley Periodicals, Inc.

  16. Comparing Mental Health of School-Age Children of Parents With/Without Bipolar Disorders: A Case Control Study

    Directory of Open Access Journals (Sweden)

    Shamsaei

    2015-05-01

    Full Text Available Background Children of parents with bipolar disorder appear to have an increased risk of early-onset Bipolar Disorder (BP, mood disorders and other psychiatric disorders. Objectives The aim of this study was to compare the mental health of school-age children of parents, with/without bipolar disorder. Materials and Methods This case-control study included one hundred children aged six to twelve years, who had parents with bipolar disorder and 200 children of 163 demographically-matched control parents. Parents with bipolar disorder were recruited from Farshchian Psychiatric Hospital of Hamadan, Iran, during year 2014. The parent version of the Child Symptom Inventory-4 questionnaire was used to measure mental health. Mean comparisons were performed using Student’s t test while effect sizes were estimated by Cohen’s d coefficient. The Chi-square test was used to assess significant differences between frequency distribution of demographic variables in both groups. The significance level was considered less than 0.05. Results There were statistically significant differences between children of parents with and those without bipolar disorder regarding attention deficit hyperactivity disorder, oppositional defiant disorder, conduct, generalized anxiety disorder, schizophrenia, major depression, separation anxiety (P< 0.001 and social phobia (P < 0.05. Children of parents with BP are at high risk for psychiatric disorders. Conclusions These findings support that the careful evaluation and prospective following of the psychopathology of children of parents with bipolar disorder are critical for early identification and treatment.

  17. Comorbidity as a predictor and moderator of treatment outcome in youth with anxiety, affective, attention deficit/hyperactivity disorder, and oppositional/conduct disorders.

    Science.gov (United States)

    Ollendick, Thomas H; Jarrett, Matthew A; Grills-Taquechel, Amie E; Hovey, Laura D; Wolff, Jennifer C

    2008-12-01

    In the present review, we examine one of the critical issues that have been raised about evidence-based treatments and their portability to real-world clinical settings: namely, the presence of comorbidity in the participants who have been treated in these studies and whether the presence of comorbidity predicts or moderates treatment outcomes. In doing so, we examine treatment outcomes for the four most commonly occurring childhood psychiatric disorders: Anxiety disorders, affective disorders, attention deficit/hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD)/conduct disorder (CD). For each of these disorders, we first review briefly the prevalence of comorbidity in epidemiological and clinical samples and then highlight the evidence-based treatments for these disorders. We next determine the effects of comorbidity on treatment outcomes for these disorders. For the most part, comorbidity in the treated samples is the rule, not the exception. However, the majority of studies have not explored whether comorbidity predicts or moderates treatment outcomes. For the not insignificant number of studies that have examined this issue, comorbidity has not been found to affect treatment outcomes. Notable exceptions are highlighted and recommendations for future research are presented.

  18. Preschool Anxiety Disorders: Comprehensive Assessment of Clinical, Demographic, Temperamental, Familial, and Life Stress Correlates

    Science.gov (United States)

    Dougherty, Lea R.; Tolep, Marissa R.; Bufferd, Sara J.; Olino, Thomas M.; Dyson, Margaret; Traditi, Jennifer; Rose, Suzanne; Carlson, Gabrielle A.; Klein, Daniel N.

    2013-01-01

    This study examined correlates of preschoolers’ anxiety disorders using a comprehensive, multi-method design. Participants included a community sample of 541 three-year-old children, of whom 106 (19.6%) met criteria for at least one anxiety disorder. Child and parental psychopathology and life stress were assessed with clinical interviews. Child temperament and parenting behavior were assessed with laboratory observations. Mothers and fathers reported on their parenting styles. Compared to preschoolers with no anxiety disorder, preschoolers with an anxiety disorder were more likely to meet criteria for comorbid depressive and oppositional defiant disorders and to exhibit greater temperamental behavioral inhibition and lower positive affectivity, and more sleep problems. Children with anxiety disorders also experienced more stressful life events in the previous six months, and their mothers had a higher rate of current anxiety disorders. Compared to children with other anxiety disorders, children with only specific phobia exhibited a somewhat different pattern of associations than children with other anxiety disorders. Overall, the findings suggest that many of the correlates observed in older youth with anxiety disorders are also observed in preschoolers. PMID:23368788

  19. Reliability and Validity of the MINI International Neuropsychiatric Interview for Children and Adolescents (MINI-KID)

    Science.gov (United States)

    2009-02-13

    Major Depression; Mania; Anxiety Disorders; Psychotic Disorder; Alcohol Dependence; Drug Dependence; Eating Disorders; Suicidality; Dysthymia; ADHD; Tourettes Disorder; Conduct Disorder; Oppositional Defiant Disorder; Pervasive Developmental Disorder

  20. The Single and Combined Effects of Multiple Intensities of Behavior Modification and Methylphenidate for Children with Attention Deficit Hyperactivity Disorder in a Classroom Setting

    Science.gov (United States)

    Fabiano, Gregory A.; Pelham, William E., Jr.; Gnagy, Elizabeth M.; Burrows-MacLean, Lisa; Coles, Erika K.; Chacko, Anil; Wymbs, Brian T.; Walker, Kathryn S.; Arnold, Fran; Garefino, Allison; Keenan, Jenna K.; Onyango, Adia N.; Hoffman, Martin T.; Massetti, Greta M.; Robb, Jessica A.

    2007-01-01

    Currently behavior modification, stimulant medication, and combined treatments are supported as evidence-based interventions for attention deficit hyperactivity disorder in classroom settings. However, there has been little study of the relative effects of these two modalities and their combination in classrooms. Using a within-subject design, the…

  1. The Single and Combined Effects of Multiple Intensities of Behavior Modification and Methylphenidate for Children with Attention Deficit Hyperactivity Disorder in a Classroom Setting

    Science.gov (United States)

    Fabiano, Gregory A.; Pelham, William E., Jr.; Gnagy, Elizabeth M.; Burrows-MacLean, Lisa; Coles, Erika K.; Chacko, Anil; Wymbs, Brian T.; Walker, Kathryn S.; Arnold, Fran; Garefino, Allison; Keenan, Jenna K.; Onyango, Adia N.; Hoffman, Martin T.; Massetti, Greta M.; Robb, Jessica A.

    2007-01-01

    Currently behavior modification, stimulant medication, and combined treatments are supported as evidence-based interventions for attention deficit hyperactivity disorder in classroom settings. However, there has been little study of the relative effects of these two modalities and their combination in classrooms. Using a within-subject design, the…

  2. Integrating Case Topics in Medical School Curriculum to Enhance Multiple Skill Learning: Using Fetal Alcohol Spectrum Disorders as an Exemplary Case

    Science.gov (United States)

    Paley, Blair; O'Connor, Mary J.; Baillie, Susan J.; Guiton, Gretchen; Stuber, Margaret L.

    2009-01-01

    Objectives: This article describes the use of fetal alcohol spectrum disorders (FASDs) as a theme to connect the learning of basic neurosciences with clinical applications across the age span within a systems-based, integrated curricular structure that emphasizes problem-based learning. Methods: In collaboration with the Centers for Disease…

  3. Adducts of hexamethylenetetramine with ferrocenecarboxylic acid and ferrocene-1,1'-dicarboxylic acid: multiple disorder in space groups Fmm2 and Cmcm.

    Science.gov (United States)

    Zakaria, Choudhury M; Ferguson, George; Lough, Alan J; Glidewell, Christopher

    2003-07-01

    Hexamethylenetetramine, C(6)H(12)N(4), and ferrocenecarboxylic acid, C(11)H(10)FeO(2), form a 1:2 adduct, (I), which is a salt, viz. hexamethylenetetraminium(2+) bis(ferrocenecarboxylate), (C(6)H(14)N(4))[Fe(C(5)H(5))(C(6)H(4)O(2))](2). The dication in (I) is disordered with two orientations at a site of mm2 symmetry in space group Fmm2, while the anion lies across a mirror plane with its unsubstituted cyclopentadienyl ring disordered over two sets of sites. With ferrocene-1,1'-dicarboxylic acid, C(12)H(10)FeO(4), hexamethylenetetramine forms a 1:1 adduct, (II), in which both components are neutral, viz. hexamethylenetetramine-ferrocene-1,1'-dicarboxylic acid (1/1), [Fe(C(6)H(5)O(2))(2)].C(6)H(12)N(4). The amine component in (II) is disordered with two orientations at a site of mm2 symmetry in space group Cmcm, while the acid component is disordered with two orientations at a site of 2/m symmetry. The components in (I) are linked into a finite three-ion aggregate by a single N-H.O hydrogen bond, while the components of (II) are linked into continuous chains by a single O-H.N hydrogen bond.

  4. The cognitive-energetic model: an empirical approach to attention-deficit hyperactivity disorder.

    Science.gov (United States)

    Sergeant, J

    2000-01-01

    : arousal, activation and effort. At this level, the primary deficits of ADHD are associated with the activation pool and (to some extent) effort. The third level of the model contains a management or executive function system. Barkley [Barkley RA, Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychological Bulletin 1997;121:65-94] reviewed the literature and concluded that executive function deficiencies were primarily due to a failure of inhibition. Oosterlaan, Logan and Sergeant [Oosterlaan J, Logan GD, Sergeant JA. Response inhibition in ADHD, CD, comorbid ADHD + CD, anxious and normal children: a meta-analysis of studies with the stop task. Journal of Child Psychology and Psychiatry 1998;39:411-426] demonstrated that this explanation was not specific to ADHD but also applied to children with the associated disorders of oppositional defiant and conduct disorder. Other executive functions seem to be intact, while others, are deficient. It is argued here that the cognitive-energetic model is a useful guide for determining not only ADHD deficiencies and associated disorders but also linking human cognitive neuroscience studies with neurobiological models of ADHD using animals [Sadile AG. Multiple evidence of a segmental defect in the anterior forebrain of an animal model of hyperactivity and attention deficits. Neuroscience and Biobehavioral Reviews, in press; Sagvolden T, Sergeant JA. Attention-deficit hyperactivity disorder: from brain dysyfunctions to behaviour. Behavioural Brain Research 1998;94:1-10]. A plea for an integrated attack on this research problem is made and the suggestion that conceptual refinement between levels of analysis is essential for further fundamental work to succeed is offered here.

  5. Schema therapy as treatment for adults with autism spectrum disorder and comorbid personality disorder : Protocol of a multiple-baseline case series study testing cognitive-behavioral and experiential interventions

    NARCIS (Netherlands)

    Vuijk, R.; Arntz, A.

    Background To our knowledge treatment of personality disorder (PD) comorbidity in adults with ASD is understudied and is still in its infancy. This study investigates the effectiveness of schema therapy for PD-psychopathology in adult patients with both ASD and PD. Methods/design Twelve adult

  6. Multiple Pregnancy

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG Multiple Pregnancy Home For Patients Search FAQs Multiple Pregnancy Page ... Multiple Pregnancy FAQ188, July 2015 PDF Format Multiple Pregnancy Pregnancy How does multiple pregnancy occur? What are ...

  7. Comparison of risperidone and aripiprazole in the treatment of preschool children with disruptive behavior disorder and attention deficit-hyperactivity disorder: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Parvin Safavi

    2016-01-01

    Full Text Available Although pharmacotherapy with atypical antipsychotics is common in child psychiatry, there has been little research on this issue. To compare the efficacy and safety of risperidone and aripiprazole in the treatment of preschool children with disruptive behavior disorders comorbid with attention deficit-hyperactivity disorder (ADHD. Randomized clinical trial conducted in a university-affiliated child psychiatry clinic in southwest Iran. Forty 3-6-year-old children, diagnosed with oppositional defiant disorder comorbid with ADHD, were randomized to an 8-week trial of treatment with risperidone or aripiprazole (20 patients in each group. Assessment was performed by Conners′ rating scale-revised and clinical global impressions scale, before treatment, and at weeks 2, 4, and 8 of treatment. The data were analyzed by SPSS version 16. Mean scores between the two groups were compared by analysis of variance and independent and paired t-test. Mean scores of Conners rating scales were not different between two groups in any steps of evaluation. Both groups had significantly reduced scores in week 2 of treatment (P = 0.00, with no significant change in subsequent measurements. Rates of improvement, mean increase in weight (P = 0.894, and mean change in fasting blood sugar (P = 0.671 were not significantly different between two groups. Mean serum prolactin showed a significant increase in risperidone group (P = 0.00. Both risperidone and aripiprazole were equally effective in reducing symptoms of ADHD and oppositional defiant disorder, and relatively safe, but high rates of side effects suggest the cautious use of these drugs in children.

  8. Tongue Disorders

    Science.gov (United States)

    ... Fundamentals Heart and Blood Vessel Disorders Hormonal and Metabolic Disorders Immune Disorders Infections Injuries and Poisoning Kidney and ... Fundamentals Heart and Blood Vessel Disorders Hormonal and Metabolic Disorders Immune Disorders Infections Injuries and Poisoning Kidney and ...

  9. Mental Disorders

    Science.gov (United States)

    Mental disorders include a wide range of problems, including Anxiety disorders, including panic disorder, obsessive-compulsive disorder, post- ... disorders, including schizophrenia There are many causes of mental disorders. Your genes and family history may play a ...

  10. Multiple sclerosis; Multiple Sklerose

    Energy Technology Data Exchange (ETDEWEB)

    Grunwald, I.Q.; Kuehn, A.L.; Backens, M.; Papanagiotou, P. [Universitaet des Saarlandes, Abteilung fuer Diagnostische und Interventionelle Neuroradiologie, Radiologische Klinik, Homburg/Saar (Germany); Shariat, K. [Universitaet des Saarlandes, Klinik fuer Neurochirurgie, Homburg/Saar (Germany); Kostopoulos, P. [Universitaet des Saarlandes, Klinik fuer Neurologie, Homburg/Saar (Germany)

    2008-06-15

    Multiple sclerosis is the most common chronic inflammatory disease of myelin with interspersed lesions in the white matter of the central nervous system. Magnetic resonance imaging (MRI) plays a key role in the diagnosis and monitoring of white matter diseases. This article focuses on key findings in multiple sclerosis as detected by MRI. (orig.) [German] Die Multiple Sklerose (MS) ist die haeufigste chronisch-entzuendliche Erkrankung des Myelins mit eingesprengten Laesionen im Bereich der weissen Substanz des zentralen Nervensystems. Die Magnetresonanztomographie (MRT) hat bei der Diagnosestellung und Verlaufskontrolle eine Schluesselrolle. Dieser Artikel befasst sich mit Hauptcharakteristika der MR-Bildbebung. (orig.)

  11. Analyzing subcomponents of affective dysregulation in borderline personality disorder in comparison to other clinical groups using multiple e-diary datasets.

    Science.gov (United States)

    Santangelo, P S; Limberger, M F; Stiglmayr, C; Houben, M; Coosemans, J; Verleysen, G; Kuppens, P; Tuerlinckx, F; Vanpaemel, W; Ebner-Priemer, U W

    2016-01-01

    Affective dysregulation is widely regarded as being the core problem in patients with borderline personality disorder (BPD). Moreover, BPD is the disorder mainly associated with affective dysregulation. However, the empirical confirmation of the specificity of affective dysregulation for BPD is still pending. We used a validated approach from basic affective science that allows for simultaneously analyzing three interdependent components of affective dysregulation that are disturbed in patients with BPD: homebase, variability, and attractor strength (return to baseline). We applied two types of multilevel models on two e-diary datasets to investigate group differences regarding three subcomponents between BPD patients (n = 43; n = 51) and patients with posttraumatic stress disorder (PTSD; n = 28) and those with bulimia nervosa (BN; n = 20) as clinical control groups in dataset 1, and patients with panic disorder (PD; n = 26) and those with major depression (MD; n = 25) as clinical control groups in dataset 2. In addition, healthy controls (n = 28; n = 40) were included in the analyses. In both studies, e-diaries were used to repeatedly collect data about affective experiences during participants' daily lives. In study 1 a high-frequency sampling strategy with assessments in 15 min-intervals over 24 h was applied, whereas the assessments occurred every waking hour over 48 h in study 2. The local ethics committees approved both studies, and all participants provided written informed consent. In contradiction to our hypotheses, BPD patients did not consistently show altered affective dysregulation compared to the clinical patient groups. The only differences in affective dynamics in BPD patients emerged with regard to one of three subcomponents, affective homebase. However, these results were not even consistent. Conversely, comparing the patients to healthy controls revealed a pattern of more negative affective homebases, higher

  12. Controlled disordering of compressively strained InGaAsP multiple quantum wells under SiO:P encapsulant and application to laser-modulator integration

    Science.gov (United States)

    Hamoudi, A.; Rao, E. V. K.; Krauz, Ph.; Ramdane, A.; Ougazzaden, A.; Robein, D.; Thibierge, H.

    1995-11-01

    We investigated the potentiality of a phosphorus-doped silicon oxide (SiO:P) carrier-free disordering source for applications in photonic devices integration schemes. This is accomplished in three successive steps by employing an InGaAsP/InGaAsP structure with compressively strained wells and lattice-matched barriers designed for operation around ˜1.55 μm. First of all, we showed that the SiO:P encapsulant offers a good control over a wide range of disorder (blue shifts as high as ˜150 meV). Later on, the high optical quality of the disordered regions is demonstrated by detecting 300 K excitonic features in moderately blue-shifted (˜40 meV) samples. And, finally, a first attempt of its application in integration technology is made by realizing a monolithic composite of a distributed feedback laser and a quantum-confined stark effect electroabsorption modulator operating around 1.54 μm.

  13. Genome-wide analyses of aggressiveness in attention-deficit hyperactivity disorder.

    Science.gov (United States)

    Brevik, Erlend J; van Donkelaar, Marjolein M J; Weber, Heike; Sánchez-Mora, Cristina; Jacob, Christian; Rivero, Olga; Kittel-Schneider, Sarah; Garcia-Martínez, Iris; Aebi, Marcel; van Hulzen, Kimm; Cormand, Bru; Ramos-Quiroga, Josep A; Lesch, Klaus-Peter; Reif, Andreas; Ribasés, Marta; Franke, Barbara; Posserud, Maj-Britt; Johansson, Stefan; Lundervold, Astri J; Haavik, Jan; Zayats, Tetyana

    2016-07-01

    Aggressiveness is a behavioral trait that has the potential to be harmful to individuals and society. With an estimated heritability of about 40%, genetics is important in its development. We performed an exploratory genome-wide association (GWA) analysis of childhood aggressiveness in attention deficit hyperactivity disorder (ADHD) to gain insight into the underlying biological processes associated with this trait. Our primary sample consisted of 1,060 adult ADHD patients (aADHD). To further explore the genetic architecture of childhood aggressiveness, we performed enrichment analyses of suggestive genome-wide associations observed in aADHD among GWA signals of dimensions of oppositionality (defiant/vindictive and irritable dimensions) in childhood ADHD (cADHD). No single polymorphism reached genome-wide significance (P aggressiveness and provide targets for further genetic exploration of aggressiveness across psychiatric disorders. © 2016 The Authors. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics Published by Wiley Periodicals, Inc.

  14. [Emotional dysfunctions in attention deficit hyperactivity disorder].

    Science.gov (United States)

    Purper-Ouakil, D; Franc, N

    2011-06-01

    Inattention, motor instability, and impulsivity, associated in varying degrees of severity depending on the clinical subtype, constitute the key symptoms of attention deficit/hyperactivity disorder (ADHD). However, emotional symptoms are frequent in patients with ADHD and may, in some cases, be responsible for a major part of the negative impact on functioning and outcome. Emotional problems have been described in ADHD even in the absence of characterized comorbid conditions such as depressive or anxiety disorders. They can manifest acutely in the form of severe tantrums and aggressive behaviour, generally in reaction to an environmental trigger, or show a more chronic course of irritable or labile mood. Symptoms of emotional undercontrol seem to occur more frequently when ADHD is associated with oppositional defiant behaviour, but they are not specific and may contribute to difficulties in making a differential diagnosis, especially with bipolar disorder and prodromal symptoms of personality disorders. The frequency and negative impact of emotional symptoms and the need to differentiate them from bipolar disorder has led some authors to the description of a novel clinical entity called "severe mood dysregulation" or "temper dysregulation with dysphoria." This article aims to review the recent literature on emotional symptoms associated with ADHD and to discuss relevant clinical and biological issues. Current research highlights the links between emotional self-regulation and executive functions and possible involvement of motivational systems. The role of environmental factors in the development of emotional regulation and self-control is another important issue, especially because environmental modification is the major focus of current preventive and therapeutic interventions. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  15. Study On Multiple Risk Factors Of High Density Lipoprotein Cholesterol Disorder%高密度脂蛋白胆固醇(HDL-CH)异常的危险因素研究

    Institute of Scientific and Technical Information of China (English)

    谢娟; 来则民; 黄国伟; 木村美惠子

    2000-01-01

    用病例对照研究方法调查211名自愿者的高密度脂 蛋白胆固醇(HDL-CH)异常的危险因素进行初步研究。结果 显示:调查者HDL-CH异常患病率为42.18%,男性为 34.55%,女性为50.50%。吸烟、肥胖、缺少体力活动、舒张压 升高、脂肪、肉类摄入过多及蔬菜摄入少均为HDL-CH异常 的危险因素。%In order to find out the multiple risk factors of high density lipoprotein cholesterol disorder, we have undertaken case- control study of 211 volunteers with questionnaire, diet survey and labo- ratory examination to get the information. It was found that the prevalence of HDL - CH disorder was 42. 18 %, 34. 55 % in male and 50. 50 % in female. Smoking, obesity, poor labour and motion, high diastolic pressure, high level intake of fat and meat, and low level intake of vegetables were risk factors of HDL - CH disorder.

  16. Development of a universal psycho-educational intervention to prevent common postpartum mental disorders in primiparous women: a multiple method approach

    Directory of Open Access Journals (Sweden)

    Rowe Heather J

    2010-08-01

    Full Text Available Abstract Background Prevention of postnatal mental disorders in women is an important component of comprehensive health service delivery because of the substantial potential benefits for population health. However, diverse approaches to prevention of postnatal depression have had limited success, possibly because anxiety and adjustment disorders are also problematic, mental health problems are multifactorially determined, and because relationships amongst psychosocial risk factors are complex and difficult to modify. The aim of this paper is to describe the development of a novel psycho-educational intervention to prevent postnatal mental disorders in mothers of firstborn infants. Methods Data from a variety of sources were synthesised: a literature review summarised epidemiological evidence about neglected modifiable risk factors; clinical research evidence identified successful psychosocial treatments for postnatal mental health problems; consultations with clinicians, health professionals, policy makers and consumers informed the proposed program and psychological and health promotion theories underpinned the proposed mechanisms of effect. The intervention was pilot-tested with small groups of mothers and fathers and their first newborn infants. Results What Were We Thinking! is a psycho-educational intervention, designed for universal implementation, that addresses heightened learning needs of parents of first newborns. It re-conceptualises mental health problems in mothers of infants as reflecting unmet needs for adaptations in the intimate partner relationship after the birth of a baby, and skills to promote settled infant behaviour. It addresses these two risk factors in half-day seminars, facilitated by trained maternal and child health nurses using non-psychiatric language, in groups of up to five couples and their four-week old infants in primary care. It is designed to promote confidence and reduce mental disorders by providing skills

  17. Development of a universal psycho-educational intervention to prevent common postpartum mental disorders in primiparous women: a multiple method approach.

    Science.gov (United States)

    Rowe, Heather J; Fisher, Jane Rw

    2010-08-18

    Prevention of postnatal mental disorders in women is an important component of comprehensive health service delivery because of the substantial potential benefits for population health. However, diverse approaches to prevention of postnatal depression have had limited success, possibly because anxiety and adjustment disorders are also problematic, mental health problems are multifactorially determined, and because relationships amongst psychosocial risk factors are complex and difficult to modify. The aim of this paper is to describe the development of a novel psycho-educational intervention to prevent postnatal mental disorders in mothers of firstborn infants. Data from a variety of sources were synthesised: a literature review summarised epidemiological evidence about neglected modifiable risk factors; clinical research evidence identified successful psychosocial treatments for postnatal mental health problems; consultations with clinicians, health professionals, policy makers and consumers informed the proposed program and psychological and health promotion theories underpinned the proposed mechanisms of effect. The intervention was pilot-tested with small groups of mothers and fathers and their first newborn infants. What Were We Thinking! is a psycho-educational intervention, designed for universal implementation, that addresses heightened learning needs of parents of first newborns. It re-conceptualises mental health problems in mothers of infants as reflecting unmet needs for adaptations in the intimate partner relationship after the birth of a baby, and skills to promote settled infant behaviour. It addresses these two risk factors in half-day seminars, facilitated by trained maternal and child health nurses using non-psychiatric language, in groups of up to five couples and their four-week old infants in primary care. It is designed to promote confidence and reduce mental disorders by providing skills in sustainable sleep and settling strategies, and the

  18. Self-esteem of boys with attention deficit hyperactivity disorder – pilot study [Samoocena chłopców z zespołem nadpobudliwości psychoruchowej i zaburzeń koncentracji uwagi – doniesienie wstępne

    OpenAIRE

    Błachno, Magdalena; Kołakowski, Artur; Wójtowicz, Stanisław; Wolańczyk, Tomasz; Bryńska, Anita; Pisula, Agnieszka; Złotkowska, Małgorzata

    2013-01-01

    Aim. To compare the self concept of boys with ADHD and health subjects; to determine which symptoms of ADHD, oppositional defiant disorder (ODD) or conduct disorder (CD) have the greatest impact on self-concept. Method. Polish version of The Harter Self-Esteem Questionnaire (HSEQ) was filled by boys with ADHD and control group. In addition, a diagnosis of ODD and CD was made in ADHD group. Results. A significant difference was observed between boys with ADHD and control group on the following...

  19. Which dimension of parenting predicts the change of callous unemotional traits in children with disruptive behavior disorder?

    Science.gov (United States)

    Muratori, Pietro; Lochman, John E; Lai, Elisa; Milone, Annarita; Nocentini, Annalaura; Pisano, Simone; Righini, Elisabetta; Masi, Gabriele

    2016-08-01

    Several studies suggested that in addition to child-driven factors (i.e., temperamental style), parenting behavior can, at least in part, influence the maintenance of Callous Unemotional (CU) traits in children; however, more information is needed to distinguish which styles (negative parenting or lack of positive parenting) predict increased levels of CU traits. The aim of the present treatment study was to examine which components of parenting are longitudinally associated with levels of CU traits in children with a disruptive behavior disorder diagnosis. The current study examined cross-lagged reciprocal effects models between positive and negative parenting practices, and the levels of child CU traits over three time points, including both positive and negative dimensions of parenting in the same model. Participants were 126 Italian children with diagnosis of disruptive behavior disorder (oppositional defiant disorder or conduct disorder), 113 boys and 13 girls, 110 Caucasian, 48 with conduct disorder, and 78 with oppositional defiant disorder, treated with a multi-component intervention, based on cognitive behavioral principles and practices. Participants were all 9-10 years of age at the beginning of the study, and were followed-up until the age of 11-12 years (24 months in total, the first 12 under treatment) using parent report (Alabama Parenting Questionnaire and Child Behavior Check List) and child report (Inventory of Callous-Unemotional Traits) measures. No significant cross-lagged path was found between negative parenting and CU traits; these two variables were also unrelated when positive parenting was considered in the same model. In contrast, reciprocal effects between positive parenting and CU were found: higher levels of positive parenting predicted lower levels of CU traits. The current findings suggest that the positive dimension of parenting may need to be targeted in the treatment of DBD children with higher CU traits. Copyright © 2016

  20. [Headache disorders].

    Science.gov (United States)

    Takeshima, Takao; Kikui, Shoji

    2013-09-01

    Primary headache disorders such as migraine, tension-type headache, and cluster headache are prevalent and disabling neurological disorders. Although most headache disorders are largely treatable, they are under-recognized, under-diagnosed, and under-treated. Many headache sufferers in Japan do not receive appropriate and effective health care; hence, the illness, which should be relieved, persists and acts as an individual and societal burden. One of the barriers most responsible for this is poor awareness of the disorders. For lifting the burden, health care must be improved. Education is an essential way to resolve these issues at multiple levels. We have a Japanese version of the international headache classification and diagnostic criteria II (ICHD-II) and guidelines for the management of chronic headaches. Utilization of these resources is key for the improvement of headache management in our country. Not only neurologists, but also neurosurgeons and other medical specialists are participating in headache care in Japan. The Japanese Headache Society and the Japanese Society for Neurology should play major roles in health care service, education programs, as well as clinical and basic research for headache disorders. The road map for realizing our aim on headache treatment is as follows: (1) increase the number of units concerning headache in lectures for medical students, implement training programs for residents and neurologists, and offer continuous medical educations for physicians and neurologists; (2) secure more funding for headache research; (3) propagate medical care for headache in primary care settings and regional fundamental hospitals; (4) reform the health care system for headache and incentivize appropriate compensation for headache care in public health insurance; and (5) spread appropriate information on medical and socio-ethical issues related to headache for the sufferers and citizens. The authors expect that many neurologists have an

  1. Adult Attention Deficit Hyperactivity Disorder in Patients with Substance Use Disorders: A Study from Southern India

    Science.gov (United States)

    Ganesh, Suhas; Kandasamy, Arun; Sahayaraj, Ubahara S.; Benegal, Vivek

    2017-01-01

    Context: Externalizing disorders of childhood characterized by attention deficit hyperactivity disorder (ADHD), conduct disorder and oppositional defiant disorder are well known to predispose an individual to experiment with substances at an early age and the later lead to the development of substance use disorders (SUD). ADHD, a developmental disorder, persists into adulthood in about two-thirds of the cases. Aims: In the present study, we aimed to explore the prevalence of ADHD and its subtypes in treatment-seeking patients with SUD in an outpatient setting. Secondarily, we also aimed to compare the ADHD scores in the early onset and late onset subtypes of SUD. Subjects and Methods: Adult ADHD self-report scale symptom checklist was administered in 240 patients with SUD. The prevalence of ADHD and the difference in scores in early onset and late onset dependent groups of SUD patients were calculated. Statistical Analysis: Independent sample t-test was used to calculate the mean differences, and Chi-square test was used to calculate the difference in the proportion of cases screening positive across subgroups. Results: Among the 240 patients with SUD, 135 (56.25%) screened positive for “likely ADHD” and 52 (21.7%) for “highly likely ADHD.” The scores on the inattention domain and the prevalence of “likely ADHD” were significantly higher among the early onset group. Conclusions: The results are in agreement with similar studies of larger samples performed worldwide. Routine screening for ADHD in the treatment-seeking patients with SUD will enable the early detection and management of this highly comorbid condition.

  2. Prevalence, correlates, and comorbidities of DSM-IV psychiatric disorders in children in Seoul, Korea.

    Science.gov (United States)

    Park, Subin; Kim, Bung-Nyun; Cho, Soo-Churl; Kim, Jae-Won; Shin, Min-Sup; Yoo, Hee-Jeong

    2015-03-01

    The present study reports past-year prevalence of and comorbidities associated with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) disorders in 1645 children aged 6 to 12 years in Seoul, Korea. The diagnosis was based on the parental version of the Diagnostic Interview Schedule for Children (DISC-IV). Our participants completed the Children's Depression Inventory (CDI). The estimated prevalence of any full-syndrome and subthreshold DSM-IV disorders were 16.2% and 28.1%, respectively. The most prevalent disorders were specific phobia (9.6%), attention-deficit hyperactivity disorder (ADHD; 5.9%), and oppositional defiant disorder (ODD; 4.9%). The estimated prevalence of depressive disorder was 0.1% according to the DISC-IV and1.9% according to the CDI. ADHD, ODD, and anxiety disorders were highly comorbid. Our study highlights the importance of obtaining children's self-report data in addition to the parents' interview, particularly for depression, and the importance of early detection of subthreshold conditions and considering comorbid diagnoses.

  3. Co-transmission of conduct problems with attention-deficit/hyperactivity disorder: familial evidence for a distinct disorder.

    Science.gov (United States)

    Christiansen, H; Chen, W; Oades, R D; Asherson, P; Taylor, E A; Lasky-Su, J; Zhou, K; Banaschewski, T; Buschgens, C; Franke, B; Gabriels, I; Manor, I; Marco, R; Müller, U C; Mulligan, A; Psychogiou, L; Rommelse, N N J; Uebel, H; Buitelaar, J; Ebstein, R P; Eisenberg, J; Gill, M; Miranda, A; Mulas, F; Roeyers, H; Rothenberger, A; Sergeant, J A; Sonuga-Barke, E J S; Steinhausen, H-C; Thompson, M; Faraone, S V

    2008-01-01

    Common disorders of childhood and adolescence are attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD). For one to two cases in three diagnosed with ADHD the disorders may be comorbid. However, whether comorbid conduct problems (CP) represents a separate disorder or a severe form of ADHD remains controversial. We investigated familial recurrence patterns of the pure or comorbid condition in families with at least two children and one definite case of DSM-IV ADHDct (combined-type) as part of the International Multicentre ADHD Genetics Study (IMAGE). Using case diagnoses (PACS, parental account) and symptom ratings (Parent/Teacher Strengths and Difficulties [SDQ], and Conners Questionnaires [CPTRS]) we studied 1009 cases (241 with ADHDonly and 768 with ADHD + CP), and their 1591 siblings. CP was defined as > or =4 on the SDQ conduct-subscale, and T > or = 65, on Conners' oppositional-score. Multinomial logistic regression was used to ascertain recurrence risks of the pure and comorbid conditions in the siblings as predicted by the status of the cases. There was a higher relative risk to develop ADHD + CP for siblings of cases with ADHD + CP (RRR = 4.9; 95%CI: 2.59-9.41); p < 0.001) than with ADHDonly. Rates of ADHDonly in siblings of cases with ADHD + CP were lower but significant (RRR = 2.9; 95%CI: 1.6-5.3, p < 0.001). Children with ADHD + CP scored higher on the Conners ADHDct symptom-scales than those with ADHDonly. Our finding that ADHD + CP can represent a familial distinct subtype possibly with a distinct genetic etiology is consistent with a high risk for cosegregation. Further, ADHD + CP can be a more severe disorder than ADHDonly with symptoms stable from childhood through adolescence. The findings provide partial support for the ICD-10 distinction between hyperkinetic disorder (F90.0) and hyperkinetic conduct disorder (F90.1).

  4. The impact of self-efficacy, alexithymia and multiple traumas on posttraumatic stress disorder and psychiatric co-morbidity following epileptic seizures: a moderated mediation analysis.

    Science.gov (United States)

    Chung, Man Cheung; Allen, Rachel D; Dennis, Ian

    2013-12-30

    This study investigated the incidence of posttraumatic stress disorder (PTSD) and psychiatric co-morbidity following epileptic seizure, whether alexithymia mediated the relationship between self-efficacy and psychiatric outcomes, and whether the mediational effect was moderated by the severity of PTSD from other traumas. Seventy-one (M=31, F=40) people with a diagnosis of epilepsy recruited from support groups in the United Kingdom completed the Posttraumatic Stress Diagnostic Scale, the Hospital Anxiety and Depression Scale, the Toronto Alexithymia Scale-20 and the Generalized Self-Efficacy Scale. They were compared with 71 people (M=29, F=42) without epilepsy. For people with epilepsy, 51% and 22% met the diagnostic criteria for post-epileptic seizure PTSD and for PTSD following one other traumatic life event respectively. For the control group, 24% met the diagnostic criteria for PTSD following other traumatic life events. The epilepsy group reported significantly more anxiety and depression than the control. Partial least squares (PLS) analysis showed that self-efficacy was significantly correlated with alexithymia, post-epileptic seizure PTSD and psychiatric co-morbidity. Alexithymia was also significantly correlated with post-epileptic seizure PTSD and psychiatric co-morbidity. Mediation analyses confirmed that alexithymia mediated the path between self-efficacy and post-epileptic seizure PTSD and psychiatric co-morbidity. Moderated mediation also confirmed that self-efficacy and PTSD from one other trauma moderated the effect of alexithymia on outcomes. To conclude, people can develop posttraumatic stress disorder symptoms and psychiatric co-morbidity following epileptic seizure. These psychiatric outcomes are closely linked with their belief in personal competence to deal with stressful situations and regulate their own functioning, to process rather than defend against distressing emotions, and with the degree of PTSD from other traumas.

  5. Role of (18)F-FDG PET/CT in the diagnosis and management of multiple myeloma and other plasma cell disorders: a consensus statement by the International Myeloma Working Group.

    Science.gov (United States)

    Cavo, Michele; Terpos, Evangelos; Nanni, Cristina; Moreau, Philippe; Lentzsch, Suzanne; Zweegman, Sonja; Hillengass, Jens; Engelhardt, Monika; Usmani, Saad Z; Vesole, David H; San-Miguel, Jesus; Kumar, Shaji K; Richardson, Paul G; Mikhael, Joseph R; da Costa, Fernando Leal; Dimopoulos, Meletios-Athanassios; Zingaretti, Chiara; Abildgaard, Niels; Goldschmidt, Hartmut; Orlowski, Robert Z; Chng, Wee Joo; Einsele, Hermann; Lonial, Sagar; Barlogie, Bart; Anderson, Kenneth C; Rajkumar, S Vincent; Durie, Brian G M; Zamagni, Elena

    2017-04-01

    The International Myeloma Working Group consensus aimed to provide recommendations for the optimal use of (18)fluorodeoxyglucose ((18)F-FDG) PET/CT in patients with multiple myeloma and other plasma cell disorders, including smouldering multiple myeloma and solitary plasmacytoma. (18)F-FDG PET/CT can be considered a valuable tool for the work-up of patients with both newly diagnosed and relapsed or refractory multiple myeloma because it assesses bone damage with relatively high sensitivity and specificity, and detects extramedullary sites of proliferating clonal plasma cells while providing important prognostic information. The use of (18)F-FDG PET/CT is mandatory to confirm a suspected diagnosis of solitary plasmacytoma, provided that whole-body MRI is unable to be performed, and to distinguish between smouldering and active multiple myeloma, if whole-body X-ray (WBXR) is negative and whole-body MRI is unavailable. Based on the ability of (18)F-FDG PET/CT to distinguish between metabolically active and inactive disease, this technique is now the preferred functional imaging modality to evaluate and to monitor the effect of therapy on myeloma-cell metabolism. Changes in FDG avidity can provide an earlier evaluation of response to therapy compared to MRI scans, and can predict outcomes, particularly for patients who are eligible to receive autologous stem-cell transplantation. (18)F-FDG PET/CT can be coupled with sensitive bone marrow-based techniques to detect minimal residual disease (MRD) inside and outside the bone marrow, helping to identify those patients who are defined as having imaging MRD negativity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Validity of the social responsiveness scale to differentiate between autism spectrum disorders and disruptive behaviour disorders.

    Science.gov (United States)

    Cholemkery, Hannah; Kitzerow, Janina; Rohrmann, Sonja; Freitag, Christine M

    2014-02-01

    Autism spectrum disorder (ASD) as well as oppositional defiant (ODD) and conduct disorder (CD) is characterised by difficulties in social interaction with peers. The Social Responsiveness Scale (SRS) measures reciprocal social behaviour in children and adolescents and was originally developed as a quantitative measure of autistic traits. In the present study, we compare parent-rated SRS scores in children with ODD, CD, and ASD and examine the diagnostic validity of the SRS alone and in combination with additional questionnaires to differentiate between groups. We hypothesize that the SRS better differentiates ASD and typically developing controls (TD) than ASD and the disruptive behaviour disorders ODD and CD. The sample consists of three clinical groups: ASD without comorbid intellectual delay (N = 55), ODD/CD (N = 55), and TD (N = 55), between 6 and 18 years. The groups were matched by age, sex, and IQ. SRS scores were compared for the three groups. Sensitivity and specificity of the SRS total and sub-scores were examined by receiver operating characteristics (ROC) analyses. Logistic regression analyses were calculated for estimating the rate of correctly specified individuals. The SRS differentiated excellently between ASD and TD (ROC-AUC = 1.00), but sensitivity and specificity were considerably lower when ASD was compared with ODD/CD (ROC-AUC = 0.82). A combination of three parent-rated questionnaires resulted in an improved validity to differentiate ASD and ODD/CD. For clinical screening purposes in children suspicious of ASD and/or ODD/CD, the SRS should be used in combination with additional disorder-specific questionnaires to improve the rate of correct classification of both disorders.

  7. Disability in anxiety disorders.

    Science.gov (United States)

    Hendriks, Sanne M; Spijker, Jan; Licht, Carmilla M M; Beekman, Aartjan T F; Hardeveld, Florian; de Graaf, Ron; Batelaan, Neeltje M; Penninx, Brenda W J H

    2014-09-01

    This study compares disability levels between different anxiety disorders and healthy controls. We further investigate the role of anxiety arousal and avoidance behaviour in disability, and whether differences in these symptom patterns contribute to disability differences between anxiety disorders. Data were from 1826 subjects from the Netherlands Study of Depression and Anxiety (NESDA). The Composite Interview Diagnostic Instrument was used to diagnose anxiety disorders. The World Health Organization Disability Assessment Schedule II was used to measure disability in six domains (cognition, mobility, selfcare, social interaction, life activities, participation). Severity of anxiety arousal and avoidance behaviour symptoms was measured using the Beck Anxiety Inventory and the Fear Questionnaire. All anxiety disorders were associated with higher disability. Disability was generally highest in multiple anxiety disorder (e.g. mean disability in cognition=33.7) and social anxiety disorder (mean=32.7), followed by generalized anxiety disorder (mean=27.2) and panic disorder with agoraphobia (mean=26.3), and lowest in panic disorder without agoraphobia (mean=22.1). Anxiety arousal was more associated with disability in life activities (B=8.5, panxiety disorders were not completely explained by anxiety arousal and avoidance behaviour. The cross-sectional study design precludes any causal interpretations. In order to examine the full range of comorbidity among anxiety, a greater range of anxiety disorders would have been preferable. Disability is highest in social anxiety disorder and multiple anxiety disorder. Both anxiety arousal and avoidance behaviour are associated with higher disability levels but do not fully explain the differences across anxiety disorders. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. No objectively measured sleep disturbances in children with attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Bergwerff, Catharina E; Luman, Marjolein; Oosterlaan, Jaap

    2016-10-01

    The main goal of this study was to gain more insight into sleep disturbances in children with attention-deficit/hyperactivity disorder, using objective measures of sleep quality and quantity. The evidence for sleep problems in children with attention-deficit/hyperactivity disorder thus far is inconsistent, which might be explained by confounding influences of comorbid internalizing and externalizing problems and low socio-economic status. We therefore investigated the mediating and moderating role of these factors in the association between attention-deficit/hyperactivity disorder and sleep problems. To control for the effects of stimulant medication use, all participants were tested free of medication. Sixty-three children with attention-deficit/hyperactivity disorder and 61 typically developing children, aged 6-13 years, participated. Sleep was monitored for one to three school nights using actigraphy. Parent and teacher questionnaires assessed symptoms of attention-deficit/hyperactivity disorder, internalizing behaviour, oppositional defiant disorder and conduct disorder. Results showed no differences between the attention-deficit/hyperactivity disorder and typically developing group in any sleep parameter. Within the attention-deficit/hyperactivity disorder group, severity of attention-deficit/hyperactivity disorder symptoms was not related to sleep quality or quantity. Moderation analyses in the attention-deficit/hyperactivity disorder group showed an interaction effect between attention-deficit/hyperactivity disorder symptoms and internalizing and externalizing behaviour on total sleep time, time in bed and average sleep bout duration. The results of our study suggest that having attention-deficit/hyperactivity disorder is not a risk factor for sleep problems. Internalizing and externalizing behaviour moderate the association between attention-deficit/hyperactivity disorder and sleep, indicating a complex interplay between psychiatric symptoms and sleep.

  9. Bipolar disorder

    Science.gov (United States)

    Manic depression; Bipolar affective disorder; Mood disorder - bipolar; Manic depressive disorder ... Fatigue or lack of energy Feelings of worthlessness, hopelessness, or guilt Loss of pleasure in activities once ...

  10. Symptoms of major depressive disorder subsequent to child maltreatment: Examining change across multiple levels of analysis to identify transdiagnostic risk pathways.

    Science.gov (United States)

    Shenk, Chad E; Griffin, Amanda M; O'Donnell, Kieran J

    2015-11-01

    Major depressive disorder (MDD) is a prevalent psychiatric condition in the child maltreatment population. However, not all children who have been maltreated will develop MDD or MDD symptoms, suggesting the presence of unique risk pathways that explain how certain children develop MDD symptoms when others do not. The current study tested several candidate risk pathways to MDD symptoms following child maltreatment: neuroendocrine, autonomic, affective, and emotion regulation. Female adolescents (N = 110; age range = 14-19) were recruited into a substantiated child maltreatment or comparison condition and completed a laboratory stressor, saliva samples, and measures of emotion regulation, negative affect, and MDD symptoms. MDD symptoms were reassessed 18 months later. Mediational modeling revealed that emotion regulation was the only significant indirect effect of the relationship between child maltreatment and subsequent MDD symptoms, demonstrating that children exposed to maltreatment had greater difficulties managing affective states that in turn led to more severe MDD symptoms. These results highlight the importance of emotion dysregulation as a central risk pathway to MDD following child maltreatment. Areas of future research and implications for optimizing prevention and clinical intervention through the direct targeting of transdiagnostic risk pathways are discussed.

  11. Long-term use of stimulants in children with attention deficit hyperactivity disorder: safety, efficacy, and long-term outcome.

    Science.gov (United States)

    Hechtman, Lily; Greenfield, Brian

    2003-01-01

    The purpose of this review is to summarize existing data on the long-term safety and efficacy of stimulant treatment, and how long-term stimulant treatment of children with attention deficit hyperactivity disorder (ADHD) affects their outcome. Existing controlled studies of children with ADHD treated and untreated with stimulants, as well as long-term prospective follow-up studies, are reviewed. Children with ADHD treated with stimulants for as long as 2 years continue to benefit from the treatment, with improvements observed in ADHD symptoms, comorbid oppositional defiant disorder, and academic and social functioning, with no significant problems of tolerance or adverse effects. Long-term, prospective follow-up studies into adulthood show that stimulant treatment in childhood has slight benefits regarding social skills and self-esteem. Long-term adverse effects from stimulant treatment in childhood regarding adult height or future substance abuse have not been supported by existing studies.

  12. Treatment of a Child With Obsessive-Compulsive Disorder With Limited Motivation: Course and Outcome of Cognitive-Behavior Therapy.

    Science.gov (United States)

    Weidle, Bernhard; Skarphedinsson, Gudmundur

    2016-11-01

    Motivation is a key ingredient in the successful treatment of pediatric obsessive-compulsive disorder (OCD). As a first-line treatment, cognitive-behavior therapy (CBT) requires extensive client engagement, including participating in exposures and doing homework tasks. A lack of motivation to comply with these tasks may seriously affect treatment outcome. This case study identifies factors interfering with motivation and illustrates motivational strategies to enhance compliance of a child with OCD. The patient was an 11-year-old boy with severe OCD and symptoms of oppositional defiant disorder (ODD). He had extensive OCD-related avoidance behavior but denied the presence of symptoms or did not acknowledge them as a problem. In this article, we discuss the different techniques used to enhance motivation, which subsequently led to a favorable outcome. © 2016 Wiley Periodicals, Inc.

  13. Urinary 6-hydroxymelatonin sulfate excretion in intellectually disabled subjects with sleep disorders and multiple medications: validation of measurements in urine extracted from diapers.

    Science.gov (United States)

    Laakso, M-L; Lindblom, N; Kaipainen, P; Kaski, M

    2005-01-01

    The aim of this study was to examine the applicability of urinary 6-hydroxymelatonin sulfate (MT6s) measurements in the evaluation of melatonin secretion in intellectually disabled patients with sleep disorders. All 17 patients received drugs with potential interactions with melatonin metabolism. Serum melatonin 24-h profiles were determined at hourly intervals. The area under the curve (AUC) value, peak amplitude, half-rise time, and half-decline time were calculated individually. Urinary MT6s excretion was determined from samples collected from disposable diapers during three consecutive days at varying intervals. The average excretion rate for each hour of the day was calculated. The excretion profiles were characterized by total amount of MT6s excretion/24 h/kg body mass, amount of excreted MT6s during 6 h of maximum excretion (MAX 6h), and start time of the maximum excretion (start MAX 6h). There were significant positive correlations between serum melatonin AUC value and total excretion of MT6s/body mass, between serum melatonin amplitude and urinary MAX 6h, and between melatonin half-rise time and start MAX 6h; one patient on phenobarbital medication was out of line. The serum melatonin profiles of the patients were classified by comparing them with those of matched healthy volunteers (low-, normal-, or high secretors, normal or delayed rhythm). Similarly, the parameters of MT6s profiles were compared with those obtained from healthy controls, and the patients were reclassified as normal or aberrant. The classifications based on serum melatonin and urinary MT6s measurements were mostly concordant. The daily pattern of urinary MT6s excretion reliably reflected the phase of the serum melatonin rhythm irrespective of the medications, but in some cases, the total amount of excreted MT6s was lower than expected based on serum melatonin measurements.

  14. Using mobile health technology to improve behavioral skill implementation through homework in evidence-based parenting intervention for disruptive behavior disorders in youth: study protocol for intervention development and evaluation.

    Science.gov (United States)

    Chacko, Anil; Isham, Andrew; Cleek, Andrew F; McKay, Mary M

    2016-01-01

    Disruptive behavior disorders (DBDs) (oppositional defiant disorder (ODD) and conduct disorder (CD)) are prevalent, costly, and oftentimes chronic psychiatric disorders of childhood. Evidence-based interventions that focus on assisting parents to utilize effective skills to modify children's problematic behaviors are first-line interventions for the treatment of DBDs. Although efficacious, the effects of these interventions are often attenuated by poor implementation of the skills learned during treatment by parents, often referred to as between-session homework. The multiple family group (MFG) model is an evidence-based, skills-based intervention model for the treatment of DBDs in school-age youth residing in urban, socio-economically disadvantaged communities. While data suggest benefits of MFG on DBD behaviors, similar to other skill-based interventions, the effects of MFG are mitigated by the poor homework implementation, despite considerable efforts to support parents in homework implementation. This paper focuses on the study protocol for the development and preliminary evaluation of a theory-based, smartphone mobile health (mHealth) application (My MFG) to support homework implementation by parents participating in MFG. This paper describes a study design proposal that begins with a theoretical model, uses iterative design processes to develop My MFG to support homework implementation in MFG through a series of pilot studies, and a small-scale pilot randomised controlled trial to determine if the intervention can demonstrate change (preliminary efficacy) of My MFG in outpatient mental health settings in socioeconomically disadvantaged communities. This preliminary study aims to understand the implementation of mHealth methods to improve the effectiveness of evidence-based interventions in routine outpatient mental health care settings for youth with disruptive behavior and their families. Developing methods to augment the benefits of evidence

  15. Evidence for shared idiotypy expressed by the IgM, IgG, and IgA serum proteins of a patient with a complex multiple paraprotein disorder

    Energy Technology Data Exchange (ETDEWEB)

    Hopper, J.E.; Haren, J.M.; Kmiecik, T.E.

    1979-05-01

    The results of a comparative idiotypic analysis of multiple Ig paraproteins isolated from the serum of an individual patient, Ca, with Sjoegren's syndrome and Waldenstroem's macroglobulinemia are reported. At initial presentation, Ca serum was found to contain two major paraproteins, an IgMk and an IgGk, together with a small elevation in the level of IgA protein. The patient's clinical course was characterized by dramatic and opposing changes in the respective serum levels of the IgMk and IgGk paraproteins over an extended time period that coincided in part with received chemotherapy. Idiotypic antigenic analysis of the IgMk and IgGk paraproteins revealed that the two monotypic proteins shared identical idiotypic determinants. The Ca IgA serum fraction, specifically isolated by an immunoabsorbent and free of any IgG and IgM, was shown to possess idiotypic determinants identical to the IgG and IgM proteins. In extensive tests of specificity, the idiotypic determinants shared by Ca IgM, IgG, and IgA proteins were not present in large excesses of heterologous IgM and IgG, nor on Ig molecules contained in a large number of normal and myeloma sera.

  16. Common genetic variants of the mitochondrial trafficking system and mitochondrial uncoupling proteins affect the development of two slowly developing demyelinating disorders, leukoaraiosis and multiple sclerosis.

    Science.gov (United States)

    Szolnoki, Z

    2010-01-01

    As the central energy source, the mitochondria are of great importance in the maintenance of the glia cells of the brain. It is presumed that mitochondrial energy production is affected not only by well-characterized genetic mutations of the mitochondria, which are associated with severe malfunctions and resultant acute glia and neuronal cell death, but also by a number of other unfavorable genetic variants. The genetic variants of the kinesin motor proteins and mitochondrial uncoupling proteins (UCPs) are believed to influence the mitochondrial energy production in different distress states of the glia cells. The kinesin motor proteins carry the mitochondria from the central parts to the peripheral parts of the glia cells, where myelin protein synthesis takes place. The UCPs are essential for regulation of the mitochondrial membrane potential under different physiological conditions, thereby finally attuning mitochondrial energy production in environmental states such as cold exposure, fasting or chronic mild hypoxia. While the capacity of the kinesin motor proteins can affect the number of mitochondria in the peripheral parts of the glia cells, the functional features of the UCPs can affect the degree of energy production of the mitochondria by influencing the mitochondrial membrane potential. The different genetic variants may display different activities, and some may result in a slowly developing energy shortage in the glia cells. In this context, this article discusses the roles of genetic variants of the kinesin motor proteins and UCPs in slowly developing diseases of the white matter of the brain as multiple sclerosis and leukoaraiosis.

  17. Conversion Disorder

    Science.gov (United States)

    ... Recent significant stress or emotional trauma Being female — women are much more likely to develop conversion disorder Having a mental health condition, such as mood or anxiety disorders, dissociative disorder or certain personality disorders Having ...

  18. Conduct disorder

    Science.gov (United States)

    ... Conduct disorder is often linked to attention-deficit disorder . Conduct disorder also can be an early sign of ... child or teen has a history of conduct disorder behaviors. A physical examination and blood tests can help ...

  19. Psychotic Disorders

    Science.gov (United States)

    Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. People with psychoses lose touch ... is not there. Schizophrenia is one type of psychotic disorder. People with bipolar disorder may also have ...

  20. [Deglutition disorders].

    Science.gov (United States)

    Walther, E K

    1998-08-01

    Dysphagia is related to the impairment of food passage from the mouth to the stomach. Globus pharyngis implies the frequent and often painful sensation of a lump in the throat that usually does not interfere with swallowing and may even be relieved by food intake. The diagnosis is based upon a careful history, clinical examination, endoscopy, dynamic imaging (videofluoroscopy, cinematography, videosonography) and electrophysiologic procedures (including pharyngoesophageal manometry, electromyography and pH determinations). Structural lesions of the cervical spine such as diffuse idiopathic skeletal hyperostosis are rare causes of dysphagia. Dysphagia following anterior cervical fusion as well as globus and dysphonia due to dysfunction of the vertebral joints are more likely. Symptoms with swallowing fluids indicate a neurogenic origin. Dyscoordinated swallowing, nasal reflux, dysphonia or general weakness may also occur. Chronic aspiration with respiratory compromize is the main consequence in a variety of neurological disorders as well as in cases of postsurgical dysphagia. Relaxation of the upper esophageal sphincter indicates coordinated muscle movement between the pharynx and esophagus. Dysfunction of the pharyngoesophageal segment may lead to cricopharyngeal achalasia. A dyskinetic sphincter commonly represents an extrapharyngeal cause: i.e., disease associated with gastroesophageal reflux. Disorders of the esophageal phase of deglutition can produce retrosternal pain, heartburn, regurgitation and vomiting, as well as laryngeal and respiratory signs. Esophageal motility disorders include lower achalasia, tumors, peptic strictures, inflammatory diseases, drug-induced ulcers, rings and webs. Motility disorders present with aperistaltic, spontaneous contractions, diffuse esophagospasm, or a hypermotile esophagus. Gastroesophageal reflux with esophagitis must always be excluded, especially in patients with a globus sensation. The multiple features of the

  1. Disruptive behavior in preschool children: distinguishing normal misbehavior from markers of current and later childhood conduct disorder.

    Science.gov (United States)

    Hong, Ji S; Tillman, Rebecca; Luby, Joan L

    2015-03-01

    To investigate which disruptive behaviors in preschool were normative and transient vs markers of conduct disorder, as well as which disruptive behaviors predicted the persistence of conduct disorder into school age. Data from a longitudinal study of preschool children were used to investigate disruptive behaviors. Caregivers of preschoolers ages 3.0-5.11 years (n = 273) were interviewed using the Preschool Age Psychiatric Assessment to derive the following diagnostic groups: conduct disorder, externalizing disorder without conduct disorder, internalizing disorder without externalizing disorder, and healthy. At school age, participants were again assessed via an age-appropriate diagnostic interview. Logistic and linear regression with pairwise group comparisons was used to investigate clinical markers of preschool conduct disorder and predictors of school age conduct disorder. Losing one's temper, low-intensity destruction of property, and low-intensity deceitfulness/stealing in the preschool period were found in both healthy and disordered groups. In contrast, high-intensity argument/defiant behavior, both low- and high-intensity aggression to people/animals, high-intensity destruction of property, high-intensity deceitfulness/stealing, and high-intensity peer problems were markers of preschool conduct disorder and predictors of school age conduct disorder. Inappropriate sexual behavior was not a marker for preschool conduct disorder but was a predictor of school age conduct disorder. These findings provide a guide for primary care clinicians to help identify preschoolers with clinical conduct disorder and those who are at risk for persistent conduct disorder in childhood. Preschoolers displaying these symptoms should be targeted for mental health assessment. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. MULTIPLE PERSONALITY: CASE REPORT STUDY

    Directory of Open Access Journals (Sweden)

    Miloš Židanik

    2004-07-01

    Full Text Available Background. Multiple personality disorder is characterised by splited individual ego-states and splited professional community arguing whether this disorder actually exists or not.Methods. In this case report study a supportive psychodynamic psychotherapy of a patient with multiple personality disorder is presented, that lasted for 4.5 years and resulted in ego-reintegration.Conclusions. The spliting between different ego-states is powered by unneutralised aggression with the possibility of hetero- and autoaggressive behaviour. Therefore the patient in the analytically oriented psychotherapeutic process is at high risk and a safe therapeutic (e. g. in-patient setting has to be provided.

  3. Irritable mood and the Diagnostic and Statistical Manual of Mental Disorders

    Directory of Open Access Journals (Sweden)

    Safer Daniel J

    2009-10-01

    Full Text Available Abstract Background The terms 'irritable mood' and 'irritability' have been applied to describe and define a variety of different categories in the Diagnostic and Statistical Manual of Mental Disorders (DSM. More precise diagnostic terms and concepts are needed. Methods A concise critical historical review of DSM categories characterized by irritability, anger, and aggression is presented followed by recommendations. Results This analysis describes the broad ranging and imprecise use of the term irritability since the first DSM in 1952. A more age-appropriate and functional realignment of psychiatric categories linked to dysfunctional anger is suggested. Among other recommendations, this realignment would remove irritability as a problematic definer in the present DSM mood categories: expand oppositional defiant disorder to include adults; link the callous unemotional subtype of conduct disorder in adolescents to antisocial personality disorder; move intermittent explosive disorder to an appropriate category: and expand the term 'mood' to apply also to dysfunctional anger and anxiety. Conclusion The non-specific term 'irritability' commonly used in the DSM has had an adverse effect on diagnostic specificity and thereby on treatment. Dysfunctional anger is a major mood disorder which merits a more prominent and better defined representation in psychiatric nomenclature.

  4. [Sociodemographic characteristics and mental disorders in children and adolescents psychiatric outpatient clinic children of Medellin].

    Science.gov (United States)

    Ricardo-Ramírez, Carmenza; Álvarez-Gómez, Matilde; Rodríguez-Gázquez, María de los Ángeles

    2015-01-01

    Mental disorders in the world affecting 15% to 30% in children and adolescents, altering its function and emotional, cognitive and social. Affect interpersonal relationships, school performance and increased substance use and the risk of suicide. describe the social-demographic characteristics and mental disorders of children and adolescents of psychiatric consultation. Retrospective descriptive study that analyzed all the histories of children and adolescents of both sexes from 5 to 16 years who attended for the first time outpatient psychiatry university clinic of Medellin, from July 2010 to July 2012. We studied 197 patients, the average age was 11±3.5 years, male sex was the most common 69%, 46.2% belonged to nuclear family. The most prevalent psychiatric disorders were 44.2% ADHD, depressive disorders 9.1% and 8.1% TOC. 61% had psychiatric comorbidity, the most frequent was oppositional defiant disorder with ADHD 35.6%. The frequency of mental disorders and comorbidities found in this study were similar to those reported by other researchers. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  5. 多发性硬化患者情感障碍研究%The Study of Affective Disorder in Patients with Multiple Sclerosis

    Institute of Scientific and Technical Information of China (English)

    李莉莉; 张星虎

    2009-01-01

    目的 初步探讨多发性硬化(multiple sclerosis,MS)患者情感障碍的发生频率、特点和发生机制,以及情感障碍对MS患者生活质量的影响.方法 选取37例复发-缓解型MS患者,并均经脑MRI、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、临床功能障碍评分(EDSS)、生活质量评价[包括基本生活能力(ADL)和操作性生活能力(IADL)]检查.分析MS患者情感障碍发生情况及其与其他临床表现的相关关系,以及各因素对情感障碍的影响.结果 所有MS患者发生抑郁占43.2%(16/37),焦虑占37.8%(14/37),抑郁伴焦虑占35.1%(13/37).患者中有、无抑郁组间比较临床表现差异无统计学意义,焦虑组EDSS和IADL评分高于无焦虑组(P<0.05),低收入者焦虑发生率较高(P<0.05).抑郁和焦虑与EDSS、ADL及IADL得分呈正相关,经回归分析发现EDSS评分对抑郁、焦虑的影响有统计学意义.糖皮质激素治疗对患者情感无显著影响.结论 情感障碍对MS患者日常生活功能造成不利影响,在某种程度上可能较运动或感觉障碍更影响患者的工作和社会牛活能力.

  6. Multiple osteochondromas

    Directory of Open Access Journals (Sweden)

    Bovée Judith VMG

    2008-02-01

    Full Text Available Abstract Multiple osteochondromas (MO is characterised by development of two or more cartilage capped bony outgrowths (osteochondromas of the long bones. The prevalence is estimated at 1:50,000, and it seems to be higher in males (male-to-female ratio 1.5:1. Osteochondromas develop and increase in size in the first decade of life, ceasing to grow when the growth plates close at puberty. They are pedunculated or sessile (broad base and can vary widely in size. The number of osteochondromas may vary significantly within and between families, the mean number of locations is 15–18. The majority are asymptomatic and located in bones that develop from cartilage, especially the long bones of the extremities, predominantly around the knee. The facial bones are not affected. Osteochondromas may cause pain, functional problems and deformities, especially of the forearm, that may be reason for surgical removal. The most important complication is malignant transformation of osteochondroma towards secondary peripheral chondrosarcoma, which is estimated to occur in 0.5–5%. MO is an autosomal dominant disorder and is genetically heterogeneous. In almost 90% of MO patients germline mutations in the tumour suppressor genes EXT1 or EXT2 are found. The EXT genes encode glycosyltransferases, catalyzing heparan sulphate polymerization. The diagnosis is based on radiological and clinical documentation, supplemented with, if available, histological evaluation of osteochondromas. If the exact mutation is known antenatal diagnosis is technically possible. MO should be distinguished from metachondromatosis, dysplasia epiphysealis hemimelica and Ollier disease. Osteochondromas are benign lesions and do not affect life expectancy. Management includes removal of osteochondromas when they give complaints. Removed osteochondromas should be examined for malignant transformation towards secondary peripheral chondrosarcoma. Patients should be well instructed and regular

  7. Psychiatric Disorders in Iranian Children and Adolescents

    Science.gov (United States)

    Mohammadi, Mohammad Reza; Salmanian, Maryam; Asadian-koohestani, Fatemeh; Ghanizadeh, Ahmad; Alavi, Ali; Malek, Ayyoub; Dastgiri, Saeed; Moharreri, Fatemeh; Hebrani, Paria; Arman, Soroor; Khoshhal Dastjerdi, Javad; Motavallian, Ali

    2016-01-01

    Objective: The aim of the present study was to investigate the epidemiology of psychiatric disorders in children and adolescents in five provinces of Iran: Tehran, Shiraz, Isfahan, Tabriz and Mashhad. Method: In the present study, we selected 9,636 children and adolescents aged 6–18 years through multistage cluster random sampling method from Tehran, Shiraz, Isfahan, Tabriz and Mashhad. We instructed the clinical psychologists to complete the Strengths and Difficulties Questionnaire (SDQ) for the participants, andthose who received a high score on SDQ, completed the Persian version of Kiddie-SADS-Present and Lifetime Version (K-SADS-PL). We used descriptive analysis and 95% confidence interval to investigate the relationship between scores of the K-SADS questionnaire and demographic factors. We used one-way ANOVA to test the significant differences among the disorders according to sex, age and province of residence. Results: Based on the results, oppositional defiant disorder (ODD) (4.45%) had the highest prevalence of psychiatric disorders in the five provinces and substance abuse and alcohol abuse (0%) had the lowest prevalence. In addition, attention deficit hyperactivity disorder (ADHD) had the most prevalence in boys (5.03%) and ODD had the most prevalence in girls (4.05%). Among the three age groups, 6 to 9 year olds had the highest rates of ADHD (5.69%); 10 to 14 and 15 to 18 year olds had the highest rates of ODD (4.32% and 4.37% respectively). Among the five provinces, Tehran and Mashhad allocated the highest rates of ODD; Isfahan and Shiraz had the highest rates of ADHD; and Tabriz had the highest rates of social phobia. Conclusion: The current study revealed that the overall frequency of psychiatric disorders based on Kiddie-SADS-Present and Lifetime Version (K-SADS-PL) was higher than a similar study. Moreover, in this study, among the five provinces, Tehran and Mashhad allocated the highest rates of ODD; Isfahan and Shiraz had the highest rates of

  8. Genome‐wide analyses of aggressiveness in attention‐deficit hyperactivity disorder

    Science.gov (United States)

    van Donkelaar, Marjolein M. J.; Weber, Heike; Sánchez‐Mora, Cristina; Jacob, Christian; Rivero, Olga; Kittel‐Schneider, Sarah; Garcia‐Martínez, Iris; Aebi, Marcel; van Hulzen, Kimm; Cormand, Bru; Ramos‐Quiroga, Josep A.; Lesch, Klaus‐Peter; Reif, Andreas; Ribasés, Marta; Franke, Barbara; Posserud, Maj‐Britt; Johansson, Stefan; Lundervold, Astri J.; Haavik, Jan

    2016-01-01

    Aggressiveness is a behavioral trait that has the potential to be harmful to individuals and society. With an estimated heritability of about 40%, genetics is important in its development. We performed an exploratory genome‐wide association (GWA) analysis of childhood aggressiveness in attention deficit hyperactivity disorder (ADHD) to gain insight into the underlying biological processes associated with this trait. Our primary sample consisted of 1,060 adult ADHD patients (aADHD). To further explore the genetic architecture of childhood aggressiveness, we performed enrichment analyses of suggestive genome‐wide associations observed in aADHD among GWA signals of dimensions of oppositionality (defiant/vindictive and irritable dimensions) in childhood ADHD (cADHD). No single polymorphism reached genome‐wide significance (P < 5.00E‐08). The strongest signal in aADHD was observed at rs10826548, within a long noncoding RNA gene (beta = −1.66, standard error (SE) = 0.34, P = 1.07E‐06), closely followed by rs35974940 in the neurotrimin gene (beta = 3.23, SE = 0.67, P = 1.26E‐06). The top GWA SNPs observed in aADHD showed significant enrichment of signals from both the defiant/vindictive dimension (Fisher's P‐value = 2.28E‐06) and the irritable dimension in cADHD (Fisher's P‐value = 0.0061). In sum, our results identify a number of biologically interesting markers possibly underlying childhood aggressiveness and provide targets for further genetic exploration of aggressiveness across psychiatric disorders. © 2016 The Authors. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics Published by Wiley Periodicals, Inc. PMID:27021288

  9. Multiple sclerosis: evidence and controversies

    OpenAIRE

    Gutiérrez-Álvarez, Ángela-María

    2010-01-01

    Introduction: Multiple sclerosis is a chronic recurrent inflammatory disorder of the central nervous system. The pharmacological treatment of multiple sclerosis has been evaluated with multiple controlled clinical trials that allow the clinician to count with evidence based information to decide the more indicated treatment for each patient. Methodology: A review of the scientific literature was conducted to clarify controversial issues in a clinical relevant topic. Development: The diagnosti...

  10. Preliminary data on the prevalence of psychiatric disorders in Brazilian male and female juvenile delinquents

    Directory of Open Access Journals (Sweden)

    Andrade R.C.

    2004-01-01

    Full Text Available The aim of the present investigation was to study the prevalence of psychiatric disorders in a sample of delinquent adolescents of both genders and to compare the prevalence between genders. A total of 116 adolescents (99 males and 17 females aged 12 to 19 on parole in the State of Rio de Janeiro were interviewed using the screening interview based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime (KSADS-PL. Data were collected between May 2002 and January 2003. Of 373 male and 58 female adolescents present in May 2002 in the largest institution that gives assistance to adolescents on parole in the city of Rio de Janeiro, 119 subjects were assessed (three of them refused to participate. Their average age was 16.5 years with no difference between genders. The screening interview was positive for psychopathology for most of the sample, with the frequencies of the suggested more prevalent psychiatric disorders being 54% for attention-deficit/hyperactivity disorder, 77% for conduct disorder, 41% for oppositional defiant disorder, 57% for anxiety disorder 57, 60% for depressive disorder 60, 63% for illicit drug abuse, and 58% for regular alcohol use. Internalizing disorders (depressive disorders, anxiety disorders and phobias were more prevalent in the female subsample. There was no significant difference in the prevalence of illicit drug abuse between genders. There were more male than female adolescents on parole and failure to comply with the sentence was significantly more frequent in females. The high prevalence of psychopathology suggested by this study indicates the need for psychiatric treatment as part of the prevention of juvenile delinquency or as part of the sentence. However, treatment had never been available for 93% of the sample in this study.

  11. Mitochondrial disorders.

    Science.gov (United States)

    Zeviani, M; Tiranti, V; Piantadosi, C

    1998-01-01

    Mitochondrial respiration, the most efficient metabolic pathway devoted to energy production, is at the crosspoint of 2 quite different genetic systems, the nuclear genome and the mitochondrial genome (mitochondrial DNA, mtDNA). The latter encodes a few essential components of the mitochondrial respiratory chain and has unique molecular and genetic properties that account for some of the peculiar features of mitochondrial disorders. However, the perpetuation, propagation, and expression of mtDNA, the majority of the subunits of the respiratory complexes, as well as a number of genes involved in their assembly and turnover, are contained in the nuclear genome. Although mitochondrial disorders have been known for more than 30 years, a major breakthrough in their understanding has come much later, with the discovery of an impressive, ever-increasing number of mutations of mitochondrial DNA. Partial deletions or duplications of mtDNA, or maternally inherited point mutations, have been associated with well-defined clinical syndromes. However, phenotypes transmitted as mendelian traits have also been identified. These include clinical entities defined on the basis of specific biochemical defects, and also a few autosomal dominant or recessive syndromes associated with multiple deletions or tissue-specific depletion of mtDNA. Given the complexity of mitochondrial genetics and biochemistry, the clinical manifestations of mitochondrial disorders are extremely heterogenous. They range from lesions of single tissues or structures, such as the optic nerve in Leber hereditary optic neuropathy or the cochlea in maternally inherited nonsyndromic deafness, to more widespread lesions including myopathies, encephalomyopathies, cardiopathies, or complex multisystem syndromes. The recent advances in genetic studies provide both diagnostic tools and new pathogenetic insights in this rapidly expanding area of human pathology.

  12. Multiple Sclerosis

    Science.gov (United States)

    Multiple sclerosis (MS) is a nervous system disease that affects your brain and spinal cord. It damages the ... attacks healthy cells in your body by mistake. Multiple sclerosis affects women more than men. It often begins ...

  13. Multiple Myeloma

    Science.gov (United States)

    Multiple myeloma is a cancer that begins in plasma cells, a type of white blood cell. These cells ... bones. No one knows the exact causes of multiple myeloma, but it is more common in older people ...

  14. Exposure and response prevention with or without parent management training for children with obsessive-compulsive disorder complicated by disruptive behavior: a multiple-baseline across-responses design study.

    Science.gov (United States)

    Sukhodolsky, Denis G; Gorman, Bernard S; Scahill, Lawrence; Findley, Diane; McGuire, Joseph

    2013-04-01

    Comorbidity with disruptive behavior disorders may have important implications for exposure-based cognitive behavioral treatments of children with OCD. Child noncompliance and parent-child conflict may interfere with performance of exposure activities and completion of therapeutic homework assignments, thus diminishing response to treatment. We investigated whether response to exposure and response prevention (ERP) can be enhanced if disruptive behavior is treated first with parent management training (PMT). A multiple-baseline across-responses design was used to investigate the effects of ERP with or without PMT in six children (age range 9-14 years) with OCD and disruptive behavior. Weekly ratings of OCD were conducted for four weeks to establish baseline. After that, children were randomly assigned to receive six weekly sessions of PMT and then twelve weekly sessions of ERP (ERP-plus-PMT condition) or to receive ERP after a six week waiting period (ERP-only condition). The outcome assessments were conducted weekly using the Child Yale-Brown Obsessive Compulsive Scale (CY-BOCS) administered by an experienced clinician, who was blind to treatment assignment. Three subjects in the ERP-plus-PMT condition evidenced a 39 percent reduction in the CY-BOCS score versus a 10 percent reduction in three subjects in the ERP-only condition. The results of our single-subject study suggest the feasibility and positive effects of combining ERP with PMT for children with OCD complicated by disruptive behavior.

  15. Disentangling the relative contribution of parental antisociality and family discord to child disruptive disorders.

    Science.gov (United States)

    Bornovalova, Marina A; Blazei, Ryan; Malone, Stephen H; McGue, Matt; Iacono, William G

    2013-07-01

    A number of familial risk factors for childhood disruptive disorders have been identified. However, many of these risk factors often co-occur with parental antisociality, which by itself may account for both the familial risk factors and the increased likelihood of offspring disruptive behavior disorders (DBDs). The current study aimed to examine the association of parenting behaviors, marital conflict, and divorce with child DBDs while accounting for (a) coparent parenting behaviors, and (b) parental adult antisocial behavior (AAB). A series of regressions tested the association between family-level variables (namely, parent-child relationship quality, parental willingness to use physical punishment, marital adjustment, and history of divorce) and DBDs (attention deficit hyperactivity disorder, conduct disorder, and oppositional defiant disorder) alone and after statistically adjusting for coparent variables and parental AAB. Results indicated that parents with AAB were more likely to engage in various forms of maladaptive parenting, to divorce, and to have conflictual marriages. Maladaptive parenting, marital conflict, and divorce were associated with heightened rates of child DBDs, and these associations persisted after adjusting for coparent parenting and parental AAB. Finally, the mother's parenting behaviors had a higher impact on child DBDs than the father's parenting behaviors. Thus, familial variables continue to have an effect on childhood DBDs even after accounting for confounding influences. These variables should be a focus of research on etiology and intervention.

  16. Cognitive-behavioral therapy for externalizing disorders: A meta-analysis of treatment effectiveness.

    Science.gov (United States)

    Battagliese, Gemma; Caccetta, Maria; Luppino, Olga Ines; Baglioni, Chiara; Cardi, Valentina; Mancini, Francesco; Buonanno, Carlo

    2015-12-01

    Externalizing disorders are the most common and persistent forms of maladjustment in childhood. The aim of this study was to conduct a meta-analysis evaluating the effectiveness of Cognitive Behavioral Therapy (CBT) to reduce externalizing symptoms in two disorders: Attention Deficit Hyperactivity Disorder (ADHD) and Oppositive Defiant Disorder (ODD). The efficacy of CBT to improve social competence and positive parenting and reduce internalizing behaviors, parent stress and maternal depression was also explored. The database PsycInfo, PsycARTICLES, Medline and PubMed were searched to identify relevant studies. Twenty-one trials met the inclusion criteria. Results showed that the biggest improvement, after CBT, was in ODD symptoms (-0.879) followed by parental stress (-0.607), externalizing symptoms (-0.52), parenting skills (-0.381), social competence (-0.390) and ADHD symptoms (-0.343). CBT was also associated with improved attention (-0.378), aggressive behaviors (-0.284), internalizing symptoms (-0.272) and maternal depressive symptoms (-0.231). Overall, CBT is an effective treatment option for externalizing disorders and is also associated with reduced parental distress and maternal depressive symptoms. Multimodal treatments targeting both children and caregivers' symptoms (e.g. maternal depressive symptoms) appear important to produce sustained and generalized benefits.

  17. The DSM-5 with limited prosocial emotions specifier for conduct disorder among detained girls.

    Science.gov (United States)

    Colins, Olivier F; Andershed, Henrik

    2015-04-01

    The new DSM-5 specifier 'with Limited Prosocial Emotions' (LPE) is expected to provide greater information about impairment of children and adolescents with conduct disorder (CD). This study examined the clinical utility of the LPE specifier symptom threshold among female adolescents being detained in Belgium (n = 191 girls; ages 12-17). Standardized questionnaires and a structured diagnostic interview were used to assess the LPE specifier, CD, and variables of interest. Approximately 62% (n = 118) of the girls met criteria for CD. Depending on the instrument that was used to assess the LPE specifier criteria, 26% to 37% of the girls with CD met criteria for the LPE specifier symptom threshold (CD + LPE). Overall, CD + LPE girls were not significantly different from CD-only girls regarding psychiatric morbidity (i.e., attention-deficit/hyperactivity disorder, oppositional defiant disorder, substance use disorder, major depression, and anxiety disorders). However, CD + LPE girls were more aggressive, rule-breaking, delinquent, and had higher levels of psychopathic traits than CD-only girls. This study supports the view that the LPE specifier identifies a group of seriously antisocial individuals, but could not replicate previous findings that the LPE specifier symptom threshold identifies CD individuals who exhibit more psychiatric morbidity than CD individuals who are without the specifier symptom threshold. These findings altogether suggest that the clinical usefulness of the DSM-5 specifier for the diagnosis of CD is restricted, at least in detained girls. (PsycINFO Database Record

  18. Schizoaffective disorder

    Science.gov (United States)

    ... cause of schizoaffective disorder is unknown. Changes in genes and chemicals in the brain (neurotransmitters) may play a role. Schizoaffective disorder is thought to be less common than schizophrenia and mood disorders. Women may have the condition ...

  19. Genetic Disorders

    Science.gov (United States)

    ... This can cause a medical condition called a genetic disorder. You can inherit a gene mutation from ... during your lifetime. There are three types of genetic disorders: Single-gene disorders, where a mutation affects ...

  20. Attention deficit hyperactivity disorder and bipolar mood disorder in ...

    African Journals Online (AJOL)

    2009-06-19

    Jun 19, 2009 ... aspects of this disorder, including its diagnosis, co-morbidities, longitudinal .... narcissistic personality constructs may also present with an inflated self-esteem ... of time and are often ultraradian (multiple cycles occurring within.

  1. Multiplicity Counting

    Energy Technology Data Exchange (ETDEWEB)

    Geist, William H. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-12-01

    This set of slides begins by giving background and a review of neutron counting; three attributes of a verification item are discussed: 240Pueff mass; α, the ratio of (α,n) neutrons to spontaneous fission neutrons; and leakage multiplication. It then takes up neutron detector systems – theory & concepts (coincidence counting, moderation, die-away time); detector systems – some important details (deadtime, corrections); introduction to multiplicity counting; multiplicity electronics and example distributions; singles, doubles, and triples from measured multiplicity distributions; and the point model: multiplicity mathematics.

  2. Phenomenology, psychiatric comorbidity and family history in referred preschool children with obsessive-compulsive disorder

    Directory of Open Access Journals (Sweden)

    Coskun Murat

    2012-11-01

    Full Text Available Abstract Objective The study aimed to investigate phenomenology, psychiatric comorbidity, and family history of obsessive-compulsive disorder (OCD in a clinical sample of normally developing preschool children with OCD. Method Subjects in this study were recruited from a clinical sample of preschool children (under 72 months of age who were referred to a university clinic. Subjects with a normal developmental history and significant impairment related to OCD symptoms were included in the study. Children’s Yale-Brown Obsessive-Compulsive Scale was used to assess OCD symptoms. Each subject was assessed for comorbid DSM-IV psychiatric disorders using a semi-structured interview. Parents were evaluated for lifetime history of OCD in individual sessions. Results Fifteen boys and ten girls (age range: 28 to 69 months; 54.12±9.08 months were included. Mean age of onset of OCD was 35.64±13.42 months. All subjects received at least one comorbid diagnosis. The most frequent comorbid disorders were non-OCD anxiety disorders (n=17; 68.0%, attention-deficit hyperactivity disorder (ADHD (n=15; 60.0%, oppositional defiant disorder (ODD (n=12; 48.0%, and tic disorders (n=6; 24.0%. Mean number of comorbid disorders was 3.65 and 2.35 for boys and girls, respectively. At least one parent received lifetime OCD diagnosis in 68 percent of the subjects. Conclusions The results indicated that OCD in referred preschool children is more common in males, highly comorbid with other psychiatric disorders, and associated with high rates of family history of OCD. Given the high rates of comorbidity and family history, OCD should be considered in referred preschool children with disruptive behavior disorders and/or with family history of OCD.

  3. Sleep Disorders - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Translations French (français) Common Sleep Problem Problèmes de sommeil courants - français (French) Bilingual PDF Health Information Translations Sleep Study Examen du sommeil - français (French) Bilingual PDF Health Information Translations What ...

  4. Multiple roles of metalloproteinases in neurological disorders.

    Science.gov (United States)

    Yang, Yi; Hill, Jeff W; Rosenberg, Gary A

    2011-01-01

    Once thought to mainly act in brain to remodel the extracellular matrix, the family of metalloproteinases is important in many normal and pathological processes in the nervous system. Matrix metalloproteinases (MMPs) and A disintegrin and metalloproteinases (ADAMs) are the two major families of metalloproteinases in the brain. MMPs are comprised of several related enzymes that act on extracellular molecules. Normally, they are important in angiogenesis and neurogenesis in development. In neuroinflammatory illnesses, they disrupt the basal lamina and tight junction proteins to open the blood-brain barrier (BBB). ADAMs are important in neuroinflammation through activation of tumor necrosis factor-α (TNF-α) and their action as secretases that modulate the action of receptors on the cell surface. Four tissue inhibitors of metalloproteinases (TIMPs) are the main inhibitors of the MMPs and ADAMs. Recently, MMPs were found to affect DNA repair processes by an unexpected intranuclear action. MMPs and ADAMs have been implicated in the pathophysiology of neurodegenerative diseases such as Alzheimer's disease and vascular cognitive impairment. Growing literature on the functions of MMPs and ADAMs in the central nervous system is opening up new and exciting areas of research that may lead to novel approaches to treatment of neurological diseases. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Tooth Disorders - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Traditional) Bilingual PDF Health Information Translations Wisdom Teeth English 智齒 - 繁體中文 (Chinese - Traditional) PDF California Dental Association French (français) Toothache Mal de dents - français (French) Bilingual ...

  6. Anal Disorders - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... page, please enable JavaScript. Arabic (العربية) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) Russian (Русский) ... baryté - français (French) Bilingual PDF Health Information Translations Hindi (हिन्दी) Barium Enema हिन्दी (Hindi) Bilingual ...

  7. Prevalence and Correlates of Disruptive Mood Dysregulation Disorder Among Adolescents with Bipolar Disorder.

    Science.gov (United States)

    Mitchell, Rachel H B; Timmins, Vanessa; Collins, Jordan; Scavone, Antonette; Iskric, Adam; Goldstein, Benjamin I

    2016-03-01

    The purpose of this study was to examine the prevalence and correlates of disruptive mood dysregulation disorder phenotype (DMDDP) in a clinical population of adolescents with bipolar disorder (BD). DMDD criteria were modified and applied to a sample of 116 adolescents with BD-I (n = 30), BD-II (n = 46) or BD-not otherwise specified (NOS) (n = 40) from a tertiary teaching hospital. Diagnoses were determined via the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Aged Children, Present and Lifetime version (KSADS-PL). Diagnostic and Statistical Manual of Mental Disorders (DSM-5) DMDD Criteria A-G were derived from the KSADS oppositional defiant disorder (ODD) screening interview and supplement, as well as narrative summaries. Chi-square analyses or t tests (p adolescents because of missing data from the ODD supplement. Twenty-five percent of the remainder (27/108) met criteria for DMDDP. DMDDP was not associated with BD subtype or with family history of BD. In univariate analyses, after controlling for age, sex, and race, DMDDP was associated with lower functioning, increased family conflict, assault history, and attention deficit and/or hyperactivity disorder (ADHD) (FDR adjusted p values: disorder and medication use approached significance (adjusted p = 0.05). In logistic regression, DMDDP was independently associated with greater parent-reported family conflict (odds ratio [OR] 1.17; confidence interval [CI- 1.06-1.30; p = 0.001) and greater functional impairment (OR 0.89; CI 0.82-0.97; p = 0.006). DMDDP was also associated with a threefold increase in ADHD, although ADHD was only marginally significant (OR 3.3; CI 0.98-10.94; p = 0.05). Despite the positioning of DMDD as phenotypically and biologically distinct from BD, these phenotypes commonly overlap in clinical settings. This overlap is not explained by BD-NOS or by nonfamilial BD. The association of ADHD with DMDDP in this sample draws into question whether

  8. Multiple Gliomas

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Multiple gliomas are well-recognized but uncommon tumors. The incidence of multiple gliomas according to some reports ranges from 0.5% to 20% of all gliomas diagnosed. Multiple gliomas can be divided into two categories. One is by location of the lesions (multifocal and multicentric). The second type is by the time of the lesions occur (synchronous and metachronous). The lesions generally show hypo, or isodensity on CT; a hypo- or isointense signal on T1-weighted images, and a hyperintense signal on T2-weighted images. Glioblastoma is the most frequent histotype. The prognosis of multiple gliomas remains unfavorable. The treatment of multiple gliomas includes surgery, radiotherapy and chemotherapy. Distinction between multicentric and multifocal gliomas is difficult. This report reviews in detail the aspects of multiple gliomas mentioned above.

  9. Multiple sclerosis

    Science.gov (United States)

    ... Sexual symptoms: Problems with erections Problems with vaginal lubrication Speech and swallowing symptoms: Slurred or difficult-to- ... chairs, walkers, and wall bars A planned exercise program early in the course of the disorder A ...

  10. Disrupted expected value and prediction error signaling in youths with disruptive behavior disorders during a passive avoidance task.

    Science.gov (United States)

    White, Stuart F; Pope, Kayla; Sinclair, Stephen; Fowler, Katherine A; Brislin, Sarah J; Williams, W Craig; Pine, Daniel S; Blair, R James R

    2013-03-01

    Youths with disruptive behavior disorders, including conduct disorder and oppositional defiant disorder, show major impairments in reinforcement-based decision making. However, the neural basis of these difficulties remains poorly understood. This partly reflects previous failures to differentiate responses during decision making and feedback processing and to take advantage of computational model-based functional MRI (fMRI). Participants were 38 community youths ages 10-18 (20 had disruptive behavior disorders, and 18 were healthy comparison youths). Model-based fMRI was used to assess the computational processes involved in decision making and feedback processing in the ventromedial prefrontal cortex, insula, and caudate. Youths with disruptive behavior disorders showed reduced use of expected value information within the ventromedial prefrontal cortex when choosing to respond and within the anterior insula when choosing not to respond. In addition, they showed reduced responsiveness to positive prediction errors and increased responsiveness to negative prediction errors within the caudate during feedback. This study is the first to determine impairments in the use of expected value within the ventromedial prefrontal cortex and insula during choice and in prediction error-signaling within the caudate during feedback in youths with disruptive behavior disorders.

  11. Frequency of Psychological Disorders amongst Children in Urban Areas of Tehran

    Directory of Open Access Journals (Sweden)

    Narges Joshaghani

    2010-06-01

    Full Text Available Objective: To evaluate the frequency of different psychiatric disorders among 7 to 12 years old children in urban areas of Tehran. "nMethod: A sample of 799 children (6 to 11 years old were selected from 250 clusters of the entire 22 municipality areas of Tehran using a multistage sampling method from 250 clusters from the entire 22 municipality areas of Tehran. . After responding to a Persian version of the Strengths and Difficulties Questionnaire (SDQ parent-report form, the Persian version of Kiddie Schedule for Affective Disorders and Schizophrenia - Present and Lifetime (K-SADS-PL was administered to 241 children and their families. The frequency of child psychological disorders was determined using the results of K-SADS-PL. "n Results:The overall frequency of any psychological disorders in the sample of children was 17.9 percent. Among the interviewed children childrenwho were interviewed, the most prevalent diagnoses were Attention-Deficit/ Hyperactivity Disorder (ADHD (8.6 percent8.6%, Oppositional Defiant Disorder (ODD (7.3 percent7.3%, and separation anxiety disorder (SAD (5.9 percent5.9%. There were not any statistically significant differences between sexes in the frequency of psychological disorders except enuresis that was more frequent in the boys and anorexia nervosa that was observed more frequently in the girls . "nConclusion:Higher frequency of ADHD and ODD and SAD among the studied children warrantswarrants more specific evaluation of frequency and possible causes of these high frequency rates. The frequency of psychological disorders in the studied children was comparable to the that of other studies.

  12. Dissociative disorders and suicidality in psychiatric outpatients.

    Science.gov (United States)

    Foote, Brad; Smolin, Yvette; Neft, Deborah I; Lipschitz, Deborah

    2008-01-01

    Although it is common for patients with dissociative disorders to report a history of suicide attempts, there is very little data systematically comparing suicidality in patients with dissociative disorders versus patients without these disorders. The subjects in our study were 231 patients consecutively admitted to an inner-city, hospital-based outpatient psychiatric clinic. Eighty-two of these patients completed structured interviews for dissociative disorders, borderline personality disorder, and trauma history (dissociative disorders interview schedule) and for posttraumatic stress disorder and substance abuse (Structured Clinical Interview for DSM-IV). Patients receiving a dissociative disorder diagnosis were compared with nondissociative patients on measures of self-harm and suicidality. Presence of a dissociative disorder was strongly associated with all measures of self-harm and suicidality. When we focused on patients with a history of multiple suicide attempts, significant associations were found between several diagnoses (dissociative disorder; borderline personality disorder; posttraumatic stress disorder; alcohol abuse/dependence) and multiple suicide attempter status. When these diagnoses were entered in a logistic regression, a highly significant association remained for dissociative diagnosis and multiple suicide attempter status (odds ratio, 15.09; 95% confidence interval, 2.67-85.32; p = 0.002). Dissociative disorders are commonly overlooked in studies of suicidality, but in this population they were the strongest predictor of multiple suicide attempter status.

  13. Comparative efficacy, acceptability, and safety of medicinal, cognitive-behavioral therapy, and placebo treatments for acute major depressive disorder in children and adolescents: a multiple-treatments meta-analysis.

    Science.gov (United States)

    Ma, Dongfeng; Zhang, Zhijun; Zhang, Xiangrong; Li, Lingjiang

    2014-06-01

    New generation antidepressant therapies, including serotonin-norepinephrine reuptake inhibitor (SNRIs) and selective serotonin reuptake inhibitors (SSRIs) were introduced in the late 1980s; however, few comprehensive studies compared the benefits and risks of various contemporary treatments for major depressive disorder (MDD) in pediatric patients. Multiple-treatments meta-analysis (MTM) was conducted to assess efficacy, acceptability, and safety of contemporary interventions in children and adolescents with MDD. Cochrane Library, AMED, CINAHL, EMBASE, LiLACS, MEDLINE, PSYCINFO, PSYNDEX, and Journal of Medicine and Pharmacy databases were searched for randomized controlled trials (RCTs) comparing medicinal interventions (citalopram, escitalopram, fluoxetine, mirtazapine, paroxetine, sertraline, venlafaxine), cognitive behavioral therapy (CBT), combined fluoxetine with CBT, and placebo treatment for acute MDD from January 1988 to March 2013. Treatment success, dropout rate, and suicidal ideation/attempt outcomes were measured. Bayesian methods were used to conduct a MTM including age and funding subgroups. A total of 21 RCTs (4969 participants) were identified. Combined fluoxetine/CBT exhibited the highest efficacy, with fluoxetine alone superior to CBT, paroxetine, sertraline, citalopram, escitalopram, and placebo treatment. Sertraline, paroxetine, escitalopram, and venlafaxine showed superior acceptability to fluoxetine and combined fluoxetine/CBT. Combined fluoxetine/CBT combination was less safe, though CBT was safer than fluoxetine alone. Combined fluoxetine/CBT, fluoxetine, and mirtazapine exhibited the highest efficacy; sertraline, escitalopram, venlafaxine, and paroxetine were the best tolerated; and mirtazapine and venlafaxine were the safest. Sertraline and mirtazapine exhibited optimally balanced efficacy, acceptability, and safety for first-line acute treatment of child and adolescent MDD.

  14. Treatment Options for the Cardinal Symptoms of Disruptive Mood Dysregulation Disorder.

    Science.gov (United States)

    Tourian, Leon; LeBoeuf, Amélie; Breton, Jean-Jacques; Cohen, David; Gignac, Martin; Labelle, Réal; Guile, Jean-Marc; Renaud, Johanne

    2015-01-01

    DSM-5 has added a new developmentally appropriate child and adolescent mood disorder subtype called disruptive mood dysregulation disorder (DMDD). The core features of DMDD are temper outbursts (manifested by either verbal rages and/or physical aggression) and unrelenting irritability or anger. Currently, the literature is lacking a thorough review of the possible treatment options for the cardinal symptoms constituting DMDD. The objective of this article is to provide a thorough review of peer-reviewed studies on the subject of pharmacological treatment options for children and adolescents with the cardinal symptoms of DMDD. Relevant articles for this study were obtained through Pubmed, Medline, PsychINFO and PsychINDEXplus using the key words: "adolescents," "children," "paediatric," "youth," "irritability," "temper outbursts," "aggression," "rage," "disruptive behaviour," "treatment," "dysphoria," "autism," "mental retardation/intellectual disability," "impulsivity," "ADHD," "oppositional defiant disorder," and "conduct disorder." A total of 823 studies were generated; only English studies focusing on pharmacological treatment were retained. Currently there are no established guidelines or thorough reviews summarizing the treatment of DMDD. Pharmacotherapeutic treatment options of both aggression and chronic irritability include: antidepressants/selective norepinephrine reuptake inhibitors, mood stabilizers, psychostimulants, antipsychotics, and alpha-2 agonists. Treatment options of severe, persistent irritability in youth are numerous, and a consensual treatment algorithm has not yet emerged from the literature. Further studies and clinical trials are warranted to determine efficacious and safe treatment modalities.

  15. Military Personnel: DOD and the Coast Guard Need to Screen for Gambling Disorder Addiction and Update Guidance

    Science.gov (United States)

    2017-01-01

    disorders , depressive disorders , anxiety disorders , and personality disorders . Table 2 presents the similarities and differences between substance use...gambling diagnosis. Because some servicemembers were seen for gambling disorder , pathological gambling, or problem gambling in multiple years, the total...indicate that, from a medical perspective, gambling disorder has multiple similarities with substance abuse and is treated in accordance with

  16. Familial clustering of epilepsy and behavioral disorders: Evidence for a shared genetic basis

    Science.gov (United States)

    Hesdorffer, Dale C.; Caplan, Rochelle; Berg, Anne T.

    2011-01-01

    Purpose To examine whether family history of unprovoked seizures is associated with behavioral disorders in epilepsy probands, thereby supporting the hypothesis of shared underlying genetic susceptibility to these disorders. Methods We conducted an analysis of the 308 probands with childhood onset epilepsy from the Connecticut Study of Epilepsy with information on first degree family history of unprovoked seizures and of febrile seizures whose parents completed the Child Behavior Checklist (CBCL) at the 9-year follow-up. Clinical cut-offs for CBCL problem and DSM-Oriented scales were examined. The association between first degree family history of unprovoked seizure and behavioral disorders was assessed separately in uncomplicated and complicated epilepsy and separately for first degree family history of febrile seizures. A subanalysis, accounting for the tendency for behavioral disorders to run in families, adjusted for siblings with the same disorder as the proband. Prevalence ratios were used to describe the associations. Key findings In probands with uncomplicated epilepsy, first degree family history of unprovoked seizure was significantly associated with clinical cut-offs for Total Problems and Internalizing Disorders. Among Internalizing Disorders, clinical cut-offs for Withdrawn/Depressed, and DSM-Oriented scales for Affective Disorder and Anxiety Disorder were significantly associated with family history of unprovoked seizures. Clinical cut-offs for Aggressive Behavior and Delinquent Behavior, and DSM-Oriented scales for Conduct Disorder and Oppositional Defiant Disorder were significantly associated with family history of unprovoked seizure. Adjustment for siblings with the same disorder revealed significant associations for the relationship between first degree family history of unprovoked seizure and Total Problems and Agressive Behavior in probands with uncomplicated epilepsy; marginally significant results were seen for Internalizing Disorder

  17. [The course of attention deficit hyperactivity disorder (ADHD) over the life span].

    Science.gov (United States)

    Koumoula, A

    2012-06-01

    Attention Deficit Hyperactivity Disorder is a neurodevelopmental disorder, associated with the maturation of the nervous system and appearing on a standard proceeding with special cognitive impairments. For many years ADHD was concerned as a typical childhood disorder. Long-term studies though, showed that an important percentage of children with ADHD grew as adults with ADHD. The clinical picture varies with the developmental stage. In pre-school years (3-5 years) the clinical picture is characterized by excessive physical activity, difficulty in cooperation with peers and non-compliance to the recommendations of adults. In school age (6-12 years), apart from the nuclear symptoms of the disorder, as described in the classification systems, i.e. inattention, hyperactivity and impulsivity, oppositional behavior often occurs, conflicts with peers and academic problems. In adolescence hyperactivity lessens, conflicts with parents continue and high risk behaviors often appear. In adults physical activity usually decreases significantly, while inattention and impulsivity still remain. With the passing of time the number of symptoms are usually reduced, however the impact and impairment caused by the disorder remain. The diagnosis of ADHD in adults requires a retrospective diagnosis of ADHD in childhood. Since childhood, comorbid disorders are common, most times continuing until adult life. The Oppositional Defiant Disorder during childhood is related to the presenting of Antisocial Personality Disorder in adults. On the other hand, emotional disorders, which are also rather common in children, adolescents and adults with ADHD, can be due to either common biological mechanisms or the long-standing effect of psychosocial and environmental factors which follow people with ADHD. The relationship between ADHD and substance abuse has been a subject of research, with the view of the existence of Conduct Disorder being necessary for a person to present a Substance Use Disorder

  18. Multiple homicides.

    Science.gov (United States)

    Copeland, A R

    1989-09-01

    A study of multiple homicides or multiple deaths involving a solitary incident of violence by another individual was performed on the case files of the Office of the Medical Examiner of Metropolitan Dade County in Miami, Florida, during 1983-1987. A total of 107 multiple homicides were studied: 88 double, 17 triple, one quadruple, and one quintuple. The 236 victims were analyzed regarding age, race, sex, cause of death, toxicologic data, perpetrator, locale of the incident, and reason for the incident. This article compares this type of slaying with other types of homicide including those perpetrated by serial killers. Suggestions for future research in this field are offered.

  19. Youth Gang Members: Psychiatric Disorders and Substance Use

    Directory of Open Access Journals (Sweden)

    Albert John Sargent

    2013-10-01

    Full Text Available Objective: Approximately 260,000 of youth in the United States are gang-affiliated. There is a paucity of data available to identify the prevalence of mental health disorders in this population. Gang members share many of the features of “at risk” or juvenile justice involved youth who deny gang membership. The authors identified rates of psychiatric disorders within a juvenile justice population delineated in three categories: gang members, friends of gang members, and non-gang members. Methods: A retrospective review of records obtained by a juvenile probation department. A large detention center conducted mental health screenings on 7,615 youth aged 13–17. The mental health screenings were performed by either a master level or doctoral level mental health professional. Odds ratios were computed as an effect size for gender, race/ethnic differences, and gang-membership associations with self-reported psychiatric and substance use disorders. Logistic regression was used to evaluate the risk for psychiatric and substance use disorders among gang-members and friends of gang members. Diagnostic information was generated through a clinical interview and flexible battery. Results: Of the 7,615 youth in this study, ~50% had contact with gangs; 11% were self-identified gang-members, and 38% acknowledged having at least one friendship with a gang member. Similar to other studies, being male was a risk-factor for gang-membership (2.31 odds. In this multi-racial and ethnic study, Latinos had a greater affiliation with gang membership and association with gang members as friends (1.44 odds. Gang members were found to have increased rates of post-traumatic stress disorder (1.77 odds, current substance abuse (2.58 odds, oppositional defiant disorder, (1.24 odds and conduct disorder (4.05 odds; however, they were less likely to have an adjustment disorder than non-gang members (0.70 odds. Conclusions: Juveniles who received a mental health assessment

  20. Multiple myeloma.

    LENUS (Irish Health Repository)

    Collins, Conor D

    2012-02-01

    Advances in the imaging and treatment of multiple myeloma have occurred over the past decade. This article summarises the current status and highlights how an understanding of both is necessary for optimum management.