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Sample records for severe behavioral disorders

  1. Inpatient Cognitive Behavior Therapy for Severe Eating Disorders

    Directory of Open Access Journals (Sweden)

    Riccardo Dalle Grave

    2010-12-01

    Full Text Available Enhanced cognitive behaviour therapy (CBT-E for eating disorders has been developed and evaluated only in outpatient setting. Aim of the paper is to describe a novel model of inpatient treatment, termed inpatient CBT-E, indicated for patients with an eating disorder of clinical severity not manageable in an outpatient setting or that failed outpatient treatment. Inpatient CBT-E is derived by the outpatients CBT-E with some adaptations to rend the treatments suitable for an inpatient setting. The principal adaptations include: 1 multidisciplinary and non-eclectic team composed of physicians, psychologists, dieticians and nurses all trained in CBT; 2 assisted eating; 3 group sessions; and a CBT family module for patients younger than 18 years. The treatment lasts 20 weeks (13 for inpatients followed by seven weeks of residential day treatment and, as CBT-E, is divided in four stages and can be administered in a focused form (CBT-F or in a broad form (CBT-B. A randomized control trial is evaluating the effectiveness of the treatment.

  2. Case Study: Severe Self-Injurious Behavior in Comorbid Tourette's Disorder and OCD

    Science.gov (United States)

    Hood, Korey K.; Baptista-Neto, Lourival; Beasley, Pamela J.; Lobis, Robert; Pravdova, Iva

    2004-01-01

    This case report describes the successful treatment of severe self-injurious behavior in a 16-year-old adolescent with Tourette's disorder and obsessive-compulsive disorder. Treatment is described from initial presentation to the emergency department for severe self-inflicted oral lacerations through discharge from the inpatient psychiatric…

  3. Early Prevention of Severe Neurodevelopmental Behavior Disorders: An Integration

    Science.gov (United States)

    Schroeder, Stephen R.; Courtemanche, Andrea

    2012-01-01

    There is a very substantial literature over the past 50 years on the advantages of early detection and intervention on the cognitive, communicative, and social-emotional development of infants and toddlers at risk for developmental delay due to premature birth or social disadvantage. Most of these studies excluded children with severe delays or…

  4. HIV Risk Behavior in Persons with Severe Mental Disorders in a ...

    African Journals Online (AJOL)

    HIV risk behavior was significantly related to alcohol use (P = 0.03). Conclusion: Mental health services provide an important context for HIV/AIDS interventions in resource‑constrained countries like Nigeria. Keywords: Human immuno virus, Mental health, Psychiatric patients, Risk behavior, Severe mental disorders ...

  5. The relationship between types and severity of repetitive behaviors in Gilles de la Tourette's disorder and obsessive-compulsive disorder

    NARCIS (Netherlands)

    Cath, D.C.; Spinhoven, P.; Wetering, B.J.M. van de; Hoogduin, C.A.L.; Landman, A.D.; Woerkom, T.C.A.M. van; Roos, R.A.C.; Rooijmans, H.G.M.

    2000-01-01

    BACKGROUND: This study investigated which categories of obsessive-compulsive and Tourette-related behaviors in Gilles de la Tourette's disorder and obsessive-compulsive disorder (OCD) without tics are experienced as most severe across the study groups and what the differences are in symptom

  6. Psychiatric Severity and HIV-Risk Sexual Behaviors among Persons with Substance Use Disorders

    Science.gov (United States)

    Majer, John M.; Komer, Anne C.; Jason, and Leonard A.

    2014-01-01

    Objective The relationship between mental illness and human-immunodeficiency virus (HIV)-risk sexual behavior among persons with substance use disorders is not well established because of differences in assessing psychiatric factors (types, symptoms, severity), substance use (diagnosis, survey responses, past substance use) and HIV-risk sexual behaviors (individual measures, combination of sex/drug use risk behaviors) across studies. This study utilized a more global and dimensional aspect of psychiatric issues (problem severity), to examine the relationship with HIV-risk sexual behaviors and substance use among persons with substance use disorders. Methods Participants included 224 men and 46 women, with a mean age of 40.4 years (SD = 9.5). The most common substances were heroin/opiates, with 41.4% reporting use of these substances (n = 110, 110/266), while 27.8% reported using cocaine (n = 74, 74/266) and 12.8% reported using alcohol (n = 34, 34/266). Of all participants, 39 (14.4%) were identified as having high psychiatric severity (defined using the psychiatric severity score from the Addiction Severity Index), which was used as an indication of probable comorbid psychiatric and substance use disorders. Among these participants likely to have comorbid disorders, hierarchical linear regression was conducted to examine HIV-risk sexual behaviors (number of partners and unprotected sexual behaviors in the past 30 days) in relation to psychiatric severity, substance use, and gender. Results Gender (women) and psychiatric severity (higher) were significantly related to greater HIV-risk sexual behaviors. After entering gender and substance use into the regression model, psychiatric severity accounted for another 21.9% of the variance in number of partners and 14.1% of the variance in unprotected sexual behaviors. Overall, the models accounted for 55.5% and 15.6% of the variance, respectively. A significant interaction was found for number of partners (but not

  7. Relative contribution of attention-deficit hyperactivity disorder, obsessive-compulsive disorder, and tic severity to social and behavioral problems in tic disorders

    NARCIS (Netherlands)

    Hoekstra, PJ; Steenhuis, MP; Troost, PW; Korf, J; Kallenberg, CGM; Minderaa, RB

    The aim of this study was to investigate social and behavioral problems related to attention-deficit hyperactivity disorder (ADHD), obsessions and compulsions, and tic severity in children with a tic disorder. Parents of 58 children with a tic disorder with and without different forms of ADHD

  8. Affective behavior during mother-daughter conflict and borderline personality disorder severity across adolescence.

    Science.gov (United States)

    Whalen, Diana J; Scott, Lori N; Jakubowski, Karen P; McMakin, Dana L; Hipwell, Alison E; Silk, Jennifer S; Stepp, Stephanie D

    2014-01-01

    Developmental theories of borderline personality disorder (BPD) posit that transactions between child characteristics and adverse environments, especially those in the context of the parent-child relationship, shape and maintain symptoms of the disorder over time. However, very little empirical work has investigated the role of parenting and parent-child transactions that may predict BPD severity over time. We examined maternal and dyadic affective behaviors during a mother-adolescent conflict discussion task as predictors of the course of BPD severity scores across 3 years in a diverse, at-risk sample of girls (N = 74) oversampled for affective instability and their biological mothers. Adolescent girls completed a structured conflict discussion task with their mothers at age 16. Girls' self-reported BPD severity scores were assessed annually from ages 15 to 17. Mother-adolescent interactions were coded using a global rating system of maternal and dyadic affective behaviors. Results from multilevel linear mixed models indicated that positive maternal affective behavior (i.e., supportive/validating behavior, communication skills, autonomy-promoting behavior, and positive affect) and positive dyadic affective behaviors (i.e., satisfaction and positive escalation) were associated with decreases in girls' BPD severity scores over time. Dyadic negative escalation was associated with higher overall levels of BPD severity scores, but negative maternal affective behavior (i.e., negative affect, dominance, conflict, and denial) was not. These findings suggest that the mother-daughter context is an important protective factor in shaping the course of BPD severity scores during adolescence and may be valuable in assessment, intervention, and prevention efforts.

  9. Evidence of a reduction over time in the behavioral severity of autistic disorder diagnoses.

    Science.gov (United States)

    Whitehouse, Andrew J O; Cooper, Matthew N; Bebbington, Keely; Alvares, Gail; Lin, Ashleigh; Wray, John; Glasson, Emma J

    2017-01-01

    The increasing prevalence of Autism Spectrum Disorders (ASD) may in part be due to a shift in the diagnostic threshold that has led to individuals with a less severe behavioral phenotype receiving a clinical diagnosis. This study examined whether there were changes over time in the qualitative and quantitative phenotype of individuals who received the diagnosis of Autistic Disorder. Data were from a prospective register of new diagnoses in Western Australia (n = 1252). From 2000 to 2006, we examined differences in both the percentage of newly diagnosed cases that met each criterion as well as severity ratings of the behaviors observed (not met, partially met, mild/moderate and extreme). Linear regression determined there was a statistically significant reduction from 2000 to 2006 in the percentage of new diagnoses meeting two of 12 criteria. There was also a reduction across the study period in the proportion of new cases rated as having extreme severity on six criteria. There was a reduction in the proportion of individuals with three or more criteria rated as extreme from 2000 (16.0%) to 2006 (1.6%), while percentage of new cases with no "extreme" rating on any criteria increased from 58.5% to 86.6% across the same period. This study provides the first clear evidence of a reduction over time in the behavioral severity of individuals diagnosed with Autistic Disorder during a period of stability in diagnostic criteria. A shift toward diagnosing individuals with less severe behavioral symptoms may have contributed to the increasing prevalence of Autistic Disorder diagnoses. Autism Res 2017, 10: 179-187. © 2016 International Society for Autism Research, Wiley Periodicals, Inc. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

  10. Group behavioral activation for patients with severe obesity and binge eating disorder: a randomized controlled trial.

    Science.gov (United States)

    Alfonsson, Sven; Parling, Thomas; Ghaderi, Ata

    2015-03-01

    The aim of the present study was to assess whether behavioral activation (BA) is an efficacious treatment for decreasing eating disorder symptoms in patients with obesity and binge eating disorder (BED). Ninety-six patients with severe obesity and BED were randomized to either 10 sessions of group BA or wait-list control. The study was conducted at an obesity clinic in a regular hospital setting. The treatment improved some aspects of disordered eating and had a positive effect on depressive symptoms but there was no significant difference between the groups regarding binge eating and most other symptoms. Improved mood but lack of effect on binge eating suggests that dysfunctional eating (including BED) is maintained by other mechanisms than low activation and negative mood. However, future studies need to investigate whether effects of BA on binge eating might emerge later than at post-assessment, as in interpersonal psychotherapy for bulimia nervosa. © The Author(s) 2014.

  11. The relationship of the Severe Personality disorders with behavioral activation and inhibition systems in patients with paranoid, borderline and schizotypal personality disorders

    OpenAIRE

    Setareh Jani; Mehri Molaee

    2016-01-01

    Introduction: Given the disruptive effects of personality disorders on personal and family life, it is essential to recognize their predisposing factors to understand them more accurately, and identify their preventive measures treatment facilitators. Therefore, the present study aimed to examine the relationship of severe personality disorders with behavioral activation and inhibition systems in patients with paranoid, borderline and schizotypal personality disorders. Methods: The present...

  12. Social Functioning in Youth with Anxiety Disorders: Association with Anxiety Severity and Outcomes from Cognitive-Behavioral Therapy

    Science.gov (United States)

    Settipani, Cara A.; Kendall, Philip C.

    2013-01-01

    Social functioning was assessed using the Child Behavior Checklist and Teacher Report Form for children with anxiety disorders who participated in a randomized clinical trial (N = 161, aged 7-14). Significant relationships were found between severity of children's principal anxiety disorder and most measures of social functioning, such that poorer…

  13. Drug-Refractory Aggression, Self-Injurious Behavior, and Severe Tantrums in Autism Spectrum Disorders: A Chart Review Study

    Science.gov (United States)

    Adler, Benjamin A.; Wink, Logan K.; Early, Maureen; Shaffer, Rebecca; Minshawi, Noha; McDougle, Christopher J.; Erickson, Craig A.

    2015-01-01

    Aggression, self-injurious behavior, and severe tantrums are impairing symptoms frequently experienced by individuals with autism spectrum disorders. Despite US Food and Drug Administration approval of two atypical antipsychotics targeting these symptoms in youth with autistic disorder, they remain frequently drug refractory. We define…

  14. Social functioning in youth with anxiety disorders: association with anxiety severity and outcomes from cognitive-behavioral therapy.

    Science.gov (United States)

    Settipani, Cara A; Kendall, Philip C

    2013-02-01

    Social functioning was assessed using the Child Behavior Checklist and Teacher Report Form for children with anxiety disorders who participated in a randomized clinical trial (N = 161, aged 7-14). Significant relationships were found between severity of children's principal anxiety disorder and most measures of social functioning, such that poorer social functioning was associated with more severe anxiety. Among youth who received cognitive-behavioral therapy (n = 111), significant associations were found between parent-reported social competence and both absence of principal anxiety disorder and lower anxiety severity at posttreatment and 1-year follow-up, controlling for the severity of the child's principal anxiety disorder at pretreatment. Findings support a relationship between anxiety severity and social difficulties, and suggest the importance of social competence for a favorable treatment response.

  15. Drug-refractory aggression, self-injurious behavior, and severe tantrums in autism spectrum disorders: a chart review study.

    Science.gov (United States)

    Adler, Benjamin A; Wink, Logan K; Early, Maureen; Shaffer, Rebecca; Minshawi, Noha; McDougle, Christopher J; Erickson, Craig A

    2015-01-01

    Aggression, self-injurious behavior, and severe tantrums are impairing symptoms frequently experienced by individuals with autism spectrum disorders. Despite US Food and Drug Administration approval of two atypical antipsychotics targeting these symptoms in youth with autistic disorder, they remain frequently drug refractory. We define drug-refractory aggression, self-injurious behavior, and severe tantrums in people with autism spectrum disorders as behavioral symptoms requiring medication adjustment despite previous trials of risperidone and aripiprazole or previous trials of three psychotropic drugs targeting the symptom cluster, one of which was risperidone or aripiprazole. We reviewed the medical records of individuals of all ages referred to our clinic for autism spectrum disorder diagnostic evaluation, as well as pharmacotherapy follow-up notes for all people meeting autism spectrum disorder criteria, for drug-refractory symptoms. Among 250 consecutively referred individuals, 135 met autism spectrum disorder and enrollment criteria, and 53 of these individuals met drug-refractory symptom criteria. Factors associated with drug-refractory symptoms included age 12 years or older (p diagnosis of autistic disorder (p = 0.0139), and presence of intellectual disability (p = 0.0273). This pilot report underscores the significance of drug-refractory aggression, self-injurious behavior, and severe tantrums; suggests the need for future study clarifying factors related to symptom development; and identifies the need for focused treatment study of this impairing symptom domain. © The Author(s) 2014.

  16. Low intensity behavioral treatment supplementing preschool services for young children with autism spectrum disorders and severe to mild intellectual disability

    NARCIS (Netherlands)

    Peters-Scheffer, N.C.; Didden, H.C.M.; Mulders, M.; Korzilius, H.P.L.M.

    2010-01-01

    This study evaluated the effectiveness of low intensity behavioral treatment (on average 6.5 h per week) supplementing preschool services in 3-6-year-old children with autism spectrum disorder and severe to mild intellectual disability. Treatment was implemented in preschools (i.e., daycare centers)

  17. Tic Severity and Treatment in Children: The Effect of Comorbid Attention Deficit Hyperactivity Disorder and Obsessive Compulsive Behaviors.

    Science.gov (United States)

    Pringsheim, Tamara

    2017-12-01

    While attention deficit hyperactivity disorder (ADHD) and obsessive compulsive disorder have been shown to have major impacts on quality of life in individuals with Tourette syndrome, there is comparatively little data on how the presence of these comorbidities influence tic severity and treatment. 114 children (mean age 10.25 years) were extensively clinically phenotyped at a single specialty clinic. While there was no difference in Yale Global Tic Severity Scale (YGTSS) scores in children with versus without ADHD, children with obsessive compulsive behaviors had significantly higher YGTSS scores (p = 0.008). There was a significant correlation between YGTSS scores and age (r = 0.344, p tics within the first two years of diagnosis (OR 3.51, p = 0.009). As tic severity does not appear to be greater in children with ADHD, this association may relate to greater overall psychosocial impairment in children with this comorbidity.

  18. The relationship of the Severe Personality disorders with behavioral activation and inhibition systems in patients with paranoid, borderline and schizotypal personality disorders

    Directory of Open Access Journals (Sweden)

    Setareh Jani

    2016-12-01

    Full Text Available Introduction: Given the disruptive effects of personality disorders on personal and family life, it is essential to recognize their predisposing factors to understand them more accurately, and identify their preventive measures treatment facilitators. Therefore, the present study aimed to examine the relationship of severe personality disorders with behavioral activation and inhibition systems in patients with paranoid, borderline and schizotypal personality disorders. Methods: The present descriptive-correlational study recruited patients with paranoid, borderline and schizotypal personality disorders presenting to psychiatry clinics in Ardabil using convenient sampling method. A total of 30 paranoid patients, 30 borderline patients and 20 schizotypal patients were selected by a psychiatrist through psychiatric examination, clinical interview and completing Millon Clinical Multiaxial Inventory (MCMI-III. The following instruments were used: MCMI- III and behavioral activation-inhibition system scale (BIS-BAS. The data were analyzed with Pearson’s correlation coefficient and stepwise regression. Results: BIS and BAS systems were both significant for predicting borderline and paranoid personality disorders, but only BIS was significant for predicting schizotypal personality disorder. Conclusion: These findings can help experts to have a better and more accurate understanding of personality disorders and use proper methods to predict the probability of these disorders and develop treatments.

  19. 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)…

  20. Association between severity of behavioral phenotype and comorbid attention deficit hyperactivity disorder symptoms in children with autism spectrum disorders

    OpenAIRE

    Rao, Patricia A; Landa, Rebecca J

    2013-01-01

    Autism spectrum disorder and attention deficit hyperactivity disorder are neurodevelopmental disorders that cannot be codiagnosed under existing diagnostic guidelines (Diagnostic and Statistical Manual of the American Psychiatric Association, 4th ed., text rev.). However, reports are emerging that attention deficit hyperactivity disorder is sometimes comorbid with autism spectrum disorder. In the current study, we examined rates of parent-reported clinically significant symptoms of attention ...

  1. Clinical Severity as a Moderator of Outcome in Psychodynamic and Dialectical Behavior Therapies for Borderline Personality Disorder.

    Science.gov (United States)

    Sahin, Zeynep; Vinnars, Bo; Gorman, Bernard S; Wilczek, Alexander; Åsberg, Marie; Barber, Jacques P

    2017-12-14

    The aim of the present study was to assess the effect of initial level of psychiatric severity on treatment outcome in psychodynamic therapy and dialectical behavior therapy (DBT) for borderline personality disorder (BPD). It was hypothesized that DBT would lead to better outcome for patients with high psychiatric severity, whereas dynamic treatment would lead to better outcome for patients with lower psychiatric severity. Data from the 5th-year follow-up of the Stockholm City Council's and the Karolinska Institute's Psychotherapy Project were used in the present study. A total of 106 female patients diagnosed with BPD with at least 2 past suicide attempts were randomized into object-relational psychotherapy (ORP; based on transference-focused psychotherapy), DBT, and treatment as usual. Patients' baseline global severity index was used as a moderator. Global Assessment of Functioning (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [American Psychiatric Association, 1994]) was used to examine outcome. There was a significant 3-way interaction of Time × Treatment × Severity. Post hoc analyses suggested that patients with lower levels of severity had significantly better outcomes in object-relational psychotherapy. For patients with higher severity, the 3 treatments resulted in similar outcomes in terms of level of functioning. Outcome of treatment for BPD might differ significantly for patients depending on their initial levels of overall psychiatric severity. If our findings are replicated for patients with low severity and supported for a high-severity sample, psychiatric severity can be used as a low-cost and effective tool to match patients with BPD to optimal treatments. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  2. Association between Severity of Behavioral Phenotype and Comorbid Attention Deficit Hyperactivity Disorder Symptoms in Children with Autism Spectrum Disorders

    Science.gov (United States)

    Rao, Patricia A.; Landa, Rebecca J.

    2014-01-01

    Autism spectrum disorder and attention deficit hyperactivity disorder are neurodevelopmental disorders that cannot be codiagnosed under existing diagnostic guidelines ("Diagnostic and Statistical Manual of the American Psychiatric Association," 4th ed., text rev.). However, reports are emerging that attention deficit hyperactivity…

  3. HIV Risk Behavior in Persons with Severe Mental Disorders in a ...

    African Journals Online (AJOL)

    increased risk of sexual victimization may occur in the context ... sexually transmitted disease, 5.9% (6/102) reported sex trading and no reports of intravenous drug use ... Keywords: Human immuno virus, Mental health, Psychiatric patients, Risk behavior, .... Difference ..... persistent mental illness: Patterns and psychological.

  4. Effects of Personality Disorder and Other Variables on Professionals' Evaluation of Treatment Features in Individuals with Mild Intellectual Disabilities and Severe Behavior Problems

    Science.gov (United States)

    van den Hazel, Teunis; Didden, Robert; Korzilius, Hubert

    2009-01-01

    The diagnosis personality disorder is often found among samples of adults with mild intellectual disability and severe behavioral and mental health disorders. The number of studies on the adverse effects of this diagnosis are scarce. Using vignettes in the present study, we have explored the relationship between the diagnosis personality disorder…

  5. Severe accident behavior

    International Nuclear Information System (INIS)

    Denning, R.S.

    1986-01-01

    The purpose of this paper is to provide an overview of severe accident behavior. The term source term is defined and a brief history of the regulatory use of source term is presented. The processes in severe accidents in light water reactors are described with particular emphasis on the relationships between accident thermal-hydraulics and chemistry. Those factors which have the greatest impact on predicted source terms are identified. Design differences between plants that affect source term estimation are also described. The principal unresolved issues are identified that are the focus of ongoing research and debate in the technical community

  6. Child Behavior Disorders

    Science.gov (United States)

    ... a death in the family may cause a child to act out. Behavior disorders are more serious. ... The behavior is also not appropriate for the child's age. Warning signs can include Harming or threatening ...

  7. Coping mediates the effects of cognitive-behavioral therapy for alcohol use disorder among out-patient clients in Project MATCH when dependence severity is high.

    Science.gov (United States)

    Roos, Corey R; Maisto, Stephen A; Witkiewitz, Katie

    2017-09-01

    There is inconsistent evidence that alcohol-specific coping is a mechanism of change in cognitive-behavioral therapy (CBT) for alcohol use disorder (AUD). Our primary aim was to test whether baseline dependence severity moderates the mediational effect of CBT on drinking outcomes via coping. Secondary data analysis of Project MATCH , a multi-site alcohol treatment trial in which participants, recruited in out-patient and aftercare arms, were randomized to three treatments: CBT, motivational enhancement therapy (MET) and Twelve-Step facilitation (TSF). Nine research sites in the United States. A total of 1063 adults with AUD. The primary outcomes were percentage days abstinent and percentage heavy drinking days at the 1-year follow-up. Coping was assessed with the Processes of Change Questionnaire . Dependence severity was measured with the Alcohol Dependence Scale . Among the full available sample (across treatment arms), there were no significant moderated mediation effects. Double moderated mediation analyses indicated that several moderated mediation effects were moderated by treatment arm (all P cognitive-behavioral therapy for alcohol use disorder was conditional on dependence severity. End-of-treatment coping mediated the positive treatment effects of cognitive-behavioral therapy on 1-year drinking outcomes among out-patient clients when dependence severity was high, but not when dependence severity was low or moderate. © 2017 Society for the Study of Addiction.

  8. [Evaluation of an intensive therapy program for treatment of severe behavioral disorders in mentally handicapped patients with autistic or psychotic behavior].

    Science.gov (United States)

    Elbing, U; Rohmann, U H

    1993-09-01

    The development of severely disturbed and socially accepted behavior in mentally handicapped persons with autistic or psychotic symptoms is documented before, during and after an intensive therapy program conducted in a residential institution for mentally handicapped persons. Seven single case studies were made as long term observation with a duration between 18 and 33 weeks, mostly with a multiple baseline design. One or two follow ups with at least four weeks length were conducted in six out of seven cases up to four years after the end of the intensive therapy. The main results show (1) the decrease of disturbed behavior and the increase of socially accepted behavior during the therapy program, and (2) the significant reduction of the disturbed behavior patterns taking place during the baseline phase before the beginning of the therapy in all cases but one. The results are discussed under the aspects of a possible explanation for the findings and their impact on the discussion about psychotherapy research.

  9. Further Evidence that Severe Scores in the Aggression/Anxiety-Depression/Attention Subscales of Child Behavior Checklist (Severe Dysregulation Profile) Can Screen for Bipolar Disorder Symptomatology: A Conditional Probability Analysis

    Science.gov (United States)

    Uchida, Mai; Faraone, Stephen V; Martelon, MaryKate; Kenworthy, Tara; Woodworth, K Yvonne; Spencer, Thomas; Wozniak, Janet; Biederman, Joseph

    2014-01-01

    Background Previous work shows that children with high scores (2 SD, combined score ≥ 210) on the Attention Problems, Aggressive Behavior, and Anxious-Depressed (A-A-A) subscales of the Child Behavior Checklist (CBCL) are more likely than other children to meet criteria for bipolar (BP)-I disorder. However, the utility of this profile as a screening tool has remained unclear. Methods We compared 140 patients with pediatric BP-I disorder, 83 with attention deficit hyperactivity disorder (ADHD), and 114 control subjects. We defined the CBCL-Severe Dysregulation profile as an aggregate cutoff score of ≥ 210 on the A-A-A scales. Patients were assessed with structured diagnostic interviews and functional measures. Results Patients with BP-I disorder were significantly more likely than both control subjects (Odds Ratio [OR]: 173.2; 95% Confidence Interval [CI], 21.2 to 1413.8; P < 0.001) and those with ADHD (OR: 14.6; 95% CI, 6.2 to 34.3; P < 0.001) to have a positive CBCL-Severe Dysregulation profile. Receiver Operating Characteristics analyses showed that the area under the curve for this profile comparing children with BP-I disorder against control subjects and those with ADHD was 99% and 85%, respectively. The corresponding positive predictive values for this profile were 99% and 92% with false positive rates of < 0.2% and 8% for the comparisons with control subjects and patients with ADHD, respectively. Limitations Non-clinician raters administered structured diagnostic interviews, and the sample was referred and largely Caucasian. Conclusions The CBCL-Severe Dysregulation profile can be useful as a screen for BP-I disorder in children in clinical practice. PMID:24882182

  10. Hopelessness, defeat, and entrapment in posttraumatic stress disorder: their association with suicidal behavior and severity of depression.

    Science.gov (United States)

    Panagioti, Maria; Gooding, Patricia A; Tarrier, Nicholas

    2012-08-01

    Research has shown an increased frequency of suicidal behaviors in those with PTSD, but few studies have investigated the factors that underlie the emergence of suicidal behavior in PTSD. Two theories of suicide, the Cry of Pain and the Schematic Appraisal Model of Suicide, propose that feelings of hopelessness, defeat, and entrapment are core components of suicidality. This study aimed to examine the association between suicidal behavior and hopelessness, defeat, and entrapment in trauma victims with and without a PTSD diagnosis. The results demonstrated that hopelessness, defeat, and entrapment were significantly positively associated with suicidal behavior in those with PTSD. Hopelessness and defeat were also significantly positively associated with suicidal behavior in trauma victims without PTSD. In those with PTSD, the relationship between suicidal behavior and hopelessness and entrapment remained significant after controlling for comorbid depression. The findings provide support for the contemporary theories of suicidality and have important clinical implications.

  11. Sleep Problems and Their Relationship to Maladaptive Behavior Severity in Psychiatrically Hospitalized Children with Autism Spectrum Disorder (ASD).

    Science.gov (United States)

    Sannar, Elise M; Palka, Tamara; Beresford, Carol; Peura, Christine; Kaplan, Desmond; Verdi, Mary; Siegel, Matthew; Kaplan, Shir; Grados, Marco

    2017-10-30

    We examined the relationship between sleep duration and awakenings to Aberrant Behavior Checklist-Community (ABC-C) and Autism Diagnostic Observation Schedule (ADOS-2) scores in hospitalized youth with ASD and behavioral disturbance. Participants included 106 patients with a stay of at least 10 nights. Sleep in the hospital was recorded by staff observation. Higher scores on the ABC-C (irritability, stereotypy, and hyperactivity subscales) at admission were significantly associated with fewer minutes slept during the last five nights of hospitalization. There was no association between total awakenings and ABC-C scores or ADOS-2 comparison scores. Improved understanding of the relationship between sleep quality and maladaptive behavior in this challenging cohort of patients with ASD is vital to the definition and design of future effective interventions.

  12. A Randomized Controlled Trial on the Efficacy of a Psychosocial Behavioral Intervention to Improve the Lifestyle of Patients With Severe Mental Disorders: Study Protocol

    Directory of Open Access Journals (Sweden)

    Gaia Sampogna

    2018-06-01

    Full Text Available Patients with severe mental disorders die on average 20 years prior to the general population. This mortality gap is mainly due to the higher prevalence of physical diseases and the adoption of unhealthy lifestyle behaviors.The LIFESTYLE trial aims to evaluate the efficacy of a new psychosocial group intervention (including psychoeducational, motivational, and problem-solving techniques focused on healthy lifestyle behavior compared to a brief educational group intervention in a community sample of patients with severe mental disorders. The trial is a national-funded, multicentric, randomized controlled trial with blinded outcome assessments, which is carried out in six outpatient units of the Universities of Campania “Luigi Vanvitelli” in Naples, Bari, Genova, L'Aquila, Pisa, and Rome—Tor Vergata. All patients are assessed at the following time points: baseline (T0; 2 months post-randomization (T1; 4 months post-randomization (T2; 6 months post-randomization (T3; 12 months post-randomization (T4; and 24 months post-randomization (T5. T1 and T2 assessments include only anthropometric tests. The BMI, a reliable and feasible anthropometric parameter, has been selected as primary outcome. In particular, the mean value of BMI at 6 months from baseline (T3 will be evaluated through a Generalized Estimated Equation model. The work hypothesis is that the LIFESTYLE psychosocial group intervention will be more effective than the brief educational group intervention in reducing the BMI. We expect a mean difference between the two groups of at least one point (and standard deviation of two points at BMI. Secondary outcomes are: the improvement in dietary patterns, in smoking habits, in sleeping habits, physical activity, personal and social functioning, severity of physical comorbidities, and adherence to medications. The expected sample size consists of 420 patients (70 patients for each of the six participating centers, and they are allocated with

  13. Suicidal Behavior in Eating Disorders

    Directory of Open Access Journals (Sweden)

    Bedriye Oncu

    2013-03-01

    Full Text Available Suicide associated mortality rates are notable for eating disorders. Crude mortality rate associated with suicide, varies between 0% and 5.3% in patients with eating disorders. Prominent risk factors for suicidal behavior among these patients are subtype of the eating disorders, comorbid psychiatric diagnosis (e.g. depression, alcohol and substance abuse, personality disorders, ultrarapid drug metabolism, history of childhood abuse and particular family dynamics. In this article, suicidal behavior and associated factors in eating disorders are briefly reviewed.

  14. Superior Disembedding Performance in Childhood Predicts Adolescent Severity of Repetitive Behaviors: A Seven Years Follow-Up of Individuals With Autism Spectrum Disorder.

    Science.gov (United States)

    Eussen, Mart L J M; Van Gool, Arthur R; Louwerse, Anneke; Verhulst, Frank C; Greaves-Lord, Kirstin

    2016-02-01

    Previous research suggests that individuals with autism spectrum disorder (ASD) show a detail-focused cognitive style. The aim of the current longitudinal study was to investigate whether this detail-focused cognitive style in childhood predicted a higher symptom severity of repetitive and restrictive behaviors and interests (RRBI) in adolescence. The Childhood Embedded Figures Test (CEFT) and the Autism Diagnostic Observation Schedule (ADOS) were administered in 87 children with ASD at the age of 6-12 years old (T1), and the ADOS was readministered 7 years later when the participants were 12-19 years old (T2). Linear regression analyses were performed to investigate whether accuracy and reaction time in the complex versus simple CEFT condition and performance in the complex condition predicted T2 ADOS RRBI calibrated severity scores (CSS), while taking into consideration relevant covariates and ADOS RRBI CSS at T1. The CEFT performance (accuracy in the complex condition divided by the time needed) significantly predicted higher ADOS RRBI CSS at T2 (ΔR(2)  = 15%). This finding further supports the detail-focused cognitive style in individuals with ASD, and shows that it is also predictive of future RRBI symptoms over time. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

  15. Establishing the severity of personality disorder.

    Science.gov (United States)

    Tyrer, P; Johnson, T

    1996-12-01

    The authors developed a simplified method of rating the severity of personality disorder. The new rating method is based on four levels of severity: no personality disorder, personality difficulty, simple personality disorder, and diffuse personality disorder. The new method was applied to different diagnostic systems and was then compared with an old rating system based on six severity levels. Data were derived from a longitudinal study in which 163 patients with anxiety and depressive disorders had initial assessments of personality status and were followed up over 2 years. Ratings of psychiatric symptoms were made by using the Comprehensive Psychopathological Rating Scale over this period. The results were analyzed with special attention to linear and quadratic trends. The new system was clinically useful in separating patients' initial assessments and outcomes. Patients with no personality disorder had the lowest initial symptom scores and the best outcomes, and those with diffuse personality disorder had the highest initial levels of symptoms and improved least over the 2 years. When the patients were separated by the old classification system, 72% of the variation between groups was accounted for by linear and quadratic trends; the comparable percentage was 97% when the patients were categorized by the new system. The new system of rating severity of personality disturbance is an improvement on existing methods and allows ratings to be made easily from DSM-IV and ICD-10.

  16. Disruptive Behavior Disorders

    Science.gov (United States)

    ... Ribbon Commands Skip to main content Turn off Animations Turn on Animations Our Sponsors Log in | Register Menu Log in | ... greater chance of experiencing learning disabilities such as reading disorders and verbal impairment. But what distinguishes children ...

  17. Eating disorder severity and functional impairment

    DEFF Research Database (Denmark)

    Davidsen, Annika Helgadóttir; Hoyt, William T.; Poulsen, Stig Bernt

    2017-01-01

    Purpose: The aim was to examine duration of illness and body mass index as possible moderators of the relationship between eating disorder severity and functional impairment, as well as psychological distress as a possible mediator of this relationship. Methods: The study included 159 patients...... was measured with the Sheehan Disability Scale, and psychological distress was measured with the Symptom Check List-90-R. Duration of illness and body mass index were assessed clinically. Results: Duration of illness significantly moderated the relationship between eating disorder severity and functional...... impairment; the relationship was strongest for patients with a shorter duration of illness. Psychological distress partly mediated the relationship between eating disorder severity and functional impairment. Duration of illness significantly moderated the relationship between psychological distress...

  18. Severity of the aggression/anxiety-depression/attention child behavior checklist profile discriminates between different levels of deficits in emotional regulation in youth with attention-deficit hyperactivity disorder.

    Science.gov (United States)

    Biederman, Joseph; Petty, Carter R; Day, Helen; Goldin, Rachel L; Spencer, Thomas; Faraone, Stephen V; Surman, Craig B H; Wozniak, Janet

    2012-04-01

    We examined whether severity scores (1 SD vs 2 SDs) of a unique profile of the Child Behavior Checklist (CBCL) consisting of the Anxiety/Depression, Aggression, and Attention (AAA) scales would help differentiate levels of deficits in children with attention-deficit hyperactivity disorder (ADHD). Subjects were 197 children with ADHD and 224 without ADHD. We defined deficient emotional self-regulation (DESR) as an aggregate cutoff score of >180 but siblings. In contrast, the CBCL-DESR was associated with higher rates of comorbid disruptive behavior, anxiety disorders, and impaired interpersonal functioning compared with other ADHD children. Severity scores of the AAA CBCL profiles can help distinguish 2 groups of emotional regulation problems in children with ADHD.

  19. Comorbid personality disorders in subjects with panic disorder: which personality disorders increase clinical severity?

    OpenAIRE

    Mustafa Ozkan; Abdurrahman Altindag

    2003-01-01

    Personality disorders are common in subjects with panic disorder. Personality disorders have shown to affect the course of panic disorder. The purpose of this study was to examine which personality disorders effect clinical severity in subjects with panic disorder. This study included 122 adults (71 female, 41 male), who met DSM-IV criteria for panic disorder (with or without agoraphobia). Clinical assessment was conducted by using the Structured Clinical Interview for DSM-IV Axis I Disorders...

  20. Event-related brain potentials, bilateral electrodermal activity and Mangina-Test performance in learning disabled/ADHD pre-adolescents with severe behavioral disorders as compared to age-matched normal controls.

    Science.gov (United States)

    Mangina, C A; Beuzeron-Mangina, J H; Grizenko, N

    2000-07-01

    The most frequently encountered developmental problems of learning disabilities/ADHD often co-exist with severe behavioral disorders. As a direct consequence, this condition opens the way to delinquency, school drop-out, depression, suicide, substance abuse, work absenteeism, and other psycho-social complications. In this paper, we are presenting a selective overview of our previous research and its clinical applications in this field as it relates to our present research data pertaining to the effects of our original Memory Workload Paradigm on the event-related brain potentials in differentiating normal and pathological pre-adolescents (learning disabled/ADHD with concomitant severe behavioral disorders such as oppositional and conduct). In addition, it provides data on the bilateral electrodermal activity during cognitive workload and Mangina-Test performance of pathological and normal pre-adolescents conducted in separate sessions. The results of our present research indicate that a significant memory load effect for the P450 latency (F(3,27)=4.98, PWorkload Paradigm in pre-frontal and frontal regions clearly differentiated normal from pathological pre-adolescents (F(1, 18)=12.21, Presearch findings provide an original and valuable demonstration of an integrative and effective clinical psychophysiological application of central (ERPs), autonomic (bilateral electrodermal activity) and neuro-psychometric aspects (Mangina-Test) which characterize normal and pathological pre-adolescents and underpin the neurophysiological basis of learning disabled/ADHD with severe behavioral disorders as opposed to normal subjects.

  1. Behavior Disorders and Epilepsy

    OpenAIRE

    J Gordon Millichap

    1993-01-01

    A longitudinal study of 127 children with epilepsy aged 8-12 years and their mothers, designed to identify factors contributing to behavior problems, is reported from the Indiana University School of Nursing, Indianapolis; the Minnesota Comprehensive Epilepsy Program, Minneapolis; and the Harvard School of Public Health, Boston.

  2. Relationship between motor abilities and severity of autism spectrum disorder

    Directory of Open Access Journals (Sweden)

    Cvijetić Marija

    2017-01-01

    Full Text Available According to the findings in literature, motor skills of children with autism spectrum disorders generally differ from age expectations and are increasingly being associated with speech and language and social development, and adaptive behavior. The aim of the research was to determine the relationship between the development level of fine and gross motor skills and autism severity of children with autism spectrum disorder. The sample included 30 children with autism spectrum disorder and associated intellectual disability, seven to 19 years of age (M=11.97; SD=3.70. The assessment was conducted using the Peabody Motor Development Scale, the Vineland Adaptive Behavior Scale, and the criteria for describing the level of severity of autism spectrum disorder (APA, 2013. The results have shown that participants' motor skills significantly correlate with social communication (Peabody fine motor skills r=-0.452; p=0.012; Vineland fine motor skills r=-0.511; p=0.004; Vineland total r=-0.391; p=0.032 and restricted, repetitive behaviors (Peabody fine motor skills r=-0.383; p=0.037; Vineland fine motor skills r=-0.433; p=0.017; Vineland total r=-0.371; p=0.044. Lower level of autistic symptomatology is associated with higher motor achievements. It is necessary to pay more attention to the assessment and treatment of motor skills in children with autism spectrum disorder, given the established delay in the development of these skills, and bearing in mind their relationship with the severity of the symptoms of autism spectrum disorder. Timely identification of motor disorders would allow the use of early treatment and potentially lead to better results, compared to later inclusion in intervention programs.

  3. ADHD Comorbidity, Behavior, and Tic Severity

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2003-01-01

    Full Text Available The association of disruptive behavior with social, adaptive, and family functioning in Tourette syndrome (TS, with and without comorbid attention-deficit/hyperactivity disorder (ADHD, was evaluated in 207 children (144 boys and 63 girls between the ages of 7 and 18 years, in a study at Yale University School of Medicine, New Haven, CT.

  4. [Severe mental disorders: cure? What an idea!

    Science.gov (United States)

    Vignat, Jean-Pierre

    The evolution of mental disorders, notably the most severe forms such as schizophrenia, is a constant concern in terms of the necessary assessment of treatments and their efficiency, and to the human and economic cost of the 'chronicity' of the disorders. Many patients experience a positive evolution, evaluated in terms of subjective quality of life. However, the concept of recovery does not seem appropriate. The field of representations which the patient and the caregiver form with regard to the disease and its curability is an important element. The co-construction of the patient's future, in an approach centred on the patient, on their freedom and their autonomy, opens up the way towards recovery. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  5. Autonomic symptoms in idiopathic REM behavior disorder

    DEFF Research Database (Denmark)

    Ferini-Strambi, Luigi; Oertel, Wolfgang; Dauvilliers, Yves

    2014-01-01

    Patients with idiopathic REM sleep behavior disorder (iRBD) are at very high risk of developing neurodegenerative synucleinopathies, which are disorders with prominent autonomic dysfunction. Several studies have documented autonomic dysfunction in iRBD, but large-scale assessment of autonomic...... symptoms has never been systematically performed. Patients with polysomnography-confirmed iRBD (318 cases) and controls (137 healthy volunteers and 181 sleep center controls with sleep diagnoses other than RBD) were recruited from 13 neurological centers in 10 countries from 2008 to 2011. A validated scale...

  6. Comorbid personality disorders in subjects with panic disorder: which personality disorders increase clinical severity?

    Directory of Open Access Journals (Sweden)

    Mustafa Ozkan

    2003-03-01

    Full Text Available Personality disorders are common in subjects with panic disorder. Personality disorders have shown to affect the course of panic disorder. The purpose of this study was to examine which personality disorders effect clinical severity in subjects with panic disorder. This study included 122 adults (71 female, 41 male, who met DSM-IV criteria for panic disorder (with or without agoraphobia. Clinical assessment was conducted by using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I, the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II and the Panic and Agoraphobia Scale (PAS, Global Assessment Functioning Scale (GAF, Beck Depression Inventory (BDI, and State-Trait Anxiety Inventory (STAI. Patients who had a history of sexual abuse were assessed with Sexual Abuse Severity Scale. Logistic regressions were used to identify predictors of suicide attempts, suicidal ideation, agoraphobia, different panic attack symptoms, sexual abuse, and early onset of disorders. The rates of comorbid Axis I and Axis II psychiatric disorders were 80.3% and 33.9%, consecutively, in patients with panic disorder. Panic disorder patients with comorbid personality disorders had more severe anxiety, depression and agoraphobia symptoms, and had earlier ages of onset, and lower levels of functioning. The rates of suicidal ideation and suicide attempts were 34.8% and 9.8%, consecutively, in subjects with panic disorder. The rate of patients with panic disorder had a history of childhood sexual abuse was 12.5%. The predictor of sexual abuse was more than one comorbid Axis II diagnosis. The predictors of suicide attempt were comorbid paranoid and borderline personality disorders, and the predictor of suicidal ideation was major depressive disorder in subjects with panic disorder. In conclusion, this study documents that comorbid personality disorders increase the clinical severity of panic disorder. Patients with more than one

  7. Narcissistic Personality Disorder and suicidal behavior in mood disorders.

    Science.gov (United States)

    Coleman, Daniel; Lawrence, Ryan; Parekh, Amrita; Galfalvy, Hanga; Blasco-Fontecilla, Hilario; Brent, David A; Mann, J John; Baca-Garcia, Enrique; Oquendo, Maria A

    2017-02-01

    The relationship of Narcissistic Personality Disorder (NPD) to suicidal behavior is understudied. The modest body of existing research suggests that NPD is protective against low-lethality suicide attempts, but is associated with high lethality attempts. Mood-disordered patients (N = 657) received structured interviews including Axis I and II diagnosis and standardized clinical measures. Following chi-square and t-tests, a logistical regression model was constructed to identify predictors of suicide attempt. While there was no bivariate relationship of NPD on suicide attempt, in the logistic regression patients with NPD were 2.4 times less likely to make a suicide attempt (OR = 0.41; 95% CI = 0.19 - 0.88; p disorder, and to have high aggression and hostility scores. Limitations include that the sample consists of only mood-disordered patients, a modest sample size of NPD, and the data are cross-sectional. The multivariate protective effect of NPD on suicide attempt is consistent with most previous research. The lower impulsivity of NPD patients and less severe personality pathology relative to other personality disorders may contribute to this effect. No relationship of NPD to attempt lethality was found, contradicting other research, but perhaps reflecting differences between study samples. Future studies should oversample NPD patients and include suicide death as an outcome. Clinical implications include discussion of individualized suicide risk assessment with NPD patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Personality Disorders in patients with disorders in eating behaviors

    Directory of Open Access Journals (Sweden)

    Vanesa Carina Góngora

    2016-02-01

    Full Text Available The interest for the systematic study of personality disorder in patients with eating disorders starts in 1980 with the edition of the DSM III multiaxial classification system. Since then, several publications have been focused on the prevalence and the effect on treatment of personality disorders in bulimic and anorexic patients. These researches showed inconsistent results due to conceptual and methodological divergences. In this paper, the more relevant findings of these studies are presented and the possible sources of discrepancy are analyzed. In general, there is a moderate comorbidity between personality disorders and eating disorders. The most frequent disorders are borderline, histrionic, obsessive-compulsive, dependent and avoidant personality disorders. Borderline and histrionic personality disorders are more frequently associated with bulimia, whereas avoidant and obsessive- compulsive personality disorders are more characteristic of anorexia nervosa. Nevertheless, the effect of the relationship between eating disorders and personality disorders in treatment remains uncertain, giving raise to several controversies and researches. 

  9. Solutions and Hope for Severe Behaviors: The Development of Functional Behavioral Assessment

    Science.gov (United States)

    DeLeon, Iser; Silverman, Wayne

    2008-01-01

    Severe behavior disorders are among the most perplexing conditions encountered by clinicians, and as a front page article in the past Christmas Day's "New York Times" illustrates ("Parents defend school's use of shock therapy"), treatment options remain a topic of contentious debate. Not all that long ago physical restraint was the only option,…

  10. Children with Usher syndrome: mental and behavioral disorders.

    Science.gov (United States)

    Dammeyer, Jesper

    2012-03-27

    Mental and behavioral disorders among adults with Usher syndrome have been discussed and reported in some case studies but no research has been reported on children with Usher syndrome. This article investigates the prevalence and characteristics of mental and behavioral disorders among 26 children, 3-17 years of age, with Usher syndrome. Six of the 26 children were diagnosed with a mental or behavioral disorder (1 with schizophrenia and mild mental retardation, 1 with atypical autism and severe mental retardation, 1 with atypical autism and mild mental retardation, 1 with mild mental retardation, and 2 with conduct disorder). Another 3 children had had a mental or behavioral disorder previously in their childhood. Even though vision impairment first manifests in late childhood, some children with Usher syndrome seem to develop mental and behavioral disorders during childhood. The aetiology and treatment of mental and behavioral disorders among children with Usher syndrome are discussed. Children with Usher syndrome and their parents may need clinical support during early childhood to prevent development of mental and behavioral disorders.

  11. Children with Usher syndrome: mental and behavioral disorders

    Directory of Open Access Journals (Sweden)

    Dammeyer Jesper

    2012-03-01

    Full Text Available Abstract Background Mental and behavioral disorders among adults with Usher syndrome have been discussed and reported in some case studies but no research has been reported on children with Usher syndrome. Methods This article investigates the prevalence and characteristics of mental and behavioral disorders among 26 children, 3-17 years of age, with Usher syndrome. Results Six of the 26 children were diagnosed with a mental or behavioral disorder (1 with schizophrenia and mild mental retardation, 1 with atypical autism and severe mental retardation, 1 with atypical autism and mild mental retardation, 1 with mild mental retardation, and 2 with conduct disorder. Another 3 children had had a mental or behavioral disorder previously in their childhood. Conclusion Even though vision impairment first manifests in late childhood, some children with Usher syndrome seem to develop mental and behavioral disorders during childhood. The aetiology and treatment of mental and behavioral disorders among children with Usher syndrome are discussed. Children with Usher syndrome and their parents may need clinical support during early childhood to prevent development of mental and behavioral disorders.

  12. Rapid eye movement sleep behavior disorder

    DEFF Research Database (Denmark)

    Schenck, C H; Montplaisir, J Y; Frauscher, B

    2013-01-01

    We aimed to provide a consensus statement by the International Rapid Eye Movement Sleep Behavior Disorder Study Group (IRBD-SG) on devising controlled active treatment studies in rapid eye movement sleep behavior disorder (RBD) and devising studies of neuroprotection against Parkinson disease (PD...

  13. Autobiographical memory and suicidal behavior in bipolar disorder

    OpenAIRE

    Sanden, Eva

    2008-01-01

    The “cry of pain” model for suicidal behavior has received empirical support in studies of several mental disorders. As the first of its kind this study aims at investigating the association between overgeneral autobiographical memory, a vital aspect in the “cry of pain” model, and suicidal behavior in Bipolar Disorder. Further, this study seeks to explore the association between overgeneral autobiographical memory and hopelessness and exposure to trauma. Individuals with previous sui...

  14. Subtyping borderline personality disorder by suicidal behavior.

    Science.gov (United States)

    Soloff, Paul H; Chiappetta, Laurel

    2012-06-01

    Course and outcome of Borderline Personality Disorder (BPD) are favorable for the vast majority of patients; however, up to 10% die by suicide. This discrepancy begs the question of whether there is a high lethality subtype in BPD, defined by recurrent suicidal behavior and increasing attempt lethality over time. In a prospective, longitudinal study, we sought predictors of high lethality among repeat attempters, and defined clinical subtypes by applying trajectory analysis to consecutive lethality scores. Criteria-defined subjects with BPD were assessed using standardized instruments and followed longitudinally. Suicidal behavior was assessed on the Columbia Suicide History, Lethality Rating Scale, and Suicide Intent Scale. Variables discriminating single and repeat attempters were entered into logistic regression models to define predictors of high and low lethality attempts. Trajectory analysis using three attempt and five attempt models identified discrete patterns of Lethality Rating Scale scores. A high lethality trajectory was associated with inpatient recruitment, and poor psychosocial function, a low lethality trajectory with greater Negativism, Substance Use Disorders, Histrionic and/or Narcissistic PD co-morbidity. Illness severity, older age, and poor psychosocial function are characteristics of a poor prognosis subtype related to suicidal behavior.

  15. [Dialectical behavior therapy approaches with disruptive behavior disorders].

    Science.gov (United States)

    Stadler, Christina; Manetsch, Madleina; Vriends, Noortje

    2016-11-01

    Disruptive behaviour disorders comprise the diagnosis conduct disorder (CD) and in adults the diagnosis antisocial personality disorder (APD). CD is seen as a difficult-to-treat disorder with a high risk for persistent behavioral problems. In addition, CD is seen as the precursor to antisocial personality disorder (Kretschmer et al., 2014). Dialectical behavior therapy (DBT) was originally developed by Marsha Linehan (1991) for the treatment of borderline personality disorder, but because of the core deficits in emotion regulation in disruptive behavior disorders, DBT is also increasingly being recommended for the treatment of CD and APD. This review presents DBT adaptions for the forensic setting and for the treatment of CD/APD. Clinical implications are discussed.

  16. Prone positioning reduces severe pushing behavior: three case studies.

    Science.gov (United States)

    Fujino, Yuji; Amimoto, Kazu; Sugimoto, Satoshi; Fukata, Kazuhiro; Inoue, Masahide; Takahashi, Hidetoshi; Makita, Shigeru

    2016-09-01

    [Purpose] Pushing behavior is classically described as a disorder of body orientation in the coronal plane. Most interventions for pushing behavior have focused on correcting the deviation in vertical perception. However, pushing behavior seems to involve erroneous movements associated with excessive motor output by the non-paretic limbs and trunk. The present study aimed to inhibit muscular hyper-activity by placing the non-paretic limbs and trunk in the prone position. [Subjects and Methods] The subjects of the present study were 3 acute stroke patients with severe pushing behavior. The study consisted of the following 3 phases: baseline, intervention, and follow-up. In addition to conventional therapy, patients received relaxation therapy in the prone position for 10 minutes a day over 2 days. The severity of pushing behavior was assessed using the scale for contraversive pushing, and truncal balance was evaluated using the trunk control test. These assessments were performed before and after the baseline phase, and after the intervention and follow-up phases. [Results] At the baseline phase, both scores were poor. Both scores improved after the intervention and follow-up phases, and all the patients could sit independently. [Conclusion] Relaxation therapy in the prone position might ameliorate pushing behavior and impaired truncal balance.

  17. A Study on Prevalence of Behavioral Disorders in Primary School Students in Abhar

    Directory of Open Access Journals (Sweden)

    Hassan Shams-Esfandabadi

    2003-04-01

    Full Text Available Objective: The purpose of the present study was to investigate the prevalence of behavioral disorder among of primary school students in Abhar. Materials & Methods: 600 primary school students (300 boys and 300 girls of public primary schools in Abhar, Iran were used as the sample for this study. Their behavioral disorder scores were obtained by means of Rutter's teachers' questionnaire. Results: Using a cutpoint of 9, the prevalence rate of behavioral disorder was 43.3% among subjects, with boys showing higher rates of behavioral disorder (44.7% than girls (42% but no significant differences were found by gender on rates of behavioral disorders. 6.3 percent of the subjects had severe behavioral disorder. Conclusion: Academic achievement was negatively related to behavioral disorder. Significant differences were found by mothers' education on children’s rates of behavioral disorder. Significant differences were found by fathers' occupation on children’s rates of behavioral disorder.

  18. Cognitive and behavioral disorders in Parkinson's disease: an update. II: behavioral disorders.

    Science.gov (United States)

    Trojano, Luigi; Papagno, Costanza

    2018-01-01

    Patients with Parkinson's disease (PD) can experience several behavioral symptoms, such as apathy, agitation, hypersexuality, stereotypic movements, pathological gambling, abuse of antiparkinsonian drugs, and REM sleep behavioral disorders. Psychoses and hallucinations, depression and anxiety disorders, and difficulties in recognizing and experiencing emotions also impair behavior and can cause severe psychosocial problems in patients with PD. Symptoms can be present since early stages of the disease, sometimes even before the appearance of classical motor symptoms, likely in relation to dopamine depletion in basal ganglia and/or to dysfunctions of other neurotrasmitter systems, and others can develop later, in some cases in relation to dopaminergic treatment. In this paper, we review recent literature, with particular attention to the last 5 years, on the main behavioral and emotional disturbances described in PD patients as well as the hypothesized neurofunctional substrate of such impairments. Finally, we provide some suggestions on the most suitable instruments to check and assess PD-associated behavioral defects over time.

  19. Factors associated with DSM-5 severity level ratings for autism spectrum disorder.

    Science.gov (United States)

    Mazurek, Micah O; Lu, Frances; Macklin, Eric A; Handen, Benjamin L

    2018-02-01

    The newest edition of the Diagnostic and Statistical Manual of Mental Disorders (5th ed., DSM-5) introduced substantial changes to the diagnostic criteria for autism spectrum disorder, including new severity level ratings for social communication and restricted and repetitive behavior domains. The purpose of this study was to evaluate the use of these new severity ratings and to examine their relation to other measures of severity and clinical features. Participants included 248 children with autism spectrum disorder who received diagnostic evaluations at one of six Autism Treatment Network sites. Higher severity ratings in both domains were associated with younger age, lower intelligence quotient, and greater Autism Diagnostic Observation Schedule-Second Edition domain-specific symptom severity. Greater restricted and repetitive behavior severity was associated with higher parent-reported stereotyped behaviors. Severity ratings were not associated with emotional or behavioral problems. The new DSM-5 severity ratings in both domains were significantly associated with behavioral observations of autism severity but not with measures of other behavioral or emotional symptoms. However, the strong associations between intelligence quotient and DSM-5 severity ratings in both domains suggest that clinicians may be including cognitive functioning in their overall determination of severity. Further research is needed to examine clinician decision-making and interpretation of these specifiers.

  20. 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

    2008-09-01

    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. Consecutively referred and systematically assessed male children and adolescents with either ADHD (n = 65), ADHD with ODD (n = 85), or ADHD with CD (n = 50) were compared using structured diagnostic interviews and parent, teacher, and clinician rating scales. In children with ADHD, significant differences emerged between ODD and CD in the domains of delinquency, overt aggression, and ADHD symptom severity; ADHD with CD was most severe, followed by ADHD with ODD, and ADHD had the least severe symptoms. Distinctions between ADHD with CD and the other two groups were found for parenting, treatment history, and school variables. Within the limits of a cross-sectional methodology, results support clinically meaningful distinctions between ODD and CD in children with ADHD.

  1. Psychostimulants in moderate to severe affective disorder

    DEFF Research Database (Denmark)

    Abbasowa, Leda; Kessing, Lars V; Vinberg, Maj

    2013-01-01

    Background: Despite antidepressant therapy of appropriate trial duration and dose optimization, 50-60% of depressed patients have an adequate treatment response, whereas only 35-40% achieve remission. Psychostimulants have been suggested as potential candidates to promote acceleration of response...... and to alleviate residual symptoms of depression. Aims: In this review results from randomized clinical trials (RCTs) exploring the efficacy of psychostimulants in the treatment of major depressive disorder (MDD) were analyzed to clarify the current empirically founded evidence for clinical approaches involving...... provided results for unipolar depression, two for bipolar depression, whereas two articles presented mixed samples of unipolar and bipolar patients. Results: Five different psychostimulants were evaluated: modafinil, methylphenidate, dexamphetamine, methylamphetamine and pemoline. Two studies examining...

  2. Impact of ADHD symptoms on autism spectrum disorder symptom severity.

    Science.gov (United States)

    Sprenger, Linda; Bühler, Eva; Poustka, Luise; Bach, Christiane; Heinzel-Gutenbrunner, Monika; Kamp-Becker, Inge; Bachmann, Christian

    2013-10-01

    Despite the official exclusion criteria for autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) in the DSM-IV and ICD-10, patients with ASD often show ADHD symptoms. We aimed to examine the potential influence of ADHD symptoms on autistic psychopathology in a large sample of patients with ASD. We tested the hypothesis that patients with ASD and an additional ADHD (ASD+) would show a higher severity of autistic symptoms than those with ASD only (ASD-). We measured autistic symptoms using the autism diagnostic observation schedule (ADOS-G), the autism diagnostic interview (ADI-R), and the social responsiveness scale (SRS). To measure overall psychopathology and ADHD symptoms, we used the child behavior checklist (CBCL) and the ADHD rating scale (FBB-ADHS), respectively. Group differences between the ASD+ and the ASD- group (group division was conducted according to the results of the FBB-ADHS) were calculated using a univariate analysis of variance (ANOVA). The ASD+ group showed a greater severity of autistic symptoms than the ASD- group, measured by the SRS and the ADI-R. Especially in the social interaction subscale (ADI-R), a significantly higher symptom severity was found in the ASD+ group. No significant group differences were found regarding autistic symptoms measured by the ADOS-G. Patients with ASD and an additional ADHD expressed a stronger severity of autistic symptoms than patients with ASD only. According to our results, the possibility of a co-diagnosis of ADS and ADHD, as is being planned in the DSM-5, is in line with earlier studies, is highly reasonable, will simplify research, and have therapeutic implications. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Behavioral management of night eating disorders

    Directory of Open Access Journals (Sweden)

    Berner LA

    2013-03-01

    Full Text Available Laura A Berner,1 Kelly C Allison2 1Department of Psychology, Drexel University, 2Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Abstract: Night eating syndrome (NES is a form of disordered eating associated with evening hyperphagia (overeating at night and nocturnal ingestions (waking at night to eat. As with other forms of disordered eating, cognitive and behavioral treatment modalities may be effective in reducing NES symptoms. This review presents evidence for a variety of behavioral treatment approaches, including behavioral therapy, phototherapy, behavioral weight loss treatment, and cognitive-behavioral therapy. A more detailed overview of cognitive-behavioral therapy for NES is provided. All of these studies have been case studies or included small samples, and all but one have been uncontrolled, but the outcomes of many of these approaches are promising. Larger randomized controlled trials are warranted to advance NES treatment literature. With the inclusion of NES in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 as a “Feeding or Eating Disorder Not Elsewhere Classified,” more sophisticated, empirically-supported, behaviorally-based treatment approaches are much needed. Keywords: night eating syndrome, cognitive-behavioral treatment, phototherapy, behavioral weight loss, behavior therapy

  4. Life History Strategy and Disordered Eating Behavior

    Directory of Open Access Journals (Sweden)

    Catherine Salmon

    2009-10-01

    Full Text Available A sample of female undergraduates completed a packet of questionnaires consisting of the Arizona Life History Battery, a modified version of the Eating Disorders Inventory, the Behavioral Regulation scales from the Behavior Rating Inventory of Executive Function, and two measures of Female Intrasexual Competitiveness that distinguished between competition for mates and competition for status. As predicted, Executive Functions completely mediated the relation between Slow Life History Strategy and Disordered Eating Behavior. Surprisingly, however, the relation between Female Intrasexual Competitiveness (competition for mates and competition for status and Disordered Eating Behavior was completely spurious, with executive functions serving as a common cause underlying the inhibition of both Disordered Eating Behavior and Female Intrasexual Competitiveness. The protective function of Slow Life History Strategy with respect to Disordered Eating Behavior apparently resides in a higher degree of Behavioral Regulation, a type of Executive Function. The enhanced Behavioral Regulation or self-control, of individuals with a Slow Life History Strategy is also protective against hazardously escalated levels of Female Intrasexual Competitiveness.

  5. Family history of idiopathic REM behavior disorder

    DEFF Research Database (Denmark)

    Dauvilliers, Yves; Postuma, Ronald B; Ferini-Strambi, Luigi

    2013-01-01

    To compare the frequency of proxy-reported REM sleep behavior disorder (RBD) among relatives of patients with polysomnogram-diagnosed idiopathic RBD (iRBD) in comparison to controls using a large multicenter clinic-based cohort.......To compare the frequency of proxy-reported REM sleep behavior disorder (RBD) among relatives of patients with polysomnogram-diagnosed idiopathic RBD (iRBD) in comparison to controls using a large multicenter clinic-based cohort....

  6. Cognitive Behavioral Therapy for Eating Disorders

    OpenAIRE

    Murphy, Rebecca; Straebler, Suzanne; Cooper, Zafra; Fairburn, Christopher G.

    2010-01-01

    Cognitive behavioral therapy (CBT) is the leading evidence-based treatment for bulimia nervosa. A new ?enhanced? version of the treatment appears to be more potent and has the added advantage of being suitable for all eating disorders, including anorexia nervosa and eating disorder not otherwise specified. This article reviews the evidence supporting CBT in the treatment of eating disorders and provides an account of the ?transdiagnostic? theory that underpins the enhanced form of the treatme...

  7. Organic Determinants of Learning and Behavioral Disorders.

    Science.gov (United States)

    Philpott, William H.; And Others

    Theories regarding organic determinants of learning and behavior disorders are reviewed historically. Cases illustrating how a bio-ecologic examination can isolate the substances to which a person reacts and some of the reasons for those reactions are presented; and the role of various disorders in relation to the central nervous system is…

  8. Personality disorders in women with severe premenstrual syndrome.

    Science.gov (United States)

    Sassoon, Stephanie A; Colrain, Ian M; Baker, Fiona C

    2011-06-01

    Premenstrual syndrome (PMS) and its more severe form, premenstrual dysphoric disorder, affect up to 18% of women. Both are commonly associated with other mood-related disorders such as major depression, and cause significant life impairment, but their relationship with personality disorders is less clear. After completing the Structured Clinical Interview for DSM-IV-TR disorders, 33 women with severe PMS and 26 asymptomatic women, counterbalanced for menstrual cycle phase, were administered the Structured Interview for DSM-IV Personality Disorders, a diagnostic interview with low transparency, strong inter-rater reliability, and good diagnostic clarity. Women with severe PMS had a higher prevalence of personality disorders (p = 0.003) than asymptomatic women (27% versus 0%), and were more likely to have odd-eccentric, dramatic-erratic, and anxious-fearful personality disorder traits (p OCPD) was the most common character pathology in the PMS group (n = 6, 18%). OCPD, although not necessarily associated with greater severity of premenstrual symptoms, was related to poorer life functioning in women with PMS. The comorbidity of a personality disorder and severe PMS places an additive burden on general life functioning and may have implications for psychiatric treatment or medication given to those with severe premenstrual symptoms.

  9. Anomalous Solubility Behavior of Several Acidic Drugs

    Directory of Open Access Journals (Sweden)

    Alex Avdeef

    2014-04-01

    Full Text Available The “anomalous solubility behavior at higher pH values” of several acidic drugs originally studied by Higuchi et al. in 1953 [1], but hitherto not fully rationalized, has been re-analyzed using a novel solubility-pH analysis computer program, pDISOL-XTM. The program internally derives implicit solubility equations, given a set of proposed equilibria and constants (iteratively refined by weighted nonlinear regression, and does not require explicit Henderson-Hasselbalch equations. The re-analyzed original barbital, phenobarbital, oxytetracycline, and sulfathiazole solubility-pH data of Higuchi et al. is consistent with the presence of dimers in saturated solutions. In the case of barbital, phenobarbital and sulfathiazole, anionic dimers, reaching peak concentrations near pH 8. However, oxytetracycline indicated a pronounced tendency to form a cationic dimer, peaking near pH 2. Under the conditions of the original study, only barbital indicated a slight tendency to form a salt precipitate at pH > 6.8, with a highly unusual stoichiometry (consistent with a slope of 0.55 in the log S – pH plot: K+ + A2H- + 3HA D KA5H4(s. Thus the “anomaly” in the Higuchi data can be rationalized by invoking specific aggregated species.

  10. Allergies and Learning/Behavioral Disorders.

    Science.gov (United States)

    McLoughlin, James A.; Nall, Michael

    1994-01-01

    This article describes various types of allergies, how they are diagnosed medically, and the different forms of medical treatment. It also considers how allergies may affect school learning and behavior, the connection between allergies and learning and behavioral disorders, the impact of allergy medications upon classroom performance, and various…

  11. Alcohol-use disorder severity predicts first-incidence of depressive disorders

    NARCIS (Netherlands)

    Boschloo, L.; van den Brink, W.; Penninx, B.W.J.H.; Wall, M.M.; Hasin, D.S.

    2012-01-01

    Background Previous studies suggest that alcohol-use disorder severity, defined by the number of criteria met, provides a more informative phenotype than dichotomized DSM-IV diagnostic measures of alcohol use disorders. Therefore, this study examined whether alcohol-use disorder severity predicted

  12. Alcohol-use disorder severity predicts first-incidence of depressive disorders

    NARCIS (Netherlands)

    Boschloo, L.; van den Brink, W.; Penninx, B. W. J. H.; Wall, M. M.; Hasin, D. S.

    2012-01-01

    Background. Previous studies suggest that alcohol-use disorder severity, defined by the number of criteria met, provides a more informative phenotype than dichotomized DSM-IV diagnostic measures of alcohol use disorders. Therefore, this study examined whether alcohol-use disorder severity predicted

  13. Dangerous and severe personality disorder: an ethical concept?

    Science.gov (United States)

    Glen, Sally

    2005-04-01

    Most clinicians and mental health practitioners are reluctant to work with people with dangerous and severe personality disorders because they believe there is nothing that mental health services can offer. Dangerous and severe personality disorder also signals a diagnosis which is problematic morally. Moral philosophy has not found an adequate way of dealing with personality disorders. This paper explores the question: What makes a person morally responsible for his actions and what is a legitimate mitigating factor? How do psychiatric nurses working with this client group understand the awful things some clients do? What concepts do they need, if they are to know how to explain and how to react? It is suggested that dangerous and severe personality disorder is best regarded as a moral category, framed in terms of goodness, badness, obligation and other ethical concepts. It seems plausible that in important ways the dangerous and severe personality disordered client does not understand morality or understands it differently. The peculiar position of the dangerous and severe personality disordered individual in our system of moral responsibility stems from his apparent inability to see the importance of the interests of others. It might be more helpful to regard personality disordered clients as we do children: partially but not fully reasonable for their actions. We might regard the dangerous and severe personality disordered client responsible for those actions which he most clearly understands, such as causing others physical pain, but not for those with which he is only superficially engaged, such as causing emotional pain. The paper concludes by suggesting that the dangerous and severe personality disordered individual does not fit easily into any conventional moral category, be it criminal, patient, animal or child, and thus an assessment of his moral accountability must take into consideration his special circumstances.

  14. Assisted reproductive technology treatment in women with severe eating disorders

    DEFF Research Database (Denmark)

    Assens, Maria; Ebdrup, Ninna H; Pinborg, Anja

    2015-01-01

    INTRODUCTION: This national retrospective cohort study investigates the prevalence of women with severe eating disorders in assisted reproductive technology (ART) treatment compared with an age-matched background population without ART treatment. It assesses the frequency distribution of the firs...

  15. Cognitive-Behavioral Therapy for Adolescent Body Dysmorphic Disorder

    Science.gov (United States)

    Greenberg, Jennifer L.; Markowitz, Sarah; Petronko, Michael R.; Taylor, Caitlin E.; Wilhelm, Sabine; Wilson, G. Terence

    2010-01-01

    The onset of appearance-related concerns associated with body dysmorphic disorder (BDD) typically occurs in adolescence, and these concerns are often severe enough to interfere with normal development and psychosocial functioning. Cognitive behavioral therapy (CBT) is an effective treatment for adults with BDD. However, no treatment studies…

  16. Disordered Money Behaviors: Development of the Klontz Money Behavior Inventory

    Directory of Open Access Journals (Sweden)

    Brad T Klontz

    2012-06-01

    Full Text Available Much of the existing literature on financial behavior focuses on basic money management tasks (e.g., balancing a checkbook. However, it can be equally important to identify problematic financial behaviors that can sabotage one’s financial health. The purpose of this study was to create an assessment tool that can be used by mental health and financial professionals to identify disordered money behaviors that may impede on progress towards one’s financial goals. This study asked 422 respondents to indicate their agreement with disordered money behaviors, including compulsive buying, pathological gambling, compulsive hoarding, workaholism, financial enabling, financial dependence, financial denial, and financial enmeshment, which were correlated with demographic characteristics and financial outcomes. The results identified eight subscales derived from 68 disordered money behavior items. All eight subscales were found to have high reliability in measuring disordered behaviors, and six were associated with negative financial health indicators (e.g. less net worth, less income, and/or more revolving credit.

  17. Addiction in developmental perspective: influence of conduct disorder severity, subtype, and attention-deficit hyperactivity disorder on problem severity and comorbidity in adults with opioid dependence.

    NARCIS (Netherlands)

    Carpentier, P.J.; Knapen, L.J.; Gogh, M.T. van; Buitelaar, J.K.; Jong, C.A.J. de

    2012-01-01

    This retrospective cross-sectional study examines whether conduct disorder and attention deficit hyperactivity disorder are associated with problem severity and psychiatric comorbidity in 193 middle-aged, opioid-dependent patients. Conduct disorder history, attention deficit hyperactivity disorder,

  18. Gambling disorder, DSM-5 criteria and symptom severity

    DEFF Research Database (Denmark)

    Grant, Jon E.; Odlaug, Brian L.; Chamberlain, Samuel R.

    2017-01-01

    Introduction: Gambling disorder (GD) is a prevalent psychiatric condition whose severity is typically defined by the number of DSM-5 criteria met out of a maximum of nine. The relationships between the levels of gambling severity, thus defined, and other measures of psychopathology and everyday...

  19. Formal thought disorder in autism spectrum disorder predicts future symptom severity, but not psychosis prodrome

    NARCIS (Netherlands)

    Eussen, M.L.J.M.; de Bruin, E.I.; van Gool, A.R.; Louwerse, E.S.; van der Ende, J.; Verheij, F.; Verhulst, F.C.; Greaves-Lord, K.

    2015-01-01

    Formal thought disorder (FTD) is a disruption in the flow of thought, which is inferred from disorganisation of spoken language. FTD in autism spectrum disorders (ASD) might be a precursor of psychotic disorders or a manifestation of ASD symptom severity. The current longitudinal study is a

  20. Behavioral inhibition and obsessive-compulsive disorder.

    Science.gov (United States)

    Coles, Meredith E; Schofield, Casey A; Pietrefesa, Ashley S

    2006-01-01

    Behavioral inhibition is frequently cited as a vulnerability factor for development of anxiety. However, few studies have examined the unique relationship between behavioral inhibition and obsessive-compulsive disorder (OCD). Therefore, the current study addressed the relationship between behavioral inhibition and OCD in a number of ways. In a large unselected student sample, frequency of current OC symptoms was significantly correlated with retrospective self-reports of total levels of childhood behavioral inhibition. In addition, frequency of current OC symptoms was also significantly correlated with both social and nonsocial components of behavioral inhibition. Further, there was evidence for a unique relationship between behavioral inhibition and OC symptoms beyond the relationship of behavioral inhibition and social anxiety. In addition, results showed that reports of childhood levels of behavioral inhibition significantly predicted levels of OCD symptoms in adulthood. Finally, preliminary evidence suggested that behavioral inhibition may be more strongly associated with some types of OC symptoms than others, and that overprotective parenting may moderate the impact of behavioral inhibition on OC symptoms. The current findings suggest the utility of additional research examining the role of behavioral inhibition in the etiology of OCD.

  1. Cognitive-behavioral therapy for childhood repetitive behavior disorders: tic disorders and trichotillomania.

    Science.gov (United States)

    Flessner, Christopher A

    2011-04-01

    This article provides an overview of cognitive-behavioral therapy (CBT) for repetitive behavior disorders. Because tic disorders and trichotillomania are the most often studied and most debilitating of these conditions, this article focuses on the efficacy of CBT for these 2 conditions. An overview of CBT for children presenting with these concerns is provided. This review focuses particularly on habit reversal training, which is at the core of most CBT-based interventions. Two recent empirical studies on the immense potential of CBT in treating childhood repetitive behavior disorders and future areas of research are also discussed. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Cognitive behavioral therapy for bipolar disorders

    OpenAIRE

    Lotufo Neto, Francisco

    2004-01-01

    Descrição dos objetivos e principais técnicas da terapia comportamental cognitiva usadas para a psicoterapia das pessoas com transtorno bipolar.Objectives and main techniques of cognitive behavior therapy for the treatment of bipolar disorder patients are described.

  3. Factors affecting the dental erosion severity of patients with eating disorders.

    Science.gov (United States)

    Otsu, Mitsuhiro; Hamura, Akira; Ishikawa, Yuiko; Karibe, Hiroyuki; Ichijyo, Tomoyasu; Yoshinaga, Yoko

    2014-01-01

    Intraoral disease is a common occurrence in patients with eating disorders, particularly dental erosion, which frequently becomes severe and may hinder daily life. The severity varies from patient to patient. Understanding the underlying mechanisms may help prevent dental erosion in these patients. Accordingly, we investigated the relationship between the severity of erosion and the behavior of patients with eating disorders, with a focus on daily diet and vomiting behavior. A total 71 female eating disorder outpatients from the Clinical Center of Psychosomatic Dentistry of Nippon Dental University Hospital and the Psychosomatic Internal Medicine Department of Kudanzaka Hospital or who were hospitalized at Hasegawa Hospital were enrolled. Dental erosion severity and location were determined by oral examination. Patients who induced vomiting were queried on their behavior during vomiting and on routine diet habits. Patients with dental erosion were further divided into mild and severe groups based on the lesion severity and the groups compared. Dental erosion was observed in 43 of 50 subjects who induced vomiting. Dental erosion was most frequent on the palatal side of the anterior maxillary teeth, occurring in 81.3% of the subjects. There were significant differences observed between the mild and severe groups according to post-vomiting oral hygiene. Significantly more subjects in the mild group consumed large amounts of water before vomiting, and significantly more subjects in the severe group routinely consumed carbonated beverages or sweetened food. While self-induced vomiting is the main cause of dental erosion in eating disorder patients, the erosion severity may be affected by behavior when inducing vomiting or by routine consumption of certain foods and beverages. Addressing these factors may help prevent severe dental erosion in patients who chronically induce vomiting.

  4. The Ethics of Clinical Trials Research in Severe Mood Disorders.

    Science.gov (United States)

    Nugent, Allison C; Miller, Franklin G; Henter, Ioline D; Zarate, Carlos A

    2017-07-01

    Mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD), are highly prevalent, frequently disabling, and sometimes deadly. Additional research and more effective medications are desperately needed, but clinical trials research in mood disorders is fraught with ethical issues. Although many authors have discussed these issues, most do so from a theoretical viewpoint. This manuscript uses available empirical data to inform a discussion of the primary ethical issues raised in mood disorders research. These include issues of consent and decision-making capacity, including patients' motivations for participating in research. We also address drug withdrawals, placebo controls, and the overall safety of research. Finally, we examine the extant literature for studies discussing potential indirect benefits of clinical trials research to participants. Taken together, the evidence suggests that clinical trials research incorporating drug withdrawals and placebo controls can be conducted safely and ethically, even in patients with severe or treatment-resistant mood disorders. In fact, given the dearth of effective treatment options for this population, it is our opinion that a moral imperative exists to extend the offer of research participation to severely ill or treatment-resistant groups. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  5. Interactions between bipolar disorder and antisocial personality disorder in trait impulsivity and severity of illness.

    Science.gov (United States)

    Swann, A C; Lijffijt, M; Lane, S D; Steinberg, J L; Moeller, F G

    2010-06-01

    We investigated trait impulsivity in bipolar disorder and antisocial personality disorder (ASPD) with respect to severity and course of illness. Subjects included 78 controls, 34 ASPD, 61 bipolar disorder without Axis II disorder, and 24 bipolar disorder with ASPD, by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (SCID-I and -II). Data were analyzed using general linear model and probit analysis. Barratt Impulsiveness Scale (BIS-11) scores were higher in ASPD (effect sizes 0.5-0.8) or bipolar disorder (effect size 1.45) than in controls. Subjects with both had more suicide attempts and previous episodes than bipolar disorder alone, and more substance-use disorders and suicide attempts than ASPD alone. BIS-11 scores were not related to severity of crimes. Impulsivity was higher in bipolar disorder with or without ASPD than in ASPD alone, and higher in ASPD than in controls. Adverse effects of bipolar disorder in ASPD, but not of ASPD in bipolar disorder, were accounted for by increased impulsivity.

  6. Mindfulness-Based Cognitive Therapy for severe Functional Disorders

    DEFF Research Database (Denmark)

    Fjorback, Lone Overby

    MINDFULNESS-BASED COGNITIVE THERAPY FOR FUNCTIONAL DISORDERS- A RANDOMISED CONTROLLED TRIAL   Background: Mindfulness-Based Stress Reduction (MBSR) is a group skills-training program developed by Kabat-Zinn. It is designed to teach patients to become more aware of and relate differently...... to their thoughts, feelings, and bodily sensations. Randomised controlled studies of MBSR have shown mitigation of stress, anxiety, and dysphoria in general population and reduction in total mood disturbance and stress symptoms in a medical population. In Mindfulness Based Cognitive Therapy MBSR is recombined...... with cognitive therapy. Aim: To examine the efficacy of Mindfulness-Based Cognitive Therapy in severe Functional disorders, defined as severe Bodily Distress Disorder. Method: 120 patients are randomised to either Mindfulness Based Cognitive Therapy: a manualized programme with eight weekly 3 ½ hour group...

  7. Mindfulness-Based Cognitive Therapy for severe Functional Disorders

    DEFF Research Database (Denmark)

    Fjorback, Lone Overby

    with cognitive therapy. Aim: To examine the efficacy of Mindfulness-Based Cognitive Therapy in severe Functional disorders, defined as severe Bodily Distress Disorder. Method: 120 patients are randomised to either Mindfulness Based Cognitive Therapy: a manualized programme with eight weekly 3 ½ hour group......MINDFULNESS-BASED COGNITIVE THERAPY FOR FUNCTIONAL DISORDERS- A RANDOMISED CONTROLLED TRIAL   Background: Mindfulness-Based Stress Reduction (MBSR) is a group skills-training program developed by Kabat-Zinn. It is designed to teach patients to become more aware of and relate differently...... to their thoughts, feelings, and bodily sensations. Randomised controlled studies of MBSR have shown mitigation of stress, anxiety, and dysphoria in general population and reduction in total mood disturbance and stress symptoms in a medical population. In Mindfulness Based Cognitive Therapy MBSR is recombined...

  8. Excess mortality in persons with severe mental disorders

    DEFF Research Database (Denmark)

    Liu, Nancy H; Daumit, Gail L; Dua, Tarun

    2017-01-01

    Excess mortality in persons with severe mental disorders (SMD) is a major public health challenge that warrants action. The number and scope of truly tested interventions in this area remain limited, and strategies for implementation and scaling up of programmes with a strong evidence base...

  9. Severe Speech Sound Disorders: An Integrated Multimodal Intervention

    Science.gov (United States)

    King, Amie M.; Hengst, Julie A.; DeThorne, Laura S.

    2013-01-01

    Purpose: This study introduces an integrated multimodal intervention (IMI) and examines its effectiveness for the treatment of persistent and severe speech sound disorders (SSD) in young children. The IMI is an activity-based intervention that focuses simultaneously on increasing the "quantity" of a child's meaningful productions of target words…

  10. Occurrence and severity of agitated behavior after severe traumatic brain injury

    DEFF Research Database (Denmark)

    Moth Wolffbrandt, Mia; Poulsen, Ingrid; Engberg, Aase W

    2013-01-01

    To investigate the occurrence and severity of agitation in patients after severe traumatic brain injury (TBI), to identify predictors of agitation and to study interrater reliability for a translated version of the Agitated Behavior Scale (ABS).......To investigate the occurrence and severity of agitation in patients after severe traumatic brain injury (TBI), to identify predictors of agitation and to study interrater reliability for a translated version of the Agitated Behavior Scale (ABS)....

  11. Behavior Therapy for Tic Disorders: An Evidenced-based Review and New Directions for Treatment Research

    OpenAIRE

    McGuire, Joseph F.; Ricketts, Emily J.; Piacentini, John; Murphy, Tanya K.; Storch, Eric A.; Lewin, Adam B.

    2015-01-01

    Behavior therapy is an evidenced-based intervention with moderate-to-large treatment effects in reducing tic symptom severity among individuals with Persistent Tic Disorders (PTDs) and Tourette’s Disorder (TD). This review describes the behavioral treatment model for tics, delineates components of evidence-based behavior therapy for tics, and reviews the empirical support among randomized controlled trials for individuals with PTDs or TD. Additionally, this review discusses several challenges...

  12. Large animals as potential models of human mental and behavioral disorders.

    Science.gov (United States)

    Danek, Michał; Danek, Janusz; Araszkiewicz, Aleksander

    2017-12-30

    Many animal models in different species have been developed for mental and behavioral disorders. This review presents large animals (dog, ovine, swine, horse) as potential models of this disorders. The article was based on the researches that were published in the peer-reviewed journals. Aliterature research was carried out using the PubMed database. The above issues were discussed in the several problem groups in accordance with the WHO International Statistical Classification of Diseases and Related Health Problems 10thRevision (ICD-10), in particular regarding: organic, including symptomatic, disorders; mental disorders (Alzheimer's disease and Huntington's disease, pernicious anemia and hepatic encephalopathy, epilepsy, Parkinson's disease, Creutzfeldt-Jakob disease); behavioral disorders due to psychoactive substance use (alcoholic intoxication, abuse of morphine); schizophrenia and other schizotypal disorders (puerperal psychosis); mood (affective) disorders (depressive episode); neurotic, stress-related and somatoform disorders (posttraumatic stress disorder, obsessive-compulsive disorder); behavioral syndromes associated with physiological disturbances and physical factors (anxiety disorders, anorexia nervosa, narcolepsy); mental retardation (Cohen syndrome, Down syndrome, Hunter syndrome); behavioral and emotional disorders (attention deficit hyperactivity disorder). This data indicates many large animal disorders which can be models to examine the above human mental and behavioral disorders.

  13. Supported housing for people with severe mental disorders.

    Science.gov (United States)

    Chilvers, R; Macdonald, G M; Hayes, A A

    2006-10-18

    There has been a significant reduction in the number of people with severe mental illness who spend extended periods in long-stay hospitals. District health authorities, local authorities, housing associations and voluntary organisations are jointly expected to provide support for people with severe mental disorder/s. This 'support' may well involve some kind of special housing. To determine the effects of supported housing schemes compared with outreach support schemes or 'standard care' for people with severe mental disorder/s living in the community. For the 2006 update we searched the Cochrane Schizophrenia Group Trials Register (April 2006) and the Cochrane Central Register of Controlled Trials (CENTRAL, 2006 Issue 2). We included all relevant randomised, or quasi-randomised, trials dealing with people with 'severe mental disorder/s' allocated to supported housing, compared with outreach support schemes or standard care. We focused on outcomes of service utilisation, mental state, satisfaction with care, social functioning, quality of life and economic data. We reliably selected studies, quality rated them and undertook data extraction. For dichotomous data, we would have estimated relative risks (RR), with the 95% confidence intervals (CI). Where possible, we would have calculated the number needed to treat statistic (NNT). We would have carried out analysis by intention-to-treat and would have summated normal continuous data using the weighted mean difference (WMD). We would have presented scale data for only those tools that had attained pre-specified levels of quality and undertaken tests for heterogeneity and publication bias. Although 139 citations were acquired from the searches, no study met the inclusion criteria. Dedicated schemes whereby people with severe mental illness are located within one site or building with assistance from professional workers have potential for great benefit as they provide a 'safe haven' for people in need of stability and

  14. Cognitive behavioral therapy for compulsive buying disorder.

    Science.gov (United States)

    Mitchell, James E; Burgard, Melissa; Faber, Ron; Crosby, Ross D; de Zwaan, Martina

    2006-12-01

    To our knowledge, no psychotherapy treatment studies for compulsive buying have been published. The authors conducted a pilot trial comparing the efficacy of a group cognitive behavioral intervention designed for the treatment of compulsive buying to a waiting list control. Twenty-eight subjects were assigned to receive active treatment and 11 to the waiting list control group. The results at the end of treatment showed significant advantages for cognitive behavioral therapy (CBT) over the waiting list in reductions in the number of compulsive buying episodes and time spent buying, as well as scores on the Yale-Brown Obsessive Compulsive Scale--Shopping Version and the Compulsive Buying Scale. Improvement was well-maintained at 6-month follow-up. The pilot data suggests that a cognitive behavioral intervention can be quite effective in the treatment of compulsive buying disorder. This model requires further testing.

  15. Borderline or Schizotypal? Differential Psychodynamic Assessment in Severe Personality Disorders.

    Science.gov (United States)

    VAN Riel, Laura; Ingenhoven, Theo J M; VAN Dam, Quin D; Polak, Marike G; Vollema, Meinte G; Willems, Anne E; Berghuis, Han; VAN Megen, Harold

    2017-03-01

    Considerable overlap in symptoms between patients with borderline personality disorder (BPD) and schizotypal personality disorder (STPD) complicates personality diagnostics. Yet very little is known about the level of psychodynamic functioning of both personality disorders. Psychodynamic assessment procedures may specify personality characteristics relevant for differential diagnosis and treatment planning. In this cross-sectional study we explored the differences and similarities in level of personality functioning and psychodynamic features of patients with severe BPD or STPD. In total, 25 patients with BPD and 13 patients with STPD were compared regarding their level of personality functioning (General Assessment of Personality Disorder), current quasipsychotic features (Schizotypal Personality Questionnaire), and psychodynamic functioning [Developmental Profile (DP) interview and Developmental Profile Inventory (DPI) questionnaire]. Both groups of patients showed equally severe impairments in the level of personality functioning and the presence of current quasipsychotic features. As assessed by the DP interview, significant differential psychodynamic patterns were found on the primitive levels of functioning. Moreover, subjects with BPD had significantly higher scores on the adaptive developmental levels. However, the self-questionnaire DPI was not able to elucidate all of these differences. In conclusion, our study found significant differences in psychodynamic functioning between patients with BPD and STPD as assessed with the DP interview. In complicated diagnostic cases, personality assessment by psychodynamic interviewing can enhance subtle but essential differentiation between BPD and STPD.

  16. [Cardiac and metabolic risk factors in severe mental disorders. Task of a prevention manager].

    Science.gov (United States)

    Lederbogen, F; Schwarz, P; Häfner, S; Schweiger, U; Bohus, M; Deuschle, M

    2015-07-01

    People with severe mental disorders have a reduction in life expectancy of 13-30 % compared with the general population. This severe disadvantage is primarily due to an increased prevalence of cardiac and metabolic disorders, especially coronary heart disease (CHD) and type 2 diabetes mellitus and are the result of untoward health behavior characterized by smoking, low levels of physical activity and unhealthy dietary habits. Obesity, arterial hypertension and lipid disorders are also associated with this behavior and further increase the risk of CHD and type 2 diabetes. Thus, people with mental disorders constitute a population with a high risk of cardiovascular events. Appropriate measures for prevention and therapy are urgently indicated but rarely applied. This article presents new organizational structures to overcome this deficit with a prevention manager playing a central role in organizing and applying preventive and therapeutic care. Results from cardiology and diabetic medicine have shown the effectiveness of pooling this responsibility. The measure has the potential to reduce the increased mortality of people with severe mental disorders.

  17. Sexual behavior in women with bipolar disorder.

    Science.gov (United States)

    Mazza, Marianna; Harnic, Desiree; Catalano, Valeria; Di Nicola, Marco; Bruschi, Angelo; Bria, Pietro; Daniele, Antonio; Mazza, Salvatore

    2011-06-01

    There is a lack of studies regarding sexuality and sexual behavior in women with bipolar disorder. The aim of this study is to investigate sexual behavior in women affected by bipolar disorder in order to stimulate interest and debate in this area of care. Sixty women (30 BD I and 30 BD II) consent to participate in the study and were included in the sample. Moreover, sixty female healthy subjects without histories of psychiatric disorders were recruited as normal controls. Patients and healthy subjects were given the Sexual Interest and Sexual Performance Questionnaire, a questionnaire devised to explore various aspects of sexual behavior. The results of the present study suggest an increase of sexual interest in patients with BD I as compared both with BD II patients and healthy controls. In women with BD I such increase of interest was detected on some items of section I of the Sexual Interest and Sexual Performance Questionnaire, in particular "Actual Value of Sexuality" and "Implicit Sexual Interest", which implicitly explore sexual interest without overtly focusing upon sexual problems. Moreover, we observed a higher desired frequency of intercourse in women with BD I than BD II and a higher occurrence of repeated sexual intercourse in women with BD I than BD II. The main finding of the present study was an increase of sexual interest in BD I as compared with BD II female patients and normal controls. This result was detected when sexual interest was explored implicitly. Our study is limited by the small size of our subject groups. Further investigations on larger subject samples are needed to better clarify particular aspects of sexual behavior of BD patients. Copyright © 2010 Elsevier B.V. All rights reserved.

  18. [Orthorexia nervosa. A new eating behavior disorder?].

    Science.gov (United States)

    Catalina Zamora, M L; Bote Bonaechea, B; García Sánchez, F; Ríos Rial, B

    2005-01-01

    New eating behavior disorders such as bigorexia (muscle dysmorphia) and orthorexia are appearing in developed countries. These disorders have not been officially recognized so that they are not classified as independent entities. The term orthorexia comes from the Greek word orthos (straight, proper) and orexia (appetite). It is characterized by the pathological obsession for biologically pure food, which leads to important dietary restrictions. Orthorexic patients exclude foods from their diets that they consider to be impure because they have herbicides, pesticides or artificial substances and they worry in excess about the techniques and materials used in the food elaboration. This obsession leads to loss of social relationships and affective dissatisfactions which, in turn, favors obsessive concern about food. In orthorexia, that patient initially wants to improve his/her health, treat a disease or lose weight. Finally, the diet becomes the most important part of their lives. We present a clinical case that responds to the characteristics of orthorexia. The differential diagnosis with chronic delusional disorder, anorexia nervosa and obsessive-compulsive disorder is carried out.

  19. Severity of depressive episodes during the course of depressive disorder

    DEFF Research Database (Denmark)

    Kessing, L.V.

    2008-01-01

    Background It is not clear whether the severity of depressive episodes changes during the course of depressive disorder. Aims To investigate whether the severity of depressive episodes increases during the course of illness. Method Using a Danish nationwide case register, all psychiatric inpatients...... and out-patients with a main ICD-10 diagnosis of a single mild, moderate or severe depressive episode at the end of first contact were identified. Patients included in the study were from the period 1994-2003. Results A total of 19 392 patients received a diagnosis of a single depressive episode at first...... contact. The prevalence of severe depressive episodes increased from 25.5% at the first episode to 50.0% at the 15th episode and the prevalence of psychotic episodes increased from 8.7% at the first episode to 25.0% at the 15th episode. The same pattern was found regardless of gender, age at first contact...

  20. Severity of depressive episodes during the course of depressive disorder

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2008-01-01

    BACKGROUND: It is not clear whether the severity of depressive episodes changes during the course of depressive disorder. AIMS: To investigate whether the severity of depressive episodes increases during the course of illness. METHOD: Using a Danish nationwide case register, all psychiatric in......-patients and out-patients with a main ICD-10 diagnosis of a single mild, moderate or severe depressive episode at the end of first contact were identified. Patients included in the study were from the period 1994-2003. RESULTS: A total of 19 392 patients received a diagnosis of a single depressive episode at first...... contact. The prevalence of severe depressive episodes increased from 25.5% at the first episode to 50.0% at the 15th episode and the prevalence of psychotic episodes increased from 8.7% at the first episode to 25.0% at the 15th episode. The same pattern was found regardless of gender, age at first contact...

  1. Childhood Fish Consumption and Learning and Behavioral Disorders

    Directory of Open Access Journals (Sweden)

    Jenny L. Carwile

    2016-11-01

    Full Text Available Fish is a major source of nutrients critical for brain development during early life. The importance of childhood fish consumption is supported by several studies reporting associations of n-3 polyunsaturated fatty acid (n-3 PUFA supplementation with better behavior and school performance. However, fish may have a different effect than n-3 PUFA alone due to the neurotoxic effects of methylmercury, a frequent contaminant. We investigated associations of childhood fish consumption with learning and behavioral disorders in birth cohort study of the neurotoxic effects of early life exposure to solvent-contaminated drinking water. Childhood (age 7–12 years fish consumption and learning and behavioral problems were reported in self-administered questionnaires (age 23–41 at questionnaire completion. Fish consumption was not meaningfully associated with repeating a grade, tutoring, attending summer school, special class placement, or low educational attainment. However, participants who ate fish several times a week had an elevated odds of Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder (odds ratio: 5.2; 95% confidence interval: 1.5–18 compared to participants who did not eat fish. While these findings generally support the safety of the observed level of fish consumption, the absence of a beneficial effect may be attributed to insufficient fish intake or the choice of relatively low n-3 PUFA fish.

  2. Increased impulsivity associated with severity of suicide attempt history in patients with bipolar disorder.

    Science.gov (United States)

    Swann, Alan C; Dougherty, Donald M; Pazzaglia, Peggy J; Pham, Mary; Steinberg, Joel L; Moeller, F Gerard

    2005-09-01

    Impulsivity is a prominent and measurable characteristic of bipolar disorder that can contribute to risk for suicidal behavior. The purpose of this study was to investigate the relationship between impulsivity and severity of past suicidal behavior, a potential predictor of eventual suicide, in patients with bipolar disorder. In bipolar disorder subjects with either a definite history of attempted suicide or no such history, impulsivity was assessed with both a questionnaire (Barratt Impulsiveness Scale) and behavioral laboratory performance measures (immediate memory/delayed memory tasks). Diagnosis was determined with the Structured Clinical Interview for DSM-IV. Interviews of patients and review of records were used to determine the number of past suicide attempts and the medical severity of the most severe attempt. Subjects with a history of suicide attempts had more impulsive errors on the immediate memory task and had shorter response latencies, especially for impulsive responses. Impulsivity was highest in subjects with the most medically severe suicide attempts. Effects were not accounted for by presence of depression or mania at the time of testing. Barratt Impulsiveness Scale scores were numerically, but not significantly, higher in subjects with suicide attempts. A history of alcohol abuse was associated with greater probability of a suicide attempt. Multivariate analysis showed that ethanol abuse history and clinical state at the time of testing did not have a significant effect after impulsivity was taken into account. These results suggest that a history of severe suicidal behavior in patients with bipolar disorder is associated with impulsivity, manifested as a tendency toward rapid, unplanned responses.

  3. Risk factors that influence suicidal behavior in affective disorders

    Directory of Open Access Journals (Sweden)

    Stanojević Albina

    2016-01-01

    Full Text Available It is known in the literature that the incidence and prevalence of suicide and attempted suicide in psychiatric patients is significantly higher than in the general population. The paper examined risk factors for suicidal behavior in the category of admitted patients hospitalized with the diagnosis of sleep disorders and affective (Unipolar resp. Bipolar depression. Study activated by 80 patients, 40 in both diagnostic groups received treatment at the Special Psychiatric Hospital in Gornja Toponica near Nis. The work methodology used are: psychiatric interview, Hamilton Depression Rating Scale (HAMD, and the C-SSRS (Columbia-Suicide Severity Rating Scale- assessment tool that assesses suicidal ideation and behavior. The study results show that there is a relationship between suicidal behavior (suicide attempts and suicidal ideation and the diagnosis of bipolar affective disorder, positive history of previous suicide attempts, so that these factors are stronger, to the degree of suicidality higher. On this sample, clearly suicidal behavior, with the same purpose, intensity of suicidal thoughts and medical impairment after suicide attempts were significantly more frequent in patients with Bipolar Affective Disorder in the depressive phase of the illness. Patients with a previous suicide attempt, and poor personal and social circumstances had a higher rate of attempted suicide.

  4. Chaotic behavior in the disorder cellular automata

    International Nuclear Information System (INIS)

    Ko, J.-Y.; Hung, Y.-C.; Ho, M.-C.; Jiang, I-M.

    2008-01-01

    Disordered cellular automata (DCA) represent an intermediate class between elementary cellular automata and the Kauffman network. Recently, Rule 126 of DCA has been explicated: the system can be accurately described by a discrete probability function. However, a means of extending to other rules has not been developed. In this investigation, a density map of the dynamical behavior of DCA is formulated based on Rule 22 and other totalistic rules. The numerical results reveal excellent agreement between the model and original automata. Furthermore, the inhomogeneous situation is also discussed

  5. Premenstrual dysphoric disorder and severe premenstrual syndrome in adolescents.

    Science.gov (United States)

    Rapkin, Andrea J; Mikacich, Judith A

    2013-06-01

    Numerous epidemiologic studies have demonstrated that premenstrual disorders (PMDs) begin during the teenage years. At least 20 % of adolescents experience moderate-to-severe premenstrual symptoms associated with functional impairment. Premenstrual syndrome (PMS) consists of physical and/or psychological premenstrual symptoms that interfere with functioning. Symptoms are triggered by ovulation and resolve within the first few days of menses. The prevalence of premenstrual dysphoric disorder (PMDD), a severe form of PMS accompanied by affective symptoms, is likely equal to or higher than in adults. The diagnosis of a PMD requires a medical and psychological history and physical examination but it is the daily prospective charting of bothersome symptoms for two menstrual cycles that will clearly determine if the symptoms are related to a PMD or to another underlying medical or psychiatric diagnosis. The number and type of symptoms are less important than the timing. Randomized controlled trials of pharmacologic treatments in teens with moderate-to-severe PMS and PMDD have yet to be performed. However, clinical experience suggests that treatments that are effective for adults can be used in adolescents. PMS can be ameliorated by education about the nature of the disorder, improving calcium intake, performing exercise and reducing stress, but to treat severe PMS or PMDD pharmacologic therapy is usually required. Eliminating ovulation with certain hormonal contraceptive formulations or gonadotropin-releasing hormone agonists will be discussed. Serotonergic agonists are a first-line therapy for adults, and some serotonin reuptake inhibitors such as fluoxetine and escitalopram can be administered safely to teens.

  6. College Student Stress: A Predictor of Eating Disorder Precursor Behaviors

    Science.gov (United States)

    Shelton, Virginia L.; Valkyrie, Karena T.

    2010-01-01

    Eating disorders are compulsive behaviors that can consume a person's life to the point of becoming life threatening. Previous research found stress associated with eating disorders. College can be a stressful time. If stress predicted precursor behaviors to eating disorders, then counselors would have a better chance to help students sooner. This…

  7. Disruptive behavior disorders in offspring of parents with major depression: associations with parental behavior disorders.

    Science.gov (United States)

    Hirshfeld-Becker, Dina R; Petty, Carter; Micco, Jamie A; Henin, Aude; Park, Jennifer; Beilin, Ari; Rosenbaum, Jerrold F; Biederman, Joseph

    2008-12-01

    Although the offspring of parents with major depressive disorder (MDD) are at increased risk to develop disruptive behavior disorders (DBD) in addition to MDD, it remains unclear whether this heightened risk is due to MDD or to comorbid DBD in the parents. In a secondary analysis of longitudinal data from offspring at risk for MDD and panic disorder and comparison children, we stratified 169 children of parents who had been treated for MDD based upon presence (n=50) or absence (n=119) of parental history of DBD (ADHD, oppositional disorder, and conduct disorder) and contrasted them with children of parents with DBD but without MDD (n=19) and children whose parents had neither MDD nor DBD (n=106). The children had been assessed in middle childhood using structured diagnostic interviews. Offspring of parents with MDD + DBD had significantly higher rates of MDD, DBD in general, and ADHD in particular, compared with offspring of parents with MDD alone. Offspring of parents with MDD + DBD also had higher rates of mania than controls. Both parental MDD and DBD conferred independent risk for MDD and DBD in the offspring. However, only parental DBD conferred independent risk for conduct disorder and ADHD and only parental MDD conferred independent risk for oppositional defiant disorder. Elevated rates of DBD in the offspring of parents with MDD appear to be due in part to the presence of DBD in the parents. Further studies of samples not selected on the basis of parental panic disorder are needed to confirm these results.

  8. Child behavior checklist dysregulation profile in children with disruptive behavior disorders: A longitudinal study.

    Science.gov (United States)

    Masi, Gabriele; Pisano, Simone; Milone, Annarita; Muratori, Pietro

    2015-11-01

    A Child Behavior Checklist (CBCL) profile defined as Dysregulation Profile (DP) (scores 2 standard deviations or more in anxiety/depression, aggression, attention subscales) has been correlated to poor emotional and behavioral self-regulation. The clinical meaning and the prognostic implications of CBCL-DP are still debated, although it seems associated with severe psychopathology and poor adjustment. In the present study, we used the CBCL-DP score to examine the adolescent outcomes (psychiatric diagnosis, substance use, psychiatric hospitalization) in 80 referred children with disruptive behavior disorders -DBD- (Oppositional Defiant Disorder or conduct disorder), aged 8-9 years, 72 males (90%) and 8 females (10%), followed-up until the age of 14-15 years. Children with higher score on the CBCL-DP profile were at increased risk for presenting ADHD and mood disorders in adolescence. While ADHD in adolescence was predicted also by an ADHD diagnosis during childhood, CBCL-DP score was the only significant predictor of a mood disorder at 14-15 years. On the contrary, CBCL-DP score was not associated with a higher risk of conduct disorder, substance use and hospitalizations in adolescence. A cost-effective and reliable diagnostic measure such as the CBCL may be a part of the diagnostic procedure aimed to capture these at-risk children, to monitor their natural history up to adolescence, and to prevent the risk of a full-blown mood disorder. The small sample size and a selection bias of severe patients with DBD limit the generalization of the findings. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. [Exercise addiction: an emergent behavioral disorder].

    Science.gov (United States)

    Márquez, Sara; de la Vega, Ricardo

    2015-06-01

    Regular physical activity plays a relevant role in health maintenance and disease prevention. However, excess exercise may generate adverse effects both on physical and mental activity. To provide a state-of-the-art overview on exercise addiction, considering its concept, symptoms, diagnosis, epidemiological aspects, etiological factors, and potential interventions. Articles related to the topic were reviewed through Pubmed, Sportdiscus, PsycINFO, Scopus and Web of Science databases, using combinations of the following keywords: "exercise", "addiction" and "dependence". Regular exercise taken into excess may result in adverse health consequences and quality of life impairment. Diagnosis of exercise addiction requires the employment of questionnaires such as the Exercise Dependence Scale (EDS) and the Exercise Addiction Inventory (EAI). These instruments have allowed the estimation of a 3% prevalence among exercise practitioners. Proposed hypotheses to explain the etiology of this disorder include both physiological and psychological mechanisms. Treatment is based on the cognitive-behavioral approach, but effectiveness needs to be evaluated. Although different hypotheses have been proposed to explain exercise dependence, integrative models are still necessary. A clinical validation of diagnostic instruments and a deepening into the relationship with behavioral eating disorders are also required. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  10. Moving On: Transitions for Youth with Behavioral Disorders. Working with Behavioral Disorders: CEC Mini-Library.

    Science.gov (United States)

    Bullis, Michael; Gaylord-Ross, Robert

    This booklet reviews the literature on transitional services for youth with behavior disorders, provides examples of successful programs and activities, and identifies key elements of successful programs. Specific sections of the monograph address the following areas: long-term life adjustment; transition studies; vocational assessment; social…

  11. Hypnagogic behavior disorder: complex motor behaviors during wake-sleep transitions in 2 young children.

    Science.gov (United States)

    Pareja, Juan A; Cuadrado, María Luz; García-Morales, Irene; Gil-Nagel, Antonio; Franch, Oriol

    2008-08-01

    A nondescribed behavioral disorder was observed during wake-sleep transitions in 2 young children. Two boys had episodes of abnormal behavior in hypnagogic-and occasionally hypnopompic-periods for 1 year from the time they were 1 year and several months old. The episodes consisted of irregular body movements, which could be either gentle or violent but never made the children get out of bed. They lasted from a few seconds to 2 hours and were associated with poor reactivity and amnesia of the events. Electroencephalography (EEG) recordings showed wake-state features, with brief bursts of hypnagogic hypersynchrony, and did not display seizure activity. A distinctive behavior disorder occurring during wake-sleep transitions with a wake EEG pattern has been identified in very early childhood. The clinical profile does not fit any of the known parasomnias and might belong to a new category of parasomnia.

  12. Examining challenging behaviors of clients with borderline personality disorder.

    Science.gov (United States)

    Chalker, Samantha A; Carmel, Adam; Atkins, David C; Landes, Sara J; Kerbrat, Amanda H; Comtois, Katherine Anne

    2015-12-01

    Few studies have examined effects of challenging behaviors of clients with borderline personality disorder (BPD) on psychotherapy outcomes. Dialectical behavior therapy (DBT) is an evidence-based treatment designed to treat chronic suicidality, self-directed violence (SDV), and emotion dysregulation, while targeting challenging behaviors. DBT has been shown to be effective with clients with BPD. We evaluated whether therapist reported challenging behaviors, such as high volume phone contacts or violating the therapist's limits, during DBT would be associated with dropping out of DBT, severity and frequency of SDV, emotion regulation deficits, psychological symptom severity and client's and therapist's satisfaction of treatment. The current study examined challenging behaviors reported by therapists in a sample of 63 psychiatrically disabled outpatient DBT clients diagnosed with BPD (73% women, average age 37 years). More frequent phone contacts were associated with a decrease in dropout and psychological symptoms, and an increase in client and therapist satisfaction. More avoidance/disengagement behavior was associated with more than twice the risk of SDV and a decrease in therapist satisfaction. Findings suggest that the phone coaching might serve to maximize client satisfaction and reduce the likelihood of dropout. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Parenting Stress Related to Behavioral Problems and Disease Severity in Children with Problematic Severe Asthma

    NARCIS (Netherlands)

    Verkleij, Marieke; van de Griendt, Erik-Jonas; Colland, Vivian; van Loey, Nancy; Beelen, Anita; Geenen, Rinie

    2015-01-01

    Our study examined parenting stress and its association with behavioral problems and disease severity in children with problematic severe asthma. Research participants were 93 children (mean age 13.4 +/- A 2.7 years) and their parents (86 mothers, 59 fathers). As compared to reference groups

  14. Parenting Stress Related to Behavioral Problems and Disease Severity in Children with Problematic Severe Asthma

    NARCIS (Netherlands)

    Verkleij, Marieke; van de Griendt, E-J.; Colland, V.; Van Loey, N.E.E.; Beelen, A.; Geenen, R.

    2015-01-01

    Our study examined parenting stress and its association with behavioral problems and disease severity in children with problematic severe asthma. Research participants were 93 children (mean age 13.4 ± 2.7 years) and their parents (86 mothers, 59 fathers). As compared to reference groups analyzed in

  15. Severe avoidant/restrictive food intake disorder and coexisting stimulant treated attention deficit hyperactivity disorder.

    Science.gov (United States)

    Pennell, Alexandra; Couturier, Jennifer; Grant, Christina; Johnson, Natasha

    2016-11-01

    There is a growing body of literature describing the development, clinical course, and treatment of avoidant/restrictive food intake disorder (ARFID), a diagnostic category introduced in the DSM-5. However, information surrounding complex cases of ARFID involving coexisting medical and/or psychiatric disorders remains scarce. Here we report on two cases of young patients diagnosed concurrently with ARFID and attention deficit hyperactivity disorder (ADHD) who both experienced significant growth restriction following initiation of stimulant medication. The appetite suppressant effect of stimulants exacerbated longstanding avoidant and restrictive eating behaviors resulting in growth restriction and admission to an inpatient eating disorders unit. The implications of ARFID exacerbated by stimulant-treated ADHD are explored, as well as the treatment delivered. These cases suggest that further research is needed to explore management options to counteract the appetite suppression effects of stimulants, while simultaneously addressing attention deficit symptoms and oppositional behavior. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1036-1039). © 2016 Wiley Periodicals, Inc.

  16. [Behavioral disorders and substance abuse in adolescents with mental retardation].

    Science.gov (United States)

    Papachristou, Ec; Anagnostopoulos, Dk

    2014-01-01

    The percentage of people with mental retardation in the general population is estimated at about 2.3%, with adolescence (15-20 years) constituting the development period during which a peak in rates of mental retardation is observed. The increased prevalence of adolescence may be explained from the fact that the specified requirements of the school initially, and society later, inevitably lead to comparative evaluation of the teen with mental retardation in relation to peers, thus making mental retardation more apparent. Adolescents with mental retardation face a number of physical and psychological needs which are not often distinguishable and as a consequence undergo the deterioration of their already burdened quality of life. In particular, mental health problems occur 3 to 4 times more often in adolescents with mental retardation compared with adolescents of the general population. This review presents the most recent epidemiological findings regarding the correlation between behavioral disorders, substance use and the possible comorbidity in adolescents with intellectual disability, both at community level and residential care level. Epidemiological data indicate that behavioral disorders are among the most common types of psychopathology in mentally retarded adolescents with the severity and symptoms varying depending on the personal characteristics of each adolescent. Regarding substance use, the available data show that the rates of substance use (alcohol, smoking, illicit drugs) are lower in this specific population group but the differences over the last years tend to be eliminated. Finally, according to the few surveys that were examined referring to the comorbidity of behavioral disorders and substance use in adolescents with intellectual disability, the results were contradictory. Specifically, while behavioral disorders continued to be one of the most common types of psychopathology, the related substances disorders indicated lower rates compared to

  17. ADHD severity as it relates to comorbid psychiatric symptomatology in children with Autism Spectrum Disorders (ASD).

    Science.gov (United States)

    Mansour, Rosleen; Dovi, Allison T; Lane, David M; Loveland, Katherine A; Pearson, Deborah A

    2017-01-01

    Comorbid diagnoses identified in pediatric samples have been correlated with a range of outcomes, including greater levels of emotional, behavioral, and educational impairment and the need for more intensive treatment. Given that previous research has documented high levels of comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) in children with Autism Spectrum Disorders (ASD), this study closely examines the relationship between parent-reported ADHD symptoms (i.e., Conners' Parent Rating Scale, Revised [CPRS-R]) and the prevalence of additional comorbid psychiatric diagnoses in a pediatric ASD sample (n=99). Regression analyses revealed that greater severity of ADHD symptomatology was significantly related to a greater number of comorbid psychiatric diagnoses, as identified using the Diagnostic Interview for Children and adolescents, 4th Edition (DICA-IV). Additionally, more severe ADHD symptoms were also associated with higher levels of symptom severity on Child Behavior Checklist (CBCL) syndrome subscales. Interestingly, increasing severity of ASD symptomatology, as measured by the Autism Diagnostic Interview, Revised (ADI-R), was not associated with a higher prevalence of comorbid psychiatric diagnoses or CBCL syndrome severity. Our study concluded that higher levels of ADHD severity-not ASD severity-were associated with a higher prevalence of comorbid psychiatric symptomatology in school-age children with ASD. These findings may encourage clinicians to thoroughly assess ADHD symptomatology in ASD children to better inform treatment planning. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Social Support and Symptom Severity Among Patients With Obsessive-Compulsive Disorder or Panic Disorder With Agoraphobia: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Véronique Palardy

    2018-03-01

    Full Text Available Panic disorder with or without agoraphobia (PD/A and obsessive-compulsive disorder (OCD are characterized by major behavioral dysruptions that may affect patients’ social and marital functioning. The disorders’ impact on interpersonal relationships may also affect the quality of support patients receive from their social network. The main goal of this systematic review is to determine the association between social or marital support and symptom severity among adults with PD/A or OCD. A systematic search of databases was executed and provided 35 eligible articles. Results from OCD studies indicated a negative association between marital adjustment and symptom severity, and a positive association between accommodation from relatives and symptom severity. However, results were inconclusive for negative forms of social support (e.g. criticism, hostility. Results from PD/A studies indicated a negative association between perceived social support and symptom severity. Also, results from studies using an observational measure of marital adjustment indicated a negative association between quality of support from the spouse and PD/A severity. However, results were inconclusive for perceived marital adjustment and symptom severity. In conclusion, this systematic review generally suggests a major role of social and marital support in PD/A and OCD symptomatology. However, given diversity of results and methods used in studies, more are needed to clarify the links between support and symptom severity among patients with PD/A and OCD.

  19. Re-examination of chewing and spitting behavior: characteristics within and across eating disorder diagnoses.

    Science.gov (United States)

    Durkin, Nora E; Swanson, Sonja A; Crow, Scott J; Mitchell, James; Peterson, Carol B; Crosby, Ross

    2014-01-01

    Chewing and spitting (CS) out food is a relatively understudied eating disorder behavior. The aim of this study was to examine lifetime and current frequencies of CS across eating disorder diagnostic groups and to compare the severity of eating disorder symptomatology between participants who did and did not endorse CS. A total of 972 individuals presenting for outpatient eating disorder treatment between 1985 and 1996 completed a questionnaire that included items regarding current and lifetime eating disorder behaviors, including CS. Results indicated that both lifetime and current prevalence estimates of CS varied cross-diagnostically, with CS being more common among those with anorexia nervosa and bulimia nervosa compared to those with eating disorder not otherwise specified. CS was significantly associated with several eating disorder symptoms, including compensatory behaviors, meal restriction, and lower BMI. Those who reported CS were also younger in age compared to those who did not report CS. These findings indicate that CS is associated with more severe eating and weight pathology and is not equally prevalent across eating disorder diagnoses. These results also support the relatively high occurrence of CS and the importance of targeting this behavior in eating disorder treatment. Future research should clarify the correlates, mechanisms, and function of CS in eating disorders.

  20. [Psychological Treatments for Borderline Personality Disorder: A Review of Cognitive-Behavioral Oriented Therapies].

    Science.gov (United States)

    Marques, Sofia; Barrocas, Daniel; Rijo, Daniel

    2017-04-28

    Borderline personality disorder is the most common personality disorder, with a global prevalence rate between 1.6% and 6%. It is characterized by affective disturbance and impulsivity, which lead to a high number of self-harm behaviors and great amount of health services use. International guidelines recommend psychotherapy as the primary treatment for borderline personality disorder. This paper reviews evidence about the effects and efficacy of cognitive-behavioral oriented psychological treatments for borderline personality disorder. A literature review was conducted in Medline and PubMed databases, using the following keywords: borderline personality disorder, cognitive-behavioral psychotherapy and efficacy. Sixteen randomized clinical trials were evaluate in this review, which analyzed the effects of several cognitive-behavioral oriented psychotherapeutic interventions, namely dialectical behavioral therapy, cognitive behavioral therapy, schema-focused therapy and manual-assisted cognitive therapy. All above stated treatments showed clinical beneficial effects, by reducing borderline personality disorder core pathology and associated general psychopathology, as well as by reducing the severity and frequency of self-harm behaviors, and by improving the overall social, interpersonal and global adjustment. Dialectical behavioral therapy and schema-focused therapy also caused a soaring remission rate of diagnostic borderline personality disorder criteria of 57% and 94%, respectively. Although there were differences between the psychotherapeutic interventions analysed in this review, all showed clinical benefits in the treatment of borderline personality disorder. Dialectical behavioral therapy and schema-focused therapy presented the strongest scientific data documenting their efficacy, but both interventions are integrative cognitive-behavioral therapies which deviate from the traditional cognitive-behavioral model. In summary, the available studies support

  1. Problem Behavior in Children with Autism Spectrum Disorders

    OpenAIRE

    Šteglová, Dominika

    2012-01-01

    This thesis focuses on problem behavior, its manifestations and causes of origin in children with autism spectrum disorders. The thesis is divided into two parts, the theoretical and empirical. The theoretical part focuses on introduction to issues of autism spectrum disorders and problem behavior. Mentioned here is history and etiology of disorders, also the part deals with autistic triad of disability. Among others I try briefly characterize various autism spectrum disorders focusing on inf...

  2. Eating behavior and eating disorders in adults before bariatric surgery.

    Science.gov (United States)

    Mitchell, James E; King, Wendy C; Courcoulas, Anita; Dakin, George; Elder, Katherine; Engel, Scott; Flum, David; Kalarchian, Melissa; Khandelwal, Saurabh; Pender, John; Pories, Walter; Wolfe, Bruce

    2015-03-01

    To describe eating patterns, prevalence of problematic eating behaviors, and determine factors associated with binge eating disorder (BED), before bariatric surgery. Before surgery, 2,266 participants (median age 46 years; 78.6% female; 86.9% white; median body mass index 45.9 kg/m(2) ) of the Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) study completed eating behavior survey items in the self-administered LABS-2 Behavior form. Other measures included the Alcohol Use Disorder Identification Test, the LABS-2 Psychiatric and Emotional Test Survey, the Beck Depression Inventory, the Interpersonal Support Evaluation List-12, the Short Form-36 Health Survey, and Impact of Weight Quality of Life-Lite Survey. The majority (92.1%) of participants reported eating dinner regularly, whereas just over half (54.0%) reported eating breakfast regularly. Half of the participants reported eating at least four meals/week at restaurants; two meals/week were fast food. Loss of control eating was reported by 43.4%, night eating syndrome by 17.7%; 15.7% satisfied criteria for binge eating disorder (BED), 2% for bulimia nervosa. Factors that independently increased the odds of BED were being a college graduate, eating more times per day, taking medication for psychiatric or emotional problems, and having symptoms of alcohol use disorder, lower self-esteem and greater depressive symptoms. Before undergoing bariatric surgery a substantial proportion of patients report problematic eating behaviors. Several factors associated with BED were identified, most suggesting other mental health problems, including higher levels of depressive symptomotology. The strengths of this study include the large sample size, the multi-center design and use of standardized assessment practices. © 2014 Wiley Periodicals, Inc.

  3. Relations between problem behaviors, perceived symptom severity and parenting in adolescents and emerging adults with ASD: The mediating role of parental psychological need frustration

    NARCIS (Netherlands)

    Dieleman, L.M. (Lisa M.); S.S.W. de Pauw (Sarah); Soenens, B. (Bart); Mabbe, E. (Elien); Campbell, R. (Rachel); P.J. Prinzie (Peter)

    2018-01-01

    textabstractResearch in parents of youngsters with Autism Spectrum Disorder (ASD) increasingly documents associations between children's problem behaviors and symptom severity and more dysfunctional and less adaptive parenting behaviors. However, the mechanisms underlying these associations have not

  4. Body-focused repetitive behavior disorders in ICD-11

    Directory of Open Access Journals (Sweden)

    Jon E. Grant

    2014-01-01

    Full Text Available This article addresses the question of how body-focused repetitive behavior disorders (e.g., trichotillomania and skin-picking disorder should be characterized in ICD-11. The article reviews the historical nosology of the two disorders and the current approaches in DSM-5 and ICD-10. Although data are limited and mixed regarding the optimal relationship between body-focused repetitive behavior disorders and nosological categories, these conditions should be included within the obsessive-compulsive and related disorders category, as this is how most clinicians see these behaviors, and as this may optimize clinical utility. The descriptions of these disorders should largely mirror those in DSM-5, given the evidence from recent field surveys. The recommendations regarding ICD-11 and body-focused repetitive behavior disorders should promote the global identification and treatment of these conditions in primary care settings.

  5. Predictors of Broad Dimensions of Psychopathology among Patients with Panic Disorder after Cognitive-Behavioral Therapy

    Directory of Open Access Journals (Sweden)

    Sei Ogawa

    2018-01-01

    Full Text Available Background. Many patients with panic disorder meet criteria for at least one other diagnosis, most commonly other anxiety or mood disorders. Cognitive-behavioral therapy is the best empirically supported psychotherapy for panic disorder. There is now evidence indicating that cognitive-behavioral therapy for panic disorder yields positive benefits upon comorbid disorders. Objectives. The present study aimed to examine the predictors of broad dimensions of psychopathology in panic disorder after cognitive-behavioral therapy. Methods. Two hundred patients affected by panic disorder were treated with manualized group cognitive-behavioral therapy. We examined if the baseline personality dimensions of NEO Five Factor Index predicted the subscales of Symptom Checklist-90 Revised at endpoint using multiple regression analysis based on the intention-to-treat principle. Results. Conscientiousness score of NEO Five Factor Index at baseline was a predictor of four Symptom Checklist-90 Revised subscales including obsessive-compulsive (β=-0.15, P<0.01, depression (β=-0.13, P<0.05, phobic anxiety (β=-0.15, P<0.05, and Global Severity Index (β=-0.13, P<0.05. Conclusion. Conscientiousness at baseline may predict several dimensions of psychopathology in patients with panic disorder after cognitive-behavioral therapy. For the purpose of improving a wide range of psychiatric symptoms with patients affected by panic disorder, it may be useful to pay more attention to this personal trait at baseline.

  6. Cognitive flexibility and clinical severity in eating disorders.

    Directory of Open Access Journals (Sweden)

    Kate Tchanturia

    Full Text Available OBJECTIVES: The aim of this study was to explore cognitive flexibility in a large dataset of people with Eating Disorders and Healthy Controls (HC and to see how patient characteristics (body mass index [BMI] and length of illness are related to this thinking style. METHODS: A dataset was constructed from our previous studies using a conceptual shift test--the Brixton Spatial Anticipation Test. 601 participants were included, 215 patients with Anorexia Nervosa (AN (96 inpatients; 119 outpatients, 69 patients with Bulimia Nervosa (BN, 29 Eating Disorder Not Otherwise Specified (EDNOS, 72 in long-term recovery from AN (Rec AN and a comparison group of 216 HC. RESULTS: The AN and EDNOS groups had significantly more errors than the other groups on the Brixton Test. In comparison to the HC group, the effect size decrement was large for AN patients receiving inpatient treatment and moderate for AN outpatients. CONCLUSIONS: These findings confirm that patients with AN have poor cognitive flexibility. Severity of illness measured by length of illness does not fully explain the lack of flexibility and supports the trait nature of inflexibility in people with AN.

  7. Cognitive Flexibility and Clinical Severity in Eating Disorders

    Science.gov (United States)

    Tchanturia, Kate; Harrison, Amy; Davies, Helen; Roberts, Marion; Oldershaw, Anna; Nakazato, Michiko; Stahl, Daniel; Morris, Robin

    2011-01-01

    Objectives The aim of this study was to explore cognitive flexibility in a large dataset of people with Eating Disorders and Healthy Controls (HC) and to see how patient characteristics (body mass index [BMI] and length of illness) are related to this thinking style. Methods A dataset was constructed from our previous studies using a conceptual shift test - the Brixton Spatial Anticipation Test. 601 participants were included, 215 patients with Anorexia Nervosa (AN) (96 inpatients; 119 outpatients), 69 patients with Bulimia Nervosa (BN), 29 Eating Disorder Not Otherwise Specified (EDNOS), 72 in long-term recovery from AN (Rec AN) and a comparison group of 216 HC. Results The AN and EDNOS groups had significantly more errors than the other groups on the Brixton Test. In comparison to the HC group, the effect size decrement was large for AN patients receiving inpatient treatment and moderate for AN outpatients. Conclusions These findings confirm that patients with AN have poor cognitive flexibility. Severity of illness measured by length of illness does not fully explain the lack of flexibility and supports the trait nature of inflexibility in people with AN. PMID:21698277

  8. Alternative Speech Communication System for Persons with Severe Speech Disorders

    Science.gov (United States)

    Selouani, Sid-Ahmed; Sidi Yakoub, Mohammed; O'Shaughnessy, Douglas

    2009-12-01

    Assistive speech-enabled systems are proposed to help both French and English speaking persons with various speech disorders. The proposed assistive systems use automatic speech recognition (ASR) and speech synthesis in order to enhance the quality of communication. These systems aim at improving the intelligibility of pathologic speech making it as natural as possible and close to the original voice of the speaker. The resynthesized utterances use new basic units, a new concatenating algorithm and a grafting technique to correct the poorly pronounced phonemes. The ASR responses are uttered by the new speech synthesis system in order to convey an intelligible message to listeners. Experiments involving four American speakers with severe dysarthria and two Acadian French speakers with sound substitution disorders (SSDs) are carried out to demonstrate the efficiency of the proposed methods. An improvement of the Perceptual Evaluation of the Speech Quality (PESQ) value of 5% and more than 20% is achieved by the speech synthesis systems that deal with SSD and dysarthria, respectively.

  9. Web-Based Cognitive Behavioral Therapy for Female Patients With Eating Disorders : Randomized Controlled Trial

    NARCIS (Netherlands)

    ter Huurne, E.D.; de Haan, H.A.; Postel, Marloes Gerda; van der Palen, Jacobus Adrianus Maria; VanDerNagel, Joanneke E.L.; de Jong, Cor A.J.

    2015-01-01

    Background: Many patients with eating disorders do not receive help for their symptoms, even though these disorders have severe morbidity. The Internet may offer alternative low-threshold treatment interventions. Objective: This study evaluated the effects of a Web-based cognitive behavioral therapy

  10. [Comparison of attachment-related social behaviors in autistic disorder and developmental disability].

    Science.gov (United States)

    Akdemir, Devrim; Pehlivantürk, Berna; Unal, Fatih; Ozusta, Seniz

    2009-01-01

    This study examined social behaviors related to attachment in children with autistic disorder and the differences in these behaviors from those observed in developmentally disabled children. Additionally, we aimed to investigate the relationship between attachment behaviors and clinical variables, such as age, cognitive development, severity of autism, language development, and mothers' attachment styles. The study group consisted of 19 children with autistic disorder (mean age: 37.9 +/- 6.8 months) and the control group consisted of 18 developmentally disabled children without autistic disorder that were matched with respect to age, gender, and cognitive development. The Childhood Autism Rating Scale (CARS) was administered to all the children by two child psychiatrists. Mothers completed the Relationships Scale Questionnaire (RSQ). Cognitive development of the children was assessed with the Stanford-Binet intelligence scale. Attachment behaviors of the children were evaluated with a modified Strange Situation Procedure (SSP). Attachment behaviors in the children with autistic disorder and in the children with developmental disabilities were similar. In contrast to the developmentally disabled group, the children with autistic disorder stayed closer toward their mothers compared with their responses to strangers. In the autistic disorder group, attachment behaviors were not associated with age, intelligence quotient, or mothers' attachment styles; however, a significant relationship between the severity of autism and the presence of speech was observed. Parents' understanding of the attachment needs and the attachment behaviors of their autistic children in the early stages of the disorder may lead to more secure attachment relationships and improved social development.

  11. Family structure and eating behavior disorders.

    Science.gov (United States)

    Mateos-Agut, Manuel; García-Alonso, Isabel; De la Gándara-Martín, Jesús J; Vegas-Miguel, María I; Sebastián-Vega, Carlota; Sanz-Cid, Beatriz; Martínez-Villares, Ana; Martín-Martínez, Esther

    2014-01-01

    The modern way of life, characterized by the cult of individualism, discredited authority, and a proliferation of points of view about reality, has modified family structure. This social structure imbues families and the way that its members become ill, in such a way that eating behavior disorders (EDs) have become a typically postmodern way of becoming ill. The aim is to understand the systemic structure and vulnerability of families by comparing 108 families with members who have ED to 108 families without pathology. A questionnaire administered by an interview with trained personnel was used. Families with ED have a different structure from the families in the control group. They have more psychiatric history and poor coping skills. The family hierarchy is not clearly defined and the leadership is diffuse, with strict and unpredictable rules, more intergenerational coalitions, and fewer alliances. The relationship between the parents is distant or confrontational, and their attitudes towards their children are complacent and selfish, with ambivalent and unaffectionate bonds. In the case of mothers, this is manifested by separation anxiety and dyadic dependence. Their expectations concerning their offspring are either very demanding and unrealistic, or indifferent, and there is less control of their behavior, in addition to poor organization of the family meals. The structural differences between the two groups of families seem to be important for the occurrence and maintenance of EDs, although they may not be the only cause. The results suggest strategies for clinical intervention in EDs.

  12. Are diagnostic criteria for eating disorders markers of medical severity?

    Science.gov (United States)

    Peebles, Rebecka; Hardy, Kristina K; Wilson, Jenny L; Lock, James D

    2010-05-01

    The objective of this study was to compare the medical severity of adolescents who had eating disorders not otherwise specified (EDNOS) with those who had anorexia nervosa (AN) and bulimia nervosa (BN). Medical records of 1310 females aged 8 through 19 years and treated for AN, BN, or EDNOS were retrospectively reviewed. Patients with EDNOS were subcategorized into partial AN (pAN) and partial BN (pBN) when they met all Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria but 1 for AN or BN, respectively. Primary outcome variables were heart rate, systolic blood pressure, temperature, and QTc interval on electrocardiogram. Additional physiologically significant medical complications were also reviewed. A total of 25.2% of females had AN, 12.4% had BN, and 62.4% had EDNOS. The medical severity of patients with EDNOS was intermediate to that of patients with AN and BN in all primary outcomes. Patients with pAN had significantly higher heart rates, systolic blood pressures, and temperatures than those with AN; patients with pBN did not differ significantly from those with BN in any primary outcome variable; however, patients with pAN and pBN differed significantly from each other in all outcome variables. Patients with pBN and BN had longer QTc intervals and higher rates of additional medical complications reported at presentation than other groups. EDNOS is a medically heterogeneous category with serious physiologic sequelae in children and adolescents. Broadening AN and BN criteria in pediatric patients to include pAN and pBN may prove to be clinically useful.

  13. Autistic-spectrum disorders in Down syndrome: further delineation and distinction from other behavioral abnormalities.

    Science.gov (United States)

    Carter, John C; Capone, George T; Gray, Robert M; Cox, Christiane S; Kaufmann, Walter E

    2007-01-05

    The present study extends our previous work characterizing the behavioral features of autistic-spectrum disorder (ASD) in Down syndrome (DS) using the Aberrant Behavior Checklist (ABC) and Autism Behavior Checklist (AutBehav). We examined which specific behaviors distinguished the behavioral phenotype of DS + ASD from other aberrant behavior disorders in DS, by determining the relative contribution of ABC and AutBehav subscales and items to the diagnosis of ASD. A total of 127 subjects (aged 2-24 years; mean age: 8.4 years; approximately 70% male), comprising: a cohort of 64 children and adolescents with DS and co-morbid ASD (DS + ASD), 19 with DS and stereotypic movement disorder (DS + SMD), 18 with DS and disruptive behaviors (DS + DB), and 26 with DS and no co-morbid behavior disorders (DS + none) were examined using the aforementioned measures of aberrant behavior. We found that subjects with DS + ASD showed the most severe aberrant behavior, especially stereotypy compared to DS + none and lethargy/social withdrawal and relating problems compared to DS + SMD. Specifically, relatively simple stereotypic behavior differentiated DS + ASD from DS + DB, whereas odd/bizarre stereotypic and anxious behavior characterized DS + ASD relative to DS + SMD and DS + none. Additionally, in a subset of subjects with DS + ASD and anxiety, social withdrawal was particularly pronounced. Overall, our findings indicate that a diagnosis of DS + ASD represents a distinctive set of aberrant behaviors marked by characteristic odd/bizarre stereotypic behavior, anxiety, and social withdrawal.

  14. Risk for exercise dependence, eating disorder pathology, alcohol use disorder and addictive behaviors among clients of fitness centers.

    Science.gov (United States)

    Müller, Astrid; Loeber, Sabine; Söchtig, Johanna; Te Wildt, Bert; De Zwaan, Martina

    2015-12-01

    Exercise dependence (EXD) is considered a behavioral addiction that is often associated with eating disorders. To date, only few studies examined the potential overlap between EXD and other addictive behaviors. Therefore, the present study aimed at investigating the relationship of EXD with pathological buying, pathological video gaming (offline and online), hypersexual behavior, and alcohol use disorder in a sample of clients of fitness centers. The following questionnaires were answered by 128 individuals (age M = 26.5, SD = 6.7 years; 71.7% men, 74.2% university students): Exercise Dependence Scale, Eating Disorder Examination-Questionnaire, Compulsive Buying Scale, Pathological Computer-Gaming Scale, Hypersexual Behavior Inventory, and Alcohol Use Disorders Identification Test (AUDIT). 7.8% of the sample were at-risk for EXD, 10.9% reported eating disorder pathology, 2.3% pathological buying, 3.1% hypersexual behavior, and none of the participants suffered from pathological video gaming. The criteria for severe alcohol disorder pathology (AUDIT ≥ 16) were fulfilled by 10.2%. With regard to continuous symptom scores, EXD symptoms were positively correlated with both eating disorder pathology and pathological buying but not with pathological video gaming, hypersexuality or alcohol use disorder. It is noteworthy that more symptoms of pathological buying corresponded with more symptoms of hypersexual behavior. The correlation pattern did not differ by gender. The co-occurrence of EXD, pathological buying and hypersexual behavior on a subclinical level or in the early stage of the disorders should be taken into account when assessing and treating patients. More research is warranted in order to investigate possible interactions between these conditions.

  15. Prevalence of degree of severity of temporomandibular joint disorder based on sex and age group

    Directory of Open Access Journals (Sweden)

    Luciana Dewanti

    2009-03-01

    Full Text Available Temporomandibular joint disorders are disturbances of mastication system due to one or more component of mastication system does not properly function. The factors that play a role in this problem divided into three factors; a predisposition factor (systemic, occlusion disturbances and psychological trouble, b initiation factor (traumatic and c perpetuation factor (social behavior. These disorders are able to cause a variety of symptom suck as limitedness of jaw movement, clicking, deviation locked joint, muscle pain, joint pain, jaw movement pain and pain of ear and headache. The objective of this study was to obtain information about the prevalence degree of severity of the temporomandibular joint disorder, the differences of prevalence between man and woman and the different among age groups. The study was descriptive and analysis survey, done to 134 patients as an experimental sample of 3–75-year old that have visited Dental Hospital, Padjadjaran University Bandung, during February 2008. Sample consist of 57 men and 77 women were evaluated by using Helkimo Index and analysis by using Z statistical proportion test to know the existence of difference prevalence degree of severity between man and woman and using the chi-square test to know the difference prevalence among age groups.The result of this study shows that there is highly prevalence severity of temporomandibular joint disorder (84,33% and significantly different on prevalence severity between man and woman and among a group of ages.The conclusion can be drawn that patients who visited the dental hospital, Padjadjaran University have higher prevalence severity of temporomandibular joint disorder where a woman has higher level compare to man, and the young adult group has highest either man and woman. Clicking is the most often symptom appear to man and woman.

  16. Parenting Stress Related to Behavioral Problems and Disease Severity in Children with Problematic Severe Asthma.

    Science.gov (United States)

    Verkleij, Marieke; van de Griendt, Erik-Jonas; Colland, Vivian; van Loey, Nancy; Beelen, Anita; Geenen, Rinie

    2015-09-01

    Our study examined parenting stress and its association with behavioral problems and disease severity in children with problematic severe asthma. Research participants were 93 children (mean age 13.4 ± 2.7 years) and their parents (86 mothers, 59 fathers). As compared to reference groups analyzed in previous research, scores on the Parenting Stress Index in mothers and fathers of the children with problematic severe asthma were low. Higher parenting stress was associated with higher levels of internalizing and externalizing behavioral problems in children (Child Behavior Checklist). Higher parenting stress in mothers was also associated with higher airway inflammation (FeNO). Thus, although parenting stress was suggested to be low in this group, higher parenting stress, especially in the mother, is associated with more airway inflammation and greater child behavioral problems. This indicates the importance of focusing care in this group on all possible sources of problems, i.e., disease exacerbations and behavioral problems in the child as well as parenting stress.

  17. Full-length fuel rod behavior under severe accident conditions

    International Nuclear Information System (INIS)

    Lombardo, N.J.; Lanning, D.D.; Panisko, F.E.

    1992-12-01

    This document presents an assessment of the severe accident phenomena observed from four Full-Length High-Temperature (FLHT) tests that were performed by the Pacific Northwest Laboratory (PNL) in the National Research Universal (NRU) reactor at Chalk River, Ontario, Canada. These tests were conducted for the US Nuclear Regulatory Commission (NRC) as part of the Severe Accident Research Program. The objectives of the test were to simulate conditions and provide information on the behavior of full-length fuel rods during hypothetical, small-break, loss-of-coolant severe accidents, in commercial light water reactors

  18. Environmental risk factors for REM sleep behavior disorder

    DEFF Research Database (Denmark)

    Postuma, R B; Montplaisir, J Y; Pelletier, A

    2012-01-01

    Idiopathic REM sleep behavior disorder is a parasomnia characterized by dream enactment and is commonly a prediagnostic sign of parkinsonism and dementia. Since risk factors have not been defined, we initiated a multicenter case-control study to assess environmental and lifestyle risk factors...... for REM sleep behavior disorder....

  19. Mental and Behavioral Disorders among People with Congenital Deafblindness

    Science.gov (United States)

    Dammeyer, Jesper

    2011-01-01

    The population of people with congenital deafblindness faces challenges concerning communication and mobility. Due to the significance of the sensory loss it is difficult to diagnose mental and behavioral disorders. This article investigates the prevalence of mental and behavioral disorders among 95 congenitally deafblind adults. Seventy-four…

  20. Decreased striatal D2 receptor density associated with severe behavioral abnormality in Alzheimer's disease

    International Nuclear Information System (INIS)

    Tanaka, Yasuhiro; Meguro, Kenichi; Yamaguchi, Satoshi

    2003-01-01

    Since patients manifesting behavioral and psychological symptoms of dementia (BPSD) are a burden for their families and caregivers, the underlying neurobiological mechanism of this condition should be clarified. Using positron emission tomography (PET), we previously reported that wandering behavior in dementia was associated with a disturbed dopaminergic neuron system. We herein investigated the relationship between the severity of BPSD and the striatal D 2 receptor density in Alzheimer's disease (AD). Ten patients with probable AD as per the National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) and the AD and Related Disorders Association (ADRDA) criteria and five normal subjects were examined with PET. The tracer used was [ 11 C]raclopride (D 2 antagonist). The uptake of [ 11 C]raclopride was calculated as the estimation of binding potential (BP) of the striatum to the cerebellum. The AD patients were institutionalized in multiple nursing homes, and their BPSD were evaluated by the Behavioral Pathology in AD Frequency Weighted Severity Scale (BEHAVE-AD-FW) scale (Reisberg). There was a significant inverse Spearman's correlation between BEHAVE-AD-FW score and the BP, especially between the score of the behavioral domain and the BP values. The BP was found to be lower in severer BPSD patients. Patients with AD who manifest severe BPSD may have some dysfunction of striatal dopamine metabolism compared with those without BPSD. (author)

  1. 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…

  2. Using communication to reduce challenging behaviors in individuals with autism spectrum disorders and intellectual disability.

    Science.gov (United States)

    Hutchins, Tiffany L; Prelock, Patricia A

    2014-01-01

    This article describes the relationship between expressive communication impairments and common challenging behaviors in individuals with Autism Spectrum Disorder and Intellectual Disability. The communication challenges of individuals with Autism Spectrum Disorder/Intellectual Disability are described and several evidence-based intervention strategies are proposed to support communication so as to decrease challenging behaviors. Recommendations for practice are offered. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Co-morbid disorders and sexual risk behavior in Nigerian adolescents with bipolar disorder

    Directory of Open Access Journals (Sweden)

    Bakare Muideen O

    2009-06-01

    Full Text Available Abstract Background Adolescent onset bipolar disorder often presents with co-morbid disorders of which psychoactive substance use disorders are notable. Mania symptoms and co-morbid psychoactive substance use disorders prone adolescents with bipolar disorder to impulsivity, impaired judgment, and risk taking behavior which often includes sexual risk behavior. There are dearth of information on pattern of co-morbid disorders and sexual risk behavior in adolescent onset bipolar disorder in Nigeria. This study assessed the prevalence and pattern of co-morbid disorders and determined associated factors of sexual risk behavior among adolescents with bipolar disorder. Methods Socio-demographic information was obtained from the adolescents using socio-demographic questionnaire. Clinical interview, physical examination and laboratory investigations were employed to establish co-morbid disorders in these adolescents during the outpatient follow up visits over a one year period. Results A total of forty six (46 adolescents with bipolar disorder were followed up over a one year period. Twenty two (47.8% of the adolescents had co-morbid disorders with cannabis use disorders, alcohol use disorders, conduct disorder with or without other psychoactive substance use accounting for 23.9%, 8.7%, 13.0% respectively and HIV infection, though a chance finding accounting for 2.2%. Twenty one (45.7% of the adolescents had positive history of sexual risk behavior, which was significantly associated with presence of co-morbid disorders (p = 0.003, level of religion activities in the adolescents (p = 0.000, and marital status of the parents (p = 0.021. Conclusion When planning interventions for children and adolescents with bipolar disorder, special attention may need to be focused on group of adolescents with co-morbid disorders and propensity towards impulsivity and sexual risk behavior. This may help in improving long term outcome in this group of adolescents.

  4. Validity and utility of the DSM-5 severity specifier for binge-eating disorder.

    Science.gov (United States)

    Dakanalis, Antonios; Colmegna, Fabrizia; Riva, Giuseppe; Clerici, Massimo

    2017-08-01

    To test both the concurrent and predictive significance of the new DSM-5 severity specifier for binge-eating disorder (BED) in adult outpatients. Existing data from 195 adults with DSM-5 BED who received evidence-based treatment (manual-based cognitive-behavioral therapy) in an outpatient setting were re-analysed to examine whether these patients sub-grouped according to the DSM-5 severity levels, defined by the frequency of binge-eating (BE) episodes, would show meaningful differences in a range of variables of clinical interest assessed at pre-treatment and end-of treatment abstinence from BE. Participants categorized with mild (33.3% of the sample), moderate (35.4%), severe (15.9%), and extreme (15.4%) severity of BED, based on their pre-treatment clinician-rated frequency of BE episodes, differed significantly from each other in physical characteristics (body mass index) and another sixteen variables of clinical interest assessed at pre-treatment regarding eating disorder psychopathology and putative maintenance factors, lifetime and current psychiatric disorder comorbidity, general psychiatric distress, and psychosocial impairment. The four DSM-5 severity groups were statistically indistinguishable in demographics or age-of-BED onset. However, significant between-group differences were observed in the treatment outcome, i.e., abstinence from BE, achieved by 98.5%, 66.7%, 38.7% and 6.7% of participants categorized with mild, moderate, severe, and extreme severity respectively. The outcome analyses repeated in the completer sample (n = 187) yielded the same pattern of the aforementioned intent-to-treat (N = 195) results. The findings provide support for the severity specifier for BED introduced in the DSM-5 as a means of addressing within-group variability in severity. © 2017 Wiley Periodicals, Inc.

  5. [Parkinson Disease With Rapid Eye Movement Sleep Behavior Disorder].

    Science.gov (United States)

    Hu, Yang; Zhang, Wei

    2015-06-01

    Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by lack of muscle atonia during REM sleep and enactment of dream content. RBD is associated with Parkinson disease (PD) and has high incidence in PD patients. PD patient with RBD mainly presents rigid type, has longer disease duration, more severe motor and non-motor symptoms and poorer activity of daily living and life quality. The pathophysiological mechanisms of RBD may be related to dysfunctions of pontine tegmentum, locus coeruleus/sub-locus coeruleus complex and related projections. The diagnosis of RBD depends on clinical histories and video-polysomnography (v-PSG). Besides treatment for PD, protective measures have to be taken for patients and their sleep partners. If abnormal behaviors during sleep cause distress and danger,patients should be given drug therapy.

  6. Neurophysiological basis of rapid eye movement sleep behavior disorder

    DEFF Research Database (Denmark)

    Jennum, Poul; Christensen, Julie Anja Engelhard; Zoetmulder, Marielle

    2016-01-01

    Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by a history of recurrent nocturnal dream enactment behavior and loss of skeletal muscle atonia and increased phasic muscle activity during REM sleep: REM sleep without atonia. RBD and associated comorbidities have...... recently been identified as one of the most specific and potentially sensitive risk factors for later development of any of the alpha-synucleinopathies: Parkinson's disease, dementia with Lewy bodies, and other atypical parkinsonian syndromes. Several other sleep-related abnormalities have recently been...... identified in patients with RBD/Parkinson's disease who experience abnormalities in sleep electroencephalographic frequencies, sleep-wake transitions, wake and sleep stability, occurrence and morphology of sleep spindles, and electrooculography measures. These findings suggest a gradual involvement...

  7. Prevalence and severity of categorical and dimensional personality disorders in adolescents with eating disorders.

    Science.gov (United States)

    Magallón-Neri, Ernesto; González, Esther; Canalda, Gloria; Forns, Maria; De La Fuente, J Eugenio; Martínez, Estebán; García, Raquel; Lara, Anais; Vallès, Antoni; Castro-Fornieles, Josefina

    2014-05-01

    The objective of this study is to explore and compare the prevalence of categorical and dimensional personality disorders (PDs) and their severity in Spanish adolescents with Eating Disorders (EDs). Diagnostic and Statistical Manual of Mental Disorders Fourth Edition and International Classification of Diseases, Tenth Revision-10 modules of the International Personality Disorder Examination were administered to a sample of 100 female adolescents with EDs (mean age=15.8 years, SD=0.9). 'Thirty-three per cent of the sample had at least one PD, in most cases a simple PD. The rate of PDs was 64-76% in bulimia patients, 22-28% in anorexia and 25% in EDs not otherwise specified. The highest dimensional scores were observed in bulimia, [corrected] mainly in borderline and histrionic PDs, and higher scores for anankastic PD in anorexia than in the other ED diagnoses. Overall, purging type EDs had higher cluster B personality pathology scores than restrictive type.' [corrected] The Publisher would like to apologize for this error and any confusion it may have caused. [corrected]. Adolescent female patients with ED have a risk of presenting a comorbid PD, especially patients with bulimia and purging type EDs. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

  8. Does impaired socioemotional functioning account for behavioral dysexecutive disorders? Evidence from a transnosological study.

    Science.gov (United States)

    Narme, Pauline; Roussel, Martine; Mouras, Harold; Krystkowiak, Pierre; Godefroy, Olivier

    2017-01-01

    Behavioral dysexecutive disorders are highly prevalent in patients with neurological diseases but cannot be explained by cognitive dysexecutive impairments. In fact, the underlying mechanisms are poorly understood. Given that socioemotional functioning underlies appropriate behavior, socioemotional impairments may contribute to the appearance of behavioral disorders. To investigate this issue, we performed a transnosological study. Seventy-five patients suffering from various neurological diseases (Alzheimer's disease (AD), Parkinson's disease (PD), frontotemporal lobar degeneration, and stroke) were included in the study. The patients were comprehensively assessed in terms of cognitive and behavioral dysexecutive disorders and socioemotional processes (facial emotion recognition and theory of mind). As was seen for cognitive and behavioral dysexecutive impairments, the prevalence of socioemotional impairments varied according to the diagnosis. Stepwise logistic regressions showed that (i) only cognitive executive indices predicted hypoactivity with apathy/abulia, (ii) theory of mind impairments predicted hyperactivity-distractibility-impulsivity and stereotyped/perseverative behaviors, and (iii) impaired facial emotion recognition predicted social behavior disorders. Several dysexecutive behavioral disorders are associated with an underlying impairment in socioemotional processes but not with cognitive indices of executive functioning (except for apathy). These results strongly suggest that some dysexecutive behavioral disorders are the outward signs of an underlying impairment in socioemotional processes.

  9. [Epidemiology of addictive disorders and behaviors in Japan].

    Science.gov (United States)

    Osaki, Yoneatsu; Kinjo, Aya

    2015-09-01

    Nationwide surveys to clarify the characteristics and trends of the addictive disorders and behaviors including alcohol dependence, nicotine dependence, internet addiction and pathological gambling among Japanese adults were carried out in 2003, 2008, and 2013. At the part of the surveys on addictive behaviors in disaster stricken area by the Great East Japan Earthquake, the nationwide survey on benzodiazepine dependence was conducted in 2013. Epidemiological features of prevalent addictive disorders and behaviors were described. We observed large number of estimated patients with addictive disorders or behaviors in Japan, and the considerable proportion of them was not connect to appropriate medical services.

  10. Longitudinal Associations between Posttraumatic Stress Disorder and Metabolic Syndrome Severity

    Science.gov (United States)

    Wolf, Erika J.; Bovin, Michelle J.; Green, Jonathan D.; Mitchell, Karen S.; Stoop, Tawni B.; Barretto, Kenneth M.; Jackson, Colleen E.; Lee, Lewina O.; Fang, Shona C.; Trachtenberg, Felicia; Rosen, Raymond C.; Keane, Terence M.; Marx, Brian P.

    2016-01-01

    Background Posttraumatic stress disorder (PTSD) is associated with elevated risk for metabolic syndrome (MetS). However, the direction of this association is not yet established, as most prior studies employed cross-sectional designs. The primary goal of this study was to evaluate bidirectional associations between PTSD and MetS using a longitudinal design. Methods 1,355 male and female veterans of the conflicts in Iraq and Afghanistan underwent PTSD diagnostic assessments and their biometric profiles pertaining to MetS were extracted from the electronic medical record at two time points (spanning ~2.5 years, n = 971 at time 2). Results The prevalence of MetS among veterans with PTSD was just under 40% at both time points and was significantly greater than that for veterans without PTSD; the prevalence of MetS among those with PTSD was also elevated relative to age-matched population estimates. Cross-lagged panel models revealed that PTSD severity predicted subsequent increases in MetS severity (β = .08, p = .002), after controlling for initial MetS severity, but MetS did not predict later PTSD symptoms. Logistic regression results suggested that for every 10 PTSD symptoms endorsed at time 1, the odds of a subsequent MetS diagnosis increased by 56%. Conclusions Results highlight the substantial cardiometabolic concerns of young veterans with PTSD and raise the possibility that PTSD may predispose individuals to accelerated aging, in part, manifested clinically as MetS. This demonstrates the need to identify those with PTSD at greatest risk for MetS and to develop interventions that improve both conditions. PMID:27087657

  11. Reliability of the Autism Spectrum Disorder-Behavior Problems for Children (ASD-BPC)

    Science.gov (United States)

    Matson, Johnny L.; Gonzalez, Melissa L.; Rivet, Tessa T.

    2008-01-01

    A considerable amount of attention has occurred with respect to the diagnosis and treatment of Autism Spectrum Disorders (ASDs) of children and youth. Furthermore, the rationale for using the most restrictive of the applied behavior analysis methods and medication has been largely based on the presence of severe challenging behaviors such as…

  12. The Phenomenology and Clinical Correlates of Suicidal Thoughts and Behaviors in Youth with Autism Spectrum Disorders

    Science.gov (United States)

    Storch, Eric A.; Sulkowski, Michael L.; Nadeau, Josh; Lewin, Adam B.; Arnold, Elysse B.; Mutch, P. Jane; Jones, Anna M.; Murphy, Tanya K.

    2013-01-01

    This study investigated the phenomenology and clinical correlates of suicidal thoughts and behaviors in youth with ASD (N = 102; range 7-16 years). The presence of suicidal thoughts and behavior was assessed through the Anxiety Disorders Interview Schedule-Child and Parent Versions. Children and parents completed measures of anxiety severity,…

  13. Zonisamide Combined with Cognitive Behavioral Therapy in Binge Eating Disorder

    Science.gov (United States)

    Castellini, Giovanni; Lo Sauro, Carolina; Rotella, Carlo M.; Faravelli, Carlo

    2009-01-01

    Objective. Binge eating disorder is a serious, prevalent eating disorder that is associated with overweight. Zonisamide is an antiepileptic drug that can promote weight loss. We evaluated the efficacy and safety of zonisamide as augmentation to individual cognitive behavioral therapy in the treatment of binge eating disorder patients. Design: controlled open study. Participants: Twenty four threshold and subthreshold binge eating disorder patients were enrolled in the cognitive behavioral therapy treatment group, and 28 patients in the cognitive behavioral therapy plus zonisamide group. Measurements: At the beginning (T0), at the end (T1) of treatment, and one year after the end of treatment (T2), body mass index was measured and Eating Disorder Examination-Questionnaire, Binge Eating Scale, Beck Depression Inventory, and State-Trait Anxiety Inventory were administered. Results. At T1 the cognitive behavioral therapy plus zonisamide group showed a higher mean reduction of body mass index, Eating Disorder Examination-Questionnaire, Beck Depression Inventory, and Binge Eating Scale scores. At T2, the cognitive behavior therapy group regained weight, while the cognitive behavioral therapy plus zonisamide group reduced their body mass and showed a higher reduction in binge eating frequency and Binge Eating Scale, Eating Disorder Examination-Questionnaire Restraint, and State and Trait Anxiety Inventory scores. Conclusion. The zonisamide augmentation to individual cognitive behavior therapy can improve the treatment of binge eating disorder patients, reducing body weight and the number of binge eating episodes. These results are maintained one year after the end of treatment. PMID:20049147

  14. Comorbid personality disorders and violent behavior in psychotic patients.

    Science.gov (United States)

    Volavka, Jan

    2014-03-01

    Schizophrenia without any comorbidity confers a modest, but statistically significant elevation of the risk for violence. That risk is considerably increased by comorbid antisocial personality disorder or psychopathy as well as by comorbid substance use disorders. These comorbidities are frequent. Conduct disorder and conduct disorder symptoms elevate the risk for aggressive behavior in patients with schizophrenia. Violence among adults with schizophrenia may follow at least two distinct pathways-one associated with premorbid conditions, including antisocial conduct, and another associated with the acute psychopathology of schizophrenia. Aggressive behavior in bipolar disorder occurs mainly during manic episodes, but it remains elevated in euthymic patients in comparison with controls. The risk of violent behavior is increased by comorbidity with borderline personality disorder, antisocial personality disorder, and substance use disorders. These comorbidities are frequent. Borderline personality disorder and bipolar disorder are related in their phenomenology and response to medication. These two disorders share a tendency to impulsiveness, and impulsive behavior, including impulsive aggression, is particularly expressed when they co-occur.

  15. The relationship between self-injurious behavior and self-disclosure in adolescents with eating disorders.

    Science.gov (United States)

    Klomek, Anat Brunstein; Lev-Wiesel, Rachel; Shellac, Evia; Hadas, Arik; Berger, Uri; Horwitz, Mira; Fennig, Silvana

    2015-03-01

    The aim of the current study is to examine the association between self disclosure and self-injurious behaviors among adolescent patients diagnosed with an eating disorder. Sixty three female patients who fulfilled the DSM-IV diagnostic criteria of eating disorders were included (i.e. anorexia, bulimia, binge eating disorder and eating disorders not otherwise specified). Participants' age ranged from 11.5 to 20 years (M = 15.42, SD = 1.82). Participants completed self- report questionnaires about eating disorders, self-disclosure, self-injurious behaviors (FASM) and depression (BDI-II) RESULTS: 82.5% of the sample endorsed severe self-injurious behaviors. A moderate negative relationship was found between general disclosure to parents and self-injurious behaviors indicating that patients who generally self-disclose to their parents (on different topics, apart from suicidal ideation) engage less frequently in self-injurious behaviors. In addition, the more patients self-disclose their suicidal ideation to others, the more they tend to self-injure. Self-disclosure to parents on any topic may buffer against self-injurious behaviors and therefore it is important to work with adolescents suffering from eating disorders on effective self disclosure. In addition, self-disclosure about suicidal ideation to others by adolescents suffering from eating disorders should always be taken seriously, since it may be related to self-injurious behaviors.

  16. REM Sleep Behavior Disorder in Parkinson's Disease and Other Synucleinopathies.

    Science.gov (United States)

    St Louis, Erik K; Boeve, Angelica R; Boeve, Bradley F

    2017-05-01

    Rapid eye movement sleep behavior disorder is characterized by dream enactment and complex motor behaviors during rapid eye movement sleep and rapid eye movement sleep atonia loss (rapid eye movement sleep without atonia) during polysomnography. Rapid eye movement sleep behavior disorder may be idiopathic or symptomatic and in both settings is highly associated with synucleinopathy neurodegeneration, especially Parkinson's disease, dementia with Lewy bodies, multiple system atrophy, and pure autonomic failure. Rapid eye movement sleep behavior disorder frequently manifests years to decades prior to overt motor, cognitive, or autonomic impairments as the presenting manifestation of synucleinopathy, along with other subtler prodromal "soft" signs of hyposmia, constipation, and orthostatic hypotension. Between 35% and 91.9% of patients initially diagnosed with idiopathic rapid eye movement sleep behavior disorder at a sleep center later develop a defined neurodegenerative disease. Less is known about the long-term prognosis of community-dwelling younger patients, especially women, and rapid eye movement sleep behavior disorder associated with antidepressant medications. Patients with rapid eye movement sleep behavior disorder are frequently prone to sleep-related injuries and should be treated to prevent injury with either melatonin 3-12 mg or clonazepam 0.5-2.0 mg to limit injury potential. Further evidence-based studies about rapid eye movement sleep behavior disorder are greatly needed, both to enable accurate prognostic prediction of end synucleinopathy phenotypes for individual patients and to support the application of symptomatic and neuroprotective therapies. Rapid eye movement sleep behavior disorder as a prodromal synucleinopathy represents a defined time point at which neuroprotective therapies could potentially be applied for the prevention of Parkinson's disease, dementia with Lewy bodies, multiple system atrophy, and pure autonomic failure. © 2017

  17. The interaction between awareness of one's own speech disorder with linguistics variables: distinctive features and severity of phonological disorder.

    Science.gov (United States)

    Dias, Roberta Freitas; Melo, Roberta Michelon; Mezzomo, Carolina Lisbôa; Mota, Helena Bolli

    2013-01-01

    To analyze the possible relationship among the awareness of one's own speech disorder and some aspects of the phonological system, as the number and the type of changed distinctive features, as well as the interaction among the severity of the disorder and the non-specification of distinctive features. The analyzed group has 23 children with diagnosis of speech disorder, aged 5:0 to 7:7. The speech data were analyzed through the Distinctive Features Analysis and classified by the Percentage of Correct Consonants. One also applied the Awareness of one's own speech disorder test. The children were separated in two groups: with awareness of their own speech disorder established (more than 50% of correct identification) and without awareness of their own speech disorder established (less than 50% of correct identification). Finally, the variables of this research were submitted to analysis using descriptive and inferential statistics. The type of changed distinctive features weren't different between the groups, as well as the total of changed features and the severity disorder. However, a correlation between the severity disorder and the non-specification of distinctive features was verified, because the more severe disorders have more changes in these linguistic variables. The awareness of one's own speech disorder doesn't seem to be directly influenced by the type and by the number of changed distinctive features, neither by the speech disorder severity. Moreover, one verifies that the greater phonological disorder severity, the greater the number of changed distinctive features.

  18. [Nature and severity of oppositional defiant disorder and conduct disorder as they occur together or separately in children].

    Science.gov (United States)

    Lapalme, Mélanie; Déry, Michèle

    2009-09-01

    Co-occurring oppositional defiant disorder and conduct disorder symptoms are particularly common, which could be related to the greater severity (number and nature of symptoms) of each disorder. Our study aims to determine if oppositional defiant disorder and conduct disorder symptoms vary when they occur together or separately in children. Our study was conducted with 406 children (aged 6 to 13 years) divided in 4 groups (oppositional disorder only, conduct disorder only, oppositional disorder and conduct disorder, control) with no age or sex difference. Structured diagnostic interviews conducted with one parent and each child separately led to assessing the average number of symptoms for each disorder as well as the onset frequency of each symptom. When occurring together, oppositional disorder and conduct disorder appear more severe than when they occur separately, considering the number and nature of symptoms shown. Further, children with an oppositional disorder only or a conduct disorder only also have more frequent symptoms of the other disorder, compared with children in the control group. These results suggest taking into account, at the time of assessment and potential intervention, the presence of both disorders.

  19. [Cardiovascular risk factors in users with severe mental disorder].

    Science.gov (United States)

    Paños-Martínez, Montserrat; Patró-Moncunill, Ester; Santiago-Barragán, Ángel-María; Marti-Mestre, Marc; Torralbas-Ortega, Jordi; Escayola-Maranges, Anna; Granero-Lázaro, Alberto

    2016-01-01

    To identify the prevalence of the cardiovascular risk (RCV) in users with a Severe Mental Disorder (SMD) attended in mental health service in ParcTaulí (Sabadell - Barcelona). This is an observational, descriptive and transversal study of the factors of cardiovascular risk in 789 users with SMD. The instrument used was the scale of assessment of the Registre Gironí del Cor, which estimates the risk of cardiovascular disease. 26.6% of the sample has RCV (22.5% moderate, 3.8% high and 0.3% very high). The analysis of the modifiable risk factors shows that 16.5% of the patients are hypertensive, 55.2% are smokers, 19.77% have hyperglycaemia (8.2% of whom are diagnosed of diabetes mellitus), 40.2% have obesity, 36.2% overweight and 47.27% hypercholesterolemia. The study confirms that the prevalence of the RVC in SMD users is greater than the RCV in general population and it's associated to the presence of modifiable risk factors. Health education carried out by nurses is the best to prevent the RCV in SMD users. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  20. Emotional and behavioral problems associated with sleep disorders in children

    Directory of Open Access Journals (Sweden)

    I. A. Kelmanson

    2014-01-01

    Full Text Available The paper considers whether parasomnia may be associated with emotional and behavioral problems. It gives data on the relationship of impaired sleep duration and integrity to increased emotional responsiveness and lability, high levels of anxiety, and depression symptoms. Whether the clinical symptoms of attention-deficit/hyperactivity disorder, aggression, and academic underachievement are related to sleep disorders, including those in the presence of sleep disordered breathing, restless legs syndrome and periodic limb movement disorder, is discussed. There are data on the characteristic polysomnographic changes detected in the presence of the discussed emotional and behavioral disorders in children. A possible pathophysiological rationale is provided for the found associations. Practical guidelines for examination of children with complaints about emotional and behavioral disorders for possible concomitant parasomnias are substantiated. 

  1. Behavior of fission products released from severely damaged fuel during the PBF severe fuel damage tests

    International Nuclear Information System (INIS)

    Osetek, D.J.; Cronenberg, A.W.; Hagrman, D.L.; Broughton, J.M.; Rest, J.

    1984-01-01

    The results of fission product release behavior during the first two Power Burst Facility Severe Fuel Damage tests are presented. Measured fission product release is compared with calculated release using temperature dependent release rate correlations and FASTGRASS analysis. The test results indicate that release from fuel of the high volatility fission products (Xe, Kr, I, Cs, and Te) is strongly influenced by parameters other than fuel temperature; namely fuel/fission product morphology, fuel and cladding oxidation state, extent of fuel liquefaction, and quench induced fuel shattering. Fission product transport from the test fuel through the sample system was strongly influenced by chemical effects. Holdup of I and Cs was affected by fission product chemistry, and transport time while Te release was primarily influenced by the extent of zircaloy oxidation. Analysis demonstrates that such integral test data can be used to confirm physical, chemical, and mechanistic models of fission product behavior for severe accident conditions

  2. Gambling disorder and other behavioral addictions: recognition and treatment.

    Science.gov (United States)

    Yau, Yvonne H C; Potenza, Marc N

    2015-01-01

    Addiction professionals and the public are recognizing that certain nonsubstance behaviors--such as gambling, Internet use, video-game playing, sex, eating, and shopping--bear resemblance to alcohol and drug dependence. Growing evidence suggests that these behaviors warrant consideration as nonsubstance or "behavioral" addictions and has led to the newly introduced diagnostic category "Substance-Related and Addictive Disorders" in DSM-5. At present, only gambling disorder has been placed in this category, with insufficient data for other proposed behavioral addictions to justify their inclusion. This review summarizes recent advances in our understanding of behavioral addictions, describes treatment considerations, and addresses future directions. Current evidence points to overlaps between behavioral and substance-related addictions in phenomenology, epidemiology, comorbidity, neurobiological mechanisms, genetic contributions, responses to treatments, and prevention efforts. Differences also exist. Recognizing behavioral addictions and developing appropriate diagnostic criteria are important in order to increase awareness of these disorders and to further prevention and treatment strategies.

  3. ADad 9: Suicidal behavior in Anxiety Disorders among adolescents in a rural community population in India.

    Science.gov (United States)

    Russell, Paul Swamidhas Sudhakar; Nair, M K C; Chandra, Abhiram; Subramaniam, Vinod Shanmukham; Bincymol, K; George, Babu; Samuel, Beulah

    2013-11-01

    The risk of suicidal behavior associated with Anxiety Disorders (AD) among adolescents is known. However, concurrent mood disorders complicate these findings, and no data is available from India as well as from the community. This study aimed to address the suicidal risk associated with AD from different perspectives. The authors prospectively collected data for 500 adolescents in a community with independent, trained raters. Risk for suicidal behavior was measured with SADPERSONS scale, socio-economic status with Modified Kuppuswamy Scale, depression and anxiety disorders with Beck Depression Inventory and Screen for Child Anxiety Related Emotional Disorders respectively. The relationship between predictors and need for preventive action was analyzed with univariate and multivariate regression analyses and a predictive model was built. Suicidal behavior was increased by the presence of AD (adjusted OR = 6.28), the number of co-morbid AD (adjusted OR = 2.04), severity of the AD (adjusted OR = 4.98). Being a boy increased the risk of suicidal behavior associated with AD (adjusted OR = 9.37), Generalized Anxiety Disorder (adjusted OR = 5.65), Separation Anxiety Disorder (unadjusted OR = 3.28), Social Anxiety Disorder (unadjusted OR = 5.91) while controlling for the confounding effect of Depressive Disorder. Gender did not have an influence on Panic Disorder. Presence of AD and co-morbid Depressive Disorder significantly contributed to a risk model for suicidal behavior. Anxiety Disorder is associated with the risk for potential suicidal behavior. Adolescent boys with AD and Depressive Disorder need to be identified as the high risk group for suicide prevention in the community.

  4. Comorbid obsessive-compulsive personality disorder in obsessive-compulsive disorder (OCD): a marker of severity.

    Science.gov (United States)

    Lochner, Christine; Serebro, Paul; van der Merwe, Lize; Hemmings, Sian; Kinnear, Craig; Seedat, Soraya; Stein, Dan J

    2011-06-01

    Comorbid obsessive-compulsive personality disorder (OCPD) is well-described in obsessive-compulsive disorder (OCD). It remains unclear, however, whether OCPD in OCD represents a distinct subtype of OCD or whether it is simply a marker of severity in OCD. The aim of this study was to compare a large sample of OCD subjects (n=403) with and without OCPD on a range of demographic, clinical and genetic characteristics to evaluate whether comorbid OCPD in OCD represents a distinct subtype of OCD, or is a marker of severity. Our findings suggest that OCD with and without OCPD are similar in terms of gender distribution and age at onset of OC symptoms. Compared to OCD-OCPD (n=267, 66%), those with OCD+OCPD (n=136, 34%) are more likely to present with the OC symptom dimensions which reflect the diagnostic criteria for OCPD (e.g., hoarding), and have significantly greater OCD severity, comorbidity, functional impairment, and poorer insight. Furthermore there are no differences in distribution of gene variants, or response to treatment in the two groups. The majority of our findings suggest that in OCD, patients with OCPD do not have a highly distinctive phenomenological or genetic profile, but rather that OCPD represents a marker of severity. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Gender Differences in the Behavioral Symptom Severity of Prader-Willi Syndrome

    Directory of Open Access Journals (Sweden)

    Masao Gito

    2015-01-01

    Full Text Available Objectives. This study measured gender differences in Prader-Willi syndrome (PWS in regard to the severity of behavioral symptoms. Methods. The Food Related Problem Questionnaire (FRPQ, the Aberrant Behavior Checklist Japanese Version, the Childhood Routines Inventory, the Pervasive Developmental Disorders Autism Society Japan Rating Scale, and Japanese ADHD-RS were administered to PWS patients (45 males aged 6 to 58 and 37 females aged 6 to 45. To examine the effects that gender and genotype have on the severity of each symptom, two-way ANOVAs were conducted. Results. Significant interactions were found only in regard to FRPQ scores, such as FRPQ total score (F(1, 78 = 8.43, p<0.01. The FRPQ of male deletion (DEL individuals was higher than that of female DEL and male mUPD. The FRPQ of male maternal uniparental disomy (mUPD was lower than that of female mUPD. Conclusions. In terms of problem behaviors, routines, autistic behaviors, and hyperactivity, no significant differences were found. Food-related behaviors in DEL were more severe in males, although those in mUPD were less severe in males.

  6. Chewing and spitting out food as a compensatory behavior in patients with eating disorders.

    Science.gov (United States)

    Song, Youn Joo; Lee, Jung-Hyun; Jung, Young-Chul

    2015-10-01

    Recent studies suggest that chewing and spitting out food may be associated with severe eating-related pathology. The purpose of this study was to investigate the relationship between chewing and spitting, and other symptoms of eating disorders. We hypothesized that patients who chew and spit as a compensatory behavior have more severe eating-related pathology than patients who have never engaged in chewing and spitting behavior. We divided 359 patients with eating disorders into two groups according to whether they engaged in chewing and spitting as a compensatory behavior to lose weight or not. After comparing eating-related pathology between the two groups, we examined factors associated with pathologic eating behaviors using logistic regression analysis. Among our 359 participants, 24.5% reported having engaged in chewing and spitting as a compensatory behavior. The chewing and spitting (CHSP+) group showed more severe eating disorder symptoms and suicidal behaviors. This group also had significantly higher scores on subscales that measured drive for thinness, bulimia, and impulse regulation on the EDI-2, Food Craving Questionnaire, Body Shape Questionnaire, Beck Depression Inventory, Beck Anxiety Inventory, and Maudsley Obsessive Compulsive Inventory. Chewing and spitting is a common compensatory behavior among patients with eating disorders and is associated with more-pathologic eating behaviors and higher scores on psychometric tests. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Posttraumatic Stress Disorder Patients and Results of Violent Behavior

    Directory of Open Access Journals (Sweden)

    Taner Oznur

    2014-08-01

    Full Text Available AIM: High levels of anger and aggression in post-traumatic stress disorder lead to unfavorable social, legal, physical and economic results to family members and the other social layers as much as patients. In this study, it is aimed to investigate the relation between both alcohol-cigarette consumption ratios and anger levels, characteristics of aggressive behaviors and the judicial outcome in cases diagnosed post-traumatic stress disorder due to armed conflict. METHODS: 38 cases diagnosed as post-traumatic stress disorder were included to the study. Pre- and post-traumatic alcohol/cigarette consumption amounts and aggressive behaviors are determined. Impact of Events Scale (Revised (IES-R was used for evaluating post-traumatic stress disorder symptom patterns and severity, Buss Perry Aggression Questionnaire was used for measuring anger and aggression levels, and Taylor and #8217;s Violence Rating Scale was used for evaluating the judicial outcome of aggression. RESULTS: 23 of cases (60.6% were married with children, 13 of cases (34.25 were single and 2 of cases (5.2% were divorced.18 of cases (47.4% were graduate. IES-R total score was 66,9 +/- 12,7, Buss Perry total score was 111,3 +/- 20,5, and Taylor and #8217;s Violence Rate was 2,5 +/- 1,0. When the pre- and post-traumatic aggressive behaviors were compared; physical violence to the partner was increased more than ten times, Physical and verbal violence to social individuals were increased more than four and seven times, respectively. And also it is observed that inflicting damage to property was increased 17 times, reckless driving was increased 11 times, and self-mutilation was increased 5 times. Alcohol consumption was determined as 0 (0 - 126 g/day for pre-trauma cases and 16.5 (0 - 294 g/day for post-trauma cases. Cigarette smoking was determined as 5 (0 and #8211; 40 cigarette/day for pre-trauma cases and 30 (0 -60 cigarette/day for post-trauma cases. CONCLUSION: Post

  8. Behavioral symptoms and sleep problems in children with anxiety disorder.

    Science.gov (United States)

    Iwadare, Yoshitaka; Kamei, Yuichi; Usami, Masahide; Ushijima, Hirokage; Tanaka, Tetsuya; Watanabe, Kyota; Kodaira, Masaki; Saito, Kazuhiko

    2015-08-01

    Sleep disorders are frequently associated with childhood behavioral problems and mental illnesses such as anxiety disorder. To identify promising behavioral targets for pediatric anxiety disorder therapy, we investigated the associations between specific sleep and behavioral problems. We conducted retrospective reviews of 105 patients aged 4-12 years who met the DSM-IV criteria for primary diagnosis of generalized anxiety disorder (n = 33), separation anxiety disorder (n = 23), social phobia (n = 21), or obsessive compulsive disorder (n = 28). Sleep problems were evaluated using the Children's Sleep Habits Questionnaire (CSHQ) and behavioral problems by the Spence Children's Anxiety Scale, Oppositional Defiant Behavior Inventory (ODBI), and Depression Self-Rating Scale for Children. Depressive behavior was weakly correlated with CSHQ subscores for sleep onset delay and night waking but not with total sleep disturbance. Anxiety was correlated with bedtime resistance, night waking, and total sleep disturbance score. Oppositional defiance was correlated with bedtime resistance, daytime sleepiness, sleep onset delay, and most strongly with total sleep disturbance. On multiple regression analysis ODBI score had the strongest positive association with total sleep disturbance and the strongest negative association with total sleep duration. Sleep problems in children with anxiety disorders are closely related to anxiety and oppositional defiant symptoms. © 2015 Japan Pediatric Society.

  9. Differentiating Bipolar Disorder--Not Otherwise Specified and Severe Mood Dysregulation

    Science.gov (United States)

    Towbin, Kenneth; Axelson, David; Leibenluft, Ellen; Birmaher, Boris

    2013-01-01

    Objective: Bipolar disorder--not otherwise specified (BP-NOS) and severe mood dysregulation (SMD) are severe mood disorders that were defined to address questions about the diagnosis of bipolar disorder (BD) in youth. SMD and BP-NOS are distinct phenotypes that differ in clinical presentation and longitudinal course. The purpose of this review is…

  10. Aerosol behavior in the reactor containment building during severe accident

    International Nuclear Information System (INIS)

    Berthion, Y.; Lhiaubet, G.; Gauvain, J.

    1984-07-01

    Thermohydraulic behavior inside a PWR containment during severe accident depends on decay heat transferred to the sump water by aerosol gravitational settling and deposition. Conversely, aerosol behavior depends on thermal hydraulic conditions, especially atmosphere moisture for soluble aerosol GsI, and CsOH. Therefore, a small iterative procedure between thermo-hydraulic and aerosol calculations has been performed in order to evaluate the importance of this coupling between the two phenomena. In this paper, it is shown that with this procedure and using our codes JERICHO, RICOCHET and AEROSOLS/B1, the steam condensation on aerosols is an important phenomenon for a correct estimation of the attenuation factor of the suspended mass of aerosols in the airborne of the containment. Then, we have a more realistic assessment of the source term released by the containment

  11. Breastfeeding and behavior disorders among children and adolescents: a systematic review.

    Science.gov (United States)

    Poton, Wanêssa Lacerda; Soares, Ana Luiza Gonçalves; Oliveira, Elizabete Regina Araújo de; Gonçalves, Helen

    2018-02-05

    This systematic review study aimed to assess the evidence available for the association between breastfeeding and behavior disorders in childhood and adolescence. The search was carried out in the PubMed, Lilacs, and PsycINFO databases up to December 2016. Inclusion criteria were as follows: prospective, retrospective and cross-sectional studies assessing the association between breastfeeding and behavior disorders in childhood or adolescence, using psychometric tests, carried out in humans and published in Portuguese, English, or Spanish. The search was performed in several stages by two independent researchers using pre-established criteria. Eighteen studies met the inclusion criteria. Breastfeeding for a period equal to or higher than three or four months seemed to be inversely associated with total behavior and conduct disorders in childhood; however, the association remains unclear for other behavior disorders. Only four studies assessed behavior disorders in adolescence, and when an association was found, it was likely to be positive. The duration of breastfeeding seemed to be more important than the exclusive or non-exclusive pattern of breastfeeding. Breastfed children for at least three to four months had fewer total behavior and conduct disorders in childhood. Further studies are needed to better understand this association, particularly in adolescence and involving other behavioral profiles.

  12. Breastfeeding and behavior disorders among children and adolescents: a systematic review

    Directory of Open Access Journals (Sweden)

    Wanêssa Lacerda Poton

    2018-02-01

    Full Text Available ABSTRACT OBJECTIVE This systematic review study aimed to assess the evidence available for the association between breastfeeding and behavior disorders in childhood and adolescence. METHODS The search was carried out in the PubMed, Lilacs, and PsycINFO databases up to December 2016. Inclusion criteria were as follows: prospective, retrospective and cross-sectional studies assessing the association between breastfeeding and behavior disorders in childhood or adolescence, using psychometric tests, carried out in humans and published in Portuguese, English, or Spanish. The search was performed in several stages by two independent researchers using pre-established criteria. RESULTS Eighteen studies met the inclusion criteria. Breastfeeding for a period equal to or higher than three or four months seemed to be inversely associated with total behavior and conduct disorders in childhood; however, the association remains unclear for other behavior disorders. Only four studies assessed behavior disorders in adolescence, and when an association was found, it was likely to be positive. The duration of breastfeeding seemed to be more important than the exclusive or non-exclusive pattern of breastfeeding. CONCLUSIONS Breastfed children for at least three to four months had fewer total behavior and conduct disorders in childhood. Further studies are needed to better understand this association, particularly in adolescence and involving other behavioral profiles.

  13. Binge Eating Disorder and Bipolar Spectrum disorders in obesity: Psychopathological and eating behaviors differences according to comorbidities.

    Science.gov (United States)

    Segura-Garcia, Cristina; Caroleo, Mariarita; Rania, Marianna; Barbuto, Elvira; Sinopoli, Flora; Aloi, Matteo; Arturi, Franco; De Fazio, Pasquale

    2017-01-15

    Obesity is not a mental disorder, yet DSM-5 recognizes a strong association between obesity and psychiatric syndromes. Disorders within the Bipolar Spectrum (BSD) and Binge Eating Disorder (BED) are the most frequent psychiatric disorders among obese patients. The aim of this research is to investigate the psychopathological differences and the distinctive eating behaviors that accompany these comorbidities in obese patients. One hundred and nineteen obese patients (40 males; 79 females) underwent psychological evaluation and psychiatric interview, and a dietitian evaluated their eating habits. Patients were divided into four groups according to comorbidities, and comparisons were run accordingly. Forty-one percent of participants presented BED+BSD comorbidity (Group 1), 21% BED (Group 2) and 8% BSD (Group 3); only 29% obese participants had no comorbidity (Group 4). Female gender was overrepresented among Groups 1 and 2. BSD diagnosis varied according to comorbidities: Type II Bipolar Disorder and Other Specified and Related Bipolar Disorder (OSR BD) were more frequent in Group 1 and Type I Bipolar Disorder in Group 3. A trend of decreasing severity in eating behaviors and psychopathology was evident according to comorbidities (Group 1=Group2>Group3>Group 4). Limitations include the small sample size and the cross-sectional design of the study. BED and BSD are frequent comorbidities in obesity. Type II Bipolar Disorder and OSR BD are more frequent in the group with double comorbidity. The double comorbidity seems associated to more severe eating behaviors and psychopathology. Distinctive pathological eating behaviors could be considered as warning signals, symptomatic of psychiatric comorbidities in Obesity. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Comorbidity and medication in REM sleep behavior disorder

    DEFF Research Database (Denmark)

    Frauscher, Birgit; Jennum, Poul; Ju, Yo-El S

    2014-01-01

    OBJECTIVE: This controlled study investigated associations between comorbidity and medication in patients with polysomnographically confirmed idiopathic REM sleep behavior disorder (iRBD), using a large multicenter clinic-based cohort. METHODS: Data of a self-administered questionnaire...

  15. Cognitive and Behavioral Disorders in Children with Neurofibromatosis Type 1

    Directory of Open Access Journals (Sweden)

    Martha Milade Torres Nupan

    2017-10-01

    Full Text Available AimThe last systematic review of research on the behavior of children with neurofibromatosis type 1 (NF1 was in 2012. Since then, several important findings have been published. Therefore, the study aim was to synthesize recent relevant work related to this issue.MethodWe conducted a systematic review of the literature. Relevant articles were identified using the electronic databases PubMed, PsycINFO, and Scopus and a manual search of references lists. Thirty of 156 articles identified met the inclusion criteria. A quality evaluation of the articles was performed and the information was synthesized using a narrative approach.ResultsCompared with controls, children and adolescents with NF1 present significant alterations in language, reading, visuospatial skills, motor function, executive function, attention, behavior, emotion, and social skills. The prevalence of attention-deficit/hyperactivity disorder (ADHD is important and can affect cognition and executive function variables. A high prevalence of autistic traits and autistic spectrum disorder were reported. The benefits of using statins to treat cognitive deficits are unclear. However, children with NF1 and ADHD seem to benefit from methylphenidate treatment. The presence of hyperintensities in brain magnetic resonance imaging data seem to be related to poor cognitive performance. Analysis of these lesions could help to predict cognitive alterations in children with NF1.InterpretationThere has been important progress to evaluate cognitive characteristics of children with NF1 and to determine the physiological mechanisms of the concomitant disorders. However, discrepancies in relation to intelligence, learning disabilities, attention deficits, and treatment remain. Further investigations on this topic are recommended.

  16. Cognitive and Behavioral Disorders in Children with Neurofibromatosis Type 1.

    Science.gov (United States)

    Torres Nupan, Martha Milade; Velez Van Meerbeke, Alberto; López Cabra, Claudia Alejandra; Herrera Gomez, Paula Marcela

    2017-01-01

    The last systematic review of research on the behavior of children with neurofibromatosis type 1 (NF1) was in 2012. Since then, several important findings have been published. Therefore, the study aim was to synthesize recent relevant work related to this issue. We conducted a systematic review of the literature. Relevant articles were identified using the electronic databases PubMed, PsycINFO, and Scopus and a manual search of references lists. Thirty of 156 articles identified met the inclusion criteria. A quality evaluation of the articles was performed and the information was synthesized using a narrative approach. Compared with controls, children and adolescents with NF1 present significant alterations in language, reading, visuospatial skills, motor function, executive function, attention, behavior, emotion, and social skills. The prevalence of attention-deficit/hyperactivity disorder (ADHD) is important and can affect cognition and executive function variables. A high prevalence of autistic traits and autistic spectrum disorder were reported. The benefits of using statins to treat cognitive deficits are unclear. However, children with NF1 and ADHD seem to benefit from methylphenidate treatment. The presence of hyperintensities in brain magnetic resonance imaging data seem to be related to poor cognitive performance. Analysis of these lesions could help to predict cognitive alterations in children with NF1. There has been important progress to evaluate cognitive characteristics of children with NF1 and to determine the physiological mechanisms of the concomitant disorders. However, discrepancies in relation to intelligence, learning disabilities, attention deficits, and treatment remain. Further investigations on this topic are recommended.

  17. Longitudinal associations between parenting style and adolescent disordered eating behaviors.

    Science.gov (United States)

    Zubatsky, Max; Berge, Jerica; Neumark-Sztainer, Dianne

    2015-06-01

    The main purpose of this study was to identify the longitudinal association between specific parenting styles (authoritarian, authoritative, permissive, and neglectful) and adolescent disordered eating behaviors. The current study uses longitudinal data from a 5-year study to examine the associations between parenting style and disordered eating behaviors among adolescents. Data from adolescents (n = 2516) participating in Project EAT (Eating Among Teens), a population-based study from 31 Minnesota schools, were used in the analysis. Time 1 data were collected using in-class assessments of adolescents from Minneapolis/St. Paul schools, and Time 2 data were collected using mailed surveys 5 years later. General Linear Models were used to predict adolescent-reported disordered eating behaviors at Time 2 from adolescent-reported parenting style at Time 1. Adolescent boys and girls who had authoritarian mothers at Time 1 had a higher probability of extreme weight control behaviors 5 years later compared to adolescents with authoritative, permissive, or neglectful mothers. Adolescent girls with authoritarian mothers at Time 1 had a higher probability of engaging in binge-eating behaviors at Time 2 compared to adolescent girls with authoritative or permissive mothers. There were no significant associations between paternal parenting style and adolescent disordered eating behaviors. Although authoritarian parenting style served as a possible risk factor for disordered eating behaviors in adolescents, the findings were not conclusive. Future studies should investigate further the association between parenting style and weight control behaviors in adolescents.

  18. Morbidities in rapid eye movement sleep behavior disorder

    DEFF Research Database (Denmark)

    Jennum, Poul; Mayer, Geert; Ju, Yo-El

    2013-01-01

    Idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD, RBD without any obvious comorbid major neurological disease), is strongly associated with numerous comorbid conditions. The most prominent is that with neurodegenerative disorders, especially synuclein-mediated disorders, above all...... function, neuropsychiatric manifestations and sleep complaints. Furthermore, patients with PD and RBD may have worse prognosis in terms of impaired cognitive function and overall morbidity/mortality; in dementia, the presence of RBD is strongly associated with clinical hallmarks and pathological findings...

  19. Cognitive-Behavioral Body Image Therapy for Body Dysmorphic Disorder.

    Science.gov (United States)

    Rosen, James C.; And Others

    1995-01-01

    Randomly assigned 54 body dysmorphic disorder (BDD) subjects to cognitive behavior therapy or no treatment. BDD symptoms were significantly decreased in therapy subjects and the disorder was eliminated in 82 percent of cases at posttreatment and 77 percent at follow-up. Subjects' overall psychological symptoms and self-esteem also improved. (RJM)

  20. Optimizing Cognitive-Behavioral Therapy for Childhood Psychiatric Disorders

    Science.gov (United States)

    Piacentini, John

    2008-01-01

    Reports that expand the understanding of the treatment of childhood obsessive-compulsive disorder by using exposure-based cognitive-behavioral therapy in the age group of 5 to 8-year-olds are presented. A model for collecting the common core elements of evidence-based psychosocial treatments for childhood disorders is also presented.

  1. The Effects of Peer Influence on Disordered Eating Behavior

    Science.gov (United States)

    Meyer, Tiffany A.; Gast, Julie

    2008-01-01

    Peer influence has been found to be correlated with a host of harmful health behaviors. However, little research has been conducted investigating the relationship between peer influence and disordered eating. The present study surveyed 6th-, 7th-, and 8th-grade girls and boys using the Eating Disorder Inventory (EDI) and Inventory of Peer…

  2. Behavior Disorders Prevalence in High School Students in Hamedan Province

    Directory of Open Access Journals (Sweden)

    Ali Reza Zolfaghari

    2014-04-01

    Full Text Available Objective: Behavioral disorders of childhood and adolescence represent a range of problems and Its prevalence varies in different parts of Iran and the world. Knowledge of them is essential to the prevention, treatment and rehabilitation of patients. The aim of this survey is assessment of behavior disorders prevalence in high school students in Hamedan province. Materials & Methods: In this descriptive and cross sectional study, 500 boy and girl students were selected from Hamedan high schools by multistep cluster sampling, based on region and gender. Data were gathered by Achenbach experience questionnaire (YSR form and analyzed by Friedman and independent T tests. Results: The findings showed that prevalence of behavioral problems among students in the province is 10 percent and it was higher in girls than boys. Most disorders were withdrawal disorder / anxiety and attention problems and somatization disorder was the least problem. Conclusion: Prevalence of behavior disorders in Hamedan province compared to other studies is moderate, but the behavior disorders prevalence of boys and girls are different from other researchs.

  3. Suicide attempts and clinical severity of eating disorders : an exploratory study

    OpenAIRE

    Machado, Paulo P. P.; Gonçalves, Sónia; Machado, Bárbara César; Torres, António Roma; Brandão, Isabel

    2004-01-01

    The present study examines whether eating disorders patients with suicide attempts present differences in disordered eating and clinical traits compared to those without suicide attempts. Method: 144 patients with eating disorders (65 anorexia nervosa and 79 bulimia nervosa) completed the Eating Disorders Inventory (EDI; Garner, Omstead & Polivy, 1983), the Symptom Checklist - 90- Revised (SCL-90; Derrogatis, 1977), and a questionnaire to assess eating behaviors and attitudes, information reg...

  4. Etiological model of disordered eating behaviors in Brazilian adolescent girls.

    Science.gov (United States)

    Fortes, Leonardo de Sousa; Filgueiras, Juliana Fernandes; Oliveira, Fernanda da Costa; Almeida, Sebastião Sousa; Ferreira, Maria Elisa Caputo

    2016-01-01

    The objective was to construct an etiological model of disordered eating behaviors in Brazilian adolescent girls. A total of 1,358 adolescent girls from four cities participated. The study used psychometric scales to assess disordered eating behaviors, body dissatisfaction, media pressure, self-esteem, mood, depressive symptoms, and perfectionism. Weight, height, and skinfolds were measured to calculate body mass index (BMI) and percent body fat (%F). Structural equation modeling explained 76% of variance in disordered eating behaviors (F(9, 1,351) = 74.50; p = 0.001). The findings indicate that body dissatisfaction mediated the relationship between media pressures, self-esteem, mood, BMI, %F, and disordered eating behaviors (F(9, 1,351) = 59.89; p = 0.001). Although depressive symptoms were not related to body dissatisfaction, the model indicated a direct relationship with disordered eating behaviors (F(2, 1,356) = 23.98; p = 0.001). In conclusion, only perfectionism failed to fit the etiological model of disordered eating behaviors in Brazilian adolescent girls.

  5. Disordered eating behaviors and body image in male athletes

    Directory of Open Access Journals (Sweden)

    Fernanda Reistenbach Goltz

    2013-09-01

    Full Text Available Objective: To identify disordered eating behaviors and body image dissatisfaction, as well as their relationship to body fat (BF, among male athletes in high risk sports for eating disorders. Methods: One hundred and fifty-six male athletes were divided into the following categories: weight-class sports, sports where leanness improves performance, and sports with aesthetic ideals. BF was assessed and three questionnaires were used: the Eating Attitudes Test; the Bulimic Investigatory Test, Edinburgh; the Body Shape Questionnaire. Results: Disordered eating behaviors and body image dissatisfaction were found in 43 (27.6% and 23 athletes (14.7%, respectively, and an association was detected between the two variables (p < 0.001. Athletes with and without disordered eating behaviors did not differ in %BF (11.0±5.2% and 9.8±4.0%, respectively; p = 0.106. However, athletes with body image dissatisfaction had higher %BF than those who were satisfied (12.6±5.9% and 9.7±3.9%, respectively; p = 0.034. There were no differences in BF, frequency of disordered eating behaviors, and body image dissatisfaction between sports categories. Conclusion: Nearly one-quarter of athletes showed disordered eating behaviors, which was associated with body image dissatisfaction. Athletes with higher %BF were more likely to be dissatisfied with body image. There was no difference in eating behavior and body image between athletes from different sports categories.

  6. Numerical module for debris behavior under severe accident conditions

    International Nuclear Information System (INIS)

    Kisselev, A.E.; Kobelev, G.V.; Strizhov, V.F.; Vasiliev, A.D.

    2005-01-01

    The late phase of a hypothetical severe accident in a nuclear reactor is characterized by the appearance of porous debris and liquid pools in core region and lower head of the reactor vessel. Thermal hydraulics and heat transfer in these regions are very important for adequate analysis of severe accident dynamics. The purpose of this work is to develop a universal module which is able to model above-mentioned phenomena on the basis of modern physical concepts. The original approach for debris evolution is developed from classical principles using a set of parameters including debris porosity; average particle diameter; temperatures and mass fractions of solid, liquid and gas phases; specific interface areas between different phases; effective thermal conductivity of each phase, including radiative heat conductivity; mass and energy fluxes through the interfaces. The calculation results of several tests on modeling of porous debris behavior, including the MP-1 experiment, are presented in comparison with experimental data. The results are obtained using this module implemented into the Russian best estimate code, RATEG/SVECHA/HEFEST, which was developed for modeling severe accident thermal hydraulics and late phase phenomena in VVER nuclear power plants. (author)

  7. Reward deficiency syndrome: genetic aspects of behavioral disorders.

    Science.gov (United States)

    Comings, D E; Blum, K

    2000-01-01

    The dopaminergic and opioidergic reward pathways of the brain are critical for survival since they provide the pleasure drives for eating, love and reproduction; these are called 'natural rewards' and involve the release of dopamine in the nucleus accumbens and frontal lobes. However, the same release of dopamine and production of sensations of pleasure can be produced by 'unnatural rewards' such as alcohol, cocaine, methamphetamine, heroin, nicotine, marijuana, and other drugs, and by compulsive activities such as gambling, eating, and sex, and by risk taking behaviors. Since only a minority of individuals become addicted to these compounds or behaviors, it is reasonable to ask what factors distinguish those who do become addicted from those who do not. It has usually been assumed that these behaviors are entirely voluntary and that environmental factors play the major role; however, since all of these behaviors have a significant genetic component, the presence of one or more variant genes presumably act as risk factors for these behaviors. Since the primary neurotransmitter of the reward pathway is dopamine, genes for dopamine synthesis, degradation, receptors, and transporters are reasonable candidates. However, serotonin, norepinephrine, GABA, opioid, and cannabinoid neurons all modify dopamine metabolism and dopamine neurons. We have proposed that defects in various combinations of the genes for these neurotransmitters result in a Reward Deficiency Syndrome (RDS) and that such individuals are at risk for abuse of the unnatural rewards. Because of its importance, the gene for the [figure: see text] dopamine D2 receptor was a major candidate gene. Studies in the past decade have shown that in various subject groups the Taq I A1 allele of the DRD2 gene is associated with alcoholism, drug abuse, smoking, obesity, compulsive gambling, and several personality traits. A range of other dopamine, opioid, cannabinoid, norepinephrine, and related genes have since been

  8. [Association between behavioral problems and gastrointestinal disorders among children with autism spectrum disorder].

    Science.gov (United States)

    Zhu, J; Guo, M; Yang, T; Lai, X; Lei, Y Y; He, M L; Chen, J; Li, T Y

    2017-12-02

    Objective: To investigate the relationship between gastrointestinal disorders (GID) and core symptoms or behavioral problems among the children with autism spectrum disorder (ASD) . Method: Totally 328 children with ASD and 202 normal controls were enrolled in this cross-sectional study from August 2013 to October 2016. The information about the gastrointestinal disorders, behavioral and emotional problems was collected by using questionnaires. Childhood Autism Rating Scale (CARS), Autism Behavior Checklist (ABC) were used to assess the core symptoms of the children with ASD. Neurodevelopmental status was evaluated with Gesell Developmental Scale (GDS). These variables were analyzed by using student's t -test and chi-square test. Result: The prevalence of GID was significantly higher in the children with ASD than in the normally developing children (49.4% (162/328) vs .25.7% (52/202), χ(2)=29.039, P= 0.000), especially the symptoms of constipation (33.2% (109/328) vs . 13.9% (28/202)), diarrhea (9.5%(31/328) vs . 1.5% (3/202)), nausea and vomiting (9.5% (31/328) vs . 3.5% (7/202)), and foul defecation (16.5% (54/328) vs . 5.0% (10/202)) (all P 0.05). Compared with ASD children without GID ( n =166), the ASD children with GID ( n =162) got higher scores in the "Body and Object Use" of ABC scale ( (16.4±9.3) vs . (12.3±6.7) scores, t= 2.258, P= 0.028), and had more emotional problems (63.6% (103/162) vs . 49.4% (82/166), χ(2)=6.707, P= 0.010). Moreover, the score of behavior problems questionnaire was higher in the ASD children with GID ( (35.3±16.8) vs . (16.1±13.6) scores, t= 5.748, P= 0.000). Conclusion: Children with ASD have higher risk of GID than the normal developing children. While the stereotyped behaviors, problem behaviors and emotional problems are severer in the ASD children with GID. Hence, it is important to provide comprehensive treatment and management for these groups of children.

  9. Relationship between Risk Behavior for Eating Disorders and Dental Caries and Dental Erosion.

    Science.gov (United States)

    Brandt, Lorenna Mendes Temóteo; Fernandes, Liege Helena Freitas; Aragão, Amanda Silva; Aguiar, Yêska Paola Costa; Auad, Sheyla Márcia; de Castro, Ricardo Dias; Cavalcanti, Sérgio D'Ávila Lins Bezerra; Cavalcanti, Alessandro Leite

    2017-01-01

    The aim of this study was to evaluate whether there is an association between risk behavior for eating disorders (EDs) and dental erosion and caries. A controlled cross-sectional study was conducted in Brazil, involving 850 randomly selected female adolescents. After evaluating risk behavior for eating disorders through the Bulimic Investigatory Test of Edinburgh, 12 adolescents were identified with severe risk behavior for EDs and matched to 48 adolescents without such risk. Dental examinations, anthropometric measurements, and eating habits and oral hygiene were performed. Adolescents with high severity eating disorder condition were not more likely to show dental caries ( p = 0.329; OR = 2.2, 95% CI: 0.35-13.72) or dental erosion ( p = 0.590; OR = 2.33; 95% CI: 0.56-9.70). Adolescents with high body mass index (BMI) were five times more likely to have high severity eating disorder condition ( p = 0.031; OR = 5.1; 95% CI: 1.61-23.07). Therefore, high severity risk behavior for EDs was not significantly associated with dental caries and dental erosion. However, high BMI was a risk factor for developing eating disorders and should be an alert for individuals with this condition.

  10. Fathers and mothers with eating-disorder psychopathology: Associations with child eating-disorder behaviors

    Science.gov (United States)

    Lydecker, Janet A.; Grilo, Carlos M.

    2016-01-01

    Objective A limited literature suggests an association between maternal eating disorders and child feeding difficulties, and notes maternal concern about inadvertently transmitting eating disorders. Thus, parents may be an important target for eating-disorder research to guide the development of clinical programs. Methods The current study examined differences in child eating-disorder behaviors and parental feeding practices between a sample of parents (42 fathers, 130 mothers) exhibiting core features of anorexia nervosa, bulimia nervosa, binge-eating disorder, or purging disorder, and a matched sample of parents (n=172) reporting no eating-disorder characteristics. Results Parents with eating-disorder psychopathology were significantly more likely than parents without eating-disorder characteristics to report child binge-eating and compulsive exercise. Parents with eating-disorder psychopathology reported greater perceived feeding responsibility, greater concern about their child’s weight, and more monitoring of their child’s eating than parents without eating-disorder characteristics; however, they did not differ significantly in restriction of their child’s diet and pressure-to-eat. Child body mass index z-scores did not differ between parents with versus without eating-disorder characteristics. Conclusion Our findings suggest some important differences between parents with and without core eating-disorder psychopathology, which could augment clinical interventions for patients with eating disorders who are parents, or could guide pediatric eating-disorder prevention efforts. However, because our study was cross-sectional, findings could indicate increased awareness of or sensitivity to eating-disorder behaviors rather than a psychosocial cause of those behaviors. Longitudinal research and controlled trials examining prevention and intervention can clarify and address these clinical concerns. PMID:27302549

  11. Olfactory functions are not associated with autism severity in autism spectrum disorders

    Directory of Open Access Journals (Sweden)

    Dudova I

    2013-11-01

    Full Text Available Iva Dudova, Michal HrdlickaDepartment of Child Psychiatry, University Hospital Motol, Prague, Czech RepublicBackground: Changes in olfactory functions have been found in many neurodegenerative and psychiatric disorders, including autism spectrum disorders (ASDs. The aim of the present study was to evaluate the relationship between olfactory functions (odor-detection thresholds, odor identification, and odor preference and autism severity and sensory-related behavior in children and adolescents with ASD.Subjects and methods: Our sample consisted of 35 high-functioning patients with ASD (mean age 10.8±3.6 years, 31 boys. Olfactory testing (threshold and identification used the Sniffin' Sticks test. Odor pleasantness was assessed on a 5-point scale using the Identification part of the Sniffin’ Sticks test. The severity of autistic psychopathology was measured using the Childhood Autism Rating Scale (CARS.Results: Using Spearman’s correlation, we found no significant correlations between autism severity (as expressed by total CARS score and odor-detection thresholds (R=0.144, P=0.409, odor identification (R=0.07, P=0.966, or odor pleasantness (R=-0.046, P=0.794. There was also no significant relationship between CARS item 9 (“Taste, smell, and touch response and use” and odor-detection thresholds (R=0.170, P=0.330, odor identification (R=0.282, P=0.100, or odor pleasantness (R=0.017, P=0.923.Conclusion: We did not find any significant relationship between the severity of autistic psychopathology and olfactory functions.Keywords: autism spectrum disorders, psychopathology, Sniffin’ Sticks, odor threshold, odor identification, odor pleasantness

  12. Preinjury Psychological Status, Injury Severity and Postdeployment Posttraumatic Stress Disorder

    Science.gov (United States)

    2011-05-01

    separation anxiety disorder), gaining weight (anorexia nervosa), having multiple physical symptoms ( somatization dis- order), or having a serious illness... hypochondriasis ), and the anxiety and worry do not occur exclusively in relation to PTSD. On the basis of responses to questions related to depression

  13. Prevalence, severity and risk factors of allergic disorders among ...

    African Journals Online (AJOL)

    Objectives: To find out the prevalence and risk factors of allergic disorders. Methods: Data ..... with being continuously alert to their eating habits due to fear of allergic ... and fish.6,13,20,23 Genetic factors are known to be incrim- inated with ...

  14. Sleep and Behavioral Problems in Children with Autism Spectrum Disorder

    Science.gov (United States)

    Mazurek, Micah O.; Sohl, Kristin

    2016-01-01

    Children with autism spectrum disorder (ASD) are at high risk for sleep disturbance and behavioral dysregulation. However, the relationships between these difficulties are not fully understood. The current study examined the relationships between specific types of sleep and behavioral problems among 81 children with ASD. Sleep problems were…

  15. A Cognitive-Behavioral Treatment Approach for Body Dysmorphic Disorder

    Science.gov (United States)

    Wilhelm, Sabine; Buhlmann, Ulrike; Hayward, Laura C.; Greenberg, Jennifer L.; Dimaite, Ruta

    2010-01-01

    Although body dysmorphic disorder (BDD) has been described in the literature for more than a century, there has been only a limited focus on the development of cognitive behavioral treatments for BDD. Our case report provides a detailed description of a course of cognitive behavioral treatment (CBT) for an individual with BDD. The patient was…

  16. Social Skills Training and Students with Emotional and Behavioral Disorders

    Science.gov (United States)

    Casey, Kathryn J.

    2012-01-01

    There is a large body of literature suggesting that students with emotional and behavioral disorders (EBD) lack appropriate social skills, including deficits in building and maintaining interpersonal relationships, prosocial behaviors (e.g., sharing, helping, cooperation), and self-management strategies. While the literature shows small to modest…

  17. Self-Destructive Behavior in People with Dissociative Disorders.

    Science.gov (United States)

    Saxe, Glenn N.; Chawla, Neharika; Van der Kolk, Bessel

    2002-01-01

    Study assesses self-destructive behavior in a group of inpatients who have dissociative disorders compared to those who report few dissociative symptoms. Results reveal that these patients more frequently engage in self-destructive behaviors, use more methods of self-injury, and begin to injure themselves at an earlier age then patients who do not…

  18. Dissociative Disorders in Children: Behavioral Profiles and Problems.

    Science.gov (United States)

    Putnam, Frank W.

    1993-01-01

    Clinical research has established a connection between childhood trauma and the development of dissociative disorders in adults. Pathological dissociation produces a range of symptoms and behaviors such as amnesias, rapid shifts in mood and behavior, and auditory and visual hallucinations. Many of these symptoms are misdiagnosed as attention,…

  19. [Repetitive impulse-associated behavioral disorders in Parkinson's disease].

    Science.gov (United States)

    Katzenschlager, R; Goerlich, K S; van Eimeren, T

    2012-12-01

    Parkinson's disease (PD) is associated with a number of behavioral disorders which may cause considerable social, professional or financial problems. Impulse control disorders (ICDs), such as pathological gambling, binge eating, compulsive shopping and hypersexuality occur in approximately 13-14% of PD patients. Further behavioral disorders are the dopamine dysregulation syndrome (DDS), a substance dependence characterized by craving for dopaminergic substances and punding (prolonged repetitive activities which are not goal-oriented).Treatment-related risk factors are dopamine agonists for ICDs and a high total dopaminergic dose for DDS and punding. Shared risk factors are young age at onset, impulsive personality traits, depression and possibly dyskinesia. At the neuronal level these behavioral disorders seem to be associated with changes in the reward system and dysfunction of the orbitofrontal cortex. The evidence level for management strategies is at present insufficient. For ICDs current clinical practice consists of discontinuation or reduction of dopamine agonists.

  20. Overall severities of gastrointestinal symptoms in pediatric outpatients with and without autism spectrum disorder.

    Science.gov (United States)

    Thulasi, Venkatraman; Steer, Robert A; Monteiro, Iona M; Ming, Xue

    2018-03-01

    In order to determine the effectiveness of a Gastrointestinal Severity Index to screen for gastrointestinal disorders, the Gastrointestinal Severity Index was administered to 135 children with autism spectrum disorders and 146 comparisons with and without gastrointestinal disorders. The mean Gastrointestinal Severity Index scores of the groups were 3.53 ± 1.78, 3.15 ± 1.99, 0.81 ± 1.25, and 0.29 ± 0.76 (comparative pediatric patients with gastrointestinal disorder = autism spectrum disorder + gastrointestinal disorder > autism spectrum disorder-gastrointestinal disorder > comparative pediatric patients without gastrointestinal disorder, respectively), Ps disorders. The area under the receiver operating characteristic curve (0.97) for the comparison group was higher (P autism spectrum disorder children indicating that the Gastrointestinal Severity Index was more effective in screening for gastrointestinal disorders in comparisons. However, the same Gastrointestinal Severity Index cutoff score of 2 and above yielded, respectively, sensitivity and specificity rates of 92% and 93% for comparisons and 80% and 79% for autism spectrum disorder children. The negative and positive predictive values based on these sensitivity and specificity rates were calculated for a range of prevalences of gastrointestinal disorders and indicated that the Gastrointestinal Severity Index may be useful for screening children with and without autism spectrum disorder for gastrointestinal symptoms.

  1. Dopamine transporter imaging in rapid eye movement sleep behavior disorder

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yu Kyeong; Yoon, In Young; Kim, Jong Min; Jeong, Seok Hoon; Kim, Ji Sun; Lee, Byung Chul; Lee, Won Woo; Kim, Sang Eun [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    The pathogenesis of rapid eye movement (REM) sleep behavior disorder (RBD) is still unknown. However, involvement of dopaminergic system in RBD has been hypothesized because of frequent association with degenerative movement disorders such as Parkinson's disease. The purpose of this study was to examine the extent and pattern of loss of dopamine transporter in RBD using FP-CIT SPECT. Fourteen patient with idiopathic RBD (mean age:665 yrs, M:F=10:3) participated in this study. Polysonmography confirmed loss of REM atonia and determined RBD severities by amount of tonic/phasic muscle activity during REM sleep in all cases. To compare with RBD, 14 early idiopathic Parkinson's disease rated as Hoehn and Yahr stage 1 (IPD) and 12 healthy controls were also selected. All participants performed single-photon emission computed tomography (SPECT) imaging 3 hours after injection of [123I]FP-CIT. Regions of interest were drawn on bilateral caudate and putamen, whole striatum and occipital cortex. Specific binding for dopamine transporters (DAT) were calculated using region to occipital uptake ratio based on the transient equilibrium method. Overall mean of DAT density in the striatum was lower in RBD group than controls, and higher than IPD group, However, DAT density in most individual RBD was still within normal range, and total striatal DAT density was not correlated with severity of RBD. Meanwhile, the caudate to putamen uptake ratio (C/P ratio) in RBD group was insignificantly higher than those in healthy controls. Nevertheless, C/P ratio within RBD group was reversely correlated with the RBD severity. Our study suggested that nigrostriatal dopaminergic degeneration could be a part of the pathogenesis of RBD, but not essential for the development of RBD. Further longitudinal evaluation of presynaptic dopaminergic system in idiopathic RBD may guarantee the more understanding for RBD and associated neurodegenerative disease.

  2. Dopamine transporter imaging in rapid eye movement sleep behavior disorder

    International Nuclear Information System (INIS)

    Kim, Yu Kyeong; Yoon, In Young; Kim, Jong Min; Jeong, Seok Hoon; Kim, Ji Sun; Lee, Byung Chul; Lee, Won Woo; Kim, Sang Eun

    2007-01-01

    The pathogenesis of rapid eye movement (REM) sleep behavior disorder (RBD) is still unknown. However, involvement of dopaminergic system in RBD has been hypothesized because of frequent association with degenerative movement disorders such as Parkinson's disease. The purpose of this study was to examine the extent and pattern of loss of dopamine transporter in RBD using FP-CIT SPECT. Fourteen patient with idiopathic RBD (mean age:665 yrs, M:F=10:3) participated in this study. Polysonmography confirmed loss of REM atonia and determined RBD severities by amount of tonic/phasic muscle activity during REM sleep in all cases. To compare with RBD, 14 early idiopathic Parkinson's disease rated as Hoehn and Yahr stage 1 (IPD) and 12 healthy controls were also selected. All participants performed single-photon emission computed tomography (SPECT) imaging 3 hours after injection of [123I]FP-CIT. Regions of interest were drawn on bilateral caudate and putamen, whole striatum and occipital cortex. Specific binding for dopamine transporters (DAT) were calculated using region to occipital uptake ratio based on the transient equilibrium method. Overall mean of DAT density in the striatum was lower in RBD group than controls, and higher than IPD group, However, DAT density in most individual RBD was still within normal range, and total striatal DAT density was not correlated with severity of RBD. Meanwhile, the caudate to putamen uptake ratio (C/P ratio) in RBD group was insignificantly higher than those in healthy controls. Nevertheless, C/P ratio within RBD group was reversely correlated with the RBD severity. Our study suggested that nigrostriatal dopaminergic degeneration could be a part of the pathogenesis of RBD, but not essential for the development of RBD. Further longitudinal evaluation of presynaptic dopaminergic system in idiopathic RBD may guarantee the more understanding for RBD and associated neurodegenerative disease

  3. Predicting the Transition From Acute Stress Disorder to Posttraumatic Stress Disorder in Children With Severe Injuries.

    Science.gov (United States)

    Brown, Ruth C; Nugent, Nicole R; Hawn, Sage E; Koenen, Karestan C; Miller, Alisa; Amstadter, Ananda B; Saxe, Glenn

    The purpose of this study was to examine predictors of risk for and the transition between acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) in a longitudinal sample of youth with severe injuries admitted to the hospital. These data would assist with treatment and discharge planning. Youth were assessed for ASD during the initial hospital stay and were followed-up over an 18-month period for PTSD (n = 151). Youth were classified into four groups, including Resilient (ASD-, PTSD-), ASD Only (ASD+, PTSD-), PTSD Only (ASD-, PTSD+), and Chronic (ASD+, PTSD+). Demographic, psychiatric, social context, and injury-related factors were examined as predictors of diagnostic transition. The results of multivariate analysis of variance and pairwise comparisons found that peritraumatic dissociation, gender, and socioeconomic status were significant predictors after controlling for multiple testing. Results suggest that both within-child and contextual factors contribute to the longitudinal response to trauma in children. Clinicians should consider early screening and discharge planning, particularly for children most at risk. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  4. Impact of Cognitive Behavioral Therapy on Observed Autism Symptom Severity during School Recess: A Preliminary Randomized, Controlled Trial

    Science.gov (United States)

    Wood, Jeffrey J.; Fujii, Cori; Renno, Patricia; Van Dyke, Marilyn

    2014-01-01

    This study compared cognitive behavioral therapy (CBT) and treatment-as-usual (TAU) in terms of effects on observed social communication-related autism symptom severity during unstructured play time at school for children with autism spectrum disorders (ASD). Thirteen children with ASD (7-11 years old) were randomly assigned to 32 sessions of CBT…

  5. [Development of sexuality and motivational aspects of sexual behavior in men with obsessive-compulsive disorders].

    Science.gov (United States)

    2014-09-01

    Sexual behavior and formation of sexuality in men with obsessive-compulsive disorder is one of the pressing issues in contemporary medicine. Obsessive-compulsive disorder is characterized by the development of intrusive thoughts, memories, movements and actions, as well as a variety of pathological fears (phobias). Increase in the number of patients with this pathology in modern clinical practice of neurotic disorders, the young age of the patients and as a result violation of interpersonal, communicational and sexual nature is quite apparent. The study involved 35 men aged 23 to 47 years with clinical signs of OCD. We determined the severity of obsessive-compulsive symptoms using the Yale-Brown scale. We established the presence of a mild degree of disorder in 34,3% of cases; in 48,6% of cases disorder of moderate severity was diagnosed; remaining 17.1% were assessed subclinical condition of OCD at the applicable scale. The system of motivational maintenance of sexual behavior in men with obsessive-compulsive disorders is investigated. Motives of sexual behavior of the investigated men with the pathology are determined. The presented research in men with OCD have established multidimensionality and complexity of motivational ensuring of sexual behavior.

  6. Examining the Criterion-Related Validity of the Pervasive Developmental Disorder Behavior Inventory

    Science.gov (United States)

    McMorris, Carly A.; Perry, Adrienne

    2015-01-01

    The Pervasive Developmental Disorder Behavior Inventory is a questionnaire designed to aid in the diagnosis of pervasive developmental disorders or autism spectrum disorders. The Pervasive Developmental Disorder Behavior Inventory assesses adaptive and maladaptive behaviors associated with pervasive developmental disorders and provides an…

  7. The influence of (central) auditory processing disorder on the severity of speech-sound disorders in children.

    Science.gov (United States)

    Vilela, Nadia; Barrozo, Tatiane Faria; Pagan-Neves, Luciana de Oliveira; Sanches, Seisse Gabriela Gandolfi; Wertzner, Haydée Fiszbein; Carvallo, Renata Mota Mamede

    2016-02-01

    To identify a cutoff value based on the Percentage of Consonants Correct-Revised index that could indicate the likelihood of a child with a speech-sound disorder also having a (central) auditory processing disorder . Language, audiological and (central) auditory processing evaluations were administered. The participants were 27 subjects with speech-sound disorders aged 7 to 10 years and 11 months who were divided into two different groups according to their (central) auditory processing evaluation results. When a (central) auditory processing disorder was present in association with a speech disorder, the children tended to have lower scores on phonological assessments. A greater severity of speech disorder was related to a greater probability of the child having a (central) auditory processing disorder. The use of a cutoff value for the Percentage of Consonants Correct-Revised index successfully distinguished between children with and without a (central) auditory processing disorder. The severity of speech-sound disorder in children was influenced by the presence of (central) auditory processing disorder. The attempt to identify a cutoff value based on a severity index was successful.

  8. Management of REM sleep behavior disorder: An evidence based review

    OpenAIRE

    Preeti Devnani; Racheal Fernandes

    2015-01-01

    Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by dream enactment behavior resulting from a loss of REM skeletal muscle atonia. The neurobiology of REM sleep and the characteristic features of REM atonia have an important basis for understanding the aggravating etiologies the proposed pharmacological interventions in its management. This review outlines the evidence for behavioral and therapeutic measures along with evidence-based guidelines for their implementation, ...

  9. Cerebellar Cognitive Affective Syndrome Presented as Severe Borderline Personality Disorder

    Directory of Open Access Journals (Sweden)

    Danilo Pesic

    2014-01-01

    Full Text Available An increasing number of findings confirm the significance of cerebellum in affecting regulation and early learning. Most consistent findings refer to association of congenital vermis anomalies with deficits in nonmotor functions of cerebellum. In this paper we presented a young woman who was treated since sixteen years of age for polysubstance abuse, affective instability, and self-harming who was later diagnosed with borderline personality disorder. Since the neurological and neuropsychological reports pointed to signs of cerebellar dysfunction and dysexecutive syndrome, we performed magnetic resonance imaging of brain which demonstrated partially developed vermis and rhombencephalosynapsis. These findings match the description of cerebellar cognitive affective syndrome and show an overlap with clinical manifestations of borderline personality disorder.

  10. Prevalence and Severity of DSM-5 Eating Disorders in a Community Cohort of Adolescents

    NARCIS (Netherlands)

    Smink, Frederique R. E.; van Hoeken, Daphne; Oldehinkel, Albertine J.; Hoek, Hans W.

    Objective: The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a considerably revised eating disorder section. The aim of this study was to establish the prevalence and severity of eating disorders based on the new DSM-5 criteria in a community cohort of

  11. Eating disorder severity and functional impairment: moderating effects of illness duration in a clinical sample.

    Science.gov (United States)

    Davidsen, Annika Helgadóttir; Hoyt, William T; Poulsen, Stig; Waaddegaard, Mette; Lau, Marianne

    2017-09-01

    The aim was to examine duration of illness and body mass index as possible moderators of the relationship between eating disorder severity and functional impairment, as well as psychological distress as a possible mediator of this relationship. The study included 159 patients diagnosed with bulimia nervosa, binge eating disorder or eating disorder not otherwise specified. Regression analysis was applied to assess the effect of the hypothesized moderators and mediators. Eating disorder severity was measured with the Eating Disorder Examination Questionnaire, functional impairment was measured with the Sheehan Disability Scale, and psychological distress was measured with the Symptom Check List-90-R. Duration of illness and body mass index were assessed clinically. Duration of illness significantly moderated the relationship between eating disorder severity and functional impairment; the relationship was strongest for patients with a shorter duration of illness. Psychological distress partly mediated the relationship between eating disorder severity and functional impairment. Duration of illness significantly moderated the relationship between psychological distress and functional impairment; the strongest relationship was seen for patients with a shorter duration of illness. Body mass index was not a significant moderator of the relationship between ED severity and functional impairment. Overall, this study established a link between ED severity, psychological distress and functional impairment indicating that both eating disorder severity and psychological distress are more strongly related to impaired role functioning for patients with more recent onset of an eating disorder. More research in the complex relationship between ED severity and functional impairment is needed.

  12. Rapid eye movement sleep behavior disorder

    DEFF Research Database (Denmark)

    Zoetmulder, Marielle; Jennum, Poul

    2009-01-01

    Rapid eye movement (REM) sleep behaviour disorder (RBD) is characterized by loss of REM sleep and related electromyographic atonia with marked muscular activity and dream enactment behaviour. RBD is seen in 0.5% of the population. It occurs in an idiopathic form and secondarily to medical...

  13. The Appalachian Perspective: An Adaptation to a Parent Training Program for Disruptive Behavior Disorders

    Science.gov (United States)

    Newland, Jessica Marie

    2010-01-01

    Disruptive behavior disorders in children are distressing to others due to the abnormal nature of the child's behavior (Christophersen & Mortweet, 2003). These disorders include attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). Prevalent rates for these disorders range from 2% to…

  14. The validity of DSM-5 severity specifiers for anorexia nervosa, bulimia nervosa, and binge-eating disorder.

    Science.gov (United States)

    Smith, Kathryn E; Ellison, Jo M; Crosby, Ross D; Engel, Scott G; Mitchell, James E; Crow, Scott J; Peterson, Carol B; Le Grange, Daniel; Wonderlich, Stephen A

    2017-09-01

    The DSM-5 includes severity specifiers (i.e., mild, moderate, severe, extreme) for anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED), which are determined by weight status (AN) and frequencies of binge-eating episodes (BED) or inappropriate compensatory behaviors (BN). Given limited data regarding the validity of eating disorder (ED) severity specifiers, this study examined the concurrent and predictive validity of severity specifiers in AN, BN, and BED. Adults with AN (n = 109), BN (n = 76), and BED (n = 216) were identified from previous datasets. Concurrent validity was assessed by measures of ED psychopathology, depression, anxiety, quality of life, and physical health. Predictive validity was assessed by ED symptoms at the end of the treatment in BN and BED. Severity categories did not differ in baseline validators, though the mild AN group evidenced greater ED symptoms compared to the severe group. In BN, greater severity was related to greater end of treatment binge-eating and compensatory behaviors, and lower likelihood of abstinence; however, in BED, greater severity was related to lower ED symptoms at the end of the treatment. Results demonstrated limited support for the validity of DSM-5 severity specifiers. Future research is warranted to explore additional validators and possible alternative indicators of severity in EDs. © 2017 Wiley Periodicals, Inc.

  15. Behavior Modification/Traditional Techniques for Students with Emotional and Behavioral Disorders

    Science.gov (United States)

    Mooney, Paul; Ryan, Joseph B.; Gunter, Philip L.; Denny, R. Kenton

    2012-01-01

    In addressing positive general education teaching practices for use with students with or at risk for emotional and behavioral disorders (EBD), the chapter emphasizes teacher behavior change research that has been informed by applied behavior analytic (ABA) principles. Its central theme is that general education teachers can access research…

  16. [Electromyography Analysis of Rapid Eye Movement Sleep Behavior Disorder].

    Science.gov (United States)

    Nakano, Natsuko; Kinoshita, Fumiya; Takada, Hiroki; Nakayama, Meiho

    2018-01-01

    Polysomnography (PSG), which records physiological phenomena including brain waves, breathing status, and muscle tonus, is useful for the diagnosis of sleep disorders as a gold standard. However, measurement and analysis are complex for several specific sleep disorders, such as rapid eye movement (REM) sleep behavior disorder (RBD). Usually, brain waves during REM sleep indicate an awakening pattern under relaxed conditions of skeletal and antigravity muscles. However, these muscles are activated during REM sleep when patients suffer from RBD. These activated muscle movements during REM, so-called REM without atonia (RWA) recorded by PSG, may be related to a neurodegenerative disease such as Parkinson's disease. Thus, careful analysis of RWA is significant not only physically, but also clinically. Commonly, manual viewing measurement analysis of RWA is time-consuming. Therefore, quantitative studies on RWA are rarely reported. A software program, developed from Microsoft Office Excel ® , was used to semiautomatically analyze the RWA ratio extracted from PSG to compare with manual viewing measurement analysis. In addition, a quantitative muscle tonus study was carried out to evaluate the effect of medication on RBD patients. Using this new software program, we were able to analyze RWA on the same cases in approximately 15 min as compared with 60 min in the manual viewing measurement analysis. This software program can not only quantify RWA easily but also identify RWA waves for either phasic or tonic bursts. We consider that this software program will support physicians and scientists in their future research on RBD. We are planning to offer this software program for free to physicians and scientists.

  17. Cognitive Behavior Therapies (CBT) in Childhood and Adolescent Mood Disorders and Anxiety Disorders: A Review

    OpenAIRE

    Nilgün Öngider

    2014-01-01

    In this study, it is aimed to review efficacy of Cognitive Behavioral Therapy (CBT) and Cognitive Behavioral Group Therapy (CBGT) on childhood and adolescence in mood and anxiety disorders. Many researches have shown that cognitive behaviour therapy (CBT) can be effective in the treatment of depression and anxiety in children and adolescents. Child and adolescent depression and anxiety are frequent disorders which may have a recurring and chronic course. PsycINFO, Medline and the Turkish P...

  18. Behavioral Activation in the Treatment of Comorbid Posttraumatic Stress Disorder and Major Depressive Disorder

    Science.gov (United States)

    Mulick, Patrick S.; Naugle, Amy E.

    2009-01-01

    This study investigated the efficacy of 10-weeks of Behavioral Activation (BA) in the treatment of comorbid Post-traumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) in four adults using a nonconcurrent multiple baseline across participants design. All participants met full "DSM-IV" criteria for both MDD and PTSD at the…

  19. The effects of comorbid personality disorders on cognitive behavioral treatment for panic disorder

    NARCIS (Netherlands)

    Telch, M.J.; Kamphuis, J.H.; Schmidt, N.B.

    2011-01-01

    The present study investigated the influence of personality pathology assessed both dimensionally and categorically on acute clinical response to group cognitive-behavioral treatment in a large sample of panic disorder patients (N = 173) meeting DSMIII-R criteria for panic disorder with or without

  20. Needs of Persons with Severe Intellectual Disabilities: A Q-Methodological Study of Clients with Severe Behavioural Disorders and Severe Intellectual Disabilities

    Science.gov (United States)

    Kreuger, Linda; van Exel, Job; Nieboer, Anna

    2008-01-01

    Background: A demand-oriented approach is becoming increasingly important in care provision. The purpose of this study was to identify the primary needs of clients with Severe Behavioural Disorders and Severe Intellectual Disabilities. Materials and Methods: We used the theory of Social Production Function and Maslow's hierarchy of needs to…

  1. Relationship between severity of depression symptoms and iron deficiency anemia in women with major depressive disorder

    Directory of Open Access Journals (Sweden)

    Seyed gholamreza Noorazar

    2015-11-01

    Full Text Available Introduction: Iron deficiency (ID is a common nutritional problem lead to many unintended consequences such as decrease energy, immune system problems, and neurological dysfunction. The most common psychological disorder is depression. A patient with ID anemia (IDA show signs and symptoms of behavioral and mood disorders like depression. Methods: In this study, 100 female patients with diagnosed major depression in years 2010 and 2011 were studied. In all patients standard Hamilton depression rating scale (HDRS was used to evaluate depression severity. Blood samples were taken for complete blood count difference analysis and evaluating anemia and in those with hemoglobin (Hb < 12 mg/dl, ferritin, and total iron binding capacity were checked to evaluate IDA. Results: Patients mean age was 36.34 ± 10.43 years old. Mean HDRS score was 32.20 ± 4.07. 19 had anemia, and among them 8% had IDA. Mean HDRS score in patients with IDA (33.37 ± 1.90 was higher than those without (32.09 ± 4.19, but the difference was not significant (P = 0.39. There was no difference between patients with and without anemia in HDRS score. The negative relation was observed between Hb levels, and HDRS score (Pearson correlation = -0.21, P = 0.03. Conclusion: We observed that the negative correlation between Hb levels and HDRS score. It demonstrates the effect of Hb decrease and anemia occurrence on depression severity; however, it needs more studies.

  2. Common Questions About Cognitive Behavior Therapy for Psychiatric Disorders.

    Science.gov (United States)

    Coffey, Scott F; Banducci, Anne N; Vinci, Christine

    2015-11-01

    Cognitive behavior therapy (CBT) is a time-limited, goal-oriented psychotherapy that has been extensively researched and has benefits in a number of psychiatric disorders, including anxiety, depression, posttraumatic stress disorder, attention-deficit/hyperactivity disorder, autism, obsessive-compulsive and tic disorders, personality disorders, eating disorders, and insomnia. CBT uses targeted strategies to help patients adopt more adaptive patterns of thinking and behaving, which leads to positive changes in emotions and decreased functional impairments. Strategies include identifying and challenging problematic thoughts and beliefs, scheduling pleasant activities to increase environmental reinforcement, and extended exposure to unpleasant thoughts, situations, or physiologic sensations to decrease avoidance and arousal associated with anxiety-eliciting stimuli. CBT can be helpful in the treatment of posttraumatic stress disorder by emphasizing safety, trust, control, esteem, and intimacy. Prolonged exposure therapy is a CBT technique that includes a variety of strategies, such as repeated recounting of the trauma and exposure to feared real-world situations. For attention-deficit/hyperactivity disorder, CBT focuses on establishing structures and routines, and clear rules and expectations within the home and classroom. Early intensive behavioral interventions should be initiated in children with autism before three years of age; therapy consists of 12 to 40 hours of intensive treatment per week, for at least one year. In many disorders, CBT can be used alone or in combination with medications. However, CBT requires a significant commitment from patients. Family physicians are well suited to provide collaborative care for patients with psychiatric disorders, in concert with cognitive behavior therapists.

  3. Impact of severity of personality disorder on the outcome of depression.

    Science.gov (United States)

    Kelly, Brendan D; Nur, Ula A; Tyrer, Peter; Casey, Patricia

    2009-06-01

    The influence of severity of personality disorder on outcome of depression is unclear. Four hundred and ten patients with depression in 9 urban and rural communities in Finland, Ireland, Norway, Spain and the United Kingdom, were randomised to individual problem-solving treatment (n=121), group sessions on depression prevention (n=106) or treatment as usual (n=183). Depressive symptoms were recorded at baseline, 6 and 12 months. Personality assessment was performed using the Personality Assessment Schedule and analysed by severity (no personality disorder, personality difficulty, simple personality disorder, complex personality disorder). Complete personality assessments were performed on 301 individuals of whom 49.8% had no personality disorder; 19.3% had personality difficulties; 13.0% had simple personality disorder; and 17.9% had complex personality disorder. Severity of personality disorder was correlated with Beck Depression Inventory (BDI) scores at baseline (Spearman's r=0.21; ppersonality disorder and treatment type for depression. While multi-variable analyses indicate that depressive symptoms at baseline are the strongest predictor of depressive symptoms at 6 and 12 months, the strong correlations between severity of personality disorder and depressive symptoms make it difficult to establish the independent effect of personality disorder on outcome of depression.

  4. Emotional or Behavioral Disorders: Background and Current Status of the E/BD Terminology and Definition.

    Science.gov (United States)

    Forness, Steven R.; Kavale, Kenneth A.

    2000-01-01

    This article reviews the development and current status of alternatives to the federal definition of emotional disturbance or behavior disorders. It notes that several states are now revising their own terminologies or definitions in response to the 1997 reauthorization of the Individuals with Disabilities Education Act that dropped the term…

  5. Competitive Employment and Service Management for Adolescents and Young Adults with Emotional and Behavioral Disorders.

    Science.gov (United States)

    Bullis, Michael; Paris, Kathleen

    1996-01-01

    Given the variety and severity of problems associated with adolescents with emotional and behavioral disorders (EBD), it is imperative that a coordinated system of vocational training and social support be afforded adolescents and young adults with EBD for them to become successful members of the workforce. Describes such a service model.…

  6. Republication of "Functional Analysis of Classroom Variables for Students with Emotional and Behavioral Disorders"

    Science.gov (United States)

    Dunlap, Glen; Kern, Lee; dePerczel, Maria; Clarke, Shelley; Wilson, Diane; Childs, Karen E.; White, Ronnie; Falk, George D.

    2018-01-01

    Functional assessment and functional analysis are processes that have been applied successfully in work with people who have developmental disabilities, but they have been used rarely with students who experience emotional or behavioral disorders. In the present study, five students in elementary school programs for severe emotional disturbance…

  7. Rigid-Compulsive Behaviors Are Associated with Mixed Bowel Symptoms in Autism Spectrum Disorder

    Science.gov (United States)

    Peters, Brittany; Williams, Kent C.; Gorrindo, Phillip; Rosenberg, Daniel; Lee, Evon Batey; Levitt, Pat; Veenstra-VanderWeele, Jeremy

    2014-01-01

    Based on clinical experience, we hypothesized that rigid-compulsive behaviors are associated with severe constipation and co-occurring diarrhea or underwear staining in children with autism spectrum disorder. Using data from the Autism Treatment Network, we evaluated the association between these gastrointestinal symptoms and measures of rigid…

  8. Relationship of attention-deficit/hyperactivity disorder symptom severity with severity of alcohol-related problems in a sample of inpatients with alcohol use disorder

    Directory of Open Access Journals (Sweden)

    Bozkurt M

    2016-07-01

    Full Text Available Muge Bozkurt,1 Cuneyt Evren,1 Gokhan Umut,1 Bilge Evren2 1Research, Treatment and Training Center for Alcohol and Substance Dependence, Bakirkoy Prof Dr Mazhar Osman Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, 2Department of Psychiatry, Baltalimani State Hospital for Muskuloskeletal Disorders, Istanbul, Turkey Purpose: Attention-deficit/hyperactivity disorder (ADHD has been shown to be related to a higher risk of developing psychiatric problems such as depressive disorders, substance use disorder, and impulsivity. Adults who have comorbid ADHD and alcohol use disorder (AUD are at greater risk of negative outcomes. Thus, it is important to evaluate the relationship of ADHD symptoms and the severity of alcohol-related problems among patients with AUD. The aim of the present study was to evaluate the effect of ADHD symptoms on severity of alcohol-related problems, while controlling the effects of depression and impulsivity in a sample of inpatients with AUD. Patients and methods: Participants (n=190 were evaluated with the Beck Depression Inventory, the Short Form Barratt Impulsiveness Scale, the Michigan Alcohol Screening Test, and the Adult ADHD Self-Report Scale. Results: Severity of the scale scores was positively correlated with each other. Although severity of depression and impulsivity (particularly non-planning impulsivity predicted the severity of alcohol-related problems in a linear regression model, when severity of ADHD symptoms was included in the analysis, the inattentive subscale score, in particular, predicted the severity of alcohol-related problems together with non-planning impulsivity, whereas depression was no longer a predictor. Conclusion: These findings suggest that, together with non-planning impulsivity, symptoms of ADHD (particularly inattentive factor are an important factor that predict alcohol-related problems, while controlling the severity of depressive symptoms among inpatients

  9. Father-daughter relationship and the severity of eating disorders.

    Science.gov (United States)

    Horesh, N; Sommerfeld, E; Wolf, M; Zubery, E; Zalsman, G

    2015-01-01

    Mother-daughter relationship was the focus of studies on the development of eating disorders (ED) for many years. This study aimed to examine the association between the father-daughter relationship and ED and depressive symptoms. Fifty-three women diagnosed with ED were compared to a psychiatric control group (n=26) and to healthy participants (n=60) regarding their perception of their fathers and the relationship with them. Assessments were done using the Parental Bonding Instrument, the Eating Disorders Questionnaire, the Body Shape Questionnaire, the Eating Attitude Test, and the Beck Depression Inventory as well as narrative-based methods. Fathers' negative attributes were significantly associated with ED and depressive symptom. Two profiles of father-daughter relationship were found, the "caring and benevolent" relationship and the "overprotective and avoidant" one. In the latter, patients displayed significantly higher levels of food-restraint, more concerns about eating and about their body shape and appearance, and higher levels of depression. Negative perception of the father's parenting style as well as the quality of the relationship with him are crucial for the understanding of the development and persistence of ED. Therapeutic programs for ED should focus not only on the relationship with the mother but must also address the relationship with the father. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  10. Ethical Issues and Considerations for Working with Community College Students with Severe and Persistent Mental Disorders

    Science.gov (United States)

    Francis, Perry C.; Abbassi, Amir

    2010-01-01

    Students with severe and persistent mental illnesses (e.g., schizophrenia or other psychotic disorders; moderate to severe mood, anxiety, dissociative, eating, or personality disorders) are attending community colleges in increasing numbers. Their need for counseling services presents counseling centers with unique ethical issues to consider. This…

  11. Eating disorders and disordered weight and shape control behaviors in sexual minority populations

    Science.gov (United States)

    Calzo, Jerel P.; Blashill, Aaron J.; Brown, Tiffany A.; Argenal, Russell L.

    2017-01-01

    Purpose of review This review summarized trends and key findings from empirical studies conducted between 2011–2017 regarding eating disorders and disordered weight and shape control behaviors among lesbian, gay, bisexual, and other sexual minority (i.e., non-heterosexual) populations. Recent findings Recent research has examined disparities through sociocultural and minority stress approaches. Sexual minorities continue to demonstrate higher rates of disordered eating; disparities are more pronounced among males. Emerging data indicates elevated risk for disordered eating pathology among sexual minorities who are transgender or ethnic minorities. Dissonance-based eating disorder prevention programs may hold promise for sexual minority males. Summary Continued research must examine the intersections of sexual orientation, gender, and ethnic identities, given emergent data that eating disorder risk may be most prominent among specific subgroups. More research is needed within sexual minorities across the lifespan. There are still a lack of eating disorder treatment and prevention studies for sexual minorities. PMID:28660475

  12. Cognitive-Behavioral Therapy for Body Dysmorphic Disorder by Proxy.

    Science.gov (United States)

    Greenberg, Jennifer L; Mothi, Suraj Sarvode; Wilhelm, Sabine

    2016-07-01

    Body dysmorphic disorder (BDD) is a distressing or impairing preoccupation with a perceived defect in physical appearance. BDD by proxy (BDDBP) is a significant but understudied variant of BDD in which the primary preoccupation involves perceived imperfections of another person. Like BDD, individuals with BDDBP engage in time-consuming rituals to "fix" the other person's appearance or alleviate distress. Avoidance is common and the impact of BDDBP on social functioning is profound. Cognitive-behavioral therapy (CBT) is the best-studied and most promising psychological treatment for BDD, but no studies have examined its generalizability to the BDDBP variant. We tested feasibility, acceptability, and treatment outcome of CBT modified for BDDBP in a sample of 6 adults with primary BDDBP. Treatment was delivered in weekly individual sessions over 12-20weeks. Mean symptom severity (BDDBP-YBOCS) dropped from the moderately severe range at pretreatment to the subclinical range at posttreatment, t(6)=10.7, p<.001, d=3.3. One hundred percent of treatment completers were responders (≥30% reduction in BDDBP-YBOCS). Insight also improved. Treatment gains were maintained at 3-month follow-up. To our knowledge, this represents the first treatment study for BDDBP. Copyright © 2016. Published by Elsevier Ltd.

  13. Depression in Students with Behavior Disorders.

    Science.gov (United States)

    Walker, Margaret B.

    1987-01-01

    The five major characteristics of emotional disturbance identified in Public Law 94-142 are used as the framework for a review of research on childhood depression. Among characteristic behaviors are poor school performance, negative feelings about self that are reflected in difficulty with interpersonal relationships, and sleep disturbances. (JW)

  14. Zinc deficiency is common in several psychiatric disorders.

    Directory of Open Access Journals (Sweden)

    Ole Grønli

    Full Text Available BACKGROUND: Mounting evidence suggests a link between low zinc levels and depression. There is, however, little knowledge about zinc levels in older persons with other psychiatric diagnoses. Therefore, we explore the zinc status of elderly patients suffering from a wide range of psychiatric disorders. METHODS: Clinical data and blood samples for zinc analyzes were collected from 100 psychogeriatric patients over 64 of age. Psychiatric and cognitive symptoms were assessed using the Montgomery and Aasberg Depression Rating Scale, the Cornell Scale for Depression in Dementia, the Mini-Mental State Examination, the Clockdrawing Test, clinical interviews and a review of medical records. In addition, a diagnostic interview was conducted using the Mini International Neuropsychiatric Interview instrument. The prevalence of zinc deficiency in patients with depression was compared with the prevalence in patients without depression, and the prevalence in a control group of 882 older persons sampled from a population study. RESULTS: There was a significant difference in zinc deficiency prevalence between the control group (14.4% and the patient group (41.0% (χ(2 = 44.81, df = 1, p<0.001. In a logistic model with relevant predictors, zinc deficiency was positively associated with gender and with serum albumin level. The prevalence of zinc deficiency in the patient group was significantly higher in patients without depression (i.e. with other diagnoses than in patients with depression as a main diagnosis or comorbid depression (χ(2 = 4.36, df = 1, p = 0.037. CONCLUSIONS: Zinc deficiency is quite common among psychogeriatric patients and appears to be even more prominent in patients suffering from other psychiatric disorders than depression. LIMITATIONS: This study does not provide a clear answer as to whether the observed differences represent a causal relationship between zinc deficiency and psychiatric symptoms. The blood sample collection time points

  15. A Study of the Correlation between VEP and Clinical Severity in Children with Autism Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Winai Sayorwan

    2018-01-01

    Full Text Available Visual evoked potential (VEP is a technique used to assess the brain’s electrical response to visual stimuli. The aims of this study were to examine neural transmission within the visual pathway through VEP testing in preschool children with autism spectrum disorder (ASD and compare it to age-matched controls, as well as search for a correlation between the VEP parameters and the symptoms of ASD. Participants were composed of ASD children (9 males and typically developing children (8 males and 4 females, aged between 3 and 5 years. Checkerboards were chosen as the pattern-reversal VEP. The clinical severity of ASD was assessed using the Autism Treatment Evaluation Checklist (ATEC and the Vineland Adaptive Behavior Scales 2nd edition (VABS-II. Our findings demonstrated that children with ASD had significantly longer N145 latency compared to the controls. A longer N145 latency correlated with a higher score of ATEC within the sensory/cognitive awareness subdomain. In addition, a slower N145 response was also associated with a lower VABS-II score within the socialization domain. The correlation between longer VEP latency and abnormal behaviors in children with ASD suggests a delayed neural communication within other neural circuits, apart from the visual pathway. These lines of evidence support the possibility of using VEP, along with clinical parameters, for the assessment of ASD severity.

  16. Development of a Chinese medicine pattern severity index for understanding eating disorders.

    Science.gov (United States)

    Fogarty, Sarah; Harris, David; Zaslawski, Chris; McAinch, Andrew J; Stojanovska, Lily

    2012-06-01

    Eating disorders commonly affect young girls and women. Four eating disorders are analyzed in this study: anorexia nervosa (AN), bulimia nervosa (BN), eating disorders not otherwise specified (EDNOS), and binge eating disorder (BED). Eating disorders are a modern concept and as such there is no critically appraised research on how Traditional Chinese Medicine (TCM) conceptualizes of or treats eating disorders. The purpose of this study is to identify and quantify the TCM patterns relevant to eating disorders based on a systematic evaluation of the results of a self-reported questionnaire. One hundred and ninety-six (196) female participants (142 with a self-reported eating disorder and 54 with no eating disorder) completed an online survey, designed to collect data on their current general health and, where relevant, their eating disorder. The Berle methodology was used to identify TCM patterns involved in eating disorders to tabulate and score the number of signs and symptoms experienced by the participants. For many of the TCM patterns, statistically significant differences were found between presentation severity across the four eating disorders. For the first time, there is evidence-based research to classify the TCM patterns involved in AN, BN, EDNOS, and BED. Evidence is given to support the anecdotal theories of TCM patterns involved in eating disorder presentation. These results have relevance on how eating disorders are treated and viewed by TCM practitioners.

  17. Disordered gambling: the evolving concept of behavioral addiction

    Science.gov (United States)

    Clark, Luke

    2014-01-01

    The reclassification of gambling disorder within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) addictions category marks an important step for addiction science. The similarities between gambling disorder and the substance use disorders have been well documented. As gambling is unlikely to exert actively damaging effects on the brain, the cognitive sequelae of gambling disorder may provide insights into addictive vulnerabilities; this idea is critically evaluated in light of recent structural imaging data. The second part of the review analyzes a fundamental question of how a behavior can become addictive in the absence of exogenous drug stimulation. The relative potency of drug and nondrug rewards is considered, alongside evidence that cognitive distortions in the processing of chance (for example, the illusion of control and the gambler's fallacy) may constitute an important added ingredient in gambling. Further understanding of these mechanisms at neural and behavioral levels will be critical for the classification of future behavioral addictions, and I consider the current research data for obesity and binge eating, compulsive shopping, and internet gaming disorder. PMID:25336388

  18. Borderline personality disorder: nursing interventions using dialectical behavioral therapy.

    Science.gov (United States)

    Osborne, Unda L; McComish, Judith Fry

    2006-06-01

    Psychotherapeutic treatment of people with borderline personality disorder (BPD) is one of the greatest challenges confronting mental health professionals today. Clients with BPD are often difficult for nurses to work with, perhaps due to a lack of understanding of the underlying dynamics of the disorder. This article describes effective treatment strategies for BPD with a central focus on dialectical behavioral therapy (DBT). In typical mental health settings, nurses can effectively implement interventions using the concepts of DBT to help people with BPD build effective coping strategies and skillful behavioral responses for improved quality of life.

  19. Tryptophan hydroxylase type 2 variants modulate severity and outcome of addictive behaviors in Parkinson's disease.

    Science.gov (United States)

    Cilia, Roberto; Benfante, Roberta; Asselta, Rosanna; Marabini, Laura; Cereda, Emanuele; Siri, Chiara; Pezzoli, Gianni; Goldwurm, Stefano; Fornasari, Diego

    2016-08-01

    Impulse control disorders and compulsive medication intake may occur in a minority of patients with Parkinson's disease (PD). We hypothesize that genetic polymorphisms associated with addiction in the general population may increase the risk for addictive behaviors also in PD. Sixteen polymorphisms in candidate genes belonging to five neurotransmitter systems (dopaminergic, catecholaminergic, serotonergic, glutamatergic, opioidergic) and the BDNF were screened in 154 PD patients with addictive behaviors and 288 PD control subjects. Multivariate analysis investigated clinical and genetic predictors of outcome (remission vs. persistence/relapse) after 1 year and at the last follow-up (5.1 ± 2.5 years). Addictive behaviors were associated with tryptophan hydroxylase type 2 (TPH2) and dopamine transporter gene variants. A subsequent analysis within the group of cases showed a robust association between TPH2 genotype and the severity of addictive behaviors, which survived Bonferroni correction for multiple testing. At multivariate analysis, TPH2 genotype resulted the strongest predictor of no remission at the last follow-up (OR[95%CI], 7.4[3.27-16.78] and 13.2[3.89-44.98] in heterozygous and homozygous carriers, respectively, p medication dose reduction was not a predictor. TPH2 haplotype analysis confirmed the association with more severe symptoms and lower remission rates in the short- and the long-term (p addictive behaviors in PD, modulating the severity of symptoms and the rate of remission at follow-up. If confirmed in larger independent cohorts, TPH2 genotype may become a useful biomarker for the identification of at-risk individuals. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Individual quality of life of people with severe mental disorders.

    Science.gov (United States)

    Pitkänen, A; Hätönen, H; Kuosmanen, L; Välimäki, M

    2009-02-01

    People with mental disorders have been found to suffer from impaired quality of life (QoL). Therefore, the assessment of QoL has become important in psychiatric research. This explorative study was carried out in acute psychiatric wards. Thirty-five patients diagnosed with schizophrenia and related psychosis were interviewed. QoL was rated by the Schedule for Evaluation of Individual Quality of Life which is a respondent-generated QoL measure using semi-structured interview technique. Patients named five areas of life important to them and then rated their current status and placed relative weight on each QoL area. The data were analysed with qualitative content analysis and descriptive statistics. The most frequently named areas for QoL were health, family, leisure activities, work/study and social relationships, which represented 72% of all QoL areas named. Patients' average satisfaction with these QoL areas ranged 49.0-69.1 (scale 0-100). The mean global QoL score was 61.5 (standard deviation 17.4; range 24.6-89.6; scale 0-100). Awareness of patients' perceptions of their QoL areas can enhance our understanding of an individual patient's QoL and reveal unsatisfactory areas where QoL could be improved with individually tailored needs-based interventions.

  1. Mental health in Dutch adolescents: a TRAILS report on prevalence, severity, age of onset, continuity and co-morbidity of DSM disorders.

    Science.gov (United States)

    Ormel, J; Raven, D; van Oort, F; Hartman, C A; Reijneveld, S A; Veenstra, R; Vollebergh, W A M; Buitelaar, J; Verhulst, F C; Oldehinkel, A J

    2015-01-01

    With psychopathology rising during adolescence and evidence suggesting that adult mental health burden is often due to disorders beginning in youth, it is important to investigate the epidemiology of adolescent mental disorders. We analysed data gathered at ages 11 (baseline) and 19 years from the population-based Dutch TRacking Adolescents' Individual Lives Survey (TRAILS) study. At baseline we administered the Achenbach measures (Child Behavior Checklist, Youth Self-Report) and at age 19 years the World Health Organization's Composite International Diagnostic Interview version 3.0 (CIDI 3.0) to 1584 youths. Lifetime, 12-month and 30-day prevalences of any CIDI-DSM-IV disorder were 45, 31 and 15%, respectively. Half were severe. Anxiety disorders were the most common but the least severe whereas mood and behaviour disorders were less prevalent but more severe. Disorders persisted, mostly by recurrence in mood disorders and chronicity in anxiety disorders. Median onset age varied substantially across disorders. Having one disorder increased subjects' risk of developing another disorder. We found substantial homotypic and heterotypic continuity. Baseline problems predicted the development of diagnosable disorders in adolescence. Non-intact families and low maternal education predicted externalizing disorders. Most morbidity concentrated in 5-10% of the sample, experiencing 34-55% of all severe lifetime disorders. At late adolescence, 22% of youths have experienced a severe episode and 23% only mild episodes. This psychopathology is rather persistent, mostly due to recurrence, showing both monotypic and heterotypic continuity, with family context affecting particularly externalizing disorders. High problem levels at age 11 years are modest precursors of incident adolescent disorders. The burden of mental illness concentrates in 5-10% of the adolescent population.

  2. Addiction severity pattern associated with adult and childhood Attention Deficit Hyperactivity Disorder (ADHD) in patients with addictions.

    Science.gov (United States)

    Fatséas, Melina; Hurmic, Hortense; Serre, Fuschia; Debrabant, Romain; Daulouède, Jean-Pierre; Denis, Cécile; Auriacombe, Marc

    2016-12-30

    Attention Deficit Hyperactivity Disorder (ADHD) is highly prevalent among adults with addictive disorders, but little is known about addiction patterns associated with ADHD diagnosis. This study examined addiction severity in patients with co-occurring addictive disorders and ADHD controlling for the potential influence of associated psychiatric comorbidity. Data were collected in French outpatient addiction treatment centers. A total of 217 patients seeking treatment for substance or gambling addiction were included. At treatment entry, participants were interviewed with the Addiction Severity Index, the Conners Adult ADHD Diagnosis Interview for the DSM-IV (CAADID), the Mini International Neuropsychiatric Interview (MINI) and the Structured Clinical Interview for DSM-IV Axis II for borderline personality disorder (SCID II). History of ADHD was associated with an earlier onset of addiction, poly-dependence (defined by presence of at least two current substance dependence diagnoses in addition to tobacco dependence if present) and borderline personality disorder. Persistence of ADHD during adulthood was associated with a higher prevalence of poly-dependence. This study highlights the need for early implementation of preventive interventions for substance use or behavioral addiction in children/adolescents with ADHD and the need to consider ADHD in the treatment of addictive disorders. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Choice-making treatment of young children's severe behavior problems.

    OpenAIRE

    Peck, S M; Wacker, D P; Berg, W K; Cooper, L J; Brown, K A; Richman, D; McComas, J J; Frischmeyer, P; Millard, T

    1996-01-01

    The choice-making behavior of 5 young children with developmental disabilities who engaged in aberrant behavior was studied within a concurrent operants framework. Experimental analyses were conducted to identify reinforcers that maintained aberrant behavior, and functional communication training packages were implemented to teach the participants to gain reinforcement using mands. Next, a choice-making analysis, in which the participants chose one of two responses (either a mand or an altern...

  4. The turmeric protective properties at ethanol-induced behavioral disorders.

    Directory of Open Access Journals (Sweden)

    Goldina I.A.

    2017-03-01

    Full Text Available The aim of the study was to determine the effect of mechanically modified turmeric extract on the parameters of orienting-exploratory behavior in mice with chronic ethanol consumption. Material and methods. Mice behavior was assessed in the "open field" test. In the both control groups the animals received water or 10% ethanol solution; in the test group — turmeric extract in 10% ethanol solution. Amount of blood mononuclear cells, thymocytes, and splenocytes were estimated. Results. Analysis of the behavioral parameters in animals after chronic exposure to ethanol showed suppression of motor and exploratory components of the behavior. In mice that received both ethanol and turmeric extract recorded behavior parameters were significantly higher than in the group of animals who received ethanol only. It was shown that the turmeric extract enhances the amount of blood immune cells. Conclusion. Mechanically modified turmeric extract possesses protective properties against ethanol-induced behavioral disorders.

  5. Behavioral Disorders, Learning Disabilities and Megavitamin Therapy.

    Science.gov (United States)

    LaPerchia, Phyllis

    1987-01-01

    Presents findings from several sources that give results of research in megavitamin nutritional therapy. Examines vitamin therapy in learning disabilities in general, schizophrenia, autism, mental retardation and Down's syndrome, and hyperkinesis. Concludes that holistic approach to treatment is needed and that vitamin therapy, if proven…

  6. Update on Psychological Trauma, Other Severe Adverse Experiences and Eating Disorders: State of the Research and Future Research Directions.

    Science.gov (United States)

    Trottier, Kathryn; MacDonald, Danielle E

    2017-08-01

    This paper provides an updated review of the literature on the relationship between psychological trauma exposure, other severe adverse experiences, and eating disorders. Trauma exposure and other severe adverse experiences (e.g., emotional abuse) in both childhood and adulthood are associated with eating disorders. The relationship between traumatic and other adverse experiences and eating disorders appears to be mediated by emotional and behavioral dysregulation, as well as by cognitive factors such as self-criticism. Biological vulnerabilities may also be relevant to this relationship. Overall, the literature is limited by predominantly cross-sectional designs. There is clear evidence of a correlational relationship between trauma exposure and other severe adverse events, and eating disorders. Both risk and maintenance factor hypotheses have been put forth; however, prospective research testing these hypotheses remains limited. Future research should use prospective designs and focus on trauma-related symptoms (rather than trauma exposure) in order to advance research on risk and maintaining factors for eating disorders and inform treatment directions.

  7. Advances in the neurorehabilitation of severe disorder of consciousness

    Directory of Open Access Journals (Sweden)

    Giuliano Dolce

    2014-09-01

    Full Text Available Introduction. The paper describes the evolution of knowledge concerning severe brain injury which determines the Vegetative State/Unresponsive Wakefulness Syndrome. Background. The term Vegetative State was proposed by Jennet and Plum in 1972. Later on, the Intensive Care Units progresses increased the survival of these patients and, contemporary, decreased their characteristic conditions of cachexia and severe dystonia. In 1994, the disease was conceived as a disconnection syndrome of the hemispheres from the brainstem, mainly due to a temporary or permanent deficit of the functions of the white matter. From 2005 on, the psychophysiological parameters relative to an emotional consciousness, albeit submerged, were described. Since then, it has been recognized that the brain of these patients was not only to be considered living but also working. Conclusion. The latest studies that have greatly improved the knowledge of the physiopathology of this particular state of consciousness. These new insights have led to the formation of a European Union Task Force, which has proposed in 2009 to change the name from a Vegetative State to Unresponsive Wakefulness Syndrome, outlining the character of syndrome and not that of state, as forms of even late recovery in consciousness levels have been observed and described.

  8. REM Sleep Behavior Disorder and Cognitive Impairment in Parkinson's Disease.

    Science.gov (United States)

    Jozwiak, Natalia; Postuma, Ronald B; Montplaisir, Jacques; Latreille, Véronique; Panisset, Michel; Chouinard, Sylvain; Bourgouin, Pierre-Alexandre; Gagnon, Jean-François

    2017-08-01

    REM sleep behavior disorder (RBD) is a parasomnia affecting 33% to 46% of patients with Parkinson's disease (PD). The existence of a unique and specific impaired cognitive profile in PD patients with RBD is still controversial. We extensively assessed cognitive functions to identify whether RBD is associated with more severe cognitive deficits in nondemented patients with PD. One hundred sixty-two participants, including 53 PD patients with RBD, 40 PD patients without RBD, and 69 healthy subjects, underwent polysomnography, a neurological assessment and an extensive neuropsychological exam to assess attention, executive functions, episodic learning and memory, visuospatial abilities, and language. PD patients with RBD had poorer and clinically impaired performance in several cognitive tests compared to PD patients without RBD and healthy subjects. These two latter groups were similar on all cognitive measures. Mild cognitive impairment (MCI) diagnosis frequency was almost threefold higher in PD patients with RBD compared to PD patients without RBD (66% vs. 23%, p < .001). Moreover, subjective cognitive decline was reported in 89% of PD patients with RBD compared to 58% of PD patients without RBD (p = .024). RBD in PD is associated with a more impaired cognitive profile and higher MCI diagnosis frequency, suggesting more severe and widespread neurodegeneration. This patient subgroup and their caregivers should receive targeted medical attention to better detect and monitor impairment and to enable the development of management interventions for cognitive decline and its consequences. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  9. Hoarding in Youth with Autism Spectrum Disorders and Anxiety: Incidence, Clinical Correlates, and Behavioral Treatment Response.

    Science.gov (United States)

    Storch, Eric A; Nadeau, Joshua M; Johnco, Carly; Timpano, Kiara; McBride, Nicole; Jane Mutch, P; Lewin, Adam B; Murphy, Tanya K

    2016-05-01

    This study examined the nature and correlates of hoarding among youth with autism spectrum disorders (ASD). Forty children with ASD and a comorbid anxiety disorder were administered a battery of clinician-administered measures assessing presence of psychiatric disorders and anxiety severity. Parents completed questionnaires related to child hoarding behaviors, social responsiveness, internalizing and externalizing behaviors, and functional impairment. We examined the impact of hoarding behaviors on treatment response in a subsample of twenty-six youth who completed a course of personalized cognitive-behavioral therapy targeting anxiety symptoms. Hoarding symptoms were common and occurred in a clinically significant manner in approximately 25 % of cases. Overall hoarding severity was associated with increased internalizing and anxiety/depressive symptoms, externalizing behavior, and attention problems. Discarding items was associated with internalizing and anxious/depressive symptoms, but acquisition was not. Hoarding decreased following cognitive-behavioral therapy but did not differ between treatment responders and non-responders. These data are among the first to examine hoarding among youth with ASD; implications of study findings and future directions are highlighted.

  10. Reversing Reading Failure in Adolescents with Behavioral Disorders.

    Science.gov (United States)

    Curtis, Mary E.; Longo, Ann Marie

    Boys Town cares for boys and girls (average age 15 years) who are socially and emotionally at risk because of problems such as chronic neglect or abuse, broken homes, and school failure. The majority are behaviorally disordered and emotionally impaired. Within a week of coming to Boys Town, students take the Diagnostic Assessments of Reading Test.…

  11. Learning assessment for students with mental and behavioral disorders

    DEFF Research Database (Denmark)

    Dræby, Anders

    The session aims at presenting a learning-based model for how to conduct a comprehensive psychological evaluation of the learning resources and challenges amongst students with mental and behavioral disorders. In the learning assessment model the learning resources and challenges of the students...

  12. Mindfulness for Students Classified with Emotional/Behavioral Disorder

    Science.gov (United States)

    Malow, Micheline S.; Austin, Vance L.

    2016-01-01

    A six-week investigation utilizing a standard mindfulness for adolescents curriculum and norm-based standardized resiliency scale was implemented in a self-contained school for students with Emotional/Behavioral Disorders (E/BD). Informal integration of mindfulness activities into a classroom setting was examined for ecological appropriateness and…

  13. Energy Drinks, Weight Loss, and Disordered Eating Behaviors

    Science.gov (United States)

    Jeffers, Amy J.; Vatalaro Hill, Katherine E.; Benotsch, Eric G.

    2014-01-01

    Objective: The present study examined energy drink consumption and relations with weight loss attempts and behaviors, body image, and eating disorders. Participants/Methods: This is a secondary analysis using data from 856 undergraduate students who completed the American College Health Association-National College Health Assessment II…

  14. Cognitive-Behavioral Therapy for Rapid Cycling Bipolar Disorder

    Science.gov (United States)

    Reilly-Harrington, Noreen A.; Knauz, Robert O.

    2005-01-01

    This article describes the application of cognitive-behavioral therapy (CBT) to the treatment of rapid cycling bipolar disorder. Between 10% and 24% of bipolar patients experience a rapid cycling course, with 4 or more mood episodes occurring per year. Characterized by nonresponse to standard mood-stabilizing medications, rapid cyclers are…

  15. Family Cognitive Behavioral Therapy for Child Anxiety Disorders

    Science.gov (United States)

    Wood, Jeffrey J.; Piacentini, John C.; Southam-Gerow, Michael; Chu, Brian C.; Sigman, Marian

    2006-01-01

    Objective: This study compared family-focused cognitive behavioral therapy (CBT: the Building Confidence Program) with traditional child-focused CBT with minimal family involvement for children with anxiety disorders. Method: Forty clinically anxious youth (6-13 years old) were randomly assigned to a family- or child-focused cognitive-behavioral…

  16. Re-Engaging School Dropouts with Emotional and Behavioral Disorders

    Science.gov (United States)

    Wilkins, Julia; Bost, Loujeania Williams

    2015-01-01

    Students with emotional and behavioral disorders have the highest dropout rates of any student group--about 40%. The outcomes for students who drop out of school are dire but are particularly bleak for students with poor academic, interpersonal, and decision-making skills. Helping students earn a high school diploma and gain the skills needed to…

  17. Modular Cognitive-Behavioral Therapy for Body Dysmorphic Disorder

    Science.gov (United States)

    Wilhelm, Sabine; Phillips, Katharine A.; Fama, Jeanne M.; Greenberg, Jennifer L.; Steketee, Gail

    2011-01-01

    This study pilot tested a newly developed modular cognitive-behavioral therapy (CBT) treatment manual for body dysmorphic disorder (BDD). We tested feasibility, acceptability, and treatment outcome in a sample of 12 adults with primary BDD. Treatment was delivered in weekly individual sessions over 18 or 22 weeks. Standardized clinician ratings…

  18. Group Development for Students with Emotional/Behavioral Disorders.

    Science.gov (United States)

    Rockwell, Sylvia; Guetzloe, Eleanor

    1996-01-01

    This article addresses effective techniques for teaching students with emotional disturbances and/or behavior disorders in group settings. Three stages of group development are described with specific teaching strategies for each stage identified and related to Maslow's hierarchy of needs, including needs for safety and trust, belonging and…

  19. Constructive Conflict Resolution for Students with Behavioral Disorders.

    Science.gov (United States)

    Bullock, Cathy; Foegen, Anne

    2002-01-01

    This article describes the application of constructive conflict resolution techniques in a middle-school program for students with behavior disorders, discussing the use of mediation, negotiation, constructive controversy, and classroom meetings. Initial efforts to explore the impact of the program are recounted, and implications for implementing…

  20. A Behavioral Continuum: A Look at Personality Disorders.

    Science.gov (United States)

    Harris, George; Kirk, Nancy A.

    1985-01-01

    Suggests that narcissistic, borderline, and antisocial personality disorders are not discrete diagnostic categories, but that they lie along a continuum and have in common the dimensions of degree of self-centeredness and degree of differentiation. Presents evidence supporting existence of continuum of behavior rather than discrete diagnostic…

  1. Using Puppets with Students with Emotional and Behavioral Disorders.

    Science.gov (United States)

    Caputo, Rosario Anthony

    1993-01-01

    This article suggests ways in which special educators of students with emotional and behavioral disorders can introduce puppets into their classrooms as educational and therapeutic instruments. Puppets are able to help students identify problems and find rational solutions in a nonthreatening situation. Two sample applications are included. (DB)

  2. Sex differences in the brain, behavior, and neuropsychiatric disorders

    NARCIS (Netherlands)

    Bao, Ai-Min; Swaab, Dick F.

    2010-01-01

    Sex differences in the brain are reflected in behavior and in the risk for neuropsychiatric disorders. The fetal brain develops in the male direction due to a direct effect of testosterone on the developing neurons, or in the female direction due to the absence of such a testosterone surge. Because

  3. Torey Hayden's Teacher Lore: Classroom Behavior Management of Children with Emotional and Behavioral Disorders

    Science.gov (United States)

    Marlowe, Mike; Disney, Gayle

    2006-01-01

    Torey Hayden's portrayal of classroom behavior management in her teacher lore, autobiographical writings about teaching children with emotional and behavioral disorders, is examined. Five of her books were sampled: "One child", "Somebody else's kids", "Just another kid", "Ghost girl" and "Beautiful child". Each of these books unfolds within the…

  4. Behavior therapy for children with Tourette disorder: a randomized controlled trial.

    Science.gov (United States)

    Piacentini, John; Woods, Douglas W; Scahill, Lawrence; Wilhelm, Sabine; Peterson, Alan L; Chang, Susanna; Ginsburg, Golda S; Deckersbach, Thilo; Dziura, James; Levi-Pearl, Sue; Walkup, John T

    2010-05-19

    Tourette disorder is a chronic and typically impairing childhood-onset neurologic condition. Antipsychotic medications, the first-line treatments for moderate to severe tics, are often associated with adverse effects. Behavioral interventions, although promising, have not been evaluated in large-scale controlled trials. To determine the efficacy of a comprehensive behavioral intervention for reducing tic severity in children and adolescents. Randomized, observer-blind, controlled trial of 126 children recruited from December 2004 through May 2007 and aged 9 through 17 years, with impairing Tourette or chronic tic disorder as a primary diagnosis, randomly assigned to 8 sessions during 10 weeks of behavior therapy (n = 61) or a control treatment consisting of supportive therapy and education (n = 65). Responders received 3 monthly booster treatment sessions and were reassessed at 3 and 6 months following treatment. Comprehensive behavioral intervention. Yale Global Tic Severity Scale (range 0-50, score >15 indicating clinically significant tics) and Clinical Global Impressions-Improvement Scale (range 1 [very much improved] to 8 [very much worse]). Behavioral intervention led to a significantly greater decrease on the Yale Global Tic Severity Scale (24.7 [95% confidence interval {CI}, 23.1-26.3] to 17.1 [95% CI, 15.1-19.1]) from baseline to end point compared with the control treatment (24.6 [95% CI, 23.2-26.0] to 21.1 [95% CI, 19.2-23.0]) (P tic worsening was reported by 4% of children (5/126). Treatment gains were durable, with 87% of available responders to behavior therapy exhibiting continued benefit 6 months following treatment. A comprehensive behavioral intervention, compared with supportive therapy and education, resulted in greater improvement in symptom severity among children with Tourette and chronic tic disorder. clinicaltrials.gov Identifier: NCT00218777.

  5. Mobile Phone Sensor Correlates of Depressive Symptom Severity in Daily-Life Behavior: An Exploratory Study

    Science.gov (United States)

    Saeb, Sohrab; Zhang, Mi; Karr, Christopher J; Schueller, Stephen M; Corden, Marya E; Kording, Konrad P

    2015-01-01

    Background Depression is a common, burdensome, often recurring mental health disorder that frequently goes undetected and untreated. Mobile phones are ubiquitous and have an increasingly large complement of sensors that can potentially be useful in monitoring behavioral patterns that might be indicative of depressive symptoms. Objective The objective of this study was to explore the detection of daily-life behavioral markers using mobile phone global positioning systems (GPS) and usage sensors, and their use in identifying depressive symptom severity. Methods A total of 40 adult participants were recruited from the general community to carry a mobile phone with a sensor data acquisition app (Purple Robot) for 2 weeks. Of these participants, 28 had sufficient sensor data received to conduct analysis. At the beginning of the 2-week period, participants completed a self-reported depression survey (PHQ-9). Behavioral features were developed and extracted from GPS location and phone usage data. Results A number of features from GPS data were related to depressive symptom severity, including circadian movement (regularity in 24-hour rhythm; r=-.63, P=.005), normalized entropy (mobility between favorite locations; r=-.58, P=.012), and location variance (GPS mobility independent of location; r=-.58, P=.012). Phone usage features, usage duration, and usage frequency were also correlated (r=.54, P=.011, and r=.52, P=.015, respectively). Using the normalized entropy feature and a classifier that distinguished participants with depressive symptoms (PHQ-9 score ≥5) from those without (PHQ-9 score mobile phone sensor data, including GPS and phone usage, provided behavioral markers that were strongly related to depressive symptom severity. While these findings must be replicated in a larger study among participants with confirmed clinical symptoms, they suggest that phone sensors offer numerous clinical opportunities, including continuous monitoring of at-risk populations with

  6. The severity of ADHD and eating disorder symptoms: a correlational study

    Directory of Open Access Journals (Sweden)

    Stulz Niklaus

    2013-02-01

    Full Text Available Abstract Background Attention deficit/hyperactivity disorders (ADHD and eating disorders (ED share several clinical features. Research on the association between ADHD and ED is still quite sparse and findings are ambiguous. Methods Correlations between the severity of ADHD key features (Barratt Impulsiveness Scale, and Attention Deficit/Hyperactivity Disorder-Self-Rating questionnaire and the severity of specific ED symptoms (Structured Interview for Anorexia and Bulimia Nervosa were examined in 32 female patients diagnosed with ED. Results Most correlations between the severity of ADHD features and the severity of ED symptoms were low (r Conclusions The findings in this small sample suggest a weak link between the severity of ADHD key features and the severity of single ED symptoms in female patients with ED. The role of ADHD features for the development, maintenance, and treatment of EDs seems to be intricate and requires further study.

  7. Neural correlates of behavior therapy for Tourette's disorder.

    Science.gov (United States)

    Deckersbach, Thilo; Chou, Tina; Britton, Jennifer C; Carlson, Lindsay E; Reese, Hannah E; Siev, Jedidiah; Scahill, Lawrence; Piacentini, John C; Woods, Douglas W; Walkup, John T; Peterson, Alan L; Dougherty, Darin D; Wilhelm, Sabine

    2014-12-30

    Tourette's disorder, also called Tourette syndrome (TS), is characterized by motor and vocal tics that can cause significant impairment in daily functioning. Tics are believed to be due to failed inhibition of both associative and motor cortico-striato-thalamo-cortical pathways. Comprehensive Behavioral Intervention for Tics (CBIT), which is an extension of Habit Reversal Therapy (HRT), teaches patients to become more aware of sensations that reliably precede tics (premonitory urges) and to initiate competing movements that inhibit the occurrence of tics. In this study, we used functional magnetic resonance imaging (fMRI) to investigate the neural changes associated with CBIT treatment in subjects with TS. Eight subjects with TS were matched with eight healthy controls in gender, education, age, and handedness. Subjects completed the Visuospatial Priming (VSP) task, a measure of response inhibition, during fMRI scanning before and after CBIT treatment (or waiting period for controls). For TS subjects, we found a significant decrease in striatal (putamen) activation from pre- to post-treatment. Change in VSP task-related activation from pre- to post-treatment in Brodmann's area 47 (the inferior frontal gyrus) was negatively correlated with changes in tic severity. CBIT may promote normalization of aberrant cortico-striato-thalamo-cortical associative and motor pathways in individuals with TS. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  8. A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder.

    Science.gov (United States)

    McMain, Shelley F; Links, Paul S; Gnam, William H; Guimond, Tim; Cardish, Robert J; Korman, Lorne; Streiner, David L

    2009-12-01

    The authors sought to evaluate the clinical efficacy of dialectical behavior therapy compared with general psychiatric management, including a combination of psychodynamically informed therapy and symptom-targeted medication management derived from specific recommendations in APA guidelines for borderline personality disorder. This was a single-blind trial in which 180 patients diagnosed with borderline personality disorder who had at least two suicidal or nonsuicidal self-injurious episodes in the past 5 years were randomly assigned to receive 1 year of dialectical behavior therapy or general psychiatric management. The primary outcome measures, assessed at baseline and every 4 months over the treatment period, were frequency and severity of suicidal and nonsuicidal self-harm episodes. Both groups showed improvement on the majority of clinical outcome measures after 1 year of treatment, including significant reductions in the frequency and severity of suicidal and nonsuicidal self-injurious episodes and significant improvements in most secondary clinical outcomes. Both groups had a reduction in general health care utilization, including emergency visits and psychiatric hospital days, as well as significant improvements in borderline personality disorder symptoms, symptom distress, depression, anger, and interpersonal functioning. No significant differences across any outcomes were found between groups. These results suggest that individuals with borderline personality disorder benefited equally from dialectical behavior therapy and a well-specified treatment delivered by psychiatrists with expertise in the treatment of borderline personality disorder.

  9. Cognitive-Behavior Therapy (CBT) for Panic Disorder: Relationship of Anxiety and Depression Comorbidity with Treatment Outcome

    OpenAIRE

    Allen, Laura B.; White, Kamila S.; Barlow, David H.; Shear, M. Katherine; Gorman, Jack M.; Woods, Scott W.

    2009-01-01

    Research evaluating the relationship of comorbidity to treatment outcome for panic disorder has produced mixed results. The current study examined the relationship of comorbid depression and anxiety to treatment outcome in a large-scale, multi-site clinical trial for cognitive-behavior therapy (CBT) for panic disorder. Comorbidity was associated with more severe panic disorder symptoms, although comorbid diagnoses were not associated with treatment response. Comorbid generalized anxiety disor...

  10. Sexual risk behaviors among women with bipolar disorder.

    Science.gov (United States)

    Marengo, Eliana; Martino, Diego J; Igoa, Ana; Fassi, Guillermo; Scápola, María; Urtueta Baamonde, Mariana; Strejilevich, Sergio A

    2015-12-30

    The aim of this study was to investigate sexual health and sexual risk behaviors for sexually transmitted infections (STI) among women with bipolar disorder (BDW). Sixty-three euthymic women diagnosed with bipolar disorder type I, II or not otherwise specified were included and matched with a control group of 63 healthy women. Demographic and clinical data, structured sexual health measures and extensive assessment of sexual risk behavior were obtained and compared between groups. BDW had casual partners, were in non-monogamous sexual partnerships and had sex with partners with unknown HIV condition more frequently than healthy control women. History of two or more STI was more frequent among BDW. Inclusion of sexual behavior risk assessment among BDW in treatment is necessary to better identify those women with higher risk for STI and to take measures to improve their sexual health. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Cognitive-Behavioral Treatment for Specific Phobias with a Child Demonstrating Severe Problem Behavior and Developmental Delays

    Science.gov (United States)

    Davis, Thompson E., III; Kurtz, Patricia F.; Gardner, Andrew W.; Carman, Nicole B.

    2007-01-01

    Cognitive-behavioral treatments (CBTs) are widely used for anxiety disorders in typically developing children; however, there has been no previous attempt to administer CBT for specific phobia (in this case study, one-session treatment) to developmentally or intellectually disabled children. This case study integrates both cognitive-behavioral and…

  12. Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness

    NARCIS (Netherlands)

    Mauritz, M.W.; Goossens, P.J.J.; Draijer, N.; Achterberg, T. van

    2013-01-01

    BACKGROUND: Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice. OBJECTIVE: To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. METHODS: We

  13. Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness

    NARCIS (Netherlands)

    Mauritz, M.W.; Goossens, P.J.J.; Draijer, N.; van Achterberg, T.

    2013-01-01

    Background: Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice. Objective: To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. Methods: We

  14. Infections and exposure to anti-infective agents and the risk of severe mental disorders

    DEFF Research Database (Denmark)

    Köhler, Ole; Petersen, Liselotte; Mors, O

    2017-01-01

    OBJECTIVE: Severe infections are associated with increased risks of mental disorders; however, this is the first large-scale study investigating whether infections treated with anti-infective agents in the primary care setting increase the risks of schizophrenia and affective disorders. METHOD: We...

  15. COMORBID INTERMITTENT EXPLOSIVE DISORDER AND POSTTRAUMATIC STRESS DISORDER: CLINICAL CORRELATES AND RELATIONSHIP TO SUICIDAL BEHAVIOR

    Science.gov (United States)

    Fanning, Jennifer R.; Lee, Royce; Coccaro, Emil F.

    2016-01-01

    Objective Posttraumatic stress disorder (PTSD) is associated with both aggressive and suicidal behavior. Recent research suggests that the diagnosis of Intermittent Explosive Disorder (IED), an impulse-control disorder characterized by repeated impulsive aggressive behavior, may help to identify individuals at risk for attempting suicide. Given the relationship between anger and PTSD, there is likely to be an increased prevalence of IED among individuals with PTSD; however, little is known about the overlap in these two disorders, including how individuals with comorbid IED and PTSD may differ from those with either disorder alone. The purpose of this study is to examine the clinical correlates of comorbid IED and PTSD and the contribution of these two disorders (among others) to lifetime suicide attempt and characteristics of suicidal behavior. Method In a large sample of community research volunteers (N=1460), we compared individuals with PTSD, IED, and comorbid PTSD and IED on measures of current mood, trait aggression, and trait impulsivity. We also examined the contributions of PTSD, IED, and other syndromal and personality disorders to the prediction of lifetime aggression and lifetime suicide attempt, and their relationship to characteristics of suicide attempts, including level of intent, use of violent versus non-violent means, and the medical seriousness of the attempt. Results Comorbid PTSD and IED was associated with significantly elevated levels of depression, anxiety, anger, aggression, and impulsivity, as well as with high rates of comorbidity with other psychiatric disorders. IED (β=.56, psuicide attempt in multivariate analysis (ORs: 1.6 and 1.6, pssuicide attempt (41.4% in this sample). Conclusion These findings add support to the notion that the diagnosis of IED may aid in identifying individuals at risk for aggressive and suicidal behavior. PMID:27624432

  16. SUICIDAL THOUGHTS AND BEHAVIORS IN CHILDREN AND ADOLESCENTS WITH CHRONIC TIC DISORDERS.

    Science.gov (United States)

    Storch, Eric A; Hanks, Camille E; Mink, Jonathan W; McGuire, Joseph F; Adams, Heather R; Augustine, Erika F; Vierhile, Amy; Thatcher, Alyssa; Bitsko, Rebecca; Lewin, Adam B; Murphy, Tanya K

    2015-10-01

    Despite evidence of elevated risk factors for suicidal thoughts and behavior in youth with Tourette syndrome and chronic tic disorders (CTD), few studies have actually examined that relationship. This study documented the frequency and clinical correlates of suicidal thoughts and behaviors in a sample of children and adolescents with CTD (N = 196, range 6-18 years old). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Centers for Disease Control. Youth and parents completed a battery of measures that assessed co-occurring psychiatric diagnoses, child emotional and behavioral symptoms, and impairment due to tics or co-occurring conditions. A structured diagnostic interview identified that 19 youths with CTD (9.7%) experienced suicidal thoughts and/or behaviors, which was elevated compared to 3 youths (3%) who experienced these thoughts in a community control sample (N = 100, range 6-18 years old, P = .03). For youth with CTD, suicidal thoughts and behaviors were frequently endorsed in the context of anger and frustration. The Child Behavior Checklist (CBCL) anxious/depressed, withdrawn, social problems, thought problems, and aggressive behavior subscales, as well as the total internalizing problems scale, were associated with the presence of suicidal thoughts and/or behaviors. Suicidal thoughts and/or behaviors were significantly associated with tic symptom severity; tic-related impairment; and obsessive-compulsive, depressive, anxiety, and attention-deficit/hyperactivity disorders' symptom severity. CBCL anxiety/depression scores mediated the relationship between tic severity and suicidal thoughts and behaviors. Findings suggest that about 1 in 10 youth with CTD experience suicidal thoughts and/or behaviors, which are associated with a more complex clinical presentation and often occur in the presence of anger and frustration. © 2015 Wiley Periodicals, Inc.

  17. Modeling alcohol use disorder severity: an integrative structural equation modeling approach

    Directory of Open Access Journals (Sweden)

    Nathasha R Moallem

    2013-07-01

    Full Text Available Background: Alcohol dependence is a complex psychological disorder whose phenomenology changes as the disorder progresses. Neuroscience has provided a variety of theories and evidence for the development, maintenance, and severity of addiction; however, clinically, it has been difficult to evaluate alcohol use disorder (AUD severity. Objective: This study seeks to evaluate and validate a data-driven approach to capturing alcohol severity in a community sample. Method: Participants were non-treatment seeking problem drinkers (n = 283. A structural equation modeling (SEM approach was used to (a verify the latent factor structure of the indices of AUD severity; and (b test the relationship between the AUD severity factor and measures of alcohol use, affective symptoms, and motivation to change drinking. Results: The model was found to fit well, with all chosen indices of AUD severity loading significantly and positively onto the severity factor. In addition, the paths from the alcohol use, motivation, and affective factors accounted for 68% of the variance in AUD severity. Greater AUD severity was associated with greater alcohol use, increased affective symptoms, and higher motivation to change.Conclusions: Unlike the categorical diagnostic criteria, the AUD severity factor is comprised of multiple quantitative dimensions of impairment observed across the progression of the disorder. The AUD severity factor was validated by testing it in relation to other outcomes such as alcohol use, affective symptoms, and motivation for change. Clinically, this approach to AUD severity can be used to inform treatment planning and ultimately to improve outcomes.

  18. Post-Traumatic Stress Disorder and severe maternal morbidity: is there an association?

    Science.gov (United States)

    Angelini, Carina R; Pacagnella, Rodolfo C; Parpinelli, Mary A; Silveira, Carla; Andreucci, Carla B; Ferreira, Elton C; Santos, Juliana P; Zanardi, Dulce M; Souza, Renato T; Cecatti, Jose G

    2018-01-01

    To evaluate the occurrence of Post-Traumatic Stress Disorder among women experiencing a severe maternal morbidity event and associated factors in comparison with those without maternal morbidity. In a retrospective cohort study, 803 women with or without severe maternal morbidity were evaluated at 6 months to 5 years postpartum for the presence of Post-Traumatic Stress Disorder. Interviews were conducted by telephone and electronic data was stored. Data analysis was carried out by using χ2, Fisher's Exact test, and logistic regression analysis. There was no significant change in the prevalence of Post-Traumatic Stress Disorder related to a previous severe maternal morbidity experience. There were also no differences in diagnostic criteria for severe maternal morbidity (hypertensive syndromes, hemorrhage, surgical intervention or intensive care unit admission required, among other management criteria). Low parity (2.5-fold risk) and increasing age were factors associated with Post-Traumatic Stress Disorder. A severe maternal morbidity episode is not associated with Post-Traumatic Stress Disorder symptoms within five years of the severe maternal morbidity event and birth. However, a more advanced maternal age and primiparity increased the risk of Post-Traumatic Stress Disorder. This does not imply that women who had experienced a severe maternal morbidity event did not suffer or need differentiated care.

  19. Is there an increased clinical severity of patients with eating disorders under managed care?

    Science.gov (United States)

    Bravender, T; Robertson, L; Woods, E R; Gordon, C M; Forman, S

    1999-06-01

    We sought to examine possible differences in medical status at presentation in 1996, compared to 1991, of adolescents with eating disorders (EDs) at a hospital-based multidisciplinary care program to reflect the increasing market penetration of managed care. Charts were reviewed for all new patients scheduled in a hospital-based outpatient ED program in 1996 and 1991. The 92-item standardized data extraction form included information on demographics, indicators of illness severity at the first visit, and subsequent hospitalization. The need for primary care referral was verified using billing records. Data were analyzed with Student's t-test, Chi-square, Fisher's exact, and Mann-Whitney U tests using SPSS 7.5. Of the 153 total patients, 133 kept their intake appointment and 130 (98%) of these had charts available for review. The age, racial/ethnic characteristics, and average length of disordered eating behaviors were not significantly different over the 5-year period. Referral from a primary care clinician was more commonly required in 1996 than 1991 (59% vs. 11%; p < .0001). Eighteen percent of the patients seen in 1996 were admitted from the initial appointment for medical stabilization, compared to 1.5% in 1991 (p = .002). Comparing 1996 to 1991, a similar number of patients had symptoms consistent with anorexia nervosa, whereas fewer patients in 1996 gave a history of bingeing and purging (22% vs. 40%; p = .027). There were no significant differences in indicators of illness severity, treatment by primary care clinician prior to referral, or hospitalization rates for those patients with and without managed care. Patients in 1996 were more likely to require referrals, were less likely to have symptoms consistent with bulimia nervosa, and were more likely to be admitted for medical stabilization. There were no differences in patient presentation characteristics or initial hospitalization rates based on their managed care status. Further research is needed to

  20. Preparation of Teachers of Students with Emotional/Behavioral Disorders. Retrospective Series on Critical Issues in Emotional/Behavioral Disorders.

    Science.gov (United States)

    Bullock, Lyndal M., Ed.; Gable, Robert A., Ed.; Rutherford, Robert B., Jr., Ed.

    The third in a series, this collection of previously published monographs examines the challenges of preparing teachers to work with students who have emotional and behavioral disorders (EBD). Monographs include: (1) "Issues in Training Teachers for the Seriously Emotionally Disturbed" (Frank H. Wood), which discusses preparing regular and special…

  1. The influence of mental health disorders on severity of reoffending in juveniles

    NARCIS (Netherlands)

    Hoeve, M.; McReynolds, L.S.; Wasserman, G.A.; McMillan, C.

    2013-01-01

    The authors conducted secondary data analyses on mental health assessment and offense history data for 700 juveniles referred to juvenile justice agencies in Alabama (probation and detention). Multiple regression analysis was applied to predict subsequent offense severity by disorder profile,

  2. Severity and Features of Epistaxis in Children with a Mucocutaneous Bleeding Disorder

    NARCIS (Netherlands)

    Stokhuijzen, Eva; Segbefia, Catherine I.; Biss, Tina T.; Clark, Dewi S.; James, Paula D.; Riddel, Jim; Blanchette, Victor S.; Rand, Margaret L.

    2018-01-01

    Objective To use standardized bleeding questionnaires to compare the severity and patterns of epistaxis in children with a mucocutaneous bleeding disorder and control children. Study design The epistaxis sections of the Pediatric Bleeding Questionnaire (PBQ) administered to pediatric patients with

  3. Predictors in Internet-delivered cognitive behavior therapy and behavioral stress management for severe health anxiety.

    Science.gov (United States)

    Hedman, Erik; Andersson, Erik; Lekander, Mats; Ljótsson, Brjánn

    2015-01-01

    Severe health anxiety can be effectively treated with exposure-based Internet-delivered cognitive behavior therapy (ICBT), but information about which factors that predict outcome is scarce. Using data from a recently conducted RCT comparing ICBT (n = 79) with Internet-delivered behavioral stress management (IBSM) (n = 79) the presented study investigated predictors of treatment outcome. Analyses were conducted using a two-step linear regression approach and the dependent variable was operationalized both as end state health anxiety at post-treatment and as baseline-to post-treatment improvement. A hypothesis driven approach was used where predictors expected to influence outcome were based on a previous predictor study by our research group. As hypothesized, the results showed that baseline health anxiety and treatment adherence predicted both end state health anxiety and improvement. In addition, anxiety sensitivity, treatment credibility, and working alliance were significant predictors of health anxiety improvement. Demographic variables, i.e. age, gender, marital status, computer skills, educational level, and having children, had no significant predictive value. We conclude that it is possible to predict a substantial proportion of the outcome variance in ICBT and IBSM for severe health anxiety. The findings of the present study can be of high clinical value as they provide information about factors of importance for outcome in the treatment of severe health anxiety. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Prevalence and severity of DSM-5 eating disorders in a community cohort of adolescents.

    Science.gov (United States)

    Smink, Frédérique R E; van Hoeken, Daphne; Oldehinkel, Albertine J; Hoek, Hans W

    2014-09-01

    The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a considerably revised eating disorder section. The aim of this study was to establish the prevalence and severity of eating disorders based on the new DSM-5 criteria in a community cohort of adolescents. This study is part of TRAILS (TRacking Adolescents' Individual Lives Survey), a Dutch cohort study on mental health and social development from preadolescence into young adulthood. At baseline, the participants (n = 2,230) were about 11 years old. Body mass index was measured at all four assessment waves. At age 19, the Composite International Diagnostic Interview was administered to 1,584 of the participants. A two-stage screening approach was used to estimate the prevalence of DSM-5 eating disorders. Adolescents at high risk for eating disorders (n = 312) were selected for an additional interview administered by eating disorder experts. Of the high-risk group n = 296 (95%) could be interviewed. Among the women, the lifetime prevalence of DSM-5 anorexia nervosa was 1.7%, of bulimia nervosa 0.8% and of binge eating disorder 2.3%. Eating disorders were relatively rare among the men. The severity of most cases was mild to moderate and detection and treatment rates depended on the level of severity. The most common DSM-5 eating disorder diagnoses in adolescents in the community are anorexia nervosa and binge eating disorder. Severity ratings for eating disorders seem valid in terms of both the distribution in the community and the correlation with detection and treatment by health care services. © 2014 Wiley Periodicals, Inc.

  5. Binge-Eating Disorder: Between Eating Disorders and Obesity? A Cognitive-Behavioral Perspective

    OpenAIRE

    Gempeler Rueda, Juanita

    2005-01-01

    Abstract This article reviews the available literature on binge-eating disorder, currently included in the DSM IV as an Eating Disorder NOS. Its inclusion in the DSM V is under discussion. Conceptualization of this disorder is examined, as well as implications for clinical interventions from a cognitive-behavioral perspective. Resumen El presente artículo tiene por objeto revisar la bibliografía actualizada disponible sobre el tema del trastorno por atracones de la alimentación, que hasta ...

  6. Psychiatric disorders and symptoms severity in preschool children with atopic eczema.

    Science.gov (United States)

    Catal, F; Topal, E; Soylu, N; Ozel Ozcan, O; Celiksoy, M H; Babayiğit, A; Karakoç, H T E; Erge, D; Sancak, R

    2016-01-01

    To compare with a control group the frequency of psychiatric disorders and severity of psychiatric symptoms in preschool children with atopic eczema. The study included children between the ages of 3-5 who were diagnosed to have atopic eczema. The parents of the children with atopic eczema were interviewed in person and were asked to fill in "The Early Childhood Inventory-4" form. This form assesses the psychiatric disorders and symptoms severity in children between the ages of 3-5. The atopic eczema group included 80 patients (38 male, 42 female) with a mean age of 48.4 ± 15.7 months and the control group included 74 patients (41 male, 33 female) with a mean age of 49.9 ± 15.19 months. It was established that 68.8% of the group with atopic eczema received at least one psychiatric diagnosis. Between the psychiatric disorders, ADHD (Odds ratio: 2.57, 95% CI: 1.049-6.298, p=0.035), enuresis and encopresis (Odds ratio: 2.39, 95% CI: 1.121-5.097, p=0.022) and attachment disorder (Odds ratio: 2.03, 95% CI: 1.046-3.953, p=0.035) were found to be significantly higher when compared with the healthy control group. When the groups were compared in terms of psychiatric symptom severity scores calculated by using ECI-4, ADHD severity (p=0.043), conduct disorder severity (p=0.001), anxiety disorders severity (p<0.001), eating disorders severity (p=0.011) and tic disorder severity (p=0.01) were found to be higher in the atopic eczema group. Psychiatric illnesses are frequent in preschool children with atopic eczema. Copyright © 2015 SEICAP. Published by Elsevier Espana. All rights reserved.

  7. Dopamine and oxytocin interactions underlying behaviors: potential contributions to behavioral disorders.

    Science.gov (United States)

    Baskerville, Tracey A; Douglas, Alison J

    2010-06-01

    Dopamine is an important neuromodulator that exerts widespread effects on the central nervous system (CNS) function. Disruption in dopaminergic neurotransmission can have profound effects on mood and behavior and as such is known to be implicated in various neuropsychiatric behavioral disorders including autism and depression. The subsequent effects on other neurocircuitries due to dysregulated dopamine function have yet to be fully explored. Due to the marked social deficits observed in psychiatric patients, the neuropeptide, oxytocin is emerging as one particular neural substrate that may be influenced by the altered dopamine levels subserving neuropathologic-related behavioral diseases. Oxytocin has a substantial role in social attachment, affiliation and sexual behavior. More recently, it has emerged that disturbances in peripheral and central oxytocin levels have been detected in some patients with dopamine-dependent disorders. Thus, oxytocin is proposed to be a key neural substrate that interacts with central dopamine systems. In addition to psychosocial improvement, oxytocin has recently been implicated in mediating mesolimbic dopamine pathways during drug addiction and withdrawal. This bi-directional role of dopamine has also been implicated during some components of sexual behavior. This review will discuss evidence for the existence dopamine/oxytocin positive interaction in social behavioral paradigms and associated disorders such as sexual dysfunction, autism, addiction, anorexia/bulimia, and depression. Preliminary findings suggest that whilst further rigorous testing has to be conducted to establish a dopamine/oxytocin link in human disorders, animal models seem to indicate the existence of broad and integrated brain circuits where dopamine and oxytocin interactions at least in part mediate socio-affiliative behaviors. A profound disruption to these pathways is likely to underpin associated behavioral disorders. Central oxytocin pathways may serve as a

  8. Impulse control disorder and rapid eye movement sleep behavior disorder in Parkinson's disease.

    Science.gov (United States)

    Bayard, Sophie; Dauvilliers, Yves; Yu, Huan; Croisier-Langenier, Muriel; Rossignol, Alexia; Charif, Mahmoud; Geny, Christian; Carlander, Bertrand; Cochen De Cock, Valérie

    2014-12-01

    The relationship between ICD and RBD is still not yet understood and the results from the current literature are contradictory in PD. We aimed to explore the association between rapid eye movement (REM) sleep behavior disorder (RBD) and impulse control disorder in Parkinson's disease. Ninety-eight non-demented patients with Parkinson's disease underwent one night of video-polysomnography recording. The diagnosis of RBD was established according to clinical and polysomnographic criteria. Impulse control disorders were determined by a gold standard, semi-structured diagnostic interview. Half of the patients (n = 49) reported clinical history of RBD while polysomnographic diagnosis of RBD was confirmed in 31.6% of the patients (n = 31). At least one impulse control disorder was identified in 21.4% of patients, 22.6% with RBD and 20.9% without. Logistic regression controlling for potential confounders indicated that both clinical RBD (OR = 0.34, 95% CI = 0.07-1.48, P = 0.15) and polysomnographic confirmed RBD diagnoses (OR = 0.1.28, 95% CI = 0.31-5.33, P = 0.34) were not associated with impulse control disorder. In Parkinson's disease, REM Sleep Behavior Disorder is not associated with impulse control disorder. The results of our study do not support the notion that PSG-confirmed RBD and ICD share a common pathophysiology. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Periodic Limb Movements During Sleep Mimicking REM Sleep Behavior Disorder: A New Form of Periodic Limb Movement Disorder.

    Science.gov (United States)

    Gaig, Carles; Iranzo, Alex; Pujol, Montserrat; Perez, Hernando; Santamaria, Joan

    2017-03-01

    To describe a group of patients referred because of abnormal sleep behaviors that were suggestive of rapid eye movement (REM) sleep behavior disorder (RBD) in whom video-polysomnography ruled out RBD and showed the reported behaviors associated with vigorous periodic limb movements during sleep (PLMS). Clinical history and video-polysomnography review of patients identified during routine visits in a sleep center. Patients were 15 men and 2 women with a median age of 66 (range: 48-77) years. Reported sleep behaviors were kicking (n = 17), punching (n = 16), gesticulating (n = 8), falling out of bed (n = 5), assaulting the bed partner (n = 2), talking (n = 15), and shouting (n = 10). Behaviors resulted in injuries in 3 bed partners and 1 patient. Twelve (70.6%) patients were not aware of displaying abnormal sleep behaviors that were only noticed by their bed partners. Ten (58.8%) patients recalled unpleasant dreams such as being attacked or chased. Video-polysomnography showed (1) frequent and vigorous stereotyped PLMS involving the lower limbs, upper limbs, and trunk (median PLMS index 61.2; median PLMS index in NREM sleep 61.9; during REM sleep only 8 patients had PLMS and their median PLMS index in REM sleep was 39.5); (2) abnormal behaviors (e.g., punching, groaning) during some of the arousals that immediately followed PLMS in NREM sleep; and (3) ruled out RBD and other sleep disorders such as obstructive sleep apnea. Dopaminergic agents were prescribed in 14 out of the 17 patients and resulted in improvement of abnormal sleep behaviors and unpleasant dreams in all of them. After dopaminergic treatment, follow-up video-polysomnography in 7 patients showed a decrease in the median PLMS index from baseline (108.9 vs. 19.2, p = .002) and absence of abnormal behaviors during the arousals. Abnormal sleep behaviors and unpleasant dreams simulating RBD symptomatology may occur in patients with severe PLMS. In these cases, video-polysomnography ruled out RBD and

  10. A clinical study of autogenic training-based behavioral treatment for panic disorder.

    Science.gov (United States)

    Sakai, M

    1996-03-01

    The present study investigated the effect of autogenic training-based behavioral treatment for panic disorder and identified the predictors of treatment outcome. Thirty-four patients meeting DSM-III-R criteria for panic disorder received autogenic training-based behavioral treatment from October 1981 to December 1994. They were treated individually by the author. The medical records of the patients were investigated for the purpose of this study. The results showed that this autogenic training-based behavioral treatment had successful results. Fifteen patients were cured, nine much improved, five improved, and five unchanged at the end of the treatment. Improvement trends were found as for the severity of panic attack and the severity of agoraphobic avoidance. No consistent findings about predictors emerged when such pretreatment variables as demographics and severity of symptoms were used to predict the outcome. Also, three treatment variables showed useful predictive power. First, practicing the second standard autogenic training exercise satisfactorily predicted better outcomes. Second, application of in vivo exposure was found to be positively associated with the treatment outcome in patients with agoraphobic avoidance. Third, longer treatment periods were associated with better outcomes. These findings suggested that the autogenic training-based behavioral treatment could provide relief to the majority of panic disorder patients.

  11. Altered memory and affective instability in prisoners assessed for dangerous and severe personality disorder.

    Science.gov (United States)

    Kirkpatrick, Tim; Joyce, Eileen; Milton, John; Duggan, Conor; Tyrer, Peter; Rogers, Robert D

    2007-05-01

    Previous studies of borderline personality disorder report neuropsychological impairments in several domains, including memory. No studies have compared memory functioning in high-risk prisoners with borderline personality disorder with similar prisoners with other personality disorders. To explore mnemonic impairments in prisoners undergoing personality assessment as part of the dangerous and severe personality disorder initiative or detained in a medium secure facility. We investigated memory function in 18 prisoners with borderline personality disorder and 18 prisoners with other personality disorders. Prisoners with borderline personality disorder exhibited a pattern of multi-modal impairments in the immediate and delayed recall of verbal and visual information, with some association with affective instability. These deficits were not associated with the severity of personality disturbance. These data suggest that memory deficits have some specificity in relation to the constituent traits of borderline personality disorder and indicate that neuropsychological assessment may be a source of useful adjunctive information for distinguishing between the cognitive and psychological difficulties of individual prisoners.

  12. Individual psychological and social risk factors for violent criminal behavior in adolescents with organic mental disorder

    Directory of Open Access Journals (Sweden)

    Zubkova A.A.

    2016-10-01

    Full Text Available The article describes the risk factors for criminal aggression in adolescents with an organic mental disorder depending on the level of social deviations or severity of pathopsychological factor. The study involved 113 male adolescents aged 15 to 17 years. The main group consisted of juvenile offenders with organic mental disorder. We used the methods of investigation to determine the individual psychological characteristics, we also used structured risk assessment methods. It is shown that risk factors for criminal aggressive behavior in adolescents with organic mental disorder are a high level of proactive and reactive aggression, combined with underdeveloped mechanisms deter aggressive intentions. With the increase of organic disease, these features become more stable. An important role in shaping the aggressive criminal behavior plays an unsuccessful social environment. Interfamily problems, social deprivation, learning difficulties, communication in antisocial groups and substance abuse - all this increases the risk of aggressive illegal actions.

  13. The Efficacy of Internet-based Cognitive Behavioral Therapy on the Anxiety Disorders among Adolescent Girls

    Directory of Open Access Journals (Sweden)

    Afsaneh Karbasi

    2018-01-01

    Full Text Available Background: The prevalence of anxiety disorders among children and adolescents are found to be approximately between 8–12 and 5–10, respectively, and the long-lasting effects of such disorders can expose the sufferers to impairment and dysfunction in several areas of life the examples of which are poor educational performance, low self-esteem, and depression. The present study aims to evaluate the efficacy of internet-based, cognitive-behavioral therapy (ICBT in treating the anxiety disorders among adolescent females. Materials and Methods: The sample included thirty girls aged between 10 and 18 years suffering from a variety of anxiety disorders, under pharmaceutical therapy and referred to clinics of child and adolescent psychiatry specialists in Isfahan. The sample was selected through diagnostic interviews by psychiatrists based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision; afterward, they were randomly assigned to either the experimental or the control groups. To evaluate the efficacy of an ICBT in reducing anxiety disorder symptoms, Screen for Child Anxiety Related Emotional Disorders questionnaire was administered among the patients both before and 4 weeks after the treatment. Results: The covariance analysis results aimed to compare the anxiety disorder score variations between the two groups which demonstrate the fact that anxiety disorder scores in these two groups differ from one another (P < 0.001. Conclusions: This study is comprised of two Conclusions.the significant reduction in the mean of anxiety disorders scores in the experimental group compared to those in control group can be indicative of the efficacy of ICBT. In addition the significant reduction in the average of anxiety disorders symptoms' scores according to the type of anxiety disorders in the experimental group, compared to those in control group, can be indicative of the efficacy of ICBT.

  14. Changes in emotional empathy, affective responsivity, and behavior following severe traumatic brain injury.

    Science.gov (United States)

    de Sousa, Arielle; McDonald, Skye; Rushby, Jacqueline

    2012-01-01

    This study was designed to examine the relationship between deficits in empathy, emotional responsivity, and social behavior in adults with severe traumatic brain injury (TBI). A total of 21 patients with severe TBI and 25 control participants viewed six film clips containing pleasant, unpleasant, and neutral content whilst facial muscle responses, skin conductance, and valence and arousal ratings were measured. Emotional empathy (the Balanced Emotional Empathy Scale, BEES: self-report) and changes in drive and control in social situations (The Current Behaviour Scale, CBS: relative report) were also assessed. In comparison to control participants, those in the TBI group reported less ability to empathize emotionally and had reduced facial responding to both pleasant and unpleasant films. They also exhibited lowered autonomic arousal, as well as abnormal ratings of valence and arousal, particularly to unpleasant films. Relative reported loss of emotional control was significantly associated with heightened empathy, while there was a trend to suggest that impaired drive (or motivation) may be related to lower levels of emotional empathy. The results represent the first to suggest that level of emotional empathy post traumatic brain injury may be associated with behavioral manifestations of disorders of drive and control.

  15. Investigating Habituation to Premonitory Urges in Behavior Therapy for Tic Disorders.

    Science.gov (United States)

    Houghton, David C; Capriotti, Matthew R; Scahill, Lawrence D; Wilhelm, Sabine; Peterson, Alan L; Walkup, John T; Piacentini, John; Woods, Douglas W

    2017-11-01

    Behavior therapy is effective for Persistent Tic Disorders (PTDs), but behavioral processes facilitating tic reduction are not well understood. One process, habituation, is thought to create tic reduction through decreases in premonitory urge severity. The current study tested whether premonitory urges decreased in youth with PTDs (N = 126) and adults with PTDs (N = 122) who participated in parallel randomized clinical trials comparing behavior therapy to psychoeducation and supportive therapy (PST). Trends in premonitory urges, tic severity, and treatment outcome were analyzed according to the predictions of a habituation model, whereby urge severity would be expected to decrease in those who responded to behavior therapy. Although adults who responded to behavior therapy showed a significant trend of declining premonitory urge severity across treatment, results failed to demonstrate that behavior therapy specifically caused changes in premonitory urge severity. In addition, reductions in premonitory urge severity in those who responded to behavior therapy were significant greater than those who did not respond to behavior therapy but no different than those who responded or did not respond to PST. Children with PTDs failed to show any significant changes in premonitory urges. Reductions in premonitory urge severity did not mediate the relationship between treatment and outcome in either adults or children. These results cast doubt on the notion that habituation is the therapeutic process underlying the effectiveness of behavior therapy, which has immediate implications for the psychoeducation and therapeutic rationale presented in clinical practice. Moreover, there may be important developmental changes in premonitory urges in PTDs, and alternative models of therapeutic change warrant investigation. Copyright © 2017. Published by Elsevier Ltd.

  16. Psychiatric disorders and symptoms severity in pre-school children with cow's milk allergy.

    Science.gov (United States)

    Topal, E; Catal, F; Soylu, N; Ozcan, O O; Celiksoy, M H; Babayiğit, A; Erge, D; Karakoç, H T E; Sancak, R

    2016-01-01

    Psychiatric disorders are seen frequently in atopic diseases. The present study aims to evaluate the frequency of psychiatric disorders and the severity of psychiatric symptoms in pre-school children with cow's milk allergy. The parents of the pre-school children with cow's milk allergy were interviewed in person and asked to fill out the Early Childhood Inventory-4 form. The cow's milk allergy group included 40 children (27 male, 13 female) with mean age, 44.5±14.7 months, and the control group included 41 children (25 male, 16 female) with mean age, 47.6±15.2 months. It was established that 65% of the group with cow's milk allergy received at least one psychiatric diagnosis, while 36.6% of the control group received at least one psychiatric diagnosis, with a statistically significant difference (p=0.02). Within the psychiatric disorders, attention deficit hyperactivity disorders (odds ratio: 4.9, 95% CI: 1.472-16.856, p=0.006), oppositional defiant disorder (odds ratio: 5.6, 95% CI: 1.139-28.128, p=0.026), and attachment disorder (odds ratio: 4.8, 95% CI: 1.747-13.506, p=0.004) were found significantly higher compared with the healthy control group. When the groups were compared in terms of psychiatric symptom severity scores, calculated by using the Early Childhood Inventory-4 form, attention deficit hyperactivity disorders severity (p=0.006) and oppositional defiant disorder severity (p=0.037) were found to be higher in the cow's milk allergy group. Psychiatric disorders are frequent and severe in pre-school children with cow's milk allergy. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  17. Effect of Group Parent Management Traning on Behavioral Disorders of Children with Attention Deficit-Hyoeractivity Disorder

    Directory of Open Access Journals (Sweden)

    Parsa Houshvar

    2009-10-01

    Conclusion: Group parent management training is significantly effective in decreasing behavioral disorders and anxiety status of children with attention deficit hyperactivity disorder and this psychosocial intervention could be used as an effective complementary method beside medication and occupational therapy programs.

  18. Personality disorder symptom severity predicts onset of mood episodes and conversion to bipolar I disorder in individuals with bipolar spectrum disorder.

    Science.gov (United States)

    Ng, Tommy H; Burke, Taylor A; Stange, Jonathan P; Walshaw, Patricia D; Weiss, Rachel B; Urosevic, Snezana; Abramson, Lyn Y; Alloy, Lauren B

    2017-04-01

    Although personality disorders (PDs) are highly comorbid with bipolar spectrum disorders (BSDs), little longitudinal research has been conducted to examine the prospective impact of PD symptoms on the course of BSDs. The aim of this study is to examine whether PD symptom severity predicts shorter time to onset of bipolar mood episodes and conversion to bipolar I disorder over time among individuals with less severe BSDs. Participants (n = 166) with bipolar II disorder, cyclothymia, or bipolar disorder not otherwise specified completed diagnostic interview assessments of PD symptoms and self-report measures of mood symptoms at baseline. They were followed prospectively with diagnostic interviews every 4 months for an average of 3.02 years. Cox proportional hazard regression analyses indicated that overall PD symptom severity significantly predicted shorter time to onset of hypomanic (hazard ratio [HR] = 1.42; p conversion to bipolar I disorder (HR = 2.51; p conversion to bipolar I disorder (HR = 2.77; p < .001), whereas cluster C severity (HR = 1.56; p < .001) predicted shorter time to onset of major depressive episodes. These results support predisposition models in suggesting that PD symptoms may act as a risk factor for a more severe course of BSDs. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. Gambling Disorder and Other Behavioral Addictions: Recognition and Treatment

    Science.gov (United States)

    Yau, Yvonne H. C.; Potenza, Marc N.

    2015-01-01

    Addiction professionals and the public are recognizing that certain nonsubstance behaviors—such as gambling, Internet use, video-game playing, sex, eating, and shopping—bear resemblance to alcohol and drug dependence. Growing evidence suggests that these behaviors warrant consideration as nonsubstance or “behavioral” addictions and has led to the newly introduced diagnostic category “Substance-Related and Addictive Disorders” in DSM-5. At present, only gambling disorder has been placed in this category, with insufficient data for other proposed behavioral addictions to justify their inclusion. This review summarizes recent advances in our understanding of behavioral addictions, describes treatment considerations, and addresses future directions. Current evidence points to overlaps between behavioral and substance-related addictions in phenomenology, epidemiology, comorbidity, neurobiological mechanisms, genetic contributions, responses to treatments, and prevention efforts. Differences also exist. Recognizing behavioral addictions and developing appropriate diagnostic criteria are important in order to increase awareness of these disorders and to further prevention and treatment strategies. PMID:25747926

  20. Sexual behavior and autism spectrum disorders: an update and discussion.

    Science.gov (United States)

    Kellaher, Denise C

    2015-04-01

    In the last few years, we have gained a deeper understanding about sexuality among individuals with autism spectrum disorder (ASD). Greater interest in this subject and improvements in the empirical study of ASD populations are driving this enlightenment. The data is dispelling antiquated notions that ASD individuals are asexual, sexually unknowledgeable and inexperienced, and/or disinterested in relationships. We still have a ways to go in examining paraphilic or deviant arousal sexual behaviors among ASD individuals. This manuscript provides an update on sexuality research in ASD in the last few years. This is accompanied by a discussion of the paraphilic type sexual behaviors observed among some ASD individuals.

  1. Characteristics of rapid eye movement sleep behavior disorder in narcolepsy

    DEFF Research Database (Denmark)

    Jennum, Poul Jørgen; Frandsen, Rune Asger Vestergaard; Knudsen, Stine

    2013-01-01

    Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by dream-enacting behavior and impaired motor inhibition during REM sleep (REM sleep without atonia, RSWA). RBD is commonly associated with Parkinsonian disorders, but is also reported in narcolepsy. Most patients...... of hypocretin deficiency. Thus, hypocretin deficiency is linked to the two major disturbances of REM sleep motor regulation in narcolepsy: RBD and cataplexy. Moreover, it is likely that hypocretin deficiency independently predicts periodic limb movements in REM and NREM sleep, probably via involvement...... of the dopaminergic system. This supports the hypothesis that an impaired hypocretin system causes general instability of motor regulation during wakefulness, REM and NREM sleep in human narcolepsy. We propose that hypocretin neurons are centrally involved in motor tone control during wakefulness and sleep in humans...

  2. Sleep Quality Improvement During Cognitive Behavioral Therapy for Anxiety Disorders.

    Science.gov (United States)

    Ramsawh, Holly J; Bomyea, Jessica; Stein, Murray B; Cissell, Shadha H; Lang, Ariel J

    2016-01-01

    Despite the ubiquity of sleep complaints among individuals with anxiety disorders, few prior studies have examined whether sleep quality improves during anxiety treatment. The current study examined pre- to posttreatment sleep quality improvement during cognitive behavioral therapy (CBT) for panic disorder (PD; n = 26) or generalized anxiety disorder (GAD; n = 24). Among sleep quality indices, only global sleep quality and sleep latency improved significantly (but modestly) during CBT. Sleep quality improvement was greater for treatment responders, but did not vary by diagnosis. Additionally, poor baseline sleep quality was independently associated with worse anxiety treatment outcome, as measured by higher intolerance of uncertainty. Additional intervention targeting sleep prior to or during CBT for anxiety may be beneficial for poor sleepers.

  3. Dialectical Behavior Therapy Group Skills Training for Bipolar Disorder.

    Science.gov (United States)

    Eisner, Lori; Eddie, David; Harley, Rebecca; Jacobo, Michelle; Nierenberg, Andrew A; Deckersbach, Thilo

    2017-07-01

    There is growing evidence that the capacity for emotion regulation is compromised in individuals with bipolar disorder. Dialectical behavior therapy (DBT), an empirically supported treatment that specifically targets emotion dysregulation, may be an effective adjunct treatment for improving emotion regulation and residual mood symptoms in patients with bipolar disorder. In this open, proof-of-concept pilot study, 37 participants engaged in a 12-week DBT group skills training program, learning mindfulness, emotion regulation, and distress tolerance skills. Repeated measures mixed models revealed skill acquisition in the areas of mindfulness, emotion regulation and distress tolerance, as well as improved psychological well-being and decreased emotion reactivity. The results of this study support a burgeoning literature that DBT is a feasible adjunct intervention for patients with bipolar disorder. Copyright © 2017. Published by Elsevier Ltd.

  4. Evaluation of the DSM-5 severity indicator for binge eating disorder in a clinical sample

    Science.gov (United States)

    Grilo, Carlos M.; Ivezaj, Valentina; White, Marney A.

    2015-01-01

    Objective This study tested the new DSM-5 severity criterion for binge eating disorder (BED) based on frequency of binge-eating in a clinical sample. This study also tested overvaluation of shape/weight as an alternative severity specifier. Method Participants were 834 treatment-seeking adults diagnosed with DSM-5 BED using semistructured diagnostic and eating-disorder interviews. Participants sub-grouped based on DSM-5 severity levels and on overvaluation of shape/weight were compared on demographic and clinical variables. Results Based on DSM-5 severity definitions, 331 (39.7%) participants were categorized as mild, 395 (47.5%) as moderate, 83 (10.0%) as severe, and 25 (3.0%) as extreme. Analyses comparing three (mild, moderate, and severe/extreme) severity groups revealed no significant differences in demographic variables or body mass index (BMI). Analyses revealed significantly higher eating-disorder psychopathology in the severe/extreme than moderate and mild groups and higher depression in moderate and severe/extreme groups than the mild group; effect sizes were small. Participants characterized with overvaluation (N = 449; 54%) versus without overvaluation (N = 384; 46%) did not differ significantly in age, sex, BMI, or binge-eating frequency, but had significantly greater eating-disorder psychopathology and depression. The robustly greater eating-disorder psychopathology and depression levels (medium-to-large effect sizes) in the overvaluation group was observed without attenuation of effect sizes after adjusting for ethnicity/race and binge-eating severity/frequency. Conclusions Our findings provide support for overvaluation of shape/weight as a severity specifier for BED as it provides stronger information about the severity of homogeneous groupings of patients than the DSM-5 rating based on binge-eating. PMID:26114779

  5. Web-Based Cognitive Behavioral Therapy for Female Patients With Eating Disorders: Randomized Controlled Trial.

    Science.gov (United States)

    ter Huurne, Elke D; de Haan, Hein A; Postel, Marloes G; van der Palen, Job; VanDerNagel, Joanne E L; DeJong, Cornelis A J

    2015-06-18

    Many patients with eating disorders do not receive help for their symptoms, even though these disorders have severe morbidity. The Internet may offer alternative low-threshold treatment interventions. This study evaluated the effects of a Web-based cognitive behavioral therapy (CBT) intervention using intensive asynchronous therapeutic support to improve eating disorder psychopathology, and to reduce body dissatisfaction and related health problems among patients with eating disorders. A two-arm open randomized controlled trial comparing a Web-based CBT intervention to a waiting list control condition (WL) was carried out among female patients with bulimia nervosa (BN), binge eating disorder (BED), and eating disorders not otherwise specified (EDNOS). The eating disorder diagnosis was in accordance with the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and was established based on participants' self-report. Participants were recruited from an open-access website, and the intervention consisted of a structured two-part program within a secure Web-based application. The aim of the first part was to analyze participant's eating attitudes and behaviors, while the second part focused on behavioral change. Participants had asynchronous contact with a personal therapist twice a week, solely via the Internet. Self-report measures of eating disorder psychopathology (primary outcome), body dissatisfaction, physical health, mental health, self-esteem, quality of life, and social functioning were completed at baseline and posttest. A total of 214 participants were randomized to either the Web-based CBT group (n=108) or to the WL group (n=106) stratified by type of eating disorder (BN: n=44; BED: n=85; EDNOS: n=85). Study attrition was low with 94% of the participants completing the posttest assignment. Overall, Web-based CBT showed a significant improvement over time for eating disorder psychopathology (F97=63.07, PWeb-based CBT participants in all three

  6. Addiction as a BAD, a Behavioral Allocation Disorder.

    Science.gov (United States)

    Lamb, R J; Ginsburg, Brett C

    2018-01-01

    Addiction is continued drug use despite its harm. As one always has alternatives, addiction can be construed as a decision to allocate behavior to drug use. While decision making is commonly discussed and studied as if it resulted from deliberative, evaluative processes, such processes are actually only rarely involved in behavior allocation. These deliberative processes are too slow, effortful and inefficient to guide behavior other than when necessary. Rather, most actions are guided by faster, more automatic processes, often labeled habits. Habits are mostly adaptive, and result from repeated reinforcement leading to over-learned behavior. Habitual behavior occurs rapidly in response to particular contexts, and the behavior occurring first is that which occurs, i.e., the behavior that is decided upon. Thus, as drug use becomes habitual, drug use is likely to be chosen over other available activities in that particular context. However, while drug use becoming habitual is necessary for addiction to develop, it is not sufficient. Typically, constraints limit even habitual drug use to safer levels. These constraints might include limiting occasions for use; and, almost always, constraints on amount consumed. However, in a minority of individuals, drug use is not sufficiently constrained and addiction develops. This review discusses the nature of these constraints, and how they might fail. These failures do not result from abnormal learning processes, but rather unfortunate interactions between a person and their environment over time. These accumulate in the maladaptive allocation of behavior to drug use. This Behavior Allocation Disorder (BAD) can be reversed; occasionally easily when the environment significantly changes, but more often by the arduous application of deliberative processes generally absent from decision making. These deliberative processes must continue until new more adaptive habits become the most probable behavior in the contexts encountered

  7. Did Immanuel Kant have dementia with Lewy bodies and REM behavior disorder?

    Science.gov (United States)

    Miranda, Marcelo; Slachevsky, Andrea; Garcia-Borreguero, Diego

    2010-06-01

    Immanuel Kant, one of the most brilliant minds of the XVIII century and of western philosophy, suffered from dementia in his late years. Based on the analysis of testimonies of his close friends, in this report we describe his neurological disorder which, after 8years of evolution, led to his death. His cognitive decline was strongly associated with a parasomnia compatible with a severe rapid eye movement (REM) behavior disorder (RBD) and dementia with Lewy bodies. Copyright 2010 Elsevier B.V. All rights reserved.

  8. 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.

  9. An etiological model of disordered eating behaviors among Brazilian women.

    Science.gov (United States)

    de Carvalho, Pedro Henrique Berbert; Alvarenga, Marle Dos Santos; Ferreira, Maria Elisa Caputo

    2017-09-01

    The Tripartite Influence Model posits that parents, peers and media influences mediated by internalization and appearance social comparison are predictors of body dissatisfaction, a key risk factor for eating disorders. However, the Tripartite Influence Model has not been tested in Brazil where the people are known to have high levels of body image and appearance concerns. This study aimed to test an adapted Tripartite Influence Model of body dissatisfaction and disordered eating behaviors among Brazilian women. A sample of 741 undergraduate students (M age  = 23.55 years, SD = 4.09) completed measures of sociocultural influences, internalization of body ideal, social appearance comparison, body dissatisfaction, muscularity dissatisfaction, disordered eating and body change behaviors. Structural equation modeling analyses indicated that the proposed etiological model for Brazilian women has good fit indexes (χ 2 (2064) = 6793.232; p = 0.0001; χ 2 /gl = 3.29; CFI = 0.82; PCFI = 0.79; RMSEA = 0.056 [IC90% = 0.053-0.057]). Parent and media influences were related with both internalization and social comparison, while peer influence with social comparison. A full mediation model was found, with both internalization and social comparison contributing to body dissatisfaction. Finally, body dissatisfaction was associated with disordered eating behaviors. The findings inform the importance of considering cultural aspects that influence body image and eating behaviors, and highlight the validity of the proposed etiological model for Brazilian women, that can be used for research and clinical purposes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Hoarding behavior among young children with obsessive-compulsive disorder

    OpenAIRE

    Frank, Hannah; Stewart, Elyse; Walther, Michael; Benito, Kristen; Freeman, Jennifer; Conelea, Christ; Garci, Abbe

    2013-01-01

    Previous research has shown that among the various subtypes of obsessive-compulsive disorder (OCD), adults (e.g. Frost, Krause & Steketee, 1996) and older children and adolescents (Bloch et al., 2009; Storch et al., 2007) with problematic hoarding have distinct features and a poor treatment prognosis. However, there is limited information on the phenomenology and prevalence of hoarding behaviors in young children. The present study characterizes children ages 10 and under who present with OCD...

  11. [Childhood traumatization, dissociation and nonsuicidal self-injurious behavior in borderline personality disorder].

    Science.gov (United States)

    Merza, Katalin; Harmatta, János; Papp, Gábor; Kuritárné Szabó, Ildikó

    2017-05-01

    Childhood traumatization plays a significant role in the etiology of borderline personality disorder. Studies found a significant association between childhood traumatization, dissociation, and nonsuicidal self-injurious behavior. The aim of our study was to assess dissociation and nonsuicidal self-injury among borderline inpatients and to reveal the association between childhood traumatization, dissociation, and self-injurious behavior. The sample consisted of 80 borderline inpatients and 73 depressed control patients. Childhood traumatization, dissociation and self-injurious behavior were assessed by questionnaires. Borderline patients reported severe and multiplex childhood traumatization. Cumulative trauma score and sexual abuse were the strongest predictors of dissociation. Furthermore, we have found that cumulative trauma score and dissociation were highly predictive of self-injurious behavior. Our results suggest that self-injurious behavior and dissociation in borderline patients can be regarded as indicators of childhood traumatization. Orv Hetil. 2017; 158(19): 740-747.

  12. Evaluation of the known behavioral heterogeneity in conduct disorder to improve its assessment and treatment.

    Science.gov (United States)

    Klahr, Ashlea M; Burt, S Alexandra

    2014-12-01

    Conduct Disorder (CD) is among the most highly represented diagnostic problems in child and adolescent mental health treatment settings. There is a great deal of heterogeneity within the CD category, with potentially important implications for case conceptualization and treatment. The current review sought to detail forms of heterogeneity within CD, including callous-unemotional traits, comorbid Attention-Deficit Hyperactivity Disorder (ADHD), aggressive and nonaggressive antisocial behavior, and age of onset. The current review summarizes research on etiological factors, correlates, and trajectories associated with distinguishable dimensions of CD, and considers how this heterogeneity should be incorporated into the assessment and treatment of CD. Callous-unemotional traits have been associated with a more severe and persistent form of CD, as have comorbid ADHD and child-onset CD. Aggressive antisocial behavior is a stable behavioral dimension that emerges in early childhood and is associated with high levels of neuroticism. Nonaggressive antisocial behavior demonstrates specific associations with impulsivity, is most frequent during adolescence, and evidences more moderate levels of stability. Conduct disorder is a highly heterogeneous disorder. Although the clinical implications of this heterogeneity are discussed, future research is clearly needed to shore up our understanding of the clinical ramifications of the sub-dimensions within CD. © 2014 The Authors. Journal of Child Psychology and Psychiatry. © 2014 Association for Child and Adolescent Mental Health.

  13. [Effectiveness of an integrated treatment for severe personality disorders. A 36-month pragmatic follow-up].

    Science.gov (United States)

    Lana, Fernando; Sánchez-Gil, Carmen; Ferrer, Laia; López-Patón, Nuria; Litvan, Lia; Marcos, Susana; Sierra, Ana C; Soldevilla, Joan M; Feixas, Guillem; Pérez, Víctor

    2015-01-01

    Over the past 25 years, several studies have shown the efficacy of a number of psychological interventions for severe personality disorders. However, the generalizability of these positive results from long traditional research settings to more ordinary ones has been questioned, requiring a need for replication in pragmatic studies. This pragmatic study compares hospitalizations and Emergency Room visits before and during a 6-month therapeutic program for severe personality disorders, and at 36 months after starting it. The therapeutic program, which integrates several specific interventions within a coherent framework, was carried out in an ordinary clinical setting. Fifty-one patients, evaluated according DSM-IV criteria by using the Spanish version of the Structured Clinical Interview for Personality Disorders (SCID-II), were included. The clinical characteristics showed a group of severely disturbed patients, of which 78.4% met criteria for borderline personality disorder. The percentage of patients hospitalized and visiting the Emergency Room, as well as the number of days of hospitalization and Emergency Room visits was significantly reduced during the treatment, and this improvement was maintained throughout. An integrated treatment for severe personality disorders could be effective in preventing reliance on readmissions, or prolonged hospital stays, when it is implemented by clinicians in ordinary clinical settings. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.

  14. Validation of the Repetitive Behavior Scale-Revised in Spanish-Speakers Participants with Autism Spectrum Disorder

    Science.gov (United States)

    Martínez-González, A. E.; Piqueras, J. A.

    2018-01-01

    Restricted and repetitive behavior (RRB) is one of the two key diagnostic features of autism spectrum disorder (ASD). DSM-5 highlights the importance of severity-based diagnostic modifiers assigned on the basis of intensity of needed supports. Therefore, there is a need for available measures that assess the severity of RRB. The repetitive…

  15. Suggestive Linkage of the Child Behavior Checklist Juvenile Bipolar Disorder Phenotype to 1p21, 6p21, and 8q21

    Science.gov (United States)

    Doyle, Alysa E.; Biederman, Joseph; Ferreira, Manuel A. R.; Wong, Patricia; Smoller, Jordan W.; Faraone, Stephen V.

    2010-01-01

    Objective: Several studies have documented a profile of elevated scores on the Attention Problems, Aggressive Behavior and Anxious/Depressed scales of the Child Behavior Checklist (CBCL) in youth with bipolar disorder. The sum of these scales, referred to as the CBCL Juvenile Bipolar Disorder (JBD) phenotype, has modest diagnostic utility, and…

  16. Autism Severity and Motor Abilities Correlates of Imitation Situations in Children with Autism Spectrum Disorders

    Science.gov (United States)

    Zachor, Ditza A.; Ilanit, Tzaig; Itzchak, Esther Ben

    2010-01-01

    Impaired performance in a range of imitation tasks has been described in children with autism spectrum disorders (ASD) and several underlying mechanism have been suggested. This study examined whether imitation abilities are related to autism severity and to motor skills. Furthermore, the performance of children with ASD in four imitation…

  17. Pediatric Bipolar Disorder versus Severe Mood Dysregulation: Risk for Manic Episodes on Follow-Up

    Science.gov (United States)

    Stringaris, Argyris; Baroni, Argelinda; Haimm, Caroline; Brotman, Melissa; Lowe, Catherine H.; Myers, Frances; Rustgi, Eileen; Wheeler, Wanda; Kayser, Reilly; Towbin, Kenneth; Leibenluft, Ellen

    2010-01-01

    Objective: An important question in pediatric bipolar research is whether marked nonepisodic irritability is a manifestation of bipolar disorder in youth. This study tests the hypothesis that youth with severe mood dysregulation (SMD), a category created for the purpose of studying children presenting with severe nonepisodic irritability, will be…

  18. The Use of Virtual Reality to Facilitate Mindfulness Skills Training in Dialectical Behavioral Therapy for Borderline Personality Disorder: A Case Study.

    OpenAIRE

    Navarro Haro, María Vicenta; Hoffman, Hunter G.; García Palacios, Azucena; Sampaio, Mariana; Alhalali, Wadee; Hall, Karyn; Linehan, Marsha

    2016-01-01

    Borderline personality disorder (BPD) is a severe mental disorder characterized by a dysfunctional pattern of affective instability, impulsivity, and disturbed interpersonal relationships. Dialectical Behavior Therapy (DBT®) is the most effective treatment for Borderline Personality Disorder, but demand for DBT® far exceeds existing clinical resources. Most patients with BPD never receive DBT®. Incorporating computer technology into the DBT® could help increase dissemination. Immersive Virtua...

  19. The use of Virtual Reality to facilitate mindfulness skills training in Dialectical Behavioral Therapy for Borderline Personality Disorder: A case study.

    OpenAIRE

    Maria V Nararro-Haro; Hunter G. Hoffman; Hunter G. Hoffman; Hunter G. Hoffman; Azucena Garcia-Palacios; Azucena Garcia-Palacios; Mariana Sampaio; Wadee Alhalabi; Wadee Alhalabi; Karyn Hall; Marsha Linehan

    2016-01-01

    Borderline personality disorder (BPD) is a severe mental disorder characterized by a dysfunctional pattern of affective instability, impulsivity, and disturbed interpersonal relationships. Dialectical Behavior Therapy (DBT®) is the most effective treatment for Borderline Personality Disorder, but demand for DBT® far exceeds existing clinical resources. Most patients with BPD never receive DBT®. Incorporating computer technology into the DBT® could help increase dissemination. Immersive Vir...

  20. The Use of Virtual Reality to Facilitate Mindfulness Skills Training in Dialectical Behavioral Therapy for Borderline Personality Disorder: A Case Study

    OpenAIRE

    Nararro-Haro, Maria V.; Hoffman, Hunter G.; Garcia-Palacios, Azucena; Sampaio, Mariana; Alhalabi, Wadee; Hall, Karyn; Linehan, Marsha

    2016-01-01

    Borderline personality disorder (BPD) is a severe mental disorder characterized by a dysfunctional pattern of affective instability, impulsivity, and disturbed interpersonal relationships. Dialectical Behavior Therapy (DBT®) is the most effective treatment for Borderline Personality Disorder, but demand for DBT® far exceeds existing clinical resources. Most patients with BPD never receive DBT®. Incorporating computer technology into the DBT® could help increase dissemination. Immersive Virtua...

  1. Severity of Anxiety Disorders in Patients with Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Mitra Safa

    2015-10-01

    Full Text Available Objective: Patients with chronic physical diseases sometimes show increased loss of function; such patients need more care. Anxiety is a well-known symptom that is prevalent among chronic obstructive pulmonary disease patients that can prolong and increase the risk of hospitalization. The purpose of this study was to evaluate the severity of anxiety in the mentioned patients and to examine the presence of symptoms and appropriate treatment strategies to understand the role of psychological functions in physical patients.Methods: This was a cross sectional study conducted in Masih Daneshvari Hospital. One hundred forty- three patients entered into the project by accessible method and signed the informed consent; they filled demographic information and Hamilton anxiety and depression questionnaires. Data were analyzed by SPSS-16 .Results: Of the participants, 68% were above 60 years of age; 78% were male; 89% were married; and 38% were self-employed. Also, among the participants, 51% were illiterate; 72% had history of smoking; 46% had history of substance abuse; and 49% had moderate to severe anxiety disorder. Moreover, of the patients with severe anxiety, 41.3% had severe muscle spasms; and severe sleeplessness was found in 38.5% of those with severe anxiety disorder. Severe anxiety related symptoms were found in 20.3% of the patients with severe anxiety disorder. Depressed mood was found in 27.3% of the patients with severe anxiety disorder. Severe physical and muscular signs were found in 35.7% of those with severe anxiety disorder .Conclusion: According to our findings, many chronic diseases such as chronic obstructive pulmonary disease may contain anxiety and depression which result in vulnerability. Therefore, evaluation of anxiety in such patients is of importance for alleviating the disease.

  2. [Modern documentary research on disease menu of acupuncture-moxibustion for mental and behavioral disorder].

    Science.gov (United States)

    Hu, You-Ping; Chen, Yong; Xing, Lin; Niu, Bai-Lu; Zhu, Feng-Juan; Han, Jing; Wang, Yu; Bian, Wei; Liu, Cong-Sheng; Wei, Li; Du, Yuan-Hao

    2011-10-01

    Dominant disease menu of mental and behavioral disorder of acupuncture therapy was summarized and obtained in this article. Literatures on clinical treatment of mental and behavioral disorder with acupuncture were picked up from CBMdisc and CNKI during 1978 to 2007. Types of mental and behavioral disorder and report frequency of each disease treated with acupuncture were counted. And dominant diseases which were favorable to be treated with acupuncture were acquired through analysis and inductive method. Twenty-nine diseases of mental and behavioral disorder are favorable to be treated with acupuncture which were mentioned in totally 1967 related documents. It is found that the number of reports of sleep disorder, depression, hysteria aphronesia, dementia and sexual disorder are ranked as the top five. It is concluded that the preponderant diseases of mental and behavioral disorder treated by acupuncture are dementia, withdrawal syndrome, mental retardation, obsessive-compulsive disorder, sleep disorder, gastrointestinal neurosis (gastrointestinal disorders), depression, alcoholism and globus hystericus.

  3. Adolescents with personality disorders suffer from severe psychiatric stigma: evidence from a sample of 131 patients

    Directory of Open Access Journals (Sweden)

    Catthoor K

    2015-05-01

    Full Text Available Kirsten Catthoor,1,3 Dine J Feenstra,2 Joost Hutsebaut,2 Didier Schrijvers,3 Bernard Sabbe3 1Department of Psychiatry, Psychiatrisch Ziekenhuis Stuivenberg, ZNA Antwerpen, Antwerp, Belgium; 2Viersprong Institute for Studies on Personality Disorders, Halsteren, the Netherlands; 3Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Wilrijk, Belgium Background: The aim of the study is to assess the severity of psychiatric stigma in a sample of personality disordered adolescents in order to evaluate whether differences in stigma can be found in adolescents with different types and severity of personality disorders (PDs. Not only adults but children and adolescents with mental health problems suffer from psychiatric stigma. In contrast to the abundance of research in adult psychiatric samples, stigma in children and adolescents has hardly been investigated. Personality disordered adolescents with fragile identities and self-esteem might be especially prone to feeling stigmatized, an experience which might further shape their identity throughout this critical developmental phase. Materials and methods: One hundred thirty-one adolescent patients underwent a standard assessment with Axis I and Axis II diagnostic interviews and two stigma instruments, Stigma Consciousness Questionnaire (SCQ and Perceived Devaluation–Discrimination Questionnaire (PDDQ. Independent sample t-tests were used to investigate differences in the mean SCQ and PDDQ total scores for patients with and without a PD. Multiple regression main effect analyses were conducted to explore the impact of the different PDs on level of stigma, as well as comorbid Axis I disorders. Age and sex were also entered in the regression models. Results and conclusions: Adolescents with severe mental health problems experience a burden of stigma. Personality disordered patients experience more stigma than adolescents with other severe psychiatric Axis I disorders. Borderline PD

  4. Stigma experienced by patients with severe mental disorders: A nationwide multicentric study from India.

    Science.gov (United States)

    Grover, Sandeep; Avasthi, Ajit; Singh, Aakanksha; Dan, Amitava; Neogi, Rajarshi; Kaur, Darpan; Lakdawala, Bhavesh; Rozatkar, Abhijit R; Nebhinani, Naresh; Patra, Suravi; Sivashankar, Priya; Subramanyam, Alka A; Tripathi, Adarsh; Gania, Ab Majid; Singh, Gurvinder Pal; Behere, Prakash

    2017-11-01

    This study aimed to evaluate the stigma and its correlates among patients with severe mental disorders. Patients with diagnosis of schizophrenia (N = 707), bipolar disorder (N = 344) and recurrent depressive disorder (N = 352) currently in clinical remission from 14 participating centres were assessed on Internalized Stigma of Mental Illness Scale (ISMIS). Patients with diagnosis of schizophrenia experienced higher level of alienation, sterotype endorsement, discrimination experience and total stigma when compared to patients with bipolar disorder and recurrent depressive disorder. Patients with bipolar disorder experienced higher stigma than those with recurrent depressive disorder in the domain of stigma resistance only. Overall compared to affective disorder groups, higher proportion of patients with schizophrenia reported stigma in all the domains of ISMIS. In general in all the 3 diagnostic groups' stigma was associated with shorter duration of illness, shorter duration of treatment and younger age of onset. To conclude, this study suggests that compared to affective disorder, patients with schizophrenia experience higher self stigma. Higher level of stigma is experienced during the early phase of illness. Stigma intervention programs must focus on patients during the initial phase of illness in order to reduce the negative consequences of stigma. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Anxiety disorders: treatable regardless of the severity of comorbid alcohol dependence

    NARCIS (Netherlands)

    Schade, Annemiek; Marquenie, Loes A.; van Balkom, Anton J. L. M.; Koeter, Maarten W. J.; de Beurs, Edwin; van Dyck, Richard; van den Brink, Wim

    2007-01-01

    AIMS: Clinical and epidemiological research has shown that comorbidity is the rule rather than exception in the case of psychiatric disorders. Cognitive behavioral therapy (CBT) has been clearly demonstrated to be effective in treating anxiety and avoidance symptoms in patient samples of social

  6. Development and Psychometric Properties of the Standardized Assessment of Severity of Personality Disorder (SASPD).

    Science.gov (United States)

    Olajide, Kike; Munjiza, Jasna; Moran, Paul; O'Connell, Lesley; Newton-Howes, Giles; Bassett, Paul; Akintomide, Gbolagade; Ng, Nicola; Tyrer, Peter; Mulder, Roger; Crawford, Mike J

    2018-02-01

    Personality disorder (PD) is increasingly categorized according to its severity, but there is no simple way to screen for severity according to ICD-11 criteria. We set out to develop the Standardized Assessment of Severity of Personality Disorder (SASPD). A total of 110 patients completed the SASPD together with a clinical assessment of the severity of personality disorder. We examined the predictive ability of the SASPD using the area under the ROC curve (AUC). Two to four weeks later, 43 patients repeated the SASPD to examine reliability. The SASPD had good predictive ability for determining mild (AUC = 0.86) and moderate (AUC = 0.84) PD at cut points of 8 and 10, respectively. Test-retest reliability of the SASPD was high (intraclass correlation coefficient = 0.93, 95% CI [0.88, 0.96]). The SASPD thus provides a simple, brief, and reliable indicator of the presence of mild or moderate PD according to ICD-11 criteria.

  7. Pica and rumination behavior among individuals seeking treatment for eating disorders or obesity.

    Science.gov (United States)

    Delaney, Charlotte B; Eddy, Kamryn T; Hartmann, Andrea S; Becker, Anne E; Murray, Helen B; Thomas, Jennifer J

    2015-03-01

    Pica and rumination disorder (RD)-formerly classified within DSM-IV Feeding and Eating Disorders of Infancy or Early Childhood-are now classified within DSM-5 Feeding and Eating Disorders. Though pica and RD have been studied in select populations (e.g., pregnant women, intellectually disabled persons), their typical features and overall prevalence remain unknown. This study examined the clinical characteristics and frequency of DSM-5 pica and RD among individuals seeking treatment for eating disorders and obesity. We conducted structured interviews with adolescent and young adult females from a residential eating disorder center (N = 149), and adult males and females with overweight or obesity from an outpatient weight-loss clinic (N = 100). Several participants reported ingesting non-nutritive substances (e.g., ice) for weight-control purposes. However, only 1.3% (n = 2; 95% CI: .06% to 5.1%) at the residential eating disorder center and 0% at the weight-loss clinic met DSM-5 criteria for pica, consuming gum and plastic. Although no eating disorder participants were eligible for an RD diagnosis due to DSM-5 trumping rules, 7.4% (n = 11; 95% CI: 4.0% to 12.9%) endorsed rumination behavior under varying degrees of volitional control. At the weight-loss clinic, 2.0% (n = 2; 95% CI: 0.1% to 7.4%) had RD. DSM-5 pica and RD were rare in our sample of individuals seeking treatment for eating disorders and obesity, but related behaviors were more common. The wide range of pica and rumination presentations highlights the challenges of differential diagnosis with other forms of disordered eating. © 2014 Wiley Periodicals, Inc.

  8. Conduct disorder in girls: neighborhoods, family characteristics, and parenting behaviors

    Directory of Open Access Journals (Sweden)

    Chang Chien-Ni

    2008-10-01

    Full Text Available Abstract Background Little is known about the social context of girls with conduct disorder (CD, a question of increasing importance to clinicians and researchers. The purpose of this study was to examine the associations between three social context domains (neighborhood, family characteristics, and parenting behaviors and CD in adolescent girls, additionally testing for race moderation effects. We predicted that disadvantaged neighborhoods, family characteristics such as parental marital status, and parenting behaviors such as negative discipline would characterize girls with CD. We also hypothesized that parenting behaviors would mediate the associations between neighborhood and family characteristics and CD. Methods We recruited 93 15–17 year-old girls from the community and used a structured psychiatric interview to assign participants to a CD group (n = 52 or a demographically matched group with no psychiatric disorder (n = 41. Each girl and parent also filled out questionnaires about neighborhood, family characteristics, and parenting behaviors. Results Neighborhood quality was not associated with CD in girls. Some family characteristics (parental antisociality and parenting behaviors (levels of family activities and negative discipline were characteristic of girls with CD, but notll. There was no moderation by race. Our hypothesis that the association between family characteristics and CD would be mediated by parenting behaviors was not supported. Conclusion This study expanded upon previous research by investigating multiple social context domains in girls with CD and by selecting a comparison group who were not different in age, social class, or race. When these factors are thus controlled, CD in adolescent girls is not significantly associated with neighborhood, but is associated with some family characteristics and some types of parental behaviors. However, the mechanisms underlying these relationships need to be further

  9. Friction and Wear Behavior of Several Hard Materials

    NARCIS (Netherlands)

    Quercia Bianchi, G.; Grigorescu, I.C.; Di Rauso, C.; Contreras, H.; Gutierrez, D.

    2001-01-01

    Sliding friction, abrasion and erosion tests were performed on several materials: cemented carbides, partially stabilized zirconia (Mg–PSZ), electroless Ni–P coatings and SAE 4140 steel as reference material. Sliding friction test was carried out in a pin-on-disk system. A micro-abrasion test was

  10. Sexual obsessions and suicidal behaviors in patients with mood disorders, panic disorder and schizophrenia

    Directory of Open Access Journals (Sweden)

    Dell’Osso Liliana

    2012-10-01

    Full Text Available Abstract Background The topic of sexual obsessions as a psychiatric symptom has not been well investigated. The aim of this study was twofold: 1 to explore the presence of sexual obsessions in patients with mood disorders (n=156, panic disorder (n=54 and schizophrenia (n=79, with respect to non-psychiatric subjects (n=100; 2 to investigate the relationship between sexual obsessions and suicidal behaviors, taking into account socio-demographic variables ad mental disorders. Methods 289 psychiatric patients with mood disorders, panic disorder or schizophrenia, were recruited at the Italian University departments of psychiatry along with 100 non-psychiatric subjects, who presented for a routine eye exam at the ophthalmology department of the same Universities. The assessments included: the Structured Clinical Interview for DSM-IV-TR, the Brief Psychiatric Rating Scale (BPRS, the Obsessive-Compulsive Spectrum Self-Report (OBS-SR, for sexual obsession, and the Mood Spectrum-Self Report lifetime version (MOODS-SR. Suicidality was assessed by means of 6 items of the MOODS-SR. Results Sexual obsessions were more frequent in schizophrenia (54.4%, followed by mood disorders (35.9%. Among schizophrenia patients, males reported more sexual obsessions than females (P Conclusions Special attention should be given to investigate and establish effective strategies of treatment for sexual obsessions, especially those with comorbid mood disorders or schizophrenia.

  11. Levels of Social Sharing and Clinical Implications for Severe Social Withdrawal in Patients with Personality Disorders.

    Science.gov (United States)

    Colle, Livia; Pellecchia, Giovanni; Moroni, Fabio; Carcione, Antonino; Nicolò, Giuseppe; Semerari, Antonio; Procacci, Michele

    2017-01-01

    Social sharing capacities have attracted attention from a number of fields of social cognition and have been variously defined and analyzed in numerous studies. Social sharing consists in the subjective awareness that aspects of the self's experience are held in common with other individuals. The definition of social sharing must take a variety of elements into consideration: the motivational element, the contents of the social sharing experience, the emotional responses it evokes, the behavioral outcomes, and finally, the circumstances and the skills which enable social sharing. The primary objective of this study is to explore some of the diverse forms of human social sharing and to classify them according to levels of complexity. We identify four different types of social sharing, categorized according to the nature of the content being shared and the complexity of the mindreading skills required. The second objective of this study is to consider possible applications of this graded model of social sharing experience in clinical settings. Specifically, this model may support the development of graded, focused clinical interventions for patients with personality disorders characterized by severe social withdrawal.

  12. Levels of Social Sharing and Clinical Implications for Severe Social Withdrawal in Patients with Personality Disorders

    Directory of Open Access Journals (Sweden)

    Livia Colle

    2017-12-01

    Full Text Available Social sharing capacities have attracted attention from a number of fields of social cognition and have been variously defined and analyzed in numerous studies. Social sharing consists in the subjective awareness that aspects of the self’s experience are held in common with other individuals. The definition of social sharing must take a variety of elements into consideration: the motivational element, the contents of the social sharing experience, the emotional responses it evokes, the behavioral outcomes, and finally, the circumstances and the skills which enable social sharing. The primary objective of this study is to explore some of the diverse forms of human social sharing and to classify them according to levels of complexity. We identify four different types of social sharing, categorized according to the nature of the content being shared and the complexity of the mindreading skills required. The second objective of this study is to consider possible applications of this graded model of social sharing experience in clinical settings. Specifically, this model may support the development of graded, focused clinical interventions for patients with personality disorders characterized by severe social withdrawal.

  13. The study of role of stress in children with behavior disorders and orofacial lesions.

    Science.gov (United States)

    Baad, R K; Jagtap, Kiran

    2012-07-01

    (1) To study the behavior disorders in children between 5 to 15 years. (2) To study the role of stress in causing behavior disorders. (3) To interpret the orofacial findings in children with behavior disorders. (4) Correlate the orofacial findings with behavior disorder. Ninty children with behavior problems between age of 5 to 15 years along with their parents who visited the Department of Child-Guidance Clinic, BYL Nair Charitable Hospital, Mumbai. Intraoral examinations were conducted. Behavioral disorders and factors predisposing to those disorders were recorded. Behavior disorders with orofacial lesions was more common in age group of 8 to 10 years. The children were continuously under stress, which manifested in the form of various orofacial disorders or oral lesions. Most common orofacial condition was bruxism. Awareness of behavior disorders in dental treatment should guide the pediatric dentist to seek child psychiatric consultation for behavioral disorders to enable early evaluation of the underlying disorder. The present study suggested that orofacial and behavior characteristics can serve as markers to diagnose children with behavioral disorders. It also serves as a guide to dental clinicians to refer such children to psychiatrists or pediatricians for early identification, prevention and treatment.

  14. Dimensional indicators of generalized anxiety disorder severity for DSM-V.

    Science.gov (United States)

    Niles, Andrea N; Lebeau, Richard T; Liao, Betty; Glenn, Daniel E; Craske, Michelle G

    2012-03-01

    For DSM-V, simple dimensional measures of disorder severity will accompany diagnostic criteria. The current studies examine convergent validity and test-retest reliability of two potential dimensional indicators of worry severity for generalized anxiety disorder (GAD): percent of the day worried and number of worry domains. In study 1, archival data from diagnostic interviews from a community sample of individuals diagnosed with one or more anxiety disorders (n = 233) were used to assess correlations between percent of the day worried and number of worry domains with other measures of worry severity (clinical severity rating (CSR), age of onset, number of comorbid disorders, Penn state worry questionnaire (PSWQ)) and DSM-IV criteria (excessiveness, uncontrollability and number of physical symptoms). Both measures were significantly correlated with CSR and number of comorbid disorders, and with all three DSM-IV criteria. In study 2, test-retest reliability of percent of the day worried and number of worry domains were compared to test-retest reliability of DSM-IV diagnostic criteria in a non-clinical sample of undergraduate students (n = 97) at a large west coast university. All measures had low test-retest reliability except percent of the day worried, which had moderate test-retest reliability. Findings suggest that these two indicators capture worry severity, and percent of the day worried may be the most reliable existing indicator. These measures may be useful as dimensional measures for DSM-V. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Unique prediction of cannabis use severity and behaviors by delay discounting and behavioral economic demand.

    Science.gov (United States)

    Strickland, Justin C; Lile, Joshua A; Stoops, William W

    2017-07-01

    Few studies have simultaneously evaluated delay discounting and behavioral economic demand to determine their unique contribution to drug use. A recent study in cannabis users found that monetary delay discounting uniquely predicted cannabis dependence symptoms, whereas cannabis demand uniquely predicted use frequency. This study sought to replicate and extend this research by evaluating delay discounting and behavioral economic demand measures for multiple commodities and including a use quantity measure. Amazon.com's Mechanical Turk was used to sample individuals reporting recent cannabis use (n=64) and controls (n=72). Participants completed measures of monetary delay discounting as well as alcohol and cannabis delay discounting and demand. Cannabis users and controls did not differ on monetary delay discounting or alcohol delay discounting and demand. Among cannabis users, regression analyses indicated that cannabis delay discounting uniquely predicted use severity, whereas cannabis demand uniquely predicted use frequency and quantity. These effects remained significant after controlling for other delay discounting and demand measures. This research replicates previous outcomes relating delay discounting and demand with cannabis use and extends them by accounting for the contribution of multiple commodities. This research also demonstrates the ability of online crowdsourcing methods to complement traditional human laboratory techniques. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. [M. Linehan dialectic behavioral psychotherapy. A new concept in the treatment of borderline personality disorders].

    Science.gov (United States)

    Bohus, M; Berger, M

    1996-11-01

    M. Linehan developed "dialectical behavioral therapy" specifically to treat chronically suicidal borderline patients. It rests on a biosocial model that assumes a disorder in the regulation of emotions and in tolerance of stress. The numerous dysfunctional patterns of behavior such as self-destructive behavior, inability to govern impulses or severe dissociative phenomena are regarded as attempts at problem-solving. This concept of therapy focuses on the continuing balance between the necessity of accepting maladaptive behavior patterns in both an intrapsychic and an interactional context while still working to change them. A comprehensive manual outlines the clearly structured therapy and integrates a wide choice of therapeutic strategies. Parallel to development of the therapy itself, a method also was developed for testing therapist adherence to the manual's guidelines, thus providing a basis for empirical evaluation. An initial controlled, randomized study demonstrated the significant superiority of this method to methods of unspecific psychotherapy at various levels. In the current endeavor to develop disorder-specific approaches to the treatment of personality disorders, "dialectical behavioral therapy" is a noteworthy model.

  17. Development and initial evaluation of Transdiagnostic Behavior Therapy (TBT) for veterans with affective disorders.

    Science.gov (United States)

    Gros, Daniel F

    2014-12-15

    Considerable attention has focused on the growing need for evidence-based psychotherapy for veterans with affective disorders within the Department of Veteran Affairs. Despite, and possibly due to, the large number of evidence-based protocols available, several obstacles remain in their widespread delivery within Veterans Affairs Medical Centers. In part as an effort to address these concerns, newer transdiagnostic approaches to psychotherapy have been developed to provide a single treatment that is capable of addressing several, related disorders. The goal of the present investigation was to develop and evaluate a transdiagnostic psychotherapy, Transdiagnostic Behavior Therapy (TBT), in veterans with affective disorders. Study 1 provided initial support for transdiagnostic presentation of evidence-based psychotherapy components in veterans with principal diagnoses of affective disorders (n=15). These findings were used to inform the development of the TBT protocol. In Study 2, an initial evaluation of TBT was completed in a second sample of veterans with principal diagnoses of affective disorders (n=29). The findings of Study 2 demonstrated significant improvements in symptoms of depression, anxiety, stress, posttraumatic stress, and related impairment across participants with various principal diagnoses. Together, the investigation provided preliminary support for effectiveness of TBT in veterans with affective disorders. Published by Elsevier Ireland Ltd.

  18. Mindfulness Moderates the Relationship Between Disordered Eating Cognitions and Disordered Eating Behaviors in a Non-Clinical College Sample.

    Science.gov (United States)

    Masuda, Akihiko; Price, Matthew; Latzman, Robert D

    2012-03-01

    Psychological flexibility and mindfulness are two related, but distinct, regulation processes that have been shown to be at the core of psychological wellbeing. The current study investigated whether these two processes independently moderated the association between disordered eating cognitions and psychological distress as well as the relation between disordered eating cognitions and disordered eating behaviors. Non-clinical, ethnically diverse college undergraduates completed a web-based survey. Of 278 participants (nfemale=208; nmale=70) aged 18-24 years old, disordered eating cognitions, mindfulness, and psychological flexibility were related to psychological distress after controlling for gender, ethnicity, and body mass index. Disordered eating cognitions and mindfulness accounted for unique variance in disordered eating behaviors. Finally, mindfulness was found to moderate the association between disordered eating cognitions and disordered eating behaviors.

  19. Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness

    OpenAIRE

    Mauritz, Maria W.; Goossens, Peter J.J.; Draijer, Nel; Achterberg, Theo van

    2013-01-01

    Background: Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice.Objective: To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI.Methods: We conducted a systematic review of four databases (1980-2010) and then described and analysed 33 studies in terms of primary diagnosis and instruments used to measure trauma exposure and traumarelated dis...

  20. Behavioral and emotional profile and parental stress in preschool children with autism spectrum disorder.

    Science.gov (United States)

    Giovagnoli, Giulia; Postorino, Valentina; Fatta, Laura M; Sanges, Veronica; De Peppo, Lavinia; Vassena, Lia; Rose, Paola De; Vicari, Stefano; Mazzone, Luigi

    2015-01-01

    Parents of children with autism spectrum disorder (ASD) were shown to experience more stress than parents of typically developing peers, although little is known about risk factors predicting stress in this population. The aim of this study was to evaluate parental stress levels and behavioral and emotional problems in a sample of preschool children with ASD as compared to typically developing (TD) peers and to investigate the role of several factors, including the severity of autistic symptoms, adaptive skills, cognitive abilities and behavioral and emotional problems, on parental stress. Results confirmed that parents of children with ASD experience higher stress levels than parents of TD and that children with ASD show more behavioral and emotional problems than controls. Moreover, our results showed that behavioral and emotional problems are strong predictors of parental stress, while stress related to a parent-child dysfunctional relationship was associated with daily living and communication skills as well as cognitive abilities. Findings revealed different behavioral and emotional problems affecting parental stress in ASD and TD samples. No association between the severity of autism symptoms and parental stress was detected. These results suggest that dysfunctional behaviors in preschool children with ASD have a strong impact on parental stress, profoundly affecting the well-being of the entire family. Therefore, strategies aimed at the early detection and management of these behavioral and emotional problems are crucial in order to prevent parental stress and to develop the most appropriate treatment interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Applied behavior analysis: behavior management of children with autism spectrum disorders in dental environments.

    Science.gov (United States)

    Hernandez, Purnima; Ikkanda, Zachary

    2011-03-01

    There are a limited number of studies addressing behavior management techniques and procedural modifications that dentists can use to treat people with an autism spectrum disorder (ASD). The authors conducted a search of the dental and behavioral analytic literature to identify management techniques that address problem behaviors exhibited by children with ASDs in dental and other health-related environments. Applied behavior analysis (ABA) is a science in which procedures are based on the principles of behavior through systematic experimentation. Clinicians have used ABA procedures successfully to modify socially significant behaviors of people with ASD. Basic behavior management techniques currently used in dentistry may not encourage people with cognitive and behavioral disabilities, such as ASD, to tolerate simple in-office dental procedures consistently. Instead, dental care providers often are required to use advanced behavior management techniques to complete simple in-office procedures such as prophylaxis, sealant placement and obtaining radiographs. ABA procedures can be integrated in the dental environment to manage problem behaviors often exhibited by children with an ASD. The authors found no evidence-based procedural modifications that address the behavioral characteristics and problematic behaviors of children with an ASD in a dental environment. Further research in this area should be conducted. Knowledge and in-depth understanding of behavioral principles is essential when a dentist is concerned with modifying behaviors. Using ABA procedures can help dentists manage problem behaviors effectively and systematically when performing routine dental treatment. Being knowledgeable about each patient's behavioral characteristics and the parents' level of involvement is important in the successful integration of the procedures and reduction of in-office time.

  2. Research and development strategy on the behavior of containments during severe accidents

    International Nuclear Information System (INIS)

    Lecomte, C.

    1990-06-01

    In case of an hypothetical severe accident leading to core melting, the last barrier preventing radionucleide release in the environnment is the containment of the main reactor building. The French research and development programmes aimed at understanding the containment behavior during severe accidents relate to several domains; some of them are: - assessment of hydrogen behavior - corium behavior and coolability - ultimate resistance of the containments and leaktightness - caracterization of filtered venting procedure. All these aspects are covered by code calculations and experimental developments

  3. The comparison of severity and prevalence of major depressive disorder, general anxiety disorder and eating disorders before and after bariatric surgery.

    Science.gov (United States)

    Matini, Diana; Ghanbari Jolfaei, Atefeh; Pazouki, Abdolreza; Pishgahroudsari, Mohadeseh; Ehtesham, Mehdi

    2014-01-01

    Severe obesity is highly co-morbid with psychiatric disorders and may have effect on the quality of life. This study aimed to compare severity and prevalence rate of depression, anxiety and eating disorders and quality of life in severe obese patients before and 6 months after the gastric bypass surgery. This was a prospective observational study which conducted at Hazarat Rasool-Akram Hospital in Tehran, 2012. Questionnaires included demographic questions, eating disorder Inventory (EDI), The Short Form Health Survey (SF-36) for quality of life, Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) and Hamilton Rating Scale for Depression (HRSD) and anxiety (HRSA). Participants were interviewed two times, before surgery and six months after, to determine changes of the disorders. Patients with the history of bariatric surgery, individuals younger than 18 year old and those who disagreed to join the study were excluded. In assessing the eating disorder inventory-3rd version (EDI-3), Significant reduction in drive for thinness (DT) (p= 0.010), bulimia (B) (pdepression in HRSD (p= 0.311), prevalence of depression (p= 0.189) and prevalence of general anxiety disorder according to SCID (p=0.167) did not differ significantly, at this period. Although weight loss after bariatric surgery improved the physical component of quality of life, this improvement did not affect the mental aspect of life, depression and anxiety and it seems that these psychopathologies need attention and treatment in addition to weight loss treatments in patients with obesity.

  4. Is the Higher Number of Suicide Attempts in Bipolar Disorder vs. Major Depressive Disorder Attributable to Illness Severity?

    Science.gov (United States)

    Michaels, Matthew S; Balthrop, Tia; Pulido, Alejandro; Rudd, M David; Joiner, Thomas E

    2018-01-01

    The present study represents an early stage investigation into the phenomenon whereby those with bipolar disorder attempt suicide more frequently than those with unipolar depression, but do not tend to attempt suicide during mania. Data for this study were obtained from baseline measurements collected in a randomized treatment study at a major southwestern United States military medical center. We demonstrated the rarity of suicide attempts during mania, the higher frequency of suicide attempts in those with bipolar disorder compared to those with depression, and the persistence of effects after accounting for severity of illness. These results provide the impetus for the development and testing of theoretical explanations.

  5. Attention deficit hyperactivity disorder and disordered eating behaviors: links, risks, and challenges faced

    Directory of Open Access Journals (Sweden)

    Ptacek R

    2016-03-01

    Full Text Available Radek Ptacek,1,2 George B Stefano,1,3 Simon Weissenberger,1 Devang Akotia,1 Jiri Raboch,1 Hana Papezova,1 Lucie Domkarova,1 Tereza Stepankova,1 Michal Goetz4 1Department of Psychiatry, Charles University 1st Medical Faculty and General Teaching Hospital, Prague, Czech Republic; 2Department of Psychology, University of New York in Prague, Prague, Czech Republic; 3MitoGenetics Research Institute, MitoGenetics, LLC, Farmingdale, NY, USA; 4Department of Child Psychiatry, Charles University Second Faculty of Medicine, University Hospital Motol, Prague, Czech Republic Abstract: Attention deficit hyperactivity disorder (ADHD is a neurodevelopmental disorder that often persists in adulthood. It is defined by inattention and/or hyperactivity–impulsivity. ADHD is associated with many comorbidities, including eating disorders (EDs. In the last decade, studies have reported that ADHD is linked with binge EDs, bulimia nervosa, and anorexia nervosa. Many postulates have been proposed to explain the association: 1 impulsive behavior in ADHD patients leads to disordered eating behavior; 2 other psychologic comorbidities present in ADHD patients account for eating behavior; 3 poor eating habits and resulting nutritional deficiencies contribute to ADHD symptoms; and 4 other risk factors common to both ADHD and EDs contribute to the coincidence of both diseases. Additionally, sex differences become a significant issue in the discussion of EDs and ADHD because of the higher incidence of bulimia nervosa and anorexia nervosa in females and the ability of females to mask the symptoms of ADHD. Interestingly, both EDs and ADHD rely on a common neural substrate, namely, dopaminergic signaling. Dopaminergic signaling is critical for motor activity and emotion, the latter enabling the former into a combined motivated movement like eating. This linkage aids in explaining the many comorbidities associated with ADHD. The interconnection of ADHD and EDs is discussed from

  6. Phonemic verbal fluency and severity of anxiety disorders in young children

    Directory of Open Access Journals (Sweden)

    Rudineia Toazza

    Full Text Available Abstract Introduction: Previous studies have implicated impaired verbal fluency as being associated with anxiety disorders in adolescents. Objectives: To replicate and extend previously reported evidence by investigating whether performance in phonemic verbal fluency tasks is related to severity of anxiety symptoms in young children with anxiety disorders. We also aim to investigate whether putative associations are independent from co-occurring attention deficit hyperactivity disorder (ADHD symptoms. Methods: Sixty children (6-12 years old with primary diagnoses of anxiety disorders participated in this study. Severity of symptoms was measured using clinician-based, parent-rated and self-rated validated scales. Verbal fluency was assessed using a simple task that measures the number of words evoked in 1-minute with the letter F, from which we quantified the number of isolated words, number of clusters (groups of similar words and number of switches (transitions between clusters and/or between isolated words. Results: There was a significant association between the number of clusters and anxiety scores. Further analysis revealed associations were independent from co-occurring ADHD symptoms. Conclusion: We replicate and extend previous findings showing that verbal fluency is consistently associated with severity in anxiety disorders in children. Further studies should explore the potential effect of cognitive training on symptoms of anxiety disorders.

  7. Aggressive behavior among military veterans in substance use disorder treatment: the roles of posttraumatic stress and impulsivity.

    Science.gov (United States)

    Heinz, Adrienne J; Makin-Byrd, Kerry; Blonigen, Daniel M; Reilly, Patrick; Timko, Christine

    2015-03-01

    This study examined posttraumatic stress disorder (PTSD) symptom severity and impulsivity as predictors of aggressive behavior among 133 male military veterans entering substance abuse treatment who endorsed difficulty controlling anger in the past year. At treatment intake, participants completed measures assessing PTSD symptom severity, impulsivity and aggressive behavior. Perpetration of aggressive behavior was reassessed 4 months later. Results from multivariate models indicated that PTSD symptom severity and impulsivity explained unique variance in aggressive behavior at intake but not follow-up. Mediation models indicated that the association between PTSD symptom severity and aggressive behavior was accounted for by impulsivity. The identification of impulsivity as a key mediator between trauma symptoms and aggressive behavior has significant clinical and research implications. Based on these findings, clinicians are encouraged to consider a standard assessment of impulsivity and the selection of interventions that target impulsivity as a trans-diagnostic process among at-risk client populations. Published by Elsevier Inc.

  8. Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness

    Directory of Open Access Journals (Sweden)

    Maria W. Mauritz

    2013-04-01

    Full Text Available Background: Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI are often not recognized in clinical practice. Objective: To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. Methods: We conducted a systematic review of four databases (1980–2010 and then described and analysed 33 studies in terms of primary diagnosis and instruments used to measure trauma exposure and trauma-related disorders. Results: Population-weighted mean prevalence rates in SMI were physical abuse 47% (range 25–72%, sexual abuse 37% (range 24–49%, and posttraumatic stress disorder (PTSD 30% (range 20–47%. Compared to men, women showed a higher prevalence of sexual abuse in schizophrenia spectrum disorder, bipolar disorder, and mixed diagnosis groups labelled as having SMI. Conclusions: Prevalence rates of interpersonal trauma and trauma-related disorders were significantly higher in SMI than in the general population. Emotional abuse and neglect, physical neglect, complex PTSD, and dissociative disorders have been scarcely examined in SMI.

  9. Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness.

    Science.gov (United States)

    Mauritz, Maria W; Goossens, Peter J J; Draijer, Nel; van Achterberg, Theo

    2013-01-01

    Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice. To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. We conducted a systematic review of four databases (1980-2010) and then described and analysed 33 studies in terms of primary diagnosis and instruments used to measure trauma exposure and trauma-related disorders. Population-weighted mean prevalence rates in SMI were physical abuse 47% (range 25-72%), sexual abuse 37% (range 24-49%), and posttraumatic stress disorder (PTSD) 30% (range 20-47%). Compared to men, women showed a higher prevalence of sexual abuse in schizophrenia spectrum disorder, bipolar disorder, and mixed diagnosis groups labelled as having SMI. Prevalence rates of interpersonal trauma and trauma-related disorders were significantly higher in SMI than in the general population. Emotional abuse and neglect, physical neglect, complex PTSD, and dissociative disorders have been scarcely examined in SMI.

  10. Perinatal risk factors in offenders with severe personality disorder: a population-based investigation.

    Science.gov (United States)

    Fazel, Seena; Bakiyeva, Liliya; Cnattingius, Sven; Grann, Martin; Hultman, Christina M; Lichtenstein, Paul; Geddes, John R

    2012-10-01

    Although perinatal factors are associated with the development of several psychiatric disorders, it is unknown whether these factors are linked with personality disorder. Cases of personality disorder were drawn from a national registry of all forensic psychiatric evaluations (n = 150). Two control groups were used: (1) A sample of forensic evaluations without any psychiatric disorder (n = 97) allowing for a nested case-control investigation; and (2) A population-based sample matched by age and gender with no history of psychiatric hospitalization (n = 1498). Prematurity (personality disorder, both in the nested and the population-based case-control comparisons with adjusted odds ratios (OR) for this risk factor ranging from 2 to 4. Asphyxia (adjusted OR = 2.4, 95% CI: 1.4-4.1) and complicated delivery (adjusted OR = 1.5, 1.0-2.1) were associated with personality disorder in the population-based study, and the former remained significant in multivariate models. Overall, perinatal complications were found to be associated with a later diagnosis of personality disorder in this selected sample. As with other psychiatric disorders where such associations have been demonstrated, changes during the perinatal period may lead to abnormal brain development and function.

  11. Adolescent health-risk behavior and community disorder.

    Directory of Open Access Journals (Sweden)

    Sarah E Wiehe

    Full Text Available Various forms of community disorder are associated with health outcomes but little is known about how dynamic context where an adolescent spends time relates to her health-related behaviors.Assess whether exposure to contexts associated with crime (as a marker of community disorder correlates with self-reported health-related behaviors among adolescent girls.Girls (N = 52, aged 14-17, were recruited from a single geographic urban area and monitored for 1 week using a GPS-enabled cell phone. Adolescents completed an audio computer-assisted self-administered interview survey on substance use (cigarette, alcohol, or marijuana use and sexual intercourse in the last 30 days. In addition to recorded home and school address, phones transmitted location data every 5 minutes (path points. Using ArcGIS, we defined community disorder as aggregated point-level Unified Crime Report data within a 200-meter Euclidian buffer from home, school and each path point. Using Stata, we analyzed how exposures to areas of higher crime prevalence differed among girls who reported each behavior or not.Participants lived and spent time in areas with variable crime prevalence within 200 meters of their home, school and path points. Significant differences in exposure occurred based on home location among girls who reported any substance use or not (p 0.04 and sexual intercourse or not (p 0.01. Differences in exposure by school and path points were only significant among girls reporting any substance use or not (p 0.03 and 0.02, respectively. Exposure also varied by school/non-school day as well as time of day.Adolescent travel patterns are not random. Furthermore, the crime context where an adolescent spends time relates to her health-related behavior. These data may guide policy relating to crime control and inform time- and space-specific interventions to improve adolescent health.

  12. Borderline Personality Disorder Symptom Severity and Sexually Transmitted Infection and HIV Risk in African American Incarcerated Men.

    Science.gov (United States)

    Scheidell, Joy D; Lejuez, Carl W; Golin, Carol E; Hobbs, Marcia M; Wohl, David A; Adimora, Adaora A; Khan, Maria R

    2016-05-01

    Sexually transmitted infections (STI)/HIV rates are disproportionately high among men involved in the criminal justice system. Mental health disorders, including personality disorders, are also elevated among inmates. Borderline personality disorder (BPD) may be an important risk factor for STI/HIV, yet remains relatively understudied, particularly among inmates. We used baseline data from Project DISRUPT, a cohort study of African American men being released from prison in North Carolina who were in heterosexual relationships at prison entry (n=189), to assess their STI/HIV risk in the 6 months before incarceration and BPD symptoms focused on emotional lability and relationship dysfunction. We created a continuous BPD symptom severity score and a dichotomous BPD indicator split at the top quartile of the score (BPD-TQ) to examine associations between BPD and STI/HIV outcomes using logistic regression. We also examined associations between individual symptoms and outcomes. After adjustment for sociodemographics and antisocial personality disorder, BPD-TQ was associated with sexual risk behaviors including multiple partnerships (adjusted odds ratio, 2.58; 95% confidence interval, 1.24-5.36) and sex with nonmonogamous partners (adjusted odds ratio, 2.54; 95% confidence interval, 1.17-5.51). Prevalence of previous STI (47.5% vs. 29.6%) and prevalent chlamydial infection (6.9% vs. 3.1%) seemed higher in those in BPD-TQ, although the associations were not statistically significant. Associations were similar to those with the continuous score. Borderline personality disorder symptoms most associated with STI/HIV risk were abandonment worry, mood swings, and shifts in opinions. Borderline personality disorder is strongly associated with STI/HIV risk in this sample. Researchers should further evaluate the relationship between STI/HIV and BPD, in addition to mood disorders.

  13. Anxiety and depression among adolescents with attention-deficit/hyperactivity disorder: The roles of behavioral temperamental traits, comorbid autism spectrum disorder, and bullying involvement

    Directory of Open Access Journals (Sweden)

    Huei-Fan Hu

    2016-02-01

    Full Text Available The aim of this study was to examine the associations of behavioral temperamental traits, comorbid autism spectrum disorder (ASD, and bullying involvement with anxiety and depression among adolescents with attention-deficit/hyperactivity disorder (ADHD in Taiwan. A total of 287 adolescents aged 11–18 years diagnosed with ADHD participated in this study. Their severities of anxiety and depression were assessed. Multiple regression analysis was used to examine the correlates of anxiety and depression. The results show that adolescents with ADHD who reported a higher behavioral inhibition system (BIS score, had comorbid ASD, and were bullying victims, reported more severe anxiety and depressive symptoms. Adolescents with ADHD who bullied others reported more severe depressive symptoms than those who did not bully. The results of this study indicated that behavioral temperamental traits on the BIS, comorbid ASD, and bullying involvement were significantly associated with anxiety and depression among the adolescents with ADHD.

  14. Excessive crying: behavioral and emotional regulation disorder in infancy

    Directory of Open Access Journals (Sweden)

    Joon Sik Kim

    2011-06-01

    Full Text Available In the pediatric literature, excessive crying has been reported solely in association with 3-month colic and is described, if at all, as unexplained crying and fussing during the first 3 months of life. The bouts of crying are generally thought to be triggered by abdominal colic (over-inflation of the still immature gastrointestinal tract, and treatment is prescribed accordingly. According to this line of reasoning, excessive crying is harmless and resolves by the end of the third month without long-term consequences. However, there is evidence that it may cause tremendous distress in the mother&#8211;infant relationship, and can lead to disorders of behavioral and emotional regulation at the toddler stage (such as sleep and feeding disorders, chronic fussiness, excessive clinginess, and temper tantrums. Early treatment of excessive crying focuses on parent&#8211;infant communication, and parent-infant interaction in the context of soothing and settling the infant to sleep is a promising approach that may prevent later behavioral and emotional disorders in infancy.

  15. Impulsivity, aggression and suicidal behavior in unipolar and bipolar disorders.

    Science.gov (United States)

    Perroud, Nader; Baud, Patrick; Mouthon, Dominique; Courtet, Philippe; Malafosse, Alain

    2011-11-01

    Predictors of suicidal behaviors (SB) in bipolar (BD) and major depressive disorder (MDD) patients are poorly understood. It has been recognized that behavioral dysregulation characterizes SB with traits of impulsivity and aggression being particularly salient. However, little is known about how these traits are segregated among mood disorder patients with and without a history of suicide attempt (SA). This article aims to compare impulsivity and aggression between 143 controls, 138 BD and 186 MDD subjects with or without a history of SA. BD and MDD patients showed higher impulsivity scores (BIS-10 = 57.9 vs. 44.7, p impulsivity helped to distinguish MDD subjects without a history of SA from those with such a history, this was not the case in BD subjects where no difference in impulsive traits was observed between BD without and with history of SA (57.2 vs. 63.2 for BIS-10; p = 0.259). Impulsive and aggressive traits were strongly correlated in suicide attempters (independently of the diagnosis) but not in non-suicide attempters. Dimensional traits were not characterized at different stages of illness. Impulsivity, as a single trait, may be a reliable suicide risk marker in MDD but not in BD patients, and its strong correlation with aggressive traits seems specifically related to SB. Our study therefore suggests that the specific dimension of impulsive aggression should be systematically assessed in mood disorder patients to address properly their suicidal risk. Copyright © 2011 Elsevier B.V. All rights reserved.

  16. Maternal Grand Multiparity and the Risk of Severe Mental Disorders in Adult Offspring.

    Directory of Open Access Journals (Sweden)

    Marius Lahti

    Full Text Available Previous studies have shown that maternal grand multiparity may predict an increased risk of mental disorders in young adult offspring, but whether such effects persist throughout adulthood remains unknown. The current study examined if maternal grand multiparity predicts the risks of severe mental disorders, suicides, suicide attempts and dementias throughout adult life.Our study sample comprised 13243 Helsinki Birth Cohort Study 1934-1944 participants (6905 men and 6338 women. According to hospital birth records, 341 offspring were born to grand multiparous mothers. From Finnish national hospital discharge and causes of death registers, we identified 1682 participants diagnosed with mental disorders during 1969-2010.Maternal grand multiparity predicted significantly increased risks of mood disorders (Hazard Ratio = 1.64, p = 0.03, non-psychotic mood disorders (Hazard Ratio = 2.02, p = 0.002, and suicide attempts (Hazard Ratio = 3.94, p = 0.01 in adult offspring. Furthermore, women born to grand multiparous mothers had significantly increased risks of any severe mental disorder (Hazard Ratio = 1.79, p = 0.01, non-psychotic substance use disorders (Hazard Ratio = 2.77, p = 0.02 schizophrenia, schizotypal and delusional disorders (Hazard Ratio = 2.40, p = 0.02, mood disorders (Hazard Ratio = 2.40, p = 0.002, non-psychotic mood disorders (Hazard Ratio = 2.91, p<0.001, and suicide attempts (Hazard Ratio = 5.05, p = 0.01 in adulthood. The effects of maternal grand multiparity on offspring psychopathology risk were independent of maternal age and body mass index at childbirth, and of year of birth, sex, childhood socioeconomic position, and birth weight of the offspring. In contrast, no significant effects were found among men.Women born to grand multiparous mothers are at an increased risk of severe mental disorders and suicide attempts across adulthood. Our findings may inform the

  17. Microstructures and recrystallization behavior of severely hot-deformed tungsten

    International Nuclear Information System (INIS)

    Mathaudhu, S.N.; De Rosset, A.J.; Hartwig, K.T.; Kecskes, L.J.

    2009-01-01

    When coarse-grained (CG) tungsten (W) is heavily worked by equal-channel angular extrusion (ECAE), the grain size is reduced to the ultrafine-grained/nanocrystalline regimes (UFG/NC) and the strength and ductility increase. Because of the brittle nature of CG W, the material must be hot-extruded, and, if the temperatures are near the recrystallization temperature (T rc ), gains in properties may not be maximized. In this study, the recrystallization behavior of ECAE-processed CG W is examined as a function of the imparted strain (i.e., number of extrusions) and the hot-working extrusion temperature. Up to four ECAE passes were performed in tooling with a 90 deg. channel intersection, and at temperatures of 1000 deg. C or 1200 deg. C. Subsequent 60 min annealing of the worked material to 1600 deg. C allowed for the determination of T rc . Vickers microhardness measurements and scanning electron microscopy, were used to characterize the microstructures in the as-worked and recrystallized states. The ECAE-processed W shows increased microstructural break-up and refinement with increasing strain and decreasing hot-working temperature in the fully worked state. T rc was determined to be ∼1400 deg. C, which is nearly independent of the number of extrusions and the working temperature. These results show that if ECAE is accomplished below 1400 deg. C (i.e., at 1000 deg. C or lower) the attractive properties of the UFG/NC-worked W may be retained. Specifically, below 1000 deg. C, with increasing strain imparted to the material, high hardness values with a concomitant grain size refinement (∼350 nm) could be expected

  18. Validating the proposed diagnostic and statistical manual of mental disorders, 5th edition, severity indicator for personality disorder.

    Science.gov (United States)

    Morey, Leslie C; Bender, Donna S; Skodol, Andrew E

    2013-09-01

    The authors sought to determine whether a 5-point global rating of personality dysfunction on the Level of Personality Functioning Scale proposed as a severity index for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), would be related to DSM-IV personality disorder diagnosis as well as to other key clinical judgments. Data were collected from a national sample of 337 mental health clinicians who provided complete diagnostic information relevant to DSM-IV and proposed DSM-5 personality disorder diagnoses, as well as demographic information and other clinical judgments, on one of their patients. Of the 337 patients described, 248 met criteria for 1 of the 10 specific DSM-IV personality disorders. A "moderate" or greater rating of impairment in personality functioning on the Level Scale demonstrated 84.6% sensitivity and 72.7% specificity for identifying patients meeting criteria for a specific DSM-IV personality disorder. The Level of Personality Functioning Scale had significant and substantial validity correlations with other measures of personality pathology and with clinical judgments regarding functioning, risk, prognosis, and optimal treatment intensity. Furthermore, the single-item Level of Personality Functioning rating was viewed as being as clinically useful as the 10 DSM-IV categories for treatment planning and patient description and was a better predictor of clinician ratings of broad psychosocial functioning than were the 10 DSM-IV categories combined. These results confirm hypotheses that the single-item Level of Personality Functioning Scale rating provides an indication of severity of personality pathology that predicts both assignment of personality disorder diagnosis and clinician appraisals of functioning, risk, prognosis, and needed treatment intensity.

  19. The Impact of Sudden Gains in Cognitive Behavioral Therapy for Posttraumatic Stress Disorder

    Science.gov (United States)

    Kelly, Kacie A.; Rizvi, Shireen L.; Monson, Candice M.; Resick, Patricia A.

    2009-01-01

    This study investigated sudden gains, i.e., rapid and stable improvements, in posttraumatic stress disorder (PTSD) symptoms that may occur in cognitive–behavioral therapy. Twenty-nine of 72 participants (39.2%) experienced a sudden gain during treatment. Mixed model ANOVAs analyzed sudden gains impact on clinician-rated PTSD symptom severity, patient-rated PTSD symptom severity, and patient-rated depressive symptom severity. Sudden gains in PTSD symptomology were associated with greater reductions in PTSD symptom severity for the avoidance/numbing and hyperarousal symptom clusters at posttreatment. By 6-month follow-up, the sudden gains group had maintained those reductions in symptoms, but the nonsudden gains group had achieved equal reductions in symptom severity. Participants experiencing sudden gains on PTSD measures had lower depression severity at posttreatment and follow-up. PMID:19637322

  20. Evaluation of the DSM-5 Severity Indicator for Binge Eating Disorder in a Community Sample

    Science.gov (United States)

    Grilo, Carlos M.; Ivezaj, Valentina; White, Marney A.

    2015-01-01

    Research has examined various aspects of the diagnostic criteria for binge-eating disorder (BED) but has yet to evaluate the DSM-5 severity criterion. This study examined the DSM-5 severity criterion for BED based on binge-eating frequency and tested an alternative severity specifier based on overvaluation of shape/weight. 338 community volunteers categorized with DSM-5 BED completed a battery of self-report instruments. Participants were categorized first using DSM-5 severity levels and second by shape/weight overvaluation and were compared on clinical variables. 264 (78.1%) participants were categorized as mild, 67 (19.8%) as moderate, 6 (1.8%) as severe, and 1 (0.3%) as extreme. Analyses comparing mild and moderate severity groups revealed no significant differences in demographic variables or BMI; moderate severity group had greater eating-disorder psychopathology (small effect-sizes) but not depression than mild group. Participants with overvaluation (N=196; 60.1%) versus without (N=130; 39.9%) did not differ significantly in age, sex, BMI, or binge-eating frequency. Overvaluation group had significantly greater eating-disorder psychopathology and depression than non-overvaluation group. The greater eating-disorder and depression levels (medium-to-large effect-sizes) persisted after adjusting for ethnicity/race and binge-eating severity/frequency, without attenuation of effect-sizes. Findings from this non-clinical community sample provide support for overvaluation of shape/weight as a specifier for BED as it provides stronger information about severity than the DSM-5 rating based on binge-eating. Future research should include treatment-seeking patients with BED to test the utility of DSM-5 severity specifiers and include broader clinical validators. PMID:25701802

  1. Temperamental correlates of disruptive behavior disorders in young children: preliminary findings.

    Science.gov (United States)

    Hirshfeld-Becker, Dina R; Biederman, Joseph; Faraone, Stephen V; Violette, Heather; Wrightsman, Jessica; Rosenbaum, Jerrold F

    2002-04-01

    Our objective was to test the hypothesis that temperamental behavioral disinhibition measured in early childhood would be associated with disruptive behavior disorders. We used variables from laboratory-based behavioral observations originally devised to assess behavioral inhibition to construct a theory-based a priori definition of "behavioral disinhibition" in 200 young children at-risk for panic disorder, depression, or both and 84 children of parents without anxiety or major depressive disorder. We then compared behaviorally disinhibited and nonbehaviorally disinhibited children on rates of DSM-III-R disorders and measures of academic and social dysfunction. Behavioral disinhibition was significantly associated with higher rates of disruptive behavior disorders and mood disorders. Children with behavioral disinhibition were significantly more likely than nondisinhibited, noninhibited children to have attention-deficit/hyperactivity disorder (ADHD) and to have comorbid mood and disruptive behavior disorders. Moreover, disinhibited children had lower Global Assessment of Functioning Scale scores and were more likely to have been in special classes and to have problems with school behavior and leisure activities. These results suggest that behavioral disinhibition may represent a temperamental precursor to disruptive behavior problems, particularly ADHD. Longitudinal studies using behavioral assessments of behavioral disinhibition are needed to confirm these findings.

  2. Cognitive behavior therapy for eating disorders versus normalization of eating behavior.

    Science.gov (United States)

    Södersten, P; Bergh, C; Leon, M; Brodin, U; Zandian, M

    2017-05-15

    We examine the science and evidence supporting cognitive behavior therapy (CBT) for the treatment of bulimia nervosa and other eating disorders. Recent trials focusing on the abnormal cognitive and emotional aspects of bulimia have reported a remission rate of about 45%, and a relapse rate of about 30% within one year. However, an early CBT trial that emphasized the normalization of eating behavior had a better outcome than treatment that focused on cognitive intervention. In support of this finding, another treatment, that restores a normal eating behavior using mealtime feedback, has an estimated remission rate of about 75% and a relapse rate of about 10% over five years. Moreover, when eating behavior was normalized, cognitive and emotional abnormalities were resolved at remission without cognitive therapy. The critical aspect of the CBT treatment of bulimia nervosa therefore may actually have been the normalization of eating behavior. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Reflections on "A Qualitative Analysis of Mainstreamed Behaviorally Disordered Aggressive Adolescents' Perceptions of Helpful and Unhelpful Teacher Attitudes and Behaviors."

    Science.gov (United States)

    Crowley, E. Paula

    1993-01-01

    The author of EC 607 583 responds to questions about her research on mainstreamed behaviorally disordered aggressive adolescents' perceptions of helpful and unhelpful teacher attitudes and behaviors. Issues relevant to future research in this area are noted. (JDD)

  4. Are patients deemed 'dangerous and severely personality disordered' different from other personality disordered patients detained in forensic settings?

    Science.gov (United States)

    Howard, Rick; Khalifa, Najat; Duggan, Conor; Lumsden, John

    2012-02-01

    In 1999, the UK government initiated a programme for the assessment and treatment of individuals deemed to have 'dangerous and severe personality disorder' (DSPD). After over 10 years of specialist service development, it is not clear whether DSPD patients represent a distinct group. The aim of this study was to establish whether people admitted to DSPD hospital units could be distinguished in presentation or personality traits from people with personality disorder admitted to standard secure hospital services. Thirty-eight men detained in high-security hospital DSPD units were compared with 62 men detained in conventional medium or high security hospital units, using the Psychopathy Checklist-Revised (PCL-R) and other standard personality disorder, clinical and offending measures. Compared with their counterparts in standard services, the DSPD group had higher scores on PCL-R psychopathy, significantly more convictions before age 18 years, greater severity of institutional violence and more prior crimes of sexual violence. Regression analysis confirmed that only PCL-R Factor 1, reflecting core interpersonal and affective features of psychopathy, predicted group membership. The DSPD group emerged as having higher psychopathy scores, but as there is currently no evidence that the core personality features of psychopathy are amenable to treatment, there is little justification for treating high-psychopathy forensic patients differently from those with other disorders of personality. Copyright © 2011 John Wiley & Sons, Ltd.

  5. [One of the approaches to psychological-pedagogical help to children with severe movement disorders].

    Science.gov (United States)

    Levchenko, I Iu; Simonova, T N

    2012-01-01

    The objective of the study was to work out an effective model of complex help to children with severe movement disorders. We examined 440 preschoolers with children cerebral palsy with severe movement disorders and 70 children with mild movement disorders. Functions of motor, emotional-personal and cognitive spheres and independence status with determination of 5 levels were studied in 47 patients. Three groups (from the group without concomitant (sensor, intellectual etc) disorders to the group with most severe disorders) were singled out. The authors characterize the model as an open integral system of methods, tools and ways providing the adaptation of children in response to external circumstances and changes in the state of patients. The creation of a correction-developing environment, consisting of 3 components: spatial-objective, technological (methodological) and social, is discussed. We present results of the development of children, evaluated by the following indices: general technique, sensory perceptive development, social adaptation, anxiety, cognitive activity, from 1997 to 2008. The 15 year follow-up demonstrated the stability of achieved positive results.

  6. Efficacy of Atomoxetine in Children with Severe Autistic Disorders and Symptoms of ADHD: An Open-Label Study

    Science.gov (United States)

    Charnsil, Chawanun

    2011-01-01

    Objective: This study aims to examine the efficacy of atomoxetine in treating symptoms of attention deficit hyperactivity disorder (ADHD) in children with severe autistic disorder. Method: Children with severe autistic disorder who had symptoms of ADHD were given atomoxetine for 10 weeks. The efficacy of atomoxetine was evaluated by using the…

  7. REM sleep behavior disorder and narcoleptic features in anti-Ma2-associated encephalitis.

    Science.gov (United States)

    Compta, Yaroslau; Iranzo, Alex; Santamaría, Joan; Casamitjana, Roser; Graus, Francesc

    2007-06-01

    A 69-year-old man with anti-Ma2 paraneoplastic encephalitis presented with subacute onset of severe hypersomnia, memory loss, parkinsonism, and gaze palsy. A brain magnetic resonance imaging study showed bilateral damage in the dorsolateral midbrain, amygdala, and paramedian thalami. Videopolysomnography disclosed rapid eye movement (REM) sleep behavior disorder, and a Multiple Sleep Latency Test showed a mean sleep latency of 7 minutes and 4 sleep-onset REM periods. The level of hypocretin-1 in the cerebrospinal fluid was low (49 pg/mL). This observation illustrates that REM sleep behavior disorder and narcoleptic features are 2 REM-sleep abnormalities that (1) may share the same autoimmune-mediated origin affecting the brainstem, limbic, and diencephalic structures and (2) may occur in the setting of the paraneoplastic anti-Ma2-associated encephalitis.

  8. Generalized Anxiety Disorder and Social Anxiety Disorder, but Not Panic Anxiety Disorder, Are Associated with Higher Sensitivity to Learning from Negative Feedback: Behavioral and Computational Investigation

    OpenAIRE

    Khdour, Hussain Y.; Abushalbaq, Oday M.; Mughrabi, Ibrahim T.; Imam, Aya F.; Gluck, Mark A.; Herzallah, Mohammad M.; Moustafa, Ahmed A.

    2016-01-01

    Anxiety disorders, including generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic anxiety disorder (PAD), are a group of common psychiatric conditions. They are characterized by excessive worrying, uneasiness, and fear of future events, such that they affect social and occupational functioning. Anxiety disorders can alter behavior and cognition as well, yet little is known about the particular domains they affect. In this study, we tested the cognitive correlates of me...

  9. The Effect of Autism Spectrum Disorders on Adaptive Independent Living Skills in Adults with Severe Intellectual Disability

    Science.gov (United States)

    Matson, Johnny L.; Dempsey, Timothy; Fodstad, Jill C.

    2009-01-01

    Autism Spectrum Disorders are a class of conditions categorized by communication problems, ritualistic behaviors, and deficits in social behaviors. While evidence supporting a genetic component of Autism Spectrum Disorders (ASDs) is strong, no specific genetic marker has been identified. Thus, professionals have had to utilize intelligence tests…

  10. Problem-gambling severity and psychiatric disorders among American-Indian/Alaska native adults.

    Science.gov (United States)

    Kong, Grace; Smith, Philip H; Pilver, Corey; Hoff, Rani; Potenza, Marc N

    2016-03-01

    Little is known about the association between problem-gambling severity and psychiatric disorders among American-Indian/Alaska-Native (AI/AN) individuals. Thus, we examined these factors among a nationally representative sample of AI/AN and other American adults in the USA. Using the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) data, we conducted separate Wald tests and multinomial logistic regression analyses comparing AI/AN to black/African American, white/Caucasian, and all other racial/ethnic groups, respectively. Relative to other American adults, AI/AN adults were least likely to report non-/low-frequency gambling (NG: AI/AN 66.5%, white/Caucasian 70.5%, black/African American 72.8%, other racial/ethnic group 72.3%) and most likely to report low-risk gambling (LRG: AI/AN 30.1%, white/Caucasian 26.5%, black/African American 23.4%, other racial/ethnic group 24.7%). The association between at-risk/problem-gambling (ARPG) and any past-year Axis-I disorder was stronger among AI/AN versus other American adults. Although ARPG and LRG were associated with multiple past-year Axis-I and lifetime Axis-II psychiatric disorders in both AI/AN and other American adults, LRG was more strongly associated with both Axis-I disorders (particularly major depression, generalized anxiety disorder and nicotine dependence) and Cluster-B Axis-II (particularly antisocial personality disorder) disorders in AI/AN versus other American adults. A stronger association between problem-gambling severity and past-year psychiatric disorders among AI/AN relative to other American adults suggests the importance of enhancing mental health and problem-gambling prevention and treatment strategies that may help AI/AN individuals. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Obsessive-compulsive personality disorder and behavioral disinhibition.

    Science.gov (United States)

    Villemarette-Pittman, Nicole R; Stanford, Matthew S; Greve, Kevin W; Houston, Rebecca J; Mathias, Charles W

    2004-01-01

    Although obsessive-compulsive personality disorder (OCPD) is an Axis II diagnosis that is not commonly associated with behavioral disinhibition, the literature contains reports of occasional explosive aggressive outbursts. Existing explanations of OCPD etiology do not address the coexistence of compulsive and impulsive features witnessed in some subpopulations of patients. In this study, the authors present a compensatory theory of OCPD in an effort to explain clinical observations of an unexpectedly large number of OCPD diagnoses among patients clinic referred and self-referred for aggression problems.

  12. The Use of a Functional Behavioral Assessment-Based Self Management Intervention for Students with Emotional/Behavioral Disorders

    Science.gov (United States)

    Rasheed, Saleem A.; Fore, Cecil, III; Jones, Arthur; Smith, Latisha

    2012-01-01

    The research literature on the use of Functional Behavioral Assessments (FBA) to develop Behavior Intervention Plans (BIP) for students with emotional/behavioral disorders, who present problem classroom behaviors for use in the schools, is well documented. There are school-wide, district-wide, and state-wide plans that are currently being…

  13. [Behavioral phenotypes of autism spectrum disorder patients and their parents].

    Science.gov (United States)

    Situ, Mingjing; Hu, Xiao; Cai, Jia; Guo, Kuifang; Huang, Yi

    2015-12-01

    To explore the relationship between the behavior phenotypes of patients with autism spectrum disorder (ASD) and their parents through family study. Forty-five core families with ASD and 30 control families from Chengdu area were examined using Autism Spectrum Quotient (AQ). Descriptive statistical analysis, correlation analysis, and Logistic regression analysis were used to investigate the effect of various factors, especially genetic factors that may affect the pathogenesis of ASD. The social skills factor and communication factor of the father's AQ scale, as well as the mother's age of childbearing and AQ social skills factor are related to whether children with ASD (R were 0.46, 0.39, 0.39 and 0.36, Pautism. ASD may be influenced by both genetic and environmental factors. The autistic behavior phenotype of parents is a risk factor for ASD and is associated with developmental anomalies of early childhood.

  14. Eye disorder differentiates seasonality outcomes in persons with severe visual impairment

    DEFF Research Database (Denmark)

    Madsen, Heller; Dam, Henrik; Hageman, Ida

    2017-01-01

    Background Light plays a crucial role in both the pathogenesis and treatment of seasonal affective disorder (SAD). Consequently decreased retinal sensitivity to light has been suggested to be a risk factor for SAD. In a population of persons with severe visual impairment we recently found a highly...

  15. Clinical Problems in Community Mental Health Care for Patients with Severe Borderline Personality Disorder

    NARCIS (Netherlands)

    Koekkoek, B.; van Meijel, B.; Schene, A.; Hutschemaekers, G.

    2009-01-01

    The objective of this research was to assess the problems that professionals perceive in the community mental health care for patients with severe borderline personality disorder that do not fit into specialized therapy. A group of national experts (n = 8) participated in a four-phase

  16. Neural Correlates of Reversal Learning in Severe Mood Dysregulation and Pediatric Bipolar Disorder

    Science.gov (United States)

    Adleman, Nancy E.; Kayser, Reilly; Dickstein, Daniel; Blair, R. James R.; Pine, Daniel; Leibenluft, Ellen

    2011-01-01

    Objective: Outcome and family history data differentiate children with severe mood dysregulation (SMD), a syndrome characterized by chronic irritability, from children with "classic" episodic bipolar disorder (BD). Nevertheless, the presence of cognitive inflexibility in SMD and BD highlights the need to delineate neurophysiologic similarities and…

  17. Impact of Posttraumatic Stress Disorder and Injury Severity on Recovery in Children with Traumatic Brain Injury

    Science.gov (United States)

    Kenardy, Justin; Le Brocque, Robyne; Hendrikz, Joan; Iselin, Greg; Anderson, Vicki; McKinlay, Lynne

    2012-01-01

    The adverse impact on recovery of posttraumatic stress disorder (PTSD) in mild traumatic brain injury (TBI) has been demonstrated in returned veterans. The study assessed this effect in children's health outcomes following TBI and extended previous work by including a full range of TBI severity, and improved assessment of PTSD within a…

  18. Clomipramine ameliorates adventitious movements and compulsions in prepubertal boys with autistic disorder and severe mental retardation.

    Science.gov (United States)

    Brasic, J R; Barnett, J Y; Kaplan, D; Sheitman, B B; Aisemberg, P; Lafargue, R T; Kowalik, S; Clark, A; Tsaltas, M O; Young, J G

    1994-07-01

    In an open, nonblind clinical trial, clomipramine reduced adventitious movements and compulsions in five previously medicated prepubertal boys with autistic disorder and severe mental retardation. Poorly adapted rating scales, interrater variability, subject heterogeneity, different treatment histories, and environmental stresses confounded the assessment of treatment effects.

  19. A complete genome screen for genes predisposing to severe bipolar disorder in two Costa Rican pedigrees

    NARCIS (Netherlands)

    McInnes, LA; Escamilla, MA; Service, SK; Reus, [No Value; Leon, P; Silva, S; Rojas, E; Spesny, M; Baharloo, S; Blankenship, K; Peterson, A; Tyler, D; Shimayoshi, N; Tobey, C; Batki, S; Vinogradov, S; Meza, L; Gallegos, A; Fournier, E; Smith, LB; Barondes, SH; Sandkuijl, LA; Freimer, NB

    1996-01-01

    Bipolar mood disorder (BP) is a debilitating syndrome characterized by episodes of mania and depression. We designed a multistage study to detect all major loci predisposing to severe BP (termed BP-I) in two pedigrees drawn from the Central Valley of Costa Rica, where the population is largely

  20. Intervention for Children with Severe Speech Disorder: A Comparison of Two Approaches

    Science.gov (United States)

    Crosbie, Sharon; Holm, Alison; Dodd, Barbara

    2005-01-01

    Background: Children with speech disorder are a heterogeneous group (e.g. in terms of severity, types of errors and underlying causal factors). Much research has ignored this heterogeneity, giving rise to contradictory intervention study findings. This situation provides clinical motivation to identify the deficits in the speech-processing chain…

  1. Binge Eating, But Not Other Disordered Eating Symptoms, Is a Significant Contributor of Binge Drinking Severity: Findings from a Cross-Sectional Study among French Students.

    Science.gov (United States)

    Rolland, Benjamin; Naassila, Mickael; Duffau, Céline; Houchi, Hakim; Gierski, Fabien; André, Judith

    2017-01-01

    Many studies have suggested the co-occurrence of eating disorders and alcohol use disorders but in which extent binge eating (BE) and other disordered eating symptoms (DES) are associated with the severity of binge drinking (BD) remains unknown. We conducted a online cross-sectional study among 1,872 French students. Participants were asked their age, gender, tobacco and cannabis use status. They completed the Alcohol Use Questionnaire (AUQ), Eating Disorder Examination Questionnaire (EDE-Q), and UPPS impulsive behavior questionnaire. BD score was calculated using the AUQ. Three items of the EDE-Q were used to construct a BE score. The predictors of the BD score were determined using a linear regression model. Our results showed that the BE score was correlated with the BD score (β 0 = 0.051 ± 0.022; p = 0.019), but no other DES was associated with BD, including purging behaviors. The severity of BD was also correlated with younger age, male gender, tobacco and cannabis use, and with the 'positive urgency,' 'premeditation,' and 'sensation seeking' UPPS subscores ( R 2 of the model: 25%). Within DES, BE appeared as an independent determinant of the BD severity. This is in line with the recent hypothesis that BE is not a subtype of DES, but more a general vulnerability factor of emotional dysregulation, which could be shared by different behavioral and addictive disorders.

  2. Binge Eating, But Not Other Disordered Eating Symptoms, Is a Significant Contributor of Binge Drinking Severity: Findings from a Cross-Sectional Study among French Students

    Directory of Open Access Journals (Sweden)

    Benjamin Rolland

    2017-10-01

    Full Text Available Many studies have suggested the co-occurrence of eating disorders and alcohol use disorders but in which extent binge eating (BE and other disordered eating symptoms (DES are associated with the severity of binge drinking (BD remains unknown. We conducted a online cross-sectional study among 1,872 French students. Participants were asked their age, gender, tobacco and cannabis use status. They completed the Alcohol Use Questionnaire (AUQ, Eating Disorder Examination Questionnaire (EDE-Q, and UPPS impulsive behavior questionnaire. BD score was calculated using the AUQ. Three items of the EDE-Q were used to construct a BE score. The predictors of the BD score were determined using a linear regression model. Our results showed that the BE score was correlated with the BD score (β0 = 0.051 ± 0.022; p = 0.019, but no other DES was associated with BD, including purging behaviors. The severity of BD was also correlated with younger age, male gender, tobacco and cannabis use, and with the ‘positive urgency,’ ‘premeditation,’ and ‘sensation seeking’ UPPS subscores (R2 of the model: 25%. Within DES, BE appeared as an independent determinant of the BD severity. This is in line with the recent hypothesis that BE is not a subtype of DES, but more a general vulnerability factor of emotional dysregulation, which could be shared by different behavioral and addictive disorders.

  3. Association between methylation of the glucocorticoid receptor gene, childhood maltreatment, and clinical severity in borderline personality disorder.

    Science.gov (United States)

    Martín-Blanco, Ana; Ferrer, Marc; Soler, Joaquim; Salazar, Juliana; Vega, Daniel; Andión, Oscar; Sanchez-Mora, Cristina; Arranz, Maria Jesús; Ribases, Marta; Feliu-Soler, Albert; Pérez, Víctor; Pascual, Juan Carlos

    2014-10-01

    The hypothalamus-pituitary-adrenal axis (HPA) is essential in the regulation of stress responses. Increased methylation of the promoter region of the glucocorticoid receptor gene (NR3C1) has been described both in subjects with history of childhood trauma and in patients with Borderline Personality Disorder (BPD). However, no data on the possible association between a higher methylation of this gene and clinical severity is available. The aim of this study was to evaluate the association between NR3C1 methylation status, the history of childhood trauma, and current clinical severity in subjects with BPD. A sample of 281 subjects with BPD (diagnosed by SCID-II and DIB-R semi-structured diagnostic interviews) was recruited. Clinical variables included previous hospitalizations, self-injurious behavior, and self-reported history of childhood trauma. DNA was extracted from peripheral blood. The results indicated a significant positive correlation between NR3C1 methylation status and childhood maltreatment (specifically physical abuse). In addition, a positive correlation between methylation status and clinical severity (DIB-R total score and hospitalizations) was observed. These findings suggest that NR3C1 methylation in subjects with BPD may be associated not only with childhood trauma but also with clinical severity, adding new evidence to the involvement of gene-environment interactions in this disorder. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Relationship between severity of obsessive-compulsive symptoms and schizotypy in obsessive-compulsive disorder

    Directory of Open Access Journals (Sweden)

    Yamamoto H

    2012-12-01

    Full Text Available Haruka Yamamoto,1 Hideto Tsuchida,1 Takashi Nakamae,1 Seiji Nishida,1 Yuki Sakai,1 Akihito Fujimori,1 Jin Narumoto,1 Yoshihisa Wada,1 Takafumi Yoshida,2 Chiaki Taga,3 Kenji Fukui11Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; 2Kyoto Cognitive Behavior Therapy Counseling Room, Kyoto, Japan; 3Department of Psychiatry, Kyoto Second Red Cross Hospital, Kyoto, JapanPurpose: Obsessive-compulsive disorder (OCD patients exhibit a noninhibition response pattern very similar to that observed in schizotypy patients in cognitive tasks. It has been suggested that the reduced cognitive inhibition observed in both schizotypy and OCD may result in the frequent entry into awareness of unacceptable urges and intrusive thoughts. The aim of this study was to investigate the relationship between the severity of obsession or compulsion and schizotypy in OCD.Patients and methods: Sixty subjects (25 males and 35 females who were OCD outpatients in the University Hospital at the Kyoto Prefectural University of Medicine during the period 2008–2010 were enrolled in the study. Assessments of these patients were made using the Yale–Brown Obsessive Compulsive Scale (Y-BOCS, the Schizotypal Personality Questionnaire (SPQ, the Hamilton Depression Rating Scale (HAM-D, and the Hamilton Anxiety Rating Scale (HAM-A. The Pearson correlation coefficients between Y-BOCS and SPQ scores were calculated. Furthermore, hierarchical multiple linear regression analyses were conducted to assess whether schizotypy predicted the severity of obsession and compulsion.Results: By calculating the Pearson correlation coefficient, it was found that the Y-BOCS obsession score, not the Y-BOCS compulsion score, was correlated with the SPQ total score. Results of the hierarchical multiple linear regression analysis showed that SPQ total score was a significant predictor of the Y-BOCS obsession score, after accounting for control

  5. Cognitive Behavioral Therapy in Children and Adolescents with Anxiety Disorder

    Directory of Open Access Journals (Sweden)

    Didem Behice ÖZTOP

    2013-03-01

    Full Text Available Currently, Cognitive Behavioral Therapy (CBT becomes one of the leading approaches in the psychotherapy. However,use of CBT in childhood psychotherapy is considerably novel. After 1990s, it has been understood that it is an effectivemethod for children and adolescents. Anxiety disorders are one of the most common problems in the field of childhoodand adolescent psychiatry. In the studies conducted, the effectiveness of CBT was demonstrated in anxiety disorders ofthe children and adolescents. Moreover, it was suggested that this effectiveness is permanent in some studies. Prioritygoal of CBT is to change inappropriate learning and thinking patterns in the children and adolescents. By “now and here”fashion, it is attempted to reveal the origin of current problems. During the process, the factors are considered, whichcause to maintain the symptoms. It is attempted to decrease signs caused to stress by improving coping skills duringtherapy. To this end, methods including observation, relaxation training, systematic desensitization, social skills training,cognitive restructuring and exposure therapy are applied in sessions by taking child’s problems into consideration. Scalesspecific to anxiety disorders are used in the assessment and follow-up. Age and development level of the child should beparticularly taken into account while using assessment tools and therapeutic modality.

  6. Cognitive Behavioral Therapy in Children and Adolescents with Anxiety Disorder

    Directory of Open Access Journals (Sweden)

    Emel KARAKAYA

    2013-04-01

    Full Text Available Currently, Cognitive Behavioral Therapy (CBT becomes one of the leading approaches in the psychotherapy. However, use of CBT in childhood psychotherapy is considerably novel. After 1990s, it has been understood that it is an effective method for children and adolescents. Anxiety disorders are one of the most common problems in the field of childhood and adolescent psychiatry. In the studies conducted, the effectiveness of CBT was demonstrated in anxiety disorders of the children and adolescents. Moreover, it was suggested that this effectiveness is permanent in some studies. Priority goal of CBT is to change inappropriate learning and thinking patterns in the children and adolescents. By “now and here” fashion, it is attempted to reveal the origin of current problems. During the process, the factors are considered, which cause to maintain the symptoms. It is attempted to decrease signs caused to stress by improving coping skills during therapy. To this end, methods including observation, relaxation training, systematic desensitization, social skills training, cognitive restructuring and exposure therapy are applied in sessions by taking child’s problems into consideration. Scales specific to anxiety disorders are used in the assessment and follow-up. Age and development level of the child should be particularly taken into account while using assessment tools and therapeutic modality [JCBPR 2013; 2(1.000: 10-24

  7. Adolescent callous-unemotional traits and conduct disorder in adoptees exposed to severe early deprivation.

    Science.gov (United States)

    Kumsta, Robert; Sonuga-Barke, Edmund; Rutter, Michael

    2012-03-01

    There is a debate over whether disruptive behaviour should be regarded as a central component of, or rather as an epiphenomenon with little diagnostic value for, psychopathy. To test whether callous-unemotional traits and conduct disorder can be dissociated in the English and Romanian Adoptee Study, a prospective longitudinal study of adopted individuals with a history of severe early institutional deprivation. The Child and Adolescent Psychiatric Assessment was used to establish DSM-IV diagnoses for conduct disorder (and also oppositional defiant disorder) at the 15-year follow-up stage. The Inventory of Callous-Unemotional Traits questionnaire was administered to assess psychopathy traits. There was no significant association between callous-unemotional traits and conduct disorder, both according to parent and youth self-report assessed categorically and dimensionally after controlling for confounds. The majority of individuals with high callous-unemotional traits did not show conduct disorder in this special sample of children. This supports the view that, while common, an overlap between these aspects of psychopathology is not inevitable and so provides evidence for the dissociation of these two concepts. In terms of classification, we argue for a diagnostic scheme where psychopathy can be diagnosed independently of conduct disorder.

  8. Common Emotional and Behavioral Disorders in Preschool Children: Presentation, Nosology, and Epidemiology

    Science.gov (United States)

    Egger, Helen Link; Angold, Adrian

    2006-01-01

    We review recent research on the presentation, nosology and epidemiology of behavioral and emotional psychiatric disorders in preschool children (children ages 2 through 5 years old), focusing on the five most common groups of childhood psychiatric disorders: attention deficit hyperactivity disorders, oppositional defiant and conduct disorders,…

  9. Attention deficit/hyperactivity disorder symptoms moderate cognition and behavior in children with autism spectrum disorders.

    Science.gov (United States)

    Yerys, Benjamin E; Wallace, Gregory L; Sokoloff, Jennifer L; Shook, Devon A; James, Joette D; Kenworthy, Lauren

    2009-12-01

    Recent estimates suggest that 31% of children with autism spectrum disorders (ASD) meet diagnostic criteria for attention deficit/hyperactivity disorder (ADHD), and another 24% of children with ASD exhibit subthreshold clinical ADHD symptoms. Presence of ADHD symptoms in the context of ASD could have a variety of effects on cognition, autistic traits, and adaptive/maladaptive behaviors including: exacerbating core ASD impairments; adding unique impairments specific to ADHD; producing new problems unreported in ASD or ADHD; having no clear impact; or producing some combination of these scenarios. Children with ASD and co-morbid ADHD symptoms (ASD+ADHD; n = 21), children with ASD without ADHD (ASD; n = 28), and a typically developing control group (n = 21) were included in the study; all groups were matched on age, gender-ratio, IQ, and socioeconomic status. Data were collected on verbal and spatial working memory, response inhibition, global executive control (EC), autistic traits, adaptive functioning, and maladaptive behavior problems. In this sample, the presence of ADHD symptoms in ASD exacerbated impairments in EC and adaptive behavior and resulted in higher autistic trait, and externalizing behavior ratings. ADHD symptoms were also associated with greater impairments on a lab measure of verbal working memory. These findings suggest that children with ASD+ADHD symptoms present with exacerbated impairments in some but not all domains of functioning relative to children with ASD, most notably in adaptive behavior and working memory. Therefore, ADHD may moderate the expression of components of the ASD cognitive and behavioral phenotype, but ASD+ADHD may not represent an etiologically distinct phenotype from ASD alone.

  10. Pharmacological treatment of severe psychiatric disorders in the developing world : lessons from India.

    Science.gov (United States)

    Patel, Vikram; Andrade, Chittaranjan

    2003-01-01

    Severe psychiatric disorders (schizophrenia, bipolar disorder and major depressive disorder) cause much morbidity and disability in developing countries. Most of the evidence on the efficacy and effectiveness of drug treatments for these disorders is based on trials conducted in Western countries. Cultural, biological and health system factors may profoundly influence the applicability of such evidence in developing countries. Attitudes towards, and concepts about, psychiatric disorders vary across cultures, and these may influence the acceptability of drug treatments. Genetic and environmental factors may lead to variations in the pharmacodynamics and pharmacokinetics of psychotropic drugs across ethnic groups. This may explain why lower doses of psychotropic drugs tend to be used for non-Caucasian patients. There is a dearth of mental health professionals and care facilities in developing countries, especially in rural areas. Epidemiological studies show that, despite this lack of services, the outcome of schizophrenia is favourable in developing countries. This suggests that cultural, genetic or environmental factors may play as much of a role in influencing outcome as access to antipsychotic treatment. Regional drug policies may influence the availability and cost of psychotropic drugs. In particular, the Indian experience, where drugs are manufactured by several local pharmaceutical firms, thus bringing their cost down, may represent a unique deregulated drug industry. However, the impending impact of the Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement, with the strict enforcement of patent laws, will almost certainly lead to a rise in drug costs in the coming years. This may influence the choice and cost effectiveness of various drugs. The implications of these cross-cultural variations for policy and practice are the need to ensure a reliable supply of affordable psychotropic drugs in developing countries, trained healthcare

  11. Initial severity and antidepressant efficacy for anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder: An individual patient data meta-analysis.

    Science.gov (United States)

    de Vries, Ymkje Anna; Roest, Annelieke M; Burgerhof, Johannes G M; de Jonge, Peter

    2018-06-01

    It has been suggested that antidepressant benefits are smaller for mild than severe depression. Because antidepressants are also used for anxiety disorders, obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD), we examined the influence of severity for these disorders. We used individual patient data of eight trials (3,430 participants) for generalized anxiety disorder (GAD); four trials (1,195 participants) for social anxiety disorder (SAD); four trials (1,132 participants) for OCD; three trials (1,071 participants) for PTSD; and 10 trials (2,151 participants) for panic disorder (PD). Mixed-effects models were used to investigate an interaction between severity and treatment group. For GAD and PD, severity moderated antidepressant efficacy. The antidepressant-placebo difference was 1.4 (95% CI: 0.4-2.5; SMD: 0.21) Hamilton Anxiety Rating Scale (HAM-A) points for participants with mild GAD (baseline HAM-A = 10), increasing to 4.0 (3.4-4.6; SMD: 0.45) or greater for severely ill participants (HAM-A ≥ 30). For PD, the difference was 0.4 (0.3-0.6) panic attacks/2 weeks for participants with 10 panic attacks/2 weeks at baseline, increasing to 4.7 (3.0-6.4) for participants with 40. For SAD, OCD, and PTSD, no interaction was found. Across severity levels, the differences were 16.1 (12.9-19.3; SMD: 0.59) Liebowitz Social Anxiety Scale points, 3.4 (2.5-4.4, SMD: 0.39) Yale-Brown Obsessive-Compulsive Scale points, and 10.3 (6.9-13.6; SMD: 0.41) Clinician-Administered PTSD Scale points. Antidepressants are equally effective across severity levels for SAD, OCD, and PTSD. For GAD and PD, however, benefits are small at low severity, and the benefit-risk ratio may be unfavorable for these patients. © 2018 Wiley Periodicals, Inc.

  12. Secondary depression in severe anxiety disorders: a population-based cohort study in Denmark

    Science.gov (United States)

    Meier, Sandra M; Petersen, Liselotte; Mattheisen, Manuel; Mors, Ole; Mortensen, Preben B; Laursen, Thomas M

    2016-01-01

    Summary Background Depression and anxiety disorders are highly comorbid conditions and a worldwide disease burden; however, large-scale studies delineating their association are scarce. In this retrospective study, we aimed to assess the effect of severe anxiety disorders on the risk and course of depression. Methods We did a population-based cohort study with prospectively gathered data in Denmark using data from three Danish population registers: The Danish Civil Registration System, the Danish Psychiatric Central Register, and the Danish National Hospital Registry. We selected the cohort from people born in Denmark between Jan 1, 1955, and Dec 31, 2002, who we followed up from Jan 1, 1994, to Dec 31, 2012. The cohort was restricted to individuals with known parents. First, we investigated the effect of specific anxiety diagnoses on risk of single depressive episodes and recurrent depressive disorder. Second, we investigated the effect of comorbid anxiety on risk of readmission for depression, adjusting for sex, age, calendar year, parental age, place at residence at time of birth, and the interaction of age with sex. Findings We included 3 380 059 individuals in our study cohort. The adjusted incidence rate ratio (IRR) for single depressive episodes was 3·0 (95% CI 2·8–3·1, pdepressive disorder was 5·0 (4·8–5·2) in patients with severe anxiety disorders compared with the general population. Compared with control individuals, the offspring of parents with anxiety disorders were more likely to be diagnosed with single depressive episodes (1·9, 1·8–2·0) or recurrent depressive disorder (2·1, 1·9–2·2). Comorbid anxiety increased the readmission rates in both patients with single depressive episodes and patients with recurrent depressive disorder. Interpretation Severe anxiety constitutes a significant risk factor for depression. Focusing on specific anxiety disorders might help to identify individuals at risk of depression, thereby providing new

  13. Fibromyalgia in patients with irritable bowel syndrome. An association with the severity of the intestinal disorder.

    Science.gov (United States)

    Lubrano, E; Iovino, P; Tremolaterra, F; Parsons, W J; Ciacci, C; Mazzacca, G

    2001-08-01

    Fibromyalgia (FM) syndrome and irritable bowel syndrome (IBS) are functional disorders in which altered somatic and or visceral perception thresholds have been found. The aim of this study was to evaluate the prevalence of FM in a group of patients with IBS and the possible association of FM with patterns and severity of the intestinal disorder. One hundred thirty consecutive IBS patients were studied. The IBS was divided into four different patterns according to the predominant bowel symptom and into three levels of severity using a functional severity index. All patients underwent rheumatological evaluation for number of positive tender points, number of tender and swollen joints, markers of inflammation, and presence of headache and weakness. Moreover, patients' assessments of diffuse pain, mood and sleep disturbance, anxiety, and fatigue were also measured on a visual analogue scale. The diagnosis of FM was made based on American College of Rheumatology classification criteria. Nonparametric tests were used for statistical analysis. Fibromyalgia was found in 20% of IBS patients. No statistical association was found between the presence of FM and the type of IBS but a significant association was found between the presence of FM and severity of the intestinal disorder. The presence of FM in IBS patients seems to be associated only with the severity of IBS. This result confirms previous studies on the association between the two syndromes.

  14. Serum 25-hyroxyvitamin D levels and tic severity in Chinese children with tic disorders.

    Science.gov (United States)

    Li, Hong-Hua; Shan, Ling; Wang, Bing; Du, Lin; Xu, Zhi-Da; Jia, Fei-Yong

    2018-05-31

    The aim of this study is to evaluate serum 25-hydroxyvitamin D[25(OH)D] levels in children with tic disorders and to explore the relationship between serum 25(OH)D level and tic severity. Children (n = 179, 31 females, 148 males, mean age at diagnosis: 8.0 ± 2.7 years old, age ranged from 3 to 14.5 years old) who were diagnosed with a tic disorder were enrolled as case group, 189 healthy children were recruited as control group. Serum level of 25(OH)D of each child was measured by high performance liquid chromatography and tandem mass spectrometry (HPLC-MS/MS). Yale Global Tic Severity Scale (YGTSS) was used to assess tic severity. Mean serum level of 25(OH)D in the case group was significantly lower than that of the control group. The serum 25(OH)D level was significantly associated with tic severity after adjusting for age and body mass index (BMI). This study identified a high prevalence of vitamin D insufficiency or deficiency in children with tic disorders, and there was a negative correlation between the serum 25(OH)D level and tic severity. In the future, large sample size studies are urgently needed to further clarify this correlation. Copyright © 2018. Published by Elsevier B.V.

  15. Genomewide Linkage Disequilibrium Mapping of Severe Bipolar Disorder in a Population Isolate

    Science.gov (United States)

    Ophoff, Roel A.; Escamilla, Michael A.; Service, Susan K.; Spesny, Mitzi; Meshi, Dar B.; Poon, Wingman; Molina, Julio; Fournier, Eduardo; Gallegos, Alvaro; Mathews, Carol; Neylan, Thomas; Batki, Steven L.; Roche, Erin; Ramirez, Margarita; Silva, Sandra; De Mille, Melissa C.; Dong, Penny; Leon, Pedro E.; Reus, Victor I.; Sandkuijl, Lodewijk A.; Freimer, Nelson B.

    2002-01-01

    Genomewide association studies may offer the best promise for genetic mapping of complex traits. Such studies in outbred populations require very densely spaced single-nucleotide polymorphisms. In recently founded population isolates, however, extensive linkage disequilibrium (LD) may make these studies feasible with currently available sets of short tandem repeat markers, spaced at intervals as large as a few centimorgans. We report the results of a genomewide association study of severe bipolar disorder (BP-I), using patients from the isolated population of the central valley of Costa Rica. We observed LD with BP-I on several chromosomes; the most striking results were in proximal 8p, a region that has previously shown linkage to schizophrenia. This region could be important for severe psychiatric disorders, rather than for a specific phenotype. PMID:12119601

  16. Family Stress and Coping From Hospitalization of Clients With Severe Alcohol Use Disorder in Korea.

    Science.gov (United States)

    Park, Gyu-Hee; Choi, Yun-Jung

    The rate of relapse and involuntary hospitalization among clients with alcohol use disorder exceeds 40% in South Korea. As a result, family members of clients experience considerable stress and require the assistance of professional services. This empirical study investigates levels of perceived stress and stress coping styles among family members of clients with severe alcohol use disorder and examines the correlations among these variables. Data were collected from three inpatient alcohol rehabilitation centers and five psychiatric hospitals in South Korea. Family stress levels and stress coping styles for 133 respondents were evaluated using the Hospital Stress Rating Scale for Family Members and the Stress Coping Style Checklist. There were significant differences in stress levels according to whether participants had attended a family educational program in the past or were doing so presently. Furthermore, significant differences in stress were observed among participants who were using the stress coping style of easing strained emotions during the client's hospitalization but who had never attended an educational program. Among the subcategories, stress levels had especially strong relationships with easing strained emotions, seeking advice, and solving problems. The results showed that families with severe alcohol use disorder experience stress from the client's hospitalization and seek advice from neighbors to deal with worries, privacy concerns, and economic problems. Family interventions are needed to provide family members with strategies to cope with stress, which can support recovery of clients with severe alcohol use disorder.

  17. Challenging Behaviors in Adults with Intellectual Disability: The Effects of Race and Autism Spectrum Disorders

    Science.gov (United States)

    Horovitz, Max; Matson, Johnny L.; Hattier, Megan A.; Tureck, Kimberly; Bamburg, Jay W.

    2013-01-01

    Rates of challenging behaviors were assessed in 175 adults with intellectual disability (ID) or ID and a comorbid autism spectrum disorder (ASD). The relationship between ASD diagnosis, race, and challenging behaviors was assessed using the "Autism Spectrum Disorders-Behavior Problems for Adults (ASD-BPA)." Those with ASD and ID were…

  18. Disturbing, Disordered or Disturbed? Perspectives on the Definition of Problem Behavior in Educational Settings.

    Science.gov (United States)

    Wood, Frank H., Ed.; Lakin, K. Charlie, Ed.

    The book contains five papers presented at a 1979 topical conference on the definition of emotional disturbance and behavioral disorders in educational settings. The first paper, by F. Wood, is titled "Defining Disturbing, Disordered, and Disturbed Behavior." Topics covered include ambivalence about defining deviant behavior by special educators,…

  19. Preliminary study of family accommodation in youth with autism spectrum disorders and anxiety: Incidence, clinical correlates, and behavioral treatment response.

    Science.gov (United States)

    Storch, Eric A; Zavrou, Sophia; Collier, Amanda B; Ung, Danielle; Arnold, Elysse B; Mutch, P Jane; Lewin, Adam B; Murphy, Tanya K

    2015-08-01

    Anxiety symptoms are common in youth with autism spectrum disorders (ASD) and directly associated with symptom severity and functional impairment. Family accommodation occurs frequently among individuals with obsessive-compulsive and anxiety disorders; to date, no data exist on the nature and correlates of family accommodation in youth with ASD and anxiety, as well as its relationship to cognitive-behavioral therapy outcome. Forty children with ASD and a comorbid anxiety disorder participated. Clinicians administered measures of ASD and anxiety disorder caseness, anxiety symptom severity, and family accommodation; parents completed questionnaires assessing social responsiveness, internalizing and externalizing behaviors, and functional impairment. A subsample of youth (n = 24) completed a course of cognitive-behavioral therapy. Family accommodation was common and positively correlated with anxiety symptom severity, but not functional impairment, general internalizing symptoms, externalizing behavior, or social responsiveness. Family accommodation decreased following cognitive-behavioral therapy with decreases in family accommodation being associated with decreases in anxiety levels. Treatment responders reported lower family accommodation frequency and lower parent impact relative to non-responders. Clinical implications of this study in assessing and psychotherapeutically treating youth with ASD and comorbid anxiety are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. High prevalence of seasonal affective disorder among persons with severe visual impairment

    DEFF Research Database (Denmark)

    Madsen, Helle Østergaard; Dam, Henrik; Hageman, Ida

    2016-01-01

    BACKGROUND: Light severely affects the occurrence of seasonal affective disorder (SAD). AIMS: To compare the prevalence of SAD in persons with severe visual impairment and persons with full sight, and in persons with severe visual impairment with or without light perception. METHOD: This cross......-sectional study assessed the Global Seasonality Score (GSS) and the prevalence of SAD among 2781 persons with visual impairment and 4099 persons with full sight using the Seasonal Pattern Assessment Questionnaire (SPAQ). RESULTS: Respondents with visual impairment had significantly higher GSS and prevalence...... of SAD compared with full sight controls, Pvisual impairment and SPAQ-defined SAD parameters...

  1. The Evolution of Post-Traumatic Stress Disorder following Moderate-to-Severe Traumatic Brain Injury.

    Science.gov (United States)

    Alway, Yvette; Gould, Kate Rachel; McKay, Adam; Johnston, Lisa; Ponsford, Jennie

    2016-05-01

    Increasing evidence indicates that post-traumatic stress disorder (PTSD) may develop following traumatic brain injury (TBI), despite most patients having no conscious memory of their accident. This prospective study examined the frequency, timing of onset, symptom profile, and trajectory of PTSD and its psychiatric comorbidities during the first 4 years following moderate-to-severe TBI. Participants were 85 individuals (78.8% male) with moderate or severe TBI recruited following admission to acute rehabilitation between 2005 and 2010. Using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Disorders (SCID-I), participants were evaluated for pre- and post-injury PTSD soon after injury and reassessed at 6 months, 12 months, 2 years, 3 years, and 4 years post-injury. Over the first 4 years post-injury, 17.6% developed injury-related PTSD, none of whom had PTSD prior to injury. PTSD onset peaked between 6 and 12 months post-injury. The majority of PTSD cases (66.7%) had a delayed-onset, which for a third was preceded by subsyndromal symptoms in the first 6 months post-injury. PTSD frequency increased over the first year post-injury, remained stable during the second year, and gradually declined thereafter. The majority of subjects with PTSD experienced a chronic symptom course and all developed one or more than one comorbid psychiatric disorder, with mood, other anxiety, and substance-use disorders being the most common. Despite event-related amnesia, post-traumatic stress symptoms, including vivid re-experiencing phenomena, may develop following moderate-to-severe TBI. Onset is typically delayed and symptoms may persist for several years post-injury.

  2. Differentiating Children with Attention-Deficit/Hyperactivity Disorder, Conduct Disorder, Learning Disabilities and Autistic Spectrum Disorders by Means of Their Motor Behavior Characteristics

    Science.gov (United States)

    Efstratopoulou, Maria; Janssen, Rianne; Simons, Johan

    2012-01-01

    The study was designed to investigate the discriminant validity of the Motor Behavior Checklist (MBC) for distinguishing four group of children independently classified with Attention-Deficit/Hyperactivity Disorder, (ADHD; N = 22), Conduct Disorder (CD; N = 17), Learning Disabilities (LD; N = 24) and Autistic Spectrum Disorders (ASD; N = 20).…

  3. Reduced heart rate variability in social anxiety disorder: associations with gender and symptom severity.

    Directory of Open Access Journals (Sweden)

    Gail A Alvares

    Full Text Available BACKGROUND: Polyvagal theory emphasizes that autonomic nervous system functioning plays a key role in social behavior and emotion. The theory predicts that psychiatric disorders of social dysfunction are associated with reduced heart rate variability, an index of autonomic control, as well as social inhibition and avoidance. The purpose of this study was to examine whether heart rate variability was reduced in treatment-seeking patients diagnosed with social anxiety disorder, a disorder characterized by social fear and avoidance. METHODS: Social anxiety patients (n = 53 were recruited prior to receiving psychological therapy. Healthy volunteers were recruited through the University of Sydney and the general community and were matched by gender and age (n = 53. Heart rate variability was assessed during a five-minute recording at rest, with participants completing a range of self-report clinical symptom measures. RESULTS: Compared to controls, participants with social anxiety exhibited significant reductions across a number of heart rate variability measures. Reductions in heart rate variability were observed in females with social anxiety, compared to female controls, and in patients taking psychotropic medication compared to non-medicated patients. Finally, within the clinical group, we observed significant associations between reduced heart rate variability and increased social interaction anxiety, psychological distress, and harmful alcohol use. CONCLUSIONS: The results of this study confirm that social anxiety disorder is associated with reduced heart rate variability. Resting state heart rate variability may therefore be considered a marker for social approach-related motivation and capacity for social engagement. Additionally, heart rate variability may provide a useful biomarker to explain underlying difficulties with social approach, impaired stress regulation, and behavioral inhibition, especially in disorders associated with

  4. Abnormal Sexual Behavior in an Adult Male with Obsessive Compulsive Disorder

    OpenAIRE

    Raguraman, Janakiraman; Priyadharshini, Kothai R.; Chandrasekaran, R.; Vijaysagar, John

    2004-01-01

    A male patient with homosexual obsession in obsessive compulsive disorder shows a better outcome following a combination of pharmacotherapy and psychotherapy. This case report emphasizes the importance of combination therapy in obsessive compulsive disorder with abnormal sexual impulses and behavior.

  5. Integrated cognitive behavioral therapy for patients with substance use disorder and comorbid ADHD: two case presentations

    NARCIS (Netherlands)

    van Emmerik-van Oortmerssen, Katelijne; Vedel, Ellen; van den Brink, Wim; Schoevers, Robert A.

    2015-01-01

    Two cases of integrated cognitive behavioral therapy (ICBT) for substance use disorder (SUD) and Attention Deficit Hyperactivity Disorder (ADHD) are presented illustrating that ICBT is a promising new treatment option

  6. Integrated cognitive behavioral therapy for patients with Substance Use Disorder and Comorbid ADHD : Two case presentations

    NARCIS (Netherlands)

    van Emmerik-van Oortmerssen, Katelijne; Vedel, Ellen; van den Brink, Wir; Schoevers, Robert A.

    Two cases of integrated cognitive behavioral therapy (ICBT) for substance use disorder (SUD) and Attention Deficit Hyperactivity Disorder (ADHD) are presented illustrating that ICBT is a promising new treatment option. (C) 2015 Elsevier Ltd. All rights reserved.

  7. Mild, moderate, meaningful? Examining the psychological and functioning correlates of DSM-5 eating disorder severity specifiers.

    Science.gov (United States)

    Gianini, Loren; Roberto, Christina A; Attia, Evelyn; Walsh, B Timothy; Thomas, Jennifer J; Eddy, Kamryn T; Grilo, Carlos M; Weigel, Thomas; Sysko, Robyn

    2017-08-01

    This study evaluated the DSM-5 severity specifiers for treatment-seeking groups of participants with anorexia nervosa (AN), the purging form of bulimia nervosa (BN), and binge-eating disorder (BED). Hundred and sixty-two participants with AN, 93 participants with BN, and 343 participants with BED were diagnosed using semi-structured interviews, sub-categorized using DSM-5 severity specifiers and compared on demographic and cross-sectional clinical measures. In AN, the number of previous hospitalizations and the duration of illness increased with severity, but there was no difference across severity groups on measures of eating pathology, depression, or measures of self-reported physical or emotional functioning. In BN, the level of eating concerns increased across the severity groups, but the groups did not differ on measures of depression, self-esteem, and most eating pathology variables. In BN, support was also found for an alternative severity classification scheme based upon number of methods of purging. In BED, levels of several measures of eating pathology and self-reported physical and emotional functioning increased across the severity groups. For BED, however, support was also found for an alternative severity classification scheme based upon overvaluation of shape and weight. Preliminary evidence was also found for a transdiagnostic severity index based upon overvaluation of shape and weight. Overall, these data show limited support for the DSM-5 severity specifiers for BN and modest support for the DSM-5 severity specifiers for AN and BED. © 2017 Wiley Periodicals, Inc.

  8. Implicit attitudes toward eating stimuli differentiate eating disorder and non-eating disorder groups and predict eating disorder behaviors.

    Science.gov (United States)

    Smith, April R; Forrest, Lauren N; Velkoff, Elizabeth A; Ribeiro, Jessica D; Franklin, Joseph

    2018-04-01

    The current study tested whether people with and without eating disorders (EDs) varied in their implicit attitudes toward ED-relevant stimuli. Additionally, the study tested whether implicit evaluations of ED-relevant stimuli predicted ED symptoms and behaviors over a 4-week interval. Participants were people without EDs (N = 85) and people seeking treatment for EDs (N = 92). All participants completed self-report questionnaires and a version of the affect misattribution procedure (AMP) at baseline. The AMP indexed implicit evaluations of average body stimuli, eating stimuli, and ED-symptom stimuli. Participants with EDs completed weekly follow-up measures of ED symptoms and behaviors for 4 weeks. Contrary to predictions, the anorexia nervosa (AN) group did not differ from the no ED group on implicit attitudes toward ED-symptom stimuli, and the bulimia nervosa (BN) group had less positive implicit attitudes toward ED-symptom stimuli relative to the no ED group. In line with predictions, people with AN and BN had more negative implicit attitudes toward average body and eating stimuli relative to the no ED group. In addition, among the ED group more negative implicit attitudes toward eating stimuli predicted ED symptoms and behaviors 4 weeks later, over and above baseline ED symptoms and behaviors. Taken together, implicit evaluations of eating stimuli differentiated people with AN and BN from people without EDs and longitudinally predicted ED symptoms and behaviors. Interventions that increase implicit liking of eating-related stimuli may reduce ED behaviors. © 2018 Wiley Periodicals, Inc.

  9. Molten Corium-Concrete Interaction Behavior Analyses for Severe Accident Management in CANDU Reactor

    International Nuclear Information System (INIS)

    Choi, Y.; Kim, D. H.; Song, Y. M.

    2014-01-01

    After the last few severe accidents, the importance of accident management in nuclear power plants has increased. Many countries, including the United States (US) and Canada, have focused on understanding severe accidents in order to identify ways to further improve the safety of nuclear plants. It has been recognized that severe accident analyses of nuclear power plants will be beneficial in understanding plant-specific vulnerabilities during severe accidents. The objectives of this paper are to describe the molten corium behavior to identify a plant response with various concrete specific components. Accident analyses techniques using ISSAC can be useful tools for MCCI behavior in severe accident mitigation

  10. Managing Behavior by Managing the Classroom: Making Learning Accessible for Deaf and Hard of Hearing Students with Autism Spectrum Disorders

    Science.gov (United States)

    Szymanski, Christen A.

    2012-01-01

    The prevalence of Autism Spectrum Disorders (ASD)--a group of developmental disabilities that cause severe problems with socialization, behavior, and communication--continues to grow. In 2008, the year that "Odyssey" focused on autism, the estimated prevalence of ASD for hearing children was 1 in 150 (CDC, 2007), while today estimates suggest…

  11. Cognitive Reappraisal Self-Efficacy Mediates the Effects of Individual Cognitive-Behavioral Therapy for Social Anxiety Disorder

    Science.gov (United States)

    Goldin, Philippe R.; Ziv, Michal; Jazaieri, Hooria; Werner, Kelly; Kraemer, Helena; Heimberg, Richard G.; Gross, James J.

    2012-01-01

    Objective: To examine whether changes in cognitive reappraisal self-efficacy (CR-SE) mediate the effects of individually administered cognitive-behavioral therapy (I-CBT) for social anxiety disorder (SAD) on severity of social anxiety symptoms. Method: A randomized controlled trial in which 75 adult patients (21-55 years of age; 53% male; 57%…

  12. REM Sleep Behavior Disorder and Narcoleptic Features in Anti–Ma2-associated Encephalitis

    Science.gov (United States)

    Compta, Yaroslau; Iranzo, Alex; Santamaría, Joan; Casamitjana, Roser; Graus, Francesc

    2007-01-01

    A 69-year-old man with anti-Ma2 paraneoplastic encephalitis presented with subacute onset of severe hypersomnia, memory loss, parkinsonism, and gaze palsy. A brain magnetic resonance imaging study showed bilateral damage in the dorsolateral midbrain, amygdala, and paramedian thalami. Videopolysomnography disclosed rapid eye movement (REM) sleep behavior disorder, and a Multiple Sleep Latency Test showed a mean sleep latency of 7 minutes and 4 sleep-onset REM periods. The level of hypocretin-1 in the cerebrospinal fluid was low (49 pg/mL). This observation illustrates that REM sleep behavior disorder and narcoleptic features are 2 REM-sleep abnormalities that (1) may share the same autoimmune-mediated origin affecting the brainstem, limbic, and diencephalic structures and (2) may occur in the setting of the paraneoplastic anti–Ma2-associated encephalitis. Citation: Compta Y; Iranzo A; Santamaría J et al. REM Sleep Behavior Disorder and Narcoleptic Features in Anti–Ma2-associated Encephalitis. SLEEP 2007;30(6):767-769. PMID:17580598

  13. The Hierarchical Implications of Internet Gaming Disorder Criteria: Which Indicate more Severe Pathology?

    Science.gov (United States)

    Lee, Seung-Yup; Lee, Hae Kook; Jeong, Hyunsuk; Yim, Hyeon Woo; Bhang, Soo-Young; Jo, Sun-Jin; Baek, Kyung-Young; Kim, Eunjin; Kim, Min Seob; Choi, Jung-Seok

    2017-01-01

    Objective To explore the structure of Internet gaming disorder (IGD) criteria and their distribution according to the different severity level of IGD. The associations of psychiatric comorbidities to each IGD symptom and to the IGD severity were also investigated. Methods Consecutively recruited 330 Korean middle school students underwent face-to-face diagnostic interviews to assess their gaming problems by clinicians. The psychiatric comorbidities were also evaluated with a semi-structured instrument. The data was analyzed using principal components analysis and the distribution of criteria among different severity groups was visualized by plotting univariate curves. Results Two principal components of ‘Compulsivity’ and ‘Tolerance’ were extracted. ‘Decrease in other activities’ and ‘Jeopardizing relationship/career’ may indicate a higher severity of IGD. While ‘Craving’ deserved more recognition in clinical utility, ‘Tolerance’ did not demonstrate much difference in distribution by the IGD severity. Internalizing and externalizing psychiatric disorders differed in distribution by the IGD severity. Conclusion A hierarchic presentation of IGD criteria was revealed. ‘Decrease in other activities’ and ‘Jeopardizing relationship/career’ may represent a higher severity, thus indicating more clinical attention to such symptoms. However, ‘Tolerance’ was not found to be a valid diagnostic criterion. PMID:28539943

  14. Investigation of the Association Between Motor Stereotypy Behavior With Fundamental Movement Skills, Adaptive Functioning, and Autistic Spectrum Disorder Symptomology in Children With Intellectual Disabilities.

    Science.gov (United States)

    Powell, Joanne L; Pringle, Lydia; Greig, Matt

    2017-02-01

    Motor stereotypy behaviors are patterned, coordinated, repetitive behaviors that are particularly evident in those with an autistic spectrum disorder and intellectual disabilities. The extent to which motor stereotypy behavior severity is associated with motor skills and maladaptive behavior, measures of adaptive functioning, along with fundamental movement skills and degree of autistic spectrum disorder symptomology is assessed in this preliminary report. Twelve participants, aged 7 to 16 years, with a reported motor stereotypy behavior and either mild or severe intellectual disability comprising developmental or global delay took part in the study. Spearman rho correlational analysis showed that severity of motor stereotypy behavior was significantly positively correlated with autistic spectrum disorder symptomology ( P = .008) and maladaptive behavior ( P = .008) but not fundamental movement skills ( P > .05). An increase in fundamental movement skills score was associated with a decrease in autistic spectrum disorder symptomology ( P = .01) and an increase in motor skills ( P = .002). This study provides evidence showing a significant relationship between motor stereotypy behavior severity with degree of autistic spectrum disorder symptomology and maladaptive behavior.

  15. Influence of attention deficit hyperactivity disorder and conduct disorder on opioid dependence severity and psychiatric comorbidity in chronic methadone-maintained patients

    NARCIS (Netherlands)

    Carpentier, P.J.; Gogh, M.T. van; Knapen, L.J.; Buitelaar, J.K.; Jong, C.A.J. de

    2011-01-01

    BACKGROUND: Persistent attention deficit hyperactivity disorder (ADHD) and a history of conduct disorder (CD) are highly prevalent among patients with substance use disorders (SUD). We examined the influence of both diagnoses on problem severity, psychiatric comorbidity, and quality of life in

  16. Influence of Attention Deficit Hyperactivity Disorder and Conduct Disorder on Opioid Dependence Severity and Psychiatric Comorbidity in Chronic Methadone-Maintained Patients

    NARCIS (Netherlands)

    Carpentier, P.J.B.; Gogh, M.T. van; Knapen, L.J.M.; Buitelaar, J.K.; Jong, C.A.J. de

    2011-01-01

    Background: Persistent attention deficit hyperactivity disorder (ADHD) and a history of conduct disorder (CD) are highly prevalent among patients with substance use disorders (SUD). We examined the influence of both diagnoses on problem severity, psychiatric comorbidity, and quality of life in

  17. Role of Perinatal Adversities on Tic Severity and Symptoms of Attention Deficit/Hyperactivity Disorder in Children and Adolescents With a Tic Disorder

    NARCIS (Netherlands)

    Bos-Veneman, Netty G. P.; Kuin, Anne; Minderaa, Ruud B.; Hoekstra, Pieter J.

    2010-01-01

    Objective: To investigate the role of perinatal adversities with regard to tic severity and comorbid attention deficit/hyperactivity disorder (ADHD) symptoms in children with a tic disorder. Methods: In 75 children and adolescents with a tic disorder, we retrospectively assessed presence of

  18. Impaired affective prosody decoding in severe alcohol use disorder and Korsakoff syndrome.

    Science.gov (United States)

    Brion, Mélanie; de Timary, Philippe; Mertens de Wilmars, Serge; Maurage, Pierre

    2018-06-01

    Recognizing others' emotions is a fundamental social skill, widely impaired in psychiatric populations. These emotional dysfunctions are involved in the development and maintenance of alcohol-related disorders, but their differential intensity across emotions and their modifications during disease evolution remain underexplored. Affective prosody decoding was assessed through a vocalization task using six emotions, among 17 patients with severe alcohol use disorder, 16 Korsakoff syndrome patients (diagnosed following DSM-V criteria) and 19 controls. Significant disturbances in emotional decoding, particularly for negative emotions, were found in alcohol-related disorders. These impairments, identical for both experimental groups, constitute a core deficit in excessive alcohol use. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. Hoarding behavior among young children with obsessive-compulsive disorder.

    Science.gov (United States)

    Frank, Hannah; Stewart, Elyse; Walther, Michael; Benito, Kristen; Freeman, Jennifer; Conelea, Christ; Garci, Abbe

    2014-01-01

    Previous research has shown that among the various subtypes of obsessive-compulsive disorder (OCD), adults (e.g. Frost, Krause & Steketee, 1996) and older children and adolescents (Bloch et al., 2009; Storch et al., 2007) with problematic hoarding have distinct features and a poor treatment prognosis. However, there is limited information on the phenomenology and prevalence of hoarding behaviors in young children. The present study characterizes children ages 10 and under who present with OCD and hoarding behaviors. Sixty-eight children received a structured interview-determined diagnosis of OCD. Clinician administered, parent-report, and child-report measures on demographic, symptomatic, and diagnostic variables were completed. Clinician ratings of hoarding symptoms and parent and child endorsement of the hoarding item on the CY-BOCS checklist (Scahill, Riddle, McSwiggin-Hardin, & Ort, 1997) determined inclusion in the hoarding group ( n =33). Compared to children without hoarding symptoms ( n =35), the presence of hoarding symptoms was associated with an earlier age of primary diagnosis onset and a higher proportion of ADHD and provisional anxiety diagnoses. These results are partially consistent with the adult literature and with findings in older children (Storch et al., 2007). Additional data on clinical presentation and phenomenology of hoarding are needed to form a developmentally appropriate definition of the behavior.

  20. Management of REM sleep behavior disorder: An evidence based review.

    Science.gov (United States)

    Devnani, Preeti; Fernandes, Racheal

    2015-01-01

    Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by dream enactment behavior resulting from a loss of REM skeletal muscle atonia. The neurobiology of REM sleep and the characteristic features of REM atonia have an important basis for understanding the aggravating etiologies the proposed pharmacological interventions in its management. This review outlines the evidence for behavioral and therapeutic measures along with evidence-based guidelines for their implementation, impact on falls, and effect on polysomnography (PSG) while highlighting the non-motor, autonomic, and cognitive impact of this entity. PubMed databases were reviewed upto May 2013 in peer-reviewed scientific literature regarding the pathophysiology and management of RBD in adults. The literature was graded according to the Oxford centre of evidence-based Medicine Levels. An early intervention that helps prevent consequences such as falls and provides a base for intervention with neuroprotective mechanisms and allocates a unique platform that RBD portrays with its high risk of disease conversion with a sufficiently long latency. RBD provides a unique platform with its high risk of disease conversion with a sufficiently long latency, providing an opportunity for early intervention both to prevent consequences such as falls and provide a base for intervention with neuroprotective mechanisms.

  1. Management of REM sleep behavior disorder: An evidence based review

    Directory of Open Access Journals (Sweden)

    Preeti Devnani

    2015-01-01

    Full Text Available Rapid eye movement (REM sleep behavior disorder (RBD is characterized by dream enactment behavior resulting from a loss of REM skeletal muscle atonia. The neurobiology of REM sleep and the characteristic features of REM atonia have an important basis for understanding the aggravating etiologies the proposed pharmacological interventions in its management. This review outlines the evidence for behavioral and therapeutic measures along with evidence-based guidelines for their implementation, impact on falls, and effect on polysomnography (PSG while highlighting the non-motor, autonomic, and cognitive impact of this entity. PubMed databases were reviewed upto May 2013 in peer-reviewed scientific literature regarding the pathophysiology and management of RBD in adults. The literature was graded according to the Oxford centre of evidence-based Medicine Levels. An early intervention that helps prevent consequences such as falls and provides a base for intervention with neuroprotective mechanisms and allocates a unique platform that RBD portrays with its high risk of disease conversion with a sufficiently long latency. RBD provides a unique platform with its high risk of disease conversion with a sufficiently long latency, providing an opportunity for early intervention both to prevent consequences such as falls and provide a base for intervention with neuroprotective mechanisms.

  2. Gender role behavior in children with XY karyotype and disorders of sex development.

    Science.gov (United States)

    Jürgensen, Martina; Hiort, Olaf; Holterhus, Paul-Martin; Thyen, Ute

    2007-03-01

    Children exhibit gender-typical preferences in play, toys, activities and interests, and playmates. Several studies suggest that high concentrations of pre- and postnatal androgens contribute to male-typical behavior development, whereas female-typical behavior develops in the absence of high androgens levels. This study aims to explore the consequences of hypoandrogenization on gender-typical behavior in children who have an XY karyotype and disorder of sex development (DSD). Participants included 33 children (ages 2-12 years) with an XY karyotype and DSD; 21 reared as girls and 12 reared as boys. Children's preferred activities and interests and playmate preferences were assessed with parent report questionnaires, a structured free-play task, and choice of a toy to keep as a gift. Participant's responses were compared to those of children recruited in a pre-school and elementary school survey (N=166). In this study, the degree of hypoandrogenization as indicated by genital stage and diagnosis showed a significant relationship to nearly all of the gender-related behaviors assessed, supporting the hypothesis that masculinization of gender role behavior is a function of prenatal androgen exposure. Despite the fact that children with partial androgen effects reared as girls showed increased "boyish" behaviors, they did not show increased signs of gender identity confusion or instability on a group level. We conclude that androgen exposure plays a decisive role in the development of gender-typical behavior in children with XY karyotype and DSD conditions.

  3. Dissociation of sad facial expressions and autonomic nervous system responding in boys with disruptive behavior disorders

    Science.gov (United States)

    Marsh, Penny; Beauchaine, Theodore P.; Williams, Bailey

    2009-01-01

    Although deficiencies in emotional responding have been linked to externalizing behaviors in children, little is known about how discrete response systems (e.g., expressive, physiological) are coordinated during emotional challenge among these youth. We examined time-linked correspondence of sad facial expressions and autonomic reactivity during an empathy-eliciting task among boys with disruptive behavior disorders (n = 31) and controls (n = 23). For controls, sad facial expressions were associated with reduced sympathetic (lower skin conductance level, lengthened cardiac preejection period [PEP]) and increased parasympathetic (higher respiratory sinus arrhythmia [RSA]) activity. In contrast, no correspondence between facial expressions and autonomic reactivity was observed among boys with conduct problems. Furthermore, low correspondence between facial expressions and PEP predicted externalizing symptom severity, whereas low correspondence between facial expressions and RSA predicted internalizing symptom severity. PMID:17868261

  4. Vineland-II adaptive behavior profile of children with attention-deficit/hyperactivity disorder or specific learning disorders.

    Science.gov (United States)

    Balboni, Giulia; Incognito, Oriana; Belacchi, Carmen; Bonichini, Sabrina; Cubelli, Roberto

    2017-02-01

    The evaluation of adaptive behavior is informative in children with attention-deficit/hyperactivity disorder (ADHD) or specific learning disorders (SLD). However, the few investigations available have focused only on the gross level of domains of adaptive behavior. To investigate which item subsets of the Vineland-II can discriminate children with ADHD or SLD from peers with typical development. Student's t-tests, ROC analysis, logistic regression, and linear discriminant function analysis were used to compare 24 children with ADHD, 61 elementary students with SLD, and controls matched on age, sex, school level attended, and both parents' education level. Several item subsets that address not only ADHD core symptoms, but also understanding in social context and development of interpersonal relationships, allowed discrimination of children with ADHD from controls. The combination of four item subsets (Listening and attending, Expressing complex ideas, Social communication, and Following instructions) classified children with ADHD with both sensitivity and specificity of 87.5%. Only Reading skills, Writing skills, and Time and dates discriminated children with SLD from controls. Evaluation of Vineland-II scores at the level of item content categories is a useful procedure for an efficient clinical description. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Altered behavior and neural activity in conspecific cagemates co-housed with mouse models of brain disorders.

    Science.gov (United States)

    Yang, Hyunwoo; Jung, Seungmoon; Seo, Jinsoo; Khalid, Arshi; Yoo, Jung-Seok; Park, Jihyun; Kim, Soyun; Moon, Jangsup; Lee, Soon-Tae; Jung, Keun-Hwa; Chu, Kon; Lee, Sang Kun; Jeon, Daejong

    2016-09-01

    The psychosocial environment is one of the major contributors of social stress. Family members or caregivers who consistently communicate with individuals with brain disorders are considered at risk for physical and mental health deterioration, possibly leading to mental disorders. However, the underlying neural mechanisms of this phenomenon remain poorly understood. To address this, we developed a social stress paradigm in which a mouse model of epilepsy or depression was housed long-term (>4weeks) with normal conspecifics. We characterized the behavioral phenotypes and electrophysiologically investigated the neural activity of conspecific cagemate mice. The cagemates exhibited deficits in behavioral tasks assessing anxiety, locomotion, learning/memory, and depression-like behavior. Furthermore, they showed severe social impairment in social behavioral tasks involving social interaction or aggression. Strikingly, behavioral dysfunction remained in the cagemates 4weeks following co-housing cessation with the mouse models. In an electrophysiological study, the cagemates showed an increased number of spikes in medial prefrontal cortex (mPFC) neurons. Our results demonstrate that conspecifics co-housed with mouse models of brain disorders develop chronic behavioral dysfunctions, and suggest a possible association between abnormal mPFC neural activity and their behavioral pathogenesis. These findings contribute to the understanding of the psychosocial and psychiatric symptoms frequently present in families or caregivers of patients with brain disorders. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Adult antisocial syndrome with comorbid borderline pathology: association with severe childhood conduct disorder.

    Science.gov (United States)

    Howard, Rick; Huband, Nick; Duggan, Conor

    2012-05-01

    This study tested the hypothesis that adult antisocial syndrome co-concurrent with borderline personality disorder (AAS + BPD) would be associated with greater conduct disorder (CD) severity than AAS alone. Sixty-nine personality disordered individuals exhibited a sufficient number of adult antisocial traits to meet DSM-IV criterion A for antisocial personality disorder (AsPD). These were subdivided into those who did (AAS + BPD) or did not (AAS alone) meet DSM-IV criteria for a BPD diagnosis. We then compared the 2 groups on CD symptoms and historical, clinical, and self-report measures. The mean number of CD criteria met and the total number of individual CD symptoms were significantly greater in the AAS + BPD group compared with the AAS alone group. The former also were more likely to be female, to have self-harmed, to show greater personality disorder comorbidity, and to self-report greater anger. The functional link between CD and adult antisocial symptoms appears to be mediated, or at least moderated, by co-occurring borderline pathology.

  7. Oxidative status and the severity of clinical symptoms in patients with post-traumatic stress disorder.

    Science.gov (United States)

    Borovac Štefanović, Leda; Kalinić, Dubravka; Mimica, Ninoslav; Beer Ljubić, Blanka; Aladrović, Jasna; Mandelsamen Perica, Marina; Curić, Maja; Grošić, Petra Folnegović; Delaš, Ivančica

    2015-01-01

    The aim of this study was to measure the parameters of oxidative stress in the blood of patients with post-traumatic stress disorder. The study included 80 male war veterans who participated actively in the Homeland war in Croatia. Volunteers were divided into two groups: 50 veterans diagnosed with post-traumatic stress disorder and 30 without diagnosis. The self-assessment Hospital Anxiety and Depression Scale and the Beck Depression Inventory were used to detect the severity of depression and anxiety in the post-traumatic stress disorder patients. Catalytic concentrations of superoxide dismutase and glutathione peroxidase in erythrocytes and the concentration of malondialdehyde in serum were measured spectrophotometrically. Although the catalytic concentrations of erythrocyte superoxide dismutase and erythrocyte glutathione peroxidase were within the reference range for both groups, the values obtained for the post-traumatic stress disorder group were significantly lower (Ppost-traumatic stress disorder may indicate a weaker response to oxidative stress due to impaired enzyme activity and/or decreased synthesis. Conversely, no significant changes in serum malondialdehyde concentrations suggest a compensated balance and adaptive response to (oxidative) stress. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  8. Emotional Dysregulation in Adults With Attention-Deficit/Hyperactivity Disorder-Validity, Predictability, Severity, and Comorbidity.

    Science.gov (United States)

    Corbisiero, Salvatore; Mörstedt, Beatrice; Bitto, Hannes; Stieglitz, Rolf-Dieter

    2017-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is characterized by inattention, hyperactivity, and impulsivity. However, this triad might not be able to explain the complete spectrum of ADHD symptoms, as emotional dysregulation (ED) frequently seems to accompany the disorder. The aim of this study was to further understand the role of ED in adult ADHD. The sample comprised 393 adults with ADHD without or with comorbidity, and 121 adults without ADHD or any other mental disorder. Additionally, the sample focused on ED. The contribution of core symptoms and the effect of comorbidity on ED were tested and the predictive value of ED for the ADHD diagnosis itself analyzed. Finally, all subjects were categorized into groups-No ADHD, ADHD, and ADHD + ED-to analyze the differences in the severity of ADHD symptomatology in the three groups. ED levels were found to be elevated in patients with ADHD. The core symptoms affected ED, and the ADHD diagnosis was predicted by ED. The addition of ED to a regression model with the core symptoms was shown to improve the predictability of the ADHD diagnosis. The presence of ED proved to be an indicator of the severity of adult ADHD independent of a present comorbidity. ED is a significant symptom in adult patients with ADHD and appears to be associated with ADHD itself. Whilst the presence of other mental disorders intensifies symptoms of ED, ED seems not to manifest solely as a consequence of comorbidity. © 2016 Wiley Periodicals, Inc.

  9. Development of an integrated model of personality, personality disorders and severe axis I disorders, with special reference to major affective disorders.

    Science.gov (United States)

    von Zerssen, Detlev

    2002-04-01

    A unidimensional model of the relationships between normal temperament, psychopathic variants of it and the two main forms of so-called endogenous psychoses (major affective disorders and schizophrenia) was derived from Kretschmer's constitutional typology. It was, however, not confirmed by means of a biometric approach nor was Kretschmer's broad concept of cyclothymia as a correlate of physical stoutness on the one hand and major affective disorders on the other supported by empirical data. Yet the concept of the 'melancholic type' of personality of patients with severe unipolar major depression (melancholia) which resembles descriptions by psychoanalysts could be corroborated. This was also true for the 'manic type' of personality as a (premorbid) correlate of predominantly manic forms of a bipolar I disorder. As predicted from a spectrum concept of major affective disorders, the ratio of traits of either type co-varied with the ratio of the depressive and the manic components in the long-term course of such a disorder. The two types of premorbid personality and a rare variant of the 'manic type', named 'relaxed, easy-going type', were conceived as 'affective types' dominating in major affective disorders. They are opposed to three 'neurotoid types' prevailing in so-called neurotic disorders as well as in schizophrenic psychoses. The similarity among the types can be visualized as spatial relationships in a circular, i.e. a two-dimensional, model (circumplex). Personality disorders as maladapted extreme variants of personality are, by definition, located outside the circle, mainly along its 'neurotoid' side. However, due to their transitional nature, axis I disorders cannot be represented adequately within the plane which represents (adapted as well as maladapted) forms of habitual behaviour (personality types and disorders, respectively). To integrate them into the spatial model of similarity interrelations, a dimension of actual psychopathology has to be added

  10. Genetic and environmental components of female depression as a function of the severity of the disorder.

    Science.gov (United States)

    Rusby, James S M; Tasker, Fiona; Cherkas, Lynn

    2016-10-01

    Both clinical care and genome-wide studies need to account for levels of severity in the etiology of depression. The purpose of the study is to estimate the genetic and environmental components of female depression as a function of the severity of the disorder. A genetic and environmental model analysis of depression incidence was made using the IOP Depression Severity Measure (IDSM). Details of lifetime depression incidence were obtained by questionnaire from twins on the DTR registry. Data from 1449 matched female twin pairs in the age range 19-85 years in four ordinal categories of increasing severity were employed in the analysis. Estimates of additive and dominance genetic components of 27% and 25% were found when all three levels of depression were included, and near zero and 33% when the recurrent/severe level was excluded. Shared environmental effects were not significant in either case, but the estimate for random environmental effects was greater when the severe level was excluded. These results suggest that the incidence of severe depression is associated with homozygotic alleles and the less severe with heterozygotic alleles. This is in accord with the finding that the hereditary component of severe depression is relatively high and that milder forms are more dependent on life-time environmental factors. Such conclusions have clinical implications for the diagnosis and treatment of the disorder by practicing psychiatrists. They also lead to the importance of focusing future genome-wide and linkage studies on those females with severe levels of depression if progress in identifying genetic risk loci is to be made.

  11. Psychosis, Mood and Behavioral Disorders in Usher Syndrome: Review of the Literature.

    Science.gov (United States)

    Domanico, Daniela; Fragiotta, Serena; Cutini, Alessandro; Grenga, Pier Luigi; Vingolo, Enzo Maria

    2015-01-01

    The aim of this review is to focus the current knowledge about mental and behavioral disorders in Usher syndrome. Previous studies described the presence of various mental disorders associated with Usher syndrome, suggesting possible mechanisms of association between these disorders. The most common manifestations are schizophrenia-like disorder and psychotic symptoms. Mood and behavioral disorders are rarely described, and often are associated with more complex cases in co-occurrence with other psychiatric disorders. Neuroimaging studies reported diffuse involvement of central nervous system (CNS) in Usher patients, suggesting a possible role of CNS damage in the pathogenesis of psychiatric manifestations. Genetic hypothesis and stress-related theories have also been proposed.

  12. Predictive Validity of the Columbia-Suicide Severity Rating Scale for Short-Term Suicidal Behavior

    DEFF Research Database (Denmark)

    Conway, Paul Maurice; Erlangsen, Annette; Teasdale, Thomas William

    2017-01-01

    adolescents (90.6% females) who participated at follow-up (85.9%) out of the 99 (49.7%) baseline respondents. All adolescents were recruited from a specialized suicide-prevention clinic in Denmark. Through multivariate logistic regression analyses, we examined whether baseline suicidal behavior predicted......Using the Columbia-Suicide Severity Rating Scale (C-SSRS), we examined the predictive and incremental predictive validity of past-month suicidal behavior and ideation for short-term suicidal behavior among adolescents at high risk of suicide. The study was conducted in 2014 on a sample of 85...... subsequent suicidal behavior (actual attempts and suicidal behavior of any type, including preparatory acts, aborted, interrupted and actual attempts; mean follow-up of 80.8 days, SD = 52.4). Furthermore, we examined whether suicidal ideation severity and intensity incrementally predicted suicidal behavior...

  13. Current perspectives on Internet delivered cognitive behavioral therapy for adults with anxiety and related disorders

    Directory of Open Access Journals (Sweden)

    Mewton L

    2014-01-01

    Full Text Available Louise Mewton, Jessica Smith, Pieter Rossouw, Gavin Andrews Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, Sydney, NSW, Australia Abstract: The aim of the current review is to provide a summary of research into Internet-delivered cognitive behavioral therapy (iCBT for anxiety disorders. We include 37 randomized controlled trials that examined the efficacy of iCBT programs in adults (aged over 18 years, as compared with waiting list or active control. The included studies were identified from Medline searches and from reference lists, and only published data were included. Several trials of iCBT for generalized anxiety disorder, panic disorder, and social phobia were identified. Two trials of iCBT for obsessive-compulsive disorder were identified, whilst one trial each was identified for hypochondriasis, specific phobia (spiders, and post-traumatic stress disorder. Finally, there were five trials that focused on transdiagnostic therapy for either a range of comorbid anxiety disorders or comorbid anxiety and depression. Between-group effect sizes were moderate to large for all disorders, and ranged from 0.30 to 2.53. iCBT was found to be commensurate with face-to-face cognitive behavioral therapy whether delivered individually or in group format. Guidance may not be necessary for iCBT to be effective for immediate gains, but may be more important in longer-term maintenance of symptom improvement and maximizing patient adherence. The clinical experience of the individual providing guidance does not appear to impact treatment outcomes. Future research needs to focus on the optimal level of guidance required to generate maximum patient benefits, whilst balancing the efficient use of clinician time and resources. Evidence-based contraindications to iCBT should also be developed so that the choice of treatment modality accurately reflects patients’ needs. Further research should be conducted into the effective elements of

  14. Mediation analysis of severity of needs, service performance and outcomes for patients with mental disorders.

    Science.gov (United States)

    Roux, Paul; Passerieux, Christine; Fleury, Marie-Josée

    2016-12-01

    Needs and service performance assessment are key components in improving recovery among individuals with mental disorders. To test the role of service performance as a mediating factor between severity of patients' needs and outcomes. A total of 339 adults with mental disorders were interviewed. A mediation analysis between severity of needs, service performance (adequacy of help, continuity of care and recovery orientation of services) and outcomes (personal recovery and quality of life) was carried out using structural equation modelling. The structural equation model provided a good fit with the data. An increase in needs was associated with lower service performance and worse outcomes, whereas higher service performance was associated with better outcomes. Service performance partially mediated the effect of patient needs on outcomes. Poorer service performance has a negative impact on outcomes for patients with the highest needs. Ensuring more efficient services for patients with high needs may help improve their recovery and quality of life. © The Royal College of Psychiatrists 2016.

  15. [Tacit metarepresentation and affective sense of personal identity. An approach to understanding severe psychiatric disorders of adolescence and young adulthood].

    Science.gov (United States)

    Balbi, Juan

    2011-01-01

    The results of present-day research in the field of "Dissociation Paradigm", regarding the capacity of the human mind to perceive, learn, and store information that in appearance passes as unnoticed, support the constructivist hypothesis of the active, selective and constructive condition of consciousness, in addition to the existence of a tacit dimension of knowledge that operates in functional relationship with the former. Unconscious mental states are intrinsically intentional. This is to say that they imply a semantic or cognitive connotation that is capable of affecting phenomenical experience and therefore behavior. In addition, the precocious existence of a tacit metarepresentational system in normally developed children has been proven, which is essential for guaranteeing the deployment of the process of functional coevolution between affectivity and consciousness, by which the experience of personal identity is acquired. These discoveries allow the inference of a "tacit affective metarepresentational recurrence", the organizational foundation on which a unified, sustainable, and continuous sense of the experience of personal identity is structured, and also allow us to hypothesize a "tacit metarepresentational mourning", a specific type of grief which is the chief foundation of the majority of psychopathological disorders. This concept may represent a potential explanation of the severe mental disorders of adolescence and young adulthood. The hypothesis of the present work is that, in the ambiguous context of Postmodern Culture, the prolongation of the adolescent period, facilitated by the welfare state, hinders the dealing with the aforementioned mourning, leading to an increment of depressive states and suicidal behavior among young people.

  16. Compulsive Buying Behavior: Characteristics of Comorbidity with Gambling Disorder.

    Science.gov (United States)

    Granero, Roser; Fernández-Aranda, Fernando; Steward, Trevor; Mestre-Bach, Gemma; Baño, Marta; Del Pino-Gutiérrez, Amparo; Moragas, Laura; Aymamí, Neus; Gómez-Peña, Mónica; Mallorquí-Bagué, Núria; Tárrega, Salomé; Menchón, José M; Jiménez-Murcia, Susana

    2016-01-01

    Compulsive buying behavior (CBB) has begun to be recognized as a condition worthy of attention by clinicians and researchers. Studies on the commonalities between CBB and other behavioral addictions such as gambling disorder (GD) exist in the literature, but additional research is needed to assess the frequency and clinical relevance of the comorbidity of CBB and GD. The aim of the study was to estimate the point-prevalence of CBB+GD in a clinical setting. Data corresponded to n = 3221 treatment-seeking patients who met criteria for CBB or GD at a public hospital unit specialized in treating behavioral addictions. Three groups were compared: only-CBB (n = 127), only-GD (n = 3118) and comorbid CBB+GD (n = 24). Prevalence for the co-occurrence of CBB+GD was 0.75%. In the stratum of patients with GD, GD+CBB comorbidity obtained relatively low point prevalence (0.77%), while in the subsample of CBB patients the estimated prevalence of comorbid GD was relatively high (18.9%). CBB+GD comorbidity was characterized by lower prevalence of single patients, higher risk of other behavioral addictions (sex, gaming or internet), older age and age of onset. CBB+GD registered a higher proportion of women compared to only-GD (37.5 vs. 10.0%) but a higher proportion of men compared to only-CBB (62.5 vs. 24.4%). Compared to only-GD patients, the simultaneous presence of CBB+GD was associated with increased psychopathology and dysfunctional levels of harm avoidance. This study provides empirical evidence to better understand CBB, GD and their co-occurrence. Future research should help delineate the processes through which people acquire and develop this comorbidity.

  17. Compulsive Buying Behavior: Characteristics of Comorbidity with Gambling Disorder

    Directory of Open Access Journals (Sweden)

    Roser eGranero

    2016-04-01

    Full Text Available Compulsive buying behavior (CBB has begun to be recognized as a condition worthy of attention by clinicians and researchers. Studies on the commonalities between CBB and other behavioral addictions such as gambling disorder (GD exist in the literature, but additional research is needed to assess the frequency and clinical relevance of the comorbidity of CBB and GD. The aim of the study was to estimate the point-prevalence of CBB+GD in a clinical setting. Data corresponded to n=3,221 treatment-seeking patients who met criteria for CBB or GD at a public hospital unit specialized in treating behavioral addictions. Three groups were compared: only-CBB (n=127, only-GD (n=3,118 and comorbid CBB+GD (n=24. Prevalence for the co-occurrence of CBB+GD was 0.75%. In the stratum of patients with GD, GD+CBB comorbidity obtained relatively low point prevalence (0.77%, while in the subsample of CBB patients the estimated prevalence of comorbid GD was relatively high (18.9%. CBB+GD comorbidity was characterized by lower prevalence of single patients, higher risk of other behavioral addictions (sex, gaming or internet, older age and age of onset. CBB+GD registered a higher proportion of women compared to only-GD (37.5% vs. 10.0% but a higher proportion of men compared to only-CBB (62.5% vs. 24.4%. Compared to only-GD patients, the simultaneous presence of CBB+GD was associated with increased psychopathology and dysfunctional levels of harm avoidance. This study provides empirical evidence to better understand CBB, GD and their co-occurrence. Future research should help delineate the processes through which people acquire and develop this comorbidity.

  18. Prevalence and severity of obsessive-compulsive disorder and their relationships with dermatological diseases.

    OpenAIRE

    Fatemeh Sheikhmoonesi; Zohreh Hajheidari; Abbas Masoudzadeh; Reza Ali Mohammadpour; Mahbubeh Mozaffari

    2014-01-01

    Most obsessive-compulsive disorder (OCD) patients meet psychiatrists 5 to 10 years after onset of OCD .Its relatively high prevalence ratio and the delay in seeking help suggest that patients with OCD may seek help at non-psychiatric clinics. The present study was undertaken to provide some epidemiological data on the prevalence and severity of OCD in dermatological patients. The participants included 265 consecutive patients with primary dermatologic chief complaint. They were visited by a d...

  19. Rivastigmine for refractory REM behavior disorder in mild cognitive impairment.

    Science.gov (United States)

    Brunetti, Valerio; Losurdo, Anna; Testani, Elisa; Lapenta, Leonardo; Mariotti, Paolo; Marra, Camillo; Rossini, Paolo Maria; Della Marca, Giacomo

    2014-03-01

    Mild Cognitive Impairment (MCI) and REM Behavior Disorder (RBD) are both associated with a degeneration of ponto-medullary cholinergic pathways. We conducted a placebo-controlled, cross-over pilot trial of Rivastigmine (RVT) in 25 consecutive patients with MCI, who presented RBD refractory to conventional first-line treatments (melatonin up to 5 mg/day and clonazepam up to 2 mg/day). RVT treatment was followed by a significant reduction of RBD episodes when compared with placebo. Our data suggest that, in MCI patients with RBD resistant to conventional therapies (muscle relaxants benzodiazepines or melatonin,) treatment with RVT may induce a reduction in the frequency of RBD episodes compared to placebo.

  20. Basal exposure therapy: A new approach for treatment resistant patients with severe and comorbid mental disorders

    Directory of Open Access Journals (Sweden)

    Didrik Heggdal

    2016-12-01

    Full Text Available New treatment approaches are needed for patients with severe and composite mental disorders who appear resistant to conventional treatments. Such treatment resistant patients often have diagnoses of psychotic or bipolar disorders or severe personality disorders and comorbid conditions. Here we evaluate Basal Exposure Therapy (BET, a novel ward-integrated psychotherapeutic approach for these patients. Central to BET is the conceptualization of undifferentiated existential fear as basic to the patients’ problem, exposure to this fear, and the therapeutic platform Complementary External Regulation (CER which integrates and governs the totality of interventions throughout the treatment process. BET is administered at a locked-door ward with six patient beds and 13.5 full time employees, including a psychiatrist and two psychologists. Thirty-eight patients who had completed BET were included, all but two being female, mean age 29.9 years. Fourteen patients had a diagnosis of schizophrenia or schizoaffective disorder (F20/25, eight had bipolar disorder or recurrent depressive disorder (F31/33, eight had diagnoses in the F40-49 domain (anxiety, stress, dissociation, five were diagnosed with emotionally unstable personality disorder (F60.3, and three patients had other diagnoses. Twenty of the patients (53% had more than one ICD-10 diagnosis. Average treatment time in BET was 13 months, ranging from 2 to 72 months. Time-series data show significant improvements in symptoms and functioning from enrolment to discharge, with effect sizes at 0.76 for the Dissociation Experience Scale, 0.93 for the Brief Symptom Inventory, 1.47 for the Avoidance and Action Questionnaire, and 1.42 and 1.56, respectively for the functioning and symptom subscales of the Global Assessment of Functioning Scale. In addition, the patients used significantly less antiepileptic, antipsychotic, anxiolytic and antidepressant medications at discharge than at treatment enrolment

  1. Behavioral Approach to Assessment of Youth with Emotional/Behavioral Disorders: A Handbook for School-Based Practitioners. Second Edition.

    Science.gov (United States)

    Breen, Michael J., Ed.; Fiedler, Craig R., Ed.

    The 15 chapters in this book address behavioral approaches to the assessment of youth with emotional and/or behavioral disorders. Chapters have the following titles and authors: (1) "Behavioral Assessment: An Overview" (Catherine Stanger); (2) "Legal and Ethical Issues in the Educational Assessment and Programming for Youth with…

  2. Behavioral activation and inhibition system's role in predicting addictive behaviors of patients with bipolar disorder of Roozbeh Psychiatric Hospital

    Directory of Open Access Journals (Sweden)

    Moslem Abbasi

    2016-01-01

    Conclusions: It can be said that the patients with bipolar disorder use substance and addictive behaviors for enjoyment and as pleasure stimulants; they also use substances to suppress unpleasant stimulants and negative emotions. These results indicate that behavioral activation and inhibition systems have an important role in the incidence and exacerbation of addictive behaviors. Therefore, preventive interventions in this direction seem to be necessary.

  3. Comparing Effective Treatments for Attention-Maintained and Escape- Maintained Behaviors in Children with Behavior Disorders: Brief Review and Analysis

    OpenAIRE

    Lauren Worcester; T. F. McLaughlin

    2013-01-01

    This literature review compares treatment for attention-maintainedversus escape maintained aberrant behavior in children with behavior disorders. Specifically, studies utilizing time out procedures, differential reinforcement procedures, noncontingent reinforcement, and functional communication training are discussed. It was found that these are effective treatments for attention-maintained behaviors; while escape extinction, positive and negative reinforcement, functional communication trai...

  4. Differences in aerobic fitness between inpatients and outpatients with severe mental disorders

    Directory of Open Access Journals (Sweden)

    Helene Daae-Qvale Holmemo

    2014-08-01

    Full Text Available AbstractBackgroundPatients with severe mental disorders have increased mortality, and cardiovascular disease (CVD accounts for a large part. Physical inactivity and low aerobic fitness have been recognized as significant risk factors for CVD. In this study, we investigated the differences in aerobic fitness and physical activity between in- and outpatients with severe mental disorders. Method and subjectsFifty in- and outpatients from a regional psychiatric department were included. The patients filled in a questionnaire on physical activity and completed a clinical examination. An estimation of aerobic fitness was calculated for each patient, using gender, age, waist circumference, resting heart rate and physical activity level as variables.ResultsInpatients had lower estimated aerobic fitness than outpatients (VO₂peak 42 vs 50 mL•kg-1•min-1, p<0.001. Compared to population data matched for age and gender, inpatients had lower aerobic fitness, while outpatients were not different from the population average.ConclusionInpatients at a psychiatric department had lower estimated aerobic fitness than outpatients, and a lower aerobic fitness compared to the general population. Our findings suggest that inpatients with severe mental disorders should be considered a high risk group for CVD.

  5. Effectiveness of low intensity behavioral treatment for children with autism spectrum disorder and intellectual disability

    NARCIS (Netherlands)

    Peters-Scheffer, N.C.; Didden, H.C.M.; Mulders, M.; Korzilius, H.P.L.M.

    2013-01-01

    To determine the effectiveness of low intensity behavioral treatment (LIBT) supplementing regular treatment in young children with autism spectrum disorder (ASD) and intellectual disability (ID) standardized tests of cognition, adaptive behavior, interpersonal relations, play, language,

  6. What are the disruptive symptoms of behavioral disorders after traumatic brain injury? A systematic review leading to recommendations for good practices.

    Science.gov (United States)

    Stéfan, Angélique; Mathé, Jean-François

    2016-02-01

    Behavioral disorders are major sequelae of severe traumatic brain injury. Before considering care management of these disorders, and in the absence of a precise definition for TBI-related behavioral disorder, it is essential to refine, according to the data from the literature, incidence, prevalence, predictive factors of commonly admitted disruptive symptoms. Systematic review of the literature targeting epidemiological data related to behavioral disorders after traumatic brain injury in order to elaborate good practice recommendations according to the methodology established by the French High Authority for Health. Two hundred and ninety-nine articles were identified. The responsibility of traumatic brain injury (TBI) in the onset of behavioral disorders is unequivocal. Globally, behavioral disorders are twice more frequent after TBI than orthopedic trauma without TBI (Masson et al., 1996). These disorders are classified into disruptive primary behaviors by excess (agitation 11-70%, aggression 25-39%, irritability 29-71%, alcohol abuse 7-26% drug abuse 2-20%), disruptive primary behaviors by default (apathy 20-71%), affective disorders - anxiety - psychosis (depression 12-76%, anxiety 0.8-24,5%, posttraumatic stress 11-18%, obsessive-compulsive disorders 1.2-30%, psychosis 0.7%), suicide attempts and suicide 1%. The improvement of care management for behavioral disorders goes through a first step of defining a common terminology. Four categories of posttraumatic behavioral clinical symptoms are defined: disruptive primary behaviors by excess, by default, affective disorders-psychosis-anxiety, suicide attempts and suicide. All these symptoms yield a higher prevalence than in the general population. They impact all of life's domains and are sustainable over time. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  7. Adult picky eaters with symptoms of avoidant/restrictive food intake disorder: comparable distress and comorbidity but different eating behaviors compared to those with disordered eating symptoms.

    Science.gov (United States)

    Zickgraf, Hana F; Franklin, Martin E; Rozin, Paul

    2016-01-01

    , and were more likely to eat from a narrow range of foods, compared to picky eaters without ARFID. Adult picky eaters can be differentiated from those with symptoms of anorexia and bulimia by their stronger endorsement of food neophobia and inflexible eating behaviors, and by eating from a very narrow range of foods. Picky eaters with ARFID symptoms can be differentiated from picky eaters without these symptoms on the basis of these three eating behaviors, and by their higher endorsement of internalizing distress, OCD symptoms, and eating-related quality of life impairment. This study provides evidence that ARFID symptoms exist independently of symptoms of other eating disorders and are characterized by several distinct eating behaviors. In a clinical analogue sample of disordered eaters, ARFID symptoms were associated with distress and impairment at levels comparable to symptoms of anorexia and bulimia.

  8. Preliminary Evidence for Cognitive Mediation During Cognitive–Behavioral Therapy of Panic Disorder

    Science.gov (United States)

    Hofmann, Stefan G.; Suvak, Michael K.; Barlow, David H.; Shear, M. Katherine; Meuret, Alicia E.; Rosenfield, David; Gorman, Jack M.; Woods, Scott W.

    2007-01-01

    Cognitive–behavioral therapy (CBT) and pharmacotherapy are similarly effective for treating panic disorder with mild or no agoraphobia, but little is known about the mechanism through which these treatments work. The present study examined some of the criteria for cognitive mediation of treatment change in CBT alone, imipramine alone, CBT plus imipramine, and CBT plus placebo. Ninety-one individuals who received 1 of these interventions were assessed before and after acute treatment, and after a 6-month maintenance period. Multilevel moderated mediation analyses provided preliminary support for the notion that changes in panic-related cognitions mediate changes in panic severity only in treatments that include CBT. PMID:17563154

  9. A systematic review of the relationship between severe maternal morbidity and post-traumatic stress disorder.

    Science.gov (United States)

    Furuta, Marie; Sandall, Jane; Bick, Debra

    2012-11-10

    The incidence of severe maternal morbidity is increasing in high-income countries as a consequence, in part, of increased obstetric intervention and increasingly complex medical needs of women who become pregnant. Access to emergency obstetric care means that for the majority of women in these countries, an experience of severe maternal morbidity is unlikely to result in loss of life. However, little is known about the subsequent impact on postnatal psychological health resulting in an evidence gap to support provision of appropriate care for these women. There has recently been increasing recognition that childbirth can be a cause of post-traumatic stress disorder (PTSD). The combination of experiencing a life-threatening complication and its management may culminate in psychological trauma. This systematic review examined the association between women's experience of severe maternal morbidity during labour, at the time of giving birth or within the first week following birth, and PTSD and its symptoms. Relevant literature was identified through multiple databases, including MEDLINE, PsycINFO, EMBASE, CINAHL, British Nursing Index, Web of Science, Cochrane library and the British Library, using predetermined search strategies. The search terms included "post-traumatic stress disorder", "PTSD", "stress disorders, post-traumatic", "maternal morbidity", "pregnancy complications" "puerperal disorders", "obstetric labo(u)r complication", "postpartum h(a)emorrhage", "eclampsia". Studies identified were categorised according to pre-defined inclusion and exclusion criteria. The quality of included studies was assessed using the relevant CASP appraisal tools. Eleven primary studies met review criteria. Evidence of a relationship between severe maternal morbidity and PTSD/PTSD symptoms was inconsistent and findings varied between studies. Nevertheless, there is some evidence that severe pre-eclampsia is a risk factor for PTSD and its symptoms, an association possibly

  10. The relationship between dysfunctional family patterns and symptom severity among adolescent patients with eating disorders: A gender-specific approach.

    Science.gov (United States)

    Anastasiadou, Dimitra; Sepulveda, Ana R; Parks, Melissa; Cuellar-Flores, Isabel; Graell, Montserrat

    2016-01-01

    The objective of the authors in this study was to identify factors related to dysfunctional family functioning that may be associated with the severity of symptoms among adolescent patients with an eating disorder (ED) at first-contact care. A total of forty-eight mothers and forty-five fathers of fifty patients with EDs were recruited from an ED unit in Madrid, Spain, between October 2011 and July 2012. Parents completed self-report assessments related to family functioning and psychological wellbeing. Patients went through clinical interviews and completed a self-report questionnaire assessing symptom severity. Compared to fathers, mothers showed higher levels of anxiety and emotional over-involvement and perceived to a greater degree the positive and negative aspects of their experience as caregivers. Regarding the relationship between family functioning and symptom severity, mothers' perceptions of their family relationships as enmeshed and less adaptive, along with anxiety, accounted for 39% of variance in the severity of ED symptoms. Anxiety and symptom accommodation by the fathers accounted for 27% of variance in the symptom severity. Interventions that help parents to cope with their caregiving role should target behavioral, cognitive, and emotional aspects of their functioning and be gender-specific, to improve the outcome of ED in patients.

  11. The effect of comorbid major depressive disorder or bipolar disorder on cognitive behavioral therapy for social anxiety disorder.

    Science.gov (United States)

    Fracalanza, Katie; McCabe, Randi E; Taylor, Valerie H; Antony, Martin M

    2014-06-01

    Major depressive disorder (MDD) and bipolar disorder (BD) commonly co-occur in individuals with social anxiety disorder (SAD), yet whether these comorbidities influence the outcomes of cognitive behavioral therapy (CBT) for SAD is unclear. The present study examined the degree to which individuals with SAD and comorbid MDD (SAD+MDD; n=76), comorbid BD (SAD+BD; n=19), a comorbid anxiety disorder (SAD+ANX; n=27), or no comorbid diagnoses (SAD+NCO; n=41) benefitted from CBT for SAD. Individuals were screened using the Structured Clinical Interview for DSM-IV and then completed the Social Phobia Inventory and the Depression Anxiety Stress Scales before and after 12-weeks of group CBT for SAD. At pretreatment the SAD+MDD and SAD+BD groups reported higher social anxiety symptoms than the SAD+ANX and SAD+NCO groups. All groups reported large and significant improvement in social anxiety with CBT. However, at posttreatment the SAD+MDD and SAD+BD groups continued to have higher social anxiety symptoms than the SAD+NCO group, and the SAD+ANX group did not differ in social anxiety symptoms from any group. The sample also showed small and statistically significant improvement in depressive symptoms with CBT for SAD. Information about medication was not collected in the present study, and we did not assess the long-term effects of CBT. Our results suggest that CBT for SAD is an effective treatment even in the presence of comorbid mood disorders in the short-term, although extending the course of treatment may be helpful for this population and should be investigated in future research. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. LAMB1 polymorphism is associated with autism symptom severity in Korean autism spectrum disorder patients.

    Science.gov (United States)

    Kim, Young Jong; Park, Jin Kyung; Kang, Won Sub; Kim, Su Kang; Park, Hae Jeong; Nam, Min; Kim, Jong Woo

    2015-01-01

    LAMB1 encodes laminin beta-1, which is expressed during early development of the human nervous system, and could be involved in the pathogenesis of neurodevelopmental disorders. In our study, we aimed to investigate whether single nucleotide polymorphisms (SNPs) in LAMB1 were associated with autism spectrum disorder (ASD) and with related clinical severities of ASD. Two coding SNPs (rs20556 and rs25659) and two intronic SNPs (rs2158836 and rs2237659) were compared between 180 patients with ASD and 147 healthy control subjects using direct sequencing. The Korean version of the Childhood Autism Rating Scale (K-CARS) was used to assess clinical severities. Multiple logistic regression models were employed to analyze genetic data, and associations with symptom severity were tested with the Kruskal-Wallis and the Mann-Whitney U tests. None of the four examined SNPs was associated with ASD risk. However, the GG genotype of rs2158836 was associated with more severe symptoms for the "object use" and "non-verbal communication" measures. The results of our study suggest the association between rs2158836 polymorphisms and symptom severity in ASD.

  13. Self-esteem in adults with Tourette syndrome and chronic tic disorders: The roles of tic severity, treatment, and comorbidity.

    Science.gov (United States)

    Weingarden, Hilary; Scahill, Lawrence; Hoeppner, Susanne; Peterson, Alan L; Woods, Douglas W; Walkup, John T; Piacentini, John; Wilhelm, Sabine

    2018-07-01

    Tourette syndrome (TS) and chronic tic disorders (CTD) are stigmatizing disorders that may significantly impact self-esteem. Alternatively, comorbid psychiatric illnesses may affect self-esteem more than tics themselves. Extant research on self-esteem in TS/CTD is limited, has inconsistently examined the effect of comorbidities on self-esteem, and yields mixed findings. This study aimed to clarify the roles of tics versus comorbid diagnoses on self-esteem in a large, carefully diagnosed sample of adults with TS/CTD (N = 122) receiving 10 weeks of Comprehensive Behavioral Intervention for Tics (CBIT) or Psychoeducation and Supportive Therapy (PST). Baseline self-esteem did not differ between adults with TS/CTD only and normative means, whereas self-esteem was significantly lower among adults with TS/CTD with a comorbid psychiatric illness. In a multiple regression testing the baseline association between tic severity, presence of comorbid psychiatric illness, and depression severity with self-esteem, comorbidity and depression severity were significantly associated with self-esteem, whereas tic severity was not. Finally, using a generalized linear model, we tested the effects of treatment assignment, comorbidity, and their interaction on changes in self-esteem across treatment, controlling for baseline depression severity. Results showed that for those with a comorbid illness, self-esteem improved significantly more with CBIT than with PST. Comorbid illnesses appear to affect self-esteem more so than tics among adults with TS/CTD. Therapeutic attention should be paid to treating comorbid diagnoses alongside tics when treating TS/CTD. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Plasma galanin is a biomarker for severity of major depressive disorder.

    Science.gov (United States)

    Wang, Yong-Jun; Yang, Yu-Tao; Li, Hui; Liu, Po-Zi; Wang, Chuan-Yue; Xu, Zhi-Qing David

    2014-01-01

    This study investigated the association between plasma galanin level and depression severity. The severity of depression symptoms of 79 patients with major depressive disorder (MDD; 52 women and 27 men, 71 patients in onset, 8 in remission) was assessed using the 17-item Hamilton Depression Rating Scale. Venous fasting blood samples (5 mL) were taken from the 79 MDD patients, 35 healthy siblings, and 19 healthy controls, and plasma samples were prepared. Galanin levels in the plasma were measured by radioimmunoassay. Plasma galanin in MDD patients was significantly higher than that of remission patients, healthy siblings, or healthy controls (P 0.05). There was a significant positive correlation between plasma galanin levels and depression severity in women MDD patients (r = 0.329, df = 42, P = 0.020), but not in men patients. Plasma galanin levels may be an important biomarker for depression severity, especially in female patients.

  15. Degeneration of rapid eye movement sleep circuitry underlies rapid eye movement sleep behavior disorder.

    Science.gov (United States)

    McKenna, Dillon; Peever, John

    2017-05-01

    During healthy rapid eye movement sleep, skeletal muscles are actively forced into a state of motor paralysis. However, in rapid eye movement sleep behavior disorder-a relatively common neurological disorder-this natural process is lost. A lack of motor paralysis (atonia) in rapid eye movement sleep behavior disorder allows individuals to actively move, which at times can be excessive and violent. At first glance this may sound harmless, but it is not because rapid eye movement sleep behavior disorder patients frequently injure themselves or the person they sleep with. It is hypothesized that the degeneration or dysfunction of the brain stem circuits that control rapid eye movement sleep paralysis is an underlying cause of rapid eye movement sleep behavior disorder. The link between brain stem degeneration and rapid eye movement sleep behavior disorder stems from the fact that rapid eye movement sleep behavior disorder precedes, in the majority (∼80%) of cases, the development of synucleinopathies such as Parkinson's disease, dementia with Lewy bodies, and multiple system atrophy, which are known to initially cause degeneration in the caudal brain stem structures where rapid eye movement sleep circuits are located. Furthermore, basic science and clinical evidence demonstrate that lesions within the rapid eye movement sleep circuits can induce rapid eye movement sleep-specific motor deficits that are virtually identical to those observed in rapid eye movement sleep behavior disorder. This review examines the evidence that rapid eye movement sleep behavior disorder is caused by synucleinopathic neurodegeneration of the core brain stem circuits that control healthy rapid eye movement sleep and concludes that rapid eye movement sleep behavior disorder is not a separate clinical entity from synucleinopathies but, rather, it is the earliest symptom of these disorders. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and

  16. Maintenance Electroconvulsive Therapy in Severe Bipolar Disorder: A Retrospective Chart Review.

    Science.gov (United States)

    Santos Pina, Laura; Bouckaert, Filip; Obbels, Jasmien; Wampers, Martien; Simons, Wim; Wyckaert, Sabien; Sienaert, Pascal

    2016-03-01

    The aim of this study was to evaluate the effectiveness of continuation and maintenance electroconvulsive therapy (C/M-ECT) in patients with bipolar or schizoaffective disorder. We reviewed the charts of all patients diagnosed with a bipolar or schizoaffective disorder treated with C/M-ECT from August 2009 until December 2013. We gathered demographic data and treatment variables (electrode placement, stimulus dose, and concomitant use of medication; number of C/M-ECT sessions; and number of new ECT courses). Primary outcome measure was the number of hospitalization days during C/M-ECT as compared with an equal period before starting the index course. Twenty women (64.5%) and 11 men (35.5%) with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition bipolar disorder (n = 22, 71%) or schizoaffective disorder (n = 9, 29%) received C/M-ECT. The mean (SD) age was 51.23 (14.86; range, 28-74) years. Before the start of the index ECT, patients had a mean of 290 hospitalization days (248.4 days, full hospitalization; 41.6 days, partial hospitalization), whereas during C/M-ECT, they had a mean of 214.7 hospitalization days (85.4 days, full hospitalization; 129.3 days, partial hospitalization). The number of readmissions before ECT was 2.13, whereas during C/M-ECT, it decreased to 1.48. Only the decrease in number of full hospitalization days was significant. Most patients (n = 23, 74.19%) needed an acute course of ECT during M-ECT. Maintenance ECT seems to significantly reduce the number of full hospitalization days in patients with severe bipolar or schizoaffective disorder.

  17. Mindfulness Moderates the Relationship Between Disordered Eating Cognitions and Disordered Eating Behaviors in a Non-Clinical College Sample

    OpenAIRE

    Masuda, Akihiko; Price, Matthew; Latzman, Robert D.

    2012-01-01

    Psychological flexibility and mindfulness are two related, but distinct, regulation processes that have been shown to be at the core of psychological wellbeing. The current study investigated whether these two processes independently moderated the association between disordered eating cognitions and psychological distress as well as the relation between disordered eating cognitions and disordered eating behaviors. Non-clinical, ethnically diverse college undergraduates completed a web-based s...

  18. Bone mineral density in male adolescents with autism spectrum disorders and disruptive behavior disorder with or without antipsychotic treatment

    NARCIS (Netherlands)

    Roke, Yvette; van Harten, Peter N.; Buitelaar, Jan K.; Tenback, Diederik E.; Quekel, Lorentz G. B. A.; de Rijke, Yolanda B.; Boot, Annemieke M.

    2012-01-01

    Objective: To investigate the long-term effects of antipsychotic (AP) treatment and AP-induced hyperprolactinemia on bone mineral density (BMD) and body composition in male adolescents with autism spectrum disorders (ASDs) and/or disruptive behavior disorder (DBD). Design: Physically healthy 10- to

  19. Combined pharmacotherapy-multimodal psychotherapy in children with Disruptive Behavior Disorders.

    Science.gov (United States)

    Masi, Gabriele; Milone, Annarita; Manfredi, Azzurra; Brovedani, Paola; Pisano, Simone; Muratori, Pietro

    2016-04-30

    Although multi-component psychotherapeutic interventions are first-line treatments for Disruptive Behavior Disorders (DBD), pharmacotherapy is often associated for more severe patients. Our aim was to explore effectiveness of an associated pharmacotherapy in referred children with DBD receiving a one-year psychotherapeutic intervention. Aggression, callous unemotional (CU) traits and emotional dysregulation were outcome measures. The sample included 144 children, aged 8-12 years, 41 (29%) with an ADHD comorbidity. Fifty-five (38%) patients received an additional pharmacotherapy with one medication, methylphenidate, a second generation antipsychotic, or a mood stabilizer. Data were collected before and after the one-year treatment. According to the Child Behavior Checklist (CBCL), aggressive behaviors, rule-breaking behaviors and emotional dysregulation improved in the whole group, as well as parent- and child-reported CU traits. The hierarchical regression model showed that additional pharmacotherapy significantly predicted lower scores at the CBCL aggressive behaviors and emotional dysregulation, but not CU traits at the end of the treatment. The interaction between methylphenidate and ADHD comorbidity predicted lower aggressive behaviors after the treatment. In summary, this naturalistic investigation suggest that an additional pharmacotherapy significantly improved aggression and emotional dysregulation, but not CU traits. When ADHD was comorbid, methylphenidate was more effective than antipsychotics or mood stabilizers in reducing aggression. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Maternal drinking behavior and Fetal Alcohol Spectrum Disorders in adolescents with criminal behavior in southern Brazil

    Directory of Open Access Journals (Sweden)

    Wakana Momino

    2012-01-01

    Full Text Available Prenatal alcohol exposure can have serious and permanent adverse effects. The developing brain is the most vulnerable organ to the insults of prenatal alcohol exposure. A behavioral phenotype of prenatal alcohol exposure including conduct disorders is also described. This study on a sample of Brazilian adolescents convicted for criminal behavior aimed to evaluate possible clinical features of Fetal Alcohol Syndrome (FAS. These were compared to a control group of school adolescents, as well as tested for other environmental risk factors for antisocial behavior. A sample of 262 institutionalized male adolescents due to criminal behavior and 154 male students aged between 13 and 21 years comprised the study population. Maternal use of alcohol was admitted by 48.8% of the mothers of institutionalized adolescents and by 39.9% of the school students. In this sample of adolescents we could not identify -individual cases with a clear diagnosis of FAS, but signs suggestive of FASD were more common in the institutionalized adolescents. Social factors like domestic and family violence were frequent in the risk group, this also being associated to maternal drinking during pregnancy. The inference is that in our sample, criminal behavior is more related to complex interactions between environmental and social issues including prenatal alcohol exposure.

  1. Effects of cognitive-behavioral therapy on improving anxiety symptoms, behavioral problems and parenting stress in Taiwanese children with anxiety disorders and their mothers.

    Science.gov (United States)

    Yen, Cheng-Fang; Chen, Yu-Min; Cheng, Jen-Wen; Liu, Tai-Ling; Huang, Tzu-Yu; Wang, Peng-Wei; Yang, Pinchen; Chou, Wen-Jiun

    2014-06-01

    The aims of this intervention study were to examine the effects of individual cognitive-behavioral therapy (CBT) based on the modified Coping Cat Program on improving anxiety symptoms and behavioral problems in Taiwanese children with anxiety disorders and parenting stress perceived by their mothers. A total of 24 children with anxiety disorders in the treatment group completed the 17-session individual CBT based on the modified Coping Cat Program, and 26 children in the control group received the treatment as usual intervention. The Taiwanese version of the MASC (MASC-T), the Child Behavior Checklist for Ages 6-18 (CBCL/6-18) and the Chinese version of the Parenting Stress Index (C-PSI) were applied to assess the severities of anxiety symptoms, behavioral problems and parenting stress, respectively. The effects of CBT on improving anxiety symptoms, behavioral problems and parenting stress were examined by using linear mixed-effect model with maximum likelihood estimation. The results indicated that the CBT significantly improved the severities of MASC-T Physical Symptoms and Social Anxiety subscales, CBCL/6-18 DSM-oriented Anxiety Problem subscale, and C-PSI Child domains Mood and Adaptability subscales. Individual CBT based on the modified Coping Cat Program can potentially improve anxiety symptoms in Taiwanese children with anxiety disorders and some child domains of parenting stress perceived by their mothers.

  2. Psychotherapy use in bipolar disorder: Association with functioning and illness severity.

    Science.gov (United States)

    Sylvia, Louisa G; Thase, Michael E; Reilly-Harrington, Noreen A; Salcedo, Stephanie; Brody, Benjamin; Kinrys, Gustavo; Kemp, David; Shelton, Richard C; McElroy, Susan L; Kocsis, James H; Bobo, William V; Kamali, Masoud; McInnis, Melvin; Friedman, Edward; Tohen, Mauricio; Bowden, Charles L; Ketter, Terence A; Singh, Vivek; Calabrese, Joseph; Nierenberg, Andrew A; Rabideau, Dustin J; Elson, Constance M; Deckersbach, Thilo

    2015-05-01

    This study examines characteristics of individuals with bipolar disorder who sought psychotherapy versus those who did not. Bipolar CHOICE was an 11-site comparative effectiveness study of lithium versus quetiapine in symptomatic outpatients (N = 482) with bipolar disorder. At baseline, participants' psychotherapy use within the past 3 months, mood, functioning, and overall health were assessed. Logistic regressions were used to test whether psychotherapy users and non-users differed on various demographic and clinical variables at baseline. Mixed-effects regression was used to determine whether psychotherapy groups differed on response to treatment over the 6-month study. Kaplan-Meier plots and log-rank tests were employed to test whether there were any differences in time to recovery (CGI-BP ≤ 2 for at least 8 weeks) between the groups. Thirty one percent of participants reported using psychotherapy services. Psychotherapy users reported greater medication side effect burden than non-users and were more likely to have moderate to high suicide risk and at least one anxiety disorder. Participants not utilizing medications or psychotherapy had greater mania symptom severity, were younger, and less educated than medication only users. Medication only users were more likely to be married than the other participants. These data suggest that a minority of individuals with bipolar disorder attend psychotherapy services, and those that do have greater illness burden. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  3. Active war in Sri Lanka: Children's war exposure, coping, and posttraumatic stress disorder symptom severity.

    Science.gov (United States)

    Soysa, Champika K; Azar, Sandra T

    2016-01-01

    Posttraumatic stress disorder (PTSD) in response to active war is understudied among Sinhalese children in Sri Lanka. We investigated PTSD symptom severity in children using child (n = 60) and mother (n = 60) reports; child-reported war exposure and coping; as well as self-reported maternal PTSD symptom severity. The study addressed active war in 2 rural locations (acute and chronic community war exposure). Child-reports were significantly greater than mother-reports of child PTSD symptom severity. Furthermore, children's war exposure, child-reported and mother-reported child PTSD symptom severity, and maternal PTSD symptom severity were significantly greater in the acute versus chronic community war exposure location, but children's approach and avoidance coping did not significantly differ, indicating a potential ceiling effect. Children's war exposure significantly, positively predicted child-reported child PTSD symptom severity, controlling for age, gender, and maternal PTSD symptom severity, but only maternal PTSD symptom severity significantly, positively predicted mother-reported child PTSD symptom severity. Avoidance coping (in both acute and chronic war) significantly positively mediated the children's war exposure-child-reported child PTSD symptom severity relation, but not mother-reports of the same. Approach coping (in chronic but not acute war) significantly, positively mediated the children's war exposure-child-reported and mother-reported child PTSD symptom severity relations. We advanced the literature on long-term active war by confirming the value of children's self-reports, establishing that both approach and avoidance coping positively mediated the war-exposure-PTSD symptom severity relation, and that the mediation effect of approach coping was situationally moderated by acute verses chronic community war exposure among Sri Lankan children. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  4. An Evaluation of Social and Adaptive Skills in Adults with Bipolar Disorder and Severe/Profound Intellectual Disability

    Science.gov (United States)

    Matson, Johnny L.; Terlonge, Cindy; Gonzalez, Melissa L.; Rivet, Tessa

    2006-01-01

    The purpose of this study was to explore the interrelationship of social and adaptive skills in adults with bipolar disorder and severe or profound intellectual disability. A bipolar group (N=14), a severe psychopathology group without bipolar disorder (N=14), and a control group with no DSM-IV Axis I diagnosis (N=14) were compared on the…

  5. Maladaptive eating behavior assessment among bariatric surgery candidates: Evaluation of the Eating Disorder Diagnostic Scale.

    Science.gov (United States)

    Williams, Gail A; Hawkins, Misty A W; Duncan, Jennifer; Rummell, Christina M; Perkins, Shannon; Crowther, Janis H

    2017-07-01

    Eating pathology among bariatric surgery candidates is common and associated with adverse outcomes. However, its assessment is complicated by the inconsistent use of standardized measures. We addressed this by examining the use of the Eating Disorder Diagnostic Scale (EDDS) in a large bariatric sample (N = 343). To evaluate the EDDS among bariatric surgery candidates via examination of: (1) Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) and fifth edition (DSM-5) rates of binge eating disorder, bulimia nervosa, and maladaptive eating behaviors, and (2) the relationship between response biases and self-reported eating disorder symptoms. Participants were bariatric surgery candidates at a large public hospital in the Midwest. As part of a larger preoperative evaluation, 343 patients seeking bariatric surgery completed the EDDS and measures of problematic response bias. Approximately 16% of the sample met full threshold criteria for binge eating disorder using DSM-5 criteria. Using the DSM-IV-TR, rates were lower but still substantial at 13%. Rates for bulimia nervosa were 8% (DSM-5) and 6% (DSM-IV-TR). The majority (66.1%) of participants reported at least one binge-eating episode per week. The most commonly used compensatory behavior was fasting (20.4%), followed by excessive exercise (11.7%), laxative use (5.6%), and vomiting (1.8%). An inverse relationship between severity of the eating symptomatology and problematic response bias emerged. The EDDS shows promise as a screening tool that uses diagnostic criteria to provide rates of binge eating and eating psychopathology among surgical candidates. Our findings suggest that subsequent validation studies of this measure are needed, should address potential response bias concerns, and should employ clear definitions of binge eating to promote standardization of eating pathology assessment in the bariatric population. Copyright © 2017 American Society for Bariatric

  6. Learned Helplessness and Students with Emotional or Behavioral Disorders: Deprivation in the Classroom

    Science.gov (United States)

    Sutherland, Kevin S.; Singh, Nirbhay N.

    2004-01-01

    Students with emotional or behavioral disorders (E/BD) are characterized by academic deficits and classroom behavioral problems. The relationship between problem behavior and academic difficulties is complex, and some researchers have hypothesized that the classroom behavior problems of students with E/BD are responses to aversive stimuli, namely…

  7. A Cognitive-Behavioral Therapy Group Intervention for Hypersexual Disorder: A Feasibility Study.

    Science.gov (United States)

    Hallberg, Jonas; Kaldo, Viktor; Arver, Stefan; Dhejne, Cecilia; Öberg, Katarina Görts

    2017-07-01

    The proposed criteria of the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition for hypersexual disorder (HD) included symptoms reported by patients seeking help for excessive and out-of-control non-paraphilic sexual behavior, including sexual behaviors in response to dysphoric mood states, impulsivity, and risk taking. Although no prior studies of cognitive-behavioral therapy (CBT) for the treatment of HD have been performed, CBT has been found effective for dysphoric mood states and impulsivity. To investigate the feasibility of a CBT manual developed for HD explored through symptom decrease, treatment attendance, and clients' treatment satisfaction. Ten men with a diagnosis of HD took part in the CBT group program. Measurements were taken before, during, and at the end of treatment and 3 and 6 months after treatment. The primary outcome was the Hypersexual Disorder: Current Assessment Scale (HD:CAS) score that measured the severity of problematic hypersexual symptoms and secondary outcomes were the Hypersexual Disorder Screening Inventory (HDSI) score, the proportion of attended sessions, and the Client Satisfaction Questionnaire (CSQ-8) score. Main results were significant decreases of HD symptoms from before to after treatment on HD:CAS and HDSI scores and a decrease in the number of problematic sexual behaviors during the course of therapy. A high attendance rate of 93% and a high treatment satisfaction score on CSQ-8 also were found. The CBT program seemed to ameliorate the symptoms of HD and therefore might be a feasible treatment option. This study provides data from a CBT program for the treatment of the specific proposed criteria of HD. Because of the small sample and lack of a control group, the results can be considered only preliminary. Although participants reported decreased HD symptoms after attending the CBT program, future studies should evaluate the treatment program with a larger sample and a randomized controlled procedure

  8. The impact of DSM-5 on the diagnosis and severity indicator of eating disorders in a treatment-seeking sample.

    Science.gov (United States)

    Nakai, Yoshikatsu; Nin, Kazuko; Noma, Shun'ichi; Teramukai, Satoshi; Fujikawa, Kei; Wonderlich, Stephen A

    2017-11-01

    To examine the impact of the DSM-5 on the diagnoses and severity indicators of eating disorders, we conducted a comparative study on the classification of eating disorders including subtypes of anorexia nervosa (AN) between the DSM-IV and DSM-5 criteria. In addition, we studied the association of the DSM-5 severity criteria and clinical variables. Participants were 304 outpatients, aged 16-45 years, with eating disorders, diagnosed using semi-structured clinical interviews and the eating disorder examination questionnaire (EDE-Q). The severity of AN, bulimia nervosa (BN), and binge-eating disorder (BED) was rated from mild to extreme using the DSM-5 severity criteria. The DSM-5 remarkably reduced the number of diagnoses in the residual category from 37.5% to 9.2% and effectively differentiated the diagnostic groups in eating disorder psychopathology. Unexpectedly, however, the scores of all the EDE-Q subscales significantly decreased as severity ratings increased in the DSM-5 AN. Furthermore, while the AN binge-eating/purging group reported significantly lower severity ratings than the AN restricting group, the former displayed more severe eating disorder psychopathology than the latter. In the BN and BED groups, the level of eating concern increased as severity ratings increased, but the severity groups did not differ on other eating pathology variables. The DSM-5 effectively reduced the reliance on residual categories and differentiated the diagnostic groups in eating disorder psychopathology. However, our findings show limited support for the DSM-5 severity specifiers for eating disorders. It is necessary to test additional clinical or functional variables for severity specifiers across eating disorders. © 2017 Wiley Periodicals, Inc.

  9. Severity of Emotional and Behavioral Problems among Poor and Typical Readers.

    Science.gov (United States)

    Arnold, Elizabeth Mayfield; Goldston, David B.; Walsh, Adam K.; Reboussin, Beth A.; Daniel, Stephanie Sergent; Hickman, Enith; Wood, Frank B.

    2005-01-01

    The purpose of this study was to examine the severity of behavioral and emotional problems among adolescents with poor and typical single word reading ability (N = 188) recruited from public schools and followed for a median of 2.4 years. Youth and parents were repeatedly assessed to obtain information regarding the severity and course of symptoms…

  10. Psychosocial functioning in children with neurodevelopmental disorders and externalizing behavior problems.

    Science.gov (United States)

    Arim, Rubab G; Kohen, Dafna E; Garner, Rochelle E; Lach, Lucyna M; Brehaut, Jamie C; MacKenzie, Michael J; Rosenbaum, Peter L

    2015-01-01

    This study examines psychosocial functioning in children with neurodevelopmental disorders (NDDs) and/or externalizing behavior problems (EBPs) as compared to children with neither condition. The longitudinal sample, drawn from the Canadian National Longitudinal Survey of Children and Youth, included children who were 6 to 9 years old in Cycle 1 who were followed-up biennially in Cycles 2 and 3 (N = 3476). The associations between NDDs and/or EBPs, child and family socio-demographic characteristics and parenting behaviors (consistency and ineffective parenting), were examined across several measures of child psychosocial functioning: peer relationships, general self-esteem, prosocial behavior and anxiety-emotional problems. Children with NDDs, EBPs, and both NDDs and EBPs self-reported lower scores on general self-esteem. Children with NDDs and both NDDs and EBPs reported lower scores on peer relationships and prosocial behavior. Lastly, children with both NDDs and EBPs self-reported higher scores on anxiety-emotional behaviors. After considering family socio-demographic characteristics and parenting behaviors, these differences remained statistically significant only for children with both NDDs and EBPs. Child age and gender, household income and parenting behaviors were important in explaining these associations. Psychosocial functioning differs for children with NDDs and/or EBPs. Children with both NDDs and EBPs appear to report poorer psychosocial functioning compared to their peers with neither condition. However, it is important to consider the context of socio-demographic characteristics, parenting behaviors and their interactions to understand differences in children's psychosocial functioning. Implication for Rehabilitation: Practitioners may wish to consider complexity in child health by examining a comprehensive set of determinants of psychosocial outcomes as well as comorbid conditions, such as neurodevelopmental disorders (NDDs) and externalizing

  11. Coraco- or Costoclavicular Paraosteoarthropathies in Patients with Severe Central Neurological Disorders

    International Nuclear Information System (INIS)

    Lacout, A.; Mompoint, D.; Perrier, Y.; Vallee, C.A.; Carlier, R.Y.

    2008-01-01

    Background: Paraosteoarthropathy (POA) is a frequent disabling orthopedic complication after severe central neurological impairment. The hip is the most frequently affected joint (32.1%) followed by the elbow and the shoulder (25%). Purpose: To evaluate coraco- and costoclavicular paraosteoarthropathy in patients with severe central neurological disorders. Material and Methods: We report a series of five consecutive patients with severe central neurological disorders who developed a POA of the clavicular region (coracoclavicular or costoclavicular POA). Every patient underwent a clinical, radiological, and computed tomographic (CT) examination of the shoulder region. Results: Four patients had a history of traumatic brain injury (TBI), and one an acute disseminated encephalomyelitis (ADEM). They developed POA of the clavicular region, although not around the glenohumeral joint. The patients complained of shoulder pain and of moderate limitation of movements. Radiological and CT examinations showed the presence of a bony formation in the coracoclavicular space in four cases and extending from the clavicle to the first rib around the costoclavicular joint in one case. Conclusion: In patients with severe brain lesions suffering from shoulder pain and moderate limitation of joint movements, POAs of the clavicular region are rare but should be considered

  12. Somatic involvement assessed through a cumulative score of clinical severity in patients with eating disorders.

    Science.gov (United States)

    Scanelli, Giovanni; Gualandi, Malvina; Simoni, Marzia; Manzato, Emilia

    2014-03-01

    To evaluate the overall somatic involvement in patients with eating disorders (EDs). The medical records of 206 patients (age 15-56 years, 96.1% females) with diagnosis of anorexia nervosa (AN, n = 63, 30.6%), bulimia nervosa (BN, n = 78, 37.9%), or eating disorder not otherwise specified (EDNOS, n = 65, 31.6 %) were analyzed. A cumulative score of clinical severity (SCS) was computed according to the presence of physical, instrumental, and laboratory abnormalities, as well as to their prognostic impact. Based on the tertile distribution of SCS, three levels of severity were defined: low, medium, and high. A medium/high level of severity was found in 63% of the whole sample, 89% of AN, 49% of BN, and 55% of EDNOS. In the whole sample, the risk of medium/high SCS was significantly and inversely related to the body mass index (BMI) and to the lifetime minimum BMI. The severity level was significantly and positively associated with diagnosis of AN, duration of amenorrhea C1 year, and presence of ED-related symptoms. EDNOS patients showed a higher risk for increased SCS than BN patients, although not significantly. The non-negligible frequency of a relevant somatic involvement in patients with EDNOS suggests that a transdiagnostic scoring system might be helpful to identify ED cases at risk of medical complications.

  13. Correlations of sleep disorders with severity of obstructive airway disease in mustard gas-injured patients.

    Science.gov (United States)

    Vahedi, Ensieh; Taheri, Saeed; Alaedini, Farshid; Poursaleh, Zohreh; Ameli, Javad; Ghanei, Mostafa

    2012-06-01

    Mustard gas has serious adverse effects on several organs and functions in humans. In this study, we analyzed potential correlations between obstructive airway disease and sleep disorders in Iranian mustard gas-injured patients. We enrolled 30 male mustard gas-injured veterans and civilians from the Chemical Warfare Exposure Clinic at Baqiyatallah Hospital, Tehran. All the subjects underwent comprehensive polysomnographic and spirometric evaluations for diagnosis of sleep disorders. Patients were categorized into three groups according to the severity of their obstructive airway disease based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria: group 1 (GOLD I and II), group 2 (GOLD III), and group 3 (GOLD IV). Patients with less severe obstructive airway disease had significantly higher rate of hypopnea (p = 0.05) and AHI (p = 0.05). The number of REM events was significantly higher in patients with less severe airway disease (p = 0.028). Stage 1 sleep among patients with higher FEV1 significantly constituted a higher proportion of sleep, and stage 4 sleep was significantly longer in patients with higher DLCO (p = 0.043, both). We found that sleep parameters in SM-exposed patients have some relations with spirometric parameters. Future studies with large patient populations are needed for confirmation of our results, and therapeutic interventions are needed to evaluate endeavors we can do to enhance health and quality of life in our mustard gas-injured population.

  14. The severity of temporomandibular joint disorder by teeth loss in the elderly

    Directory of Open Access Journals (Sweden)

    Indry Herdiyani

    2011-07-01

    Full Text Available Temporomandibular joint dysfunction is a term that covers a number of clinical problems that involves masticatory muscles, temporomandibular joints, and related structures, or both. Loss of tooth was an etiology of temporomandibular joint dysfunction. The purpose of this study was to obtain the description of temporomandibular joint dysfunction level that caused by tooth loss of elderly in three nursing home Bandung. This was a descriptive study using the survey method of the elderly in three nursing home Bandung. A total of 34 people consist 6 males and 28 females. The subjects were examined by symptoms of temporomandibular joint dysfunction and the dysfunction level was assessed by Helkimo Clinical Dysfunction Index. The result of this study shows that elderly in Nursing Home Bandung have mild dysfunction level was 7 (14.71%, moderate dysfunction level was 22 (64.71%, and severe dysfunction level is 5 (20.58%. It can be concluded that loss of the teeth is one of the etiologies of temporomandibular joint disorder. Based on the research conducted, it can be concluded that all elderly with teeth loss will have the temporomandibular joint disorder and the most severity happens based on teeth loss by using the Helkimo Clinical Disfunction Index score was the moderate disorder.

  15. REM Sleep Behavior Disorder and Prodromal Neurodegeneration - Where are We Headed?

    Directory of Open Access Journals (Sweden)

    Ronald B. Postuma

    2013-04-01

    Full Text Available Rapid eye movement (REM sleep behavior disorder (RBD is characterized by loss of normal atonia during REM sleep, such that patients appear to act out their dreams. The most important implication of research into this area is that patients with idiopathic RBD are at very high risk of developing synucleinmediated neurodegenerative disease (Parkinson's disease [PD], dementia with Lewy bodies [DLB], and multiple system atrophy, with risk estimates that approximate 40–65% at 10 years. Thus, RBD disorder is a very strong feature of prodromal synucleinopathy. This provides several opportunities for future research. First, patients with REM sleep behavior disorder can be studied to test other predictors of disease, which could potentially be applied to the general population. These studies have demonstrated that olfactory loss, decreased color vision, slowing on quantitative motor testing, and abnormal substantia nigra neuroimaging findings can predict clinical synucleinopathy. Second, prospectively studying patients with RBD allows a completely unprecedented opportunity to directly evaluate patients as they transition into clinical neurodegenerative disease. Studies assessing progression of markers of neurodegeneration in prodromal PD are beginning to appear. Third, RBD are very promising subjects for neuroprotective therapy trials because they have a high risk of disease conversion with a sufficiently long latency, which provides an opportunity for early intervention. As RBD research expands, collaboration between centers will become increasingly essential.

  16. Parental Attributions for the Behavior Problems of Children and Adolescents With Autism Spectrum Disorders

    Science.gov (United States)

    Hartley, Sigan L.; Schaidle, Emily M.; Burnson, Cynthia F.

    2014-01-01

    Objective The authors examined parental attributions for child behavior problems in 63 married couples of children and adolescents (aged 3–20 years) with autism spectrum disorders (ASDs). Both child-referent attributions (i.e., beliefs about causes related to the child or adolescent) and parent-referent attributions (i.e., beliefs about causes related to the parent) were examined along the dimensions of locus, stability, and controllability. Parent and child/adolescent factors related to parental attributions were identified, and the associations between parental attributions and parenting burden were explored. Method Mothers and fathers independently completed self-reported measures of parental attributions, parenting burden, and child behavior problems. Couples jointly reported on their son or daughter’s severity of autism symptoms, intellectual disability status, age, and gender. Results Parents tended to attribute the behavior problems of their child/adolescent with an ASD to characteristics that were not only internal to and stable in the child/adolescent but also controllable by the child/adolescent. Mothers were more likely to attribute their son or daughter’s behavior problems to characteristics that were less internal to and less stable in the child/adolescent with an ASD than were fathers. In addition, parents with a higher level of symptoms of the broader autism phenotype, parents of younger children, and parents of children/adolescents with intellectual disability, a higher severity of autism symptoms, and a higher severity of overall behavior problems were more likely to attribute their son or daughter’s behavior problems to characteristics that were more internal to and stable in the child/adolescent and factors that were less controllable by the child/adolescent. Parental attributions were related to parents’ level of parenting burden. Implications Findings have implications for designing appropriate interventions and services for families

  17. Parental attributions for the behavior problems of children and adolescents with autism spectrum disorders.

    Science.gov (United States)

    Hartley, Sigan L; Schaidle, Emily M; Burnson, Cynthia F

    2013-01-01

    The authors examined parental attributions for child behavior problems in 63 married couples of children and adolescents (aged 3-20 years) with autism spectrum disorders (ASDs). Both child-referent attributions (i.e., beliefs about causes related to the child or adolescent) and parent-referent attributions (i.e., beliefs about causes related to the parent) were examined along the dimensions of locus, stability, and controllability. Parent and child/adolescent factors related to parental attributions were identified, and the associations between parental attributions and parenting burden were explored. Mothers and fathers independently completed self-reported measures of parental attributions, parenting burden, and child behavior problems. Couples jointly reported on their son or daughter's severity of autism symptoms, intellectual disability status, age, and gender. Parents tended to attribute the behavior problems of their child/adolescent with an ASD to characteristics that were not only internal to and stable in the child/adolescent but also controllable by the child/adolescent. Mothers were more likely to attribute their son or daughter's behavior problems to characteristics that were less internal to and less stable in the child/adolescent with an ASD than were fathers. In addition, parents with a higher level of symptoms of the broader autism phenotype, parents of younger children, and parents of children/adolescents with intellectual disability, a higher severity of autism symptoms, and a higher severity of overall behavior problems were more likely to attribute their son or daughter's behavior problems to characteristics that were more internal to and stable in the child/adolescent and factors that were less controllable by the child/adolescent. Parental attributions were related to parents' level of parenting burden. Findings have implications for designing appropriate interventions and services for families of children and adolescents with ASDs.

  18. DSM-5 Alcohol Use Disorder Severity in Puerto Rico: Prevalence, Criteria Profile, and Correlates.

    Science.gov (United States)

    Caetano, Raul; Gruenewald, Paul; Vaeth, Patrice A C; Canino, Glorisa

    2018-02-01

    Our aim was to examine lifetime criteria profiles and correlates of severity (mild, moderate, severe) of DSM-5 alcohol use disorders (AUD) in Puerto Rico. Data are from a household random sample of individuals 18 to 64 years of age in San Juan, Puerto Rico. The survey response rate was 83%. DSM-5 AUD was identified with the Spanish version of the World Health Organization's Composite International Diagnostic Interview. The analyses also identify correlates of each severity level using an ordered logistic regression model. The prevalence of lifetime DSM-5 AUD among men and women was 38 and 16%, respectively. Mild lifetime DSM-5 AUD was the most prevalent severity level among both men (18%) and women (9%). The most common criteria, independent of gender and severity level, were drinking larger quantities and for longer than planned (men range: 80 to 97%; women range: 78 to 91%) and hazardous use (men range: 56 to 91%; women range: 42 to 74%). Results from ordered logistic regression showed that the adjusted odds ratio for weekly drinking frequency, greater volume of alcohol consumed per drinking occasion, positive attitudes about drinking, drinking norms, and male gender invariantly increased risks across all DSM-5 AUD severity levels (mild, moderate, severe). Greater negative attitudes about drinking, low family cohesion, and Protestant religion were related to greater risks at higher AUD severity levels. AUD prevalence is high in San Juan, Puerto Rico. Prevalence rates for some criteria are equally high across severity levels and poorly differentiate between mild, moderate, or severe DSM-5 AUD. The sociodemographic and alcohol-related risks vary across DSM-5 severity levels. Copyright © 2018 by the Research Society on Alcoholism.

  19. Accuracy of automated classification of major depressive disorder as a function of symptom severity.

    Science.gov (United States)

    Ramasubbu, Rajamannar; Brown, Matthew R G; Cortese, Filmeno; Gaxiola, Ismael; Goodyear, Bradley; Greenshaw, Andrew J; Dursun, Serdar M; Greiner, Russell

    2016-01-01

    Growing evidence documents the potential of machine learning for developing brain based diagnostic methods for major depressive disorder (MDD). As symptom severity may influence brain activity, we investigated whether the severity of MDD affected the accuracies of machine learned MDD-vs-Control diagnostic classifiers. Forty-five medication-free patients with DSM-IV defined MDD and 19 healthy controls participated in the study. Based on depression severity as determined by the Hamilton Rating Scale for Depression (HRSD), MDD patients were sorted into three groups: mild to moderate depression (HRSD 14-19), severe depression (HRSD 20-23), and very severe depression (HRSD ≥ 24). We collected functional magnetic resonance imaging (fMRI) data during both resting-state and an emotional-face matching task. Patients in each of the three severity groups were compared against controls in separate analyses, using either the resting-state or task-based fMRI data. We use each of these six datasets with linear support vector machine (SVM) binary classifiers for identifying individuals as patients or controls. The resting-state fMRI data showed statistically significant classification accuracy only for the very severe depression group (accuracy 66%, p = 0.012 corrected), while mild to moderate (accuracy 58%, p = 1.0 corrected) and severe depression (accuracy 52%, p = 1.0 corrected) were only at chance. With task-based fMRI data, the automated classifier performed at chance in all three severity groups. Binary linear SVM classifiers achieved significant classification of very severe depression with resting-state fMRI, but the contribution of brain measurements may have limited potential in differentiating patients with less severe depression from healthy controls.

  20. Neurophysiological determinants of tic severity in children with chronic motor tic disorder.

    Science.gov (United States)

    Siniatchkin, Michael; Kuppe, Andrea

    2011-06-01

    Tics wax and wane in severity. Although the understanding of the natural course of symptoms in tic disorder (TD) is important for planning and assessing therapeutic interventions, neurophysiological mechanisms and predictors of tic exacerbation and remission have not been sufficiently investigated. In each of seven children suffering from TD, contingent negative variation (CNV) was recorded on 10 occasions over a period of 2 months. CNV parameters of children with TD were compared with CNV data of healthy, age-matched children. During the entire time of observation, tic severity was assessed by parents and the investigator using a scale developed from the Yale Global Tic Severity Scale. Moreover, tic severity was also evaluated using video assessments. Patients with TD were characterized by significantly lower amplitude of the total CNV and more pronounced habituation of the early CNV component as compared to healthy children. Correlation analysis between tic severity and CNV parameters demonstrated that the more severe the tics were, the lower the amplitude of the total CNV. Since CNV amplitude represents processes of resource mobilization and control over neuronal excitability, tic severity may result from less ability to control neurophysiological functions in patients with TD.

  1. Hair Toxic Metal Concentrations and Autism Spectrum Disorder Severity in Young Children

    Directory of Open Access Journals (Sweden)

    Lisa K. Sykes

    2012-12-01

    Full Text Available Previous studies have found a higher body-burden of toxic metals, particularly mercury (Hg, among subjects diagnosed with an autism spectrum disorder (ASD in comparison to neurotypical controls. Moreover, Hg body-burden was associated with ASD severity. This cross-sectional study examined the potential correlation between hair toxic metal concentrations and ASD severity in a prospective cohort of participants diagnosed with moderate to severe ASD. The Institutional Review Board at the University of Texas Southwestern Medical Center at Dallas (Dallas, TX approved the present study. Qualifying study participants (n = 18 were evaluated for ASD severity using the Childhood Autism Rating Scale (CARS and quantitatively for arsenic, Hg, cadmium, lead, chromium, cobalt, nickel, aluminum, tin, uranium, and manganese using hair toxic element testing by Doctor’s Data (a CLIA-approved laboratory. CARS scoring and hair toxic element testing were blinded to one another. Increasing hair Hg concentrations significantly correlated with increased ASD severity. In contrast, no significant correlations were observed between any other of the hair toxic metals examined and ASD severity. This study helps to provide additional mechanistic support for Hg in the etiology of ASD severity, and is supported by an increasing number of recent critical reviews that provide biological plausibility for the role of Hg exposure in the pathogenesis of ASDs.

  2. 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

  3. Video Game Access, Parental Rules, and Problem Behavior: A Study of Boys with Autism Spectrum Disorder

    Science.gov (United States)

    Engelhardt, Christopher R.; Mazurek, Micah O.

    2014-01-01

    Environmental correlates of problem behavior among individuals with autism spectrum disorder remain relatively understudied. The current study examined the contribution of in-room (i.e. bedroom) access to a video game console as one potential correlate of problem behavior among a sample of 169 boys with autism spectrum disorder (ranging from 8 to…

  4. Suicidal Behavior Among Inpatients with Schizophrenia and Mood Disorders in Chengdu, China

    Science.gov (United States)

    Ran, Mao-Sheng; Wu, Qiu-Hua; Conwell, Yeates; Chen, Eric Yu-Hai; Chan, Cecilia Lai-Wan

    2004-01-01

    This study evaluated the characteristics of suicidal behavior (suicide attempt or suicidal ideation) among 230 consecutively admitted inpatients with schizophrenia and mood disorders in a university hospital in China. The rate of lifetime suicidal behavior was found to be significantly higher in patients with mood disorders (62.4%) than in…

  5. A Meta-Analysis of Behavioral Parent Training for Children with Attention Deficit Hyperactivity Disorder

    Science.gov (United States)

    Lee, Pei-chin; Niew, Wern-ing; Yang, Hao-jan; Chen, Vincent Chin-hung; Lin, Keh-chung

    2012-01-01

    This meta-analysis examined the effect of behavioral parent training on child and parental outcomes for children with attention deficit hyperactivity disorder. Meta-analytic procedures were used to estimate the effect of behavioral parent training on children with attention deficit hyperactivity disorder. Variables moderating the intervention…

  6. Description of an Intensive Dialectical Behavior Therapy Program for Multidiagnostic Clients with Eating Disorders

    Science.gov (United States)

    Federici, Anita; Wisniewski, Lucene; Ben-Porath, Denise

    2012-01-01

    The authors describe an intensive outpatient dialectical behavior therapy (DBT) program for multidiagnostic clients with eating disorders who had not responded adequately to standard, empirically supported treatments for eating disorders. The program integrates DBT with empirically supported cognitive behavior therapy approaches that are well…

  7. Are sedentary television watching and computer use behaviors associated with anxiety and depressive disorders?

    NARCIS (Netherlands)

    de Wit, Leonore; van Straten, Annemieke; Lamers, Femke; Cuijpers, Pim; Penninx, Brenda

    2011-01-01

    Sedentary behaviors may be more common among persons with mental disorders and thereby result in poorer health outcomes. This study examined whether independently of general physical activity level, mental disorders are linked to two important examples of sedentary behavior: computer use and

  8. Overweight and Obese Status in Children with Autism Spectrum Disorder and Disruptive Behavior

    Science.gov (United States)

    Criado, Kristen K.; Sharp, William G.; McCracken, Courtney E.; De Vinck-Baroody, Oana; Dong, Liansai; Aman, Michael G.; McDougle, Christopher J.; McCracken, James T.; Eugene Arnold, L.; Weitzman, Carol; Leventhal, John M.; Vitiello, Benedetto; Scahill, Lawrence

    2018-01-01

    Overweight and obesity are common in pediatric populations. Children with autism spectrum disorder and disruptive behavior may be at higher risk. This study examined whether children with autism spectrum disorder and disruptive behavior are more likely to be overweight or obese than matched controls. Baseline data from medication-free children…

  9. 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…

  10. Accounting for posttraumatic stress disorder symptom severity with pre- and posttrauma measures

    DEFF Research Database (Denmark)

    Ogle, Christin M.; Rubin, David C.; Siegler, Ilene C.

    2016-01-01

    Using data from a longitudinal study of community-dwelling older adults, we analyzed the most extensive set of known correlates of posttraumatic stress disorder (PTSD) symptoms obtained from a single sample to examine the measures’ independent and combined utility in accounting for PTSD symptom...... attachment and factors related to the current trauma memory, such as self-rated severity, event centrality, frequency of involuntary recall, and physical reactions to the memory, accounted for symptom severity better than did measures of pretrauma factors. In an analysis restricted to prospective measures...... severity. Fifteen measures identified as PTSD risk factors in published meta-analyses as well as 12 theoretically and empirically supported individual difference and health-related measures were included in our analysis. Individual difference measures assessed after the trauma, including insecure...

  11. Reducing perceived stigma: Work integration of people with severe mental disorders in Italian social enterprise.

    Science.gov (United States)

    Villotti, Patrizia; Zaniboni, Sara; Corbière, Marc; Guay, Stéphane; Fraccaroli, Franco

    2018-06-01

    People with mental illnesses face stigma that hinders their full integration into society. Work is a major determinant of social inclusion, however, people with mental disorders have fewer opportunities to work. Emerging evidence suggests that social enterprises help disadvantaged people with their work integration process. The purpose of this study is to enhance our understanding about how perceptions of stigma can be decreased for people with mental disorders throughout their work experience in a social enterprise. Using a longitudinal study design, 310 individuals with mental disorders employed in Italian social enterprises completed a battery of questionnaires on individual (e.g., severity of symptoms; occupational self-efficacy) and environmental (e.g., social support; organizational constraints) variables. Of the 223 individuals potentially eligible at the 12-month follow up, 139 completed a battery of questionnaires on social and working skills, perceived work productivity and perceived stigma. Path analyses were used to test a model delineating how people with mental disorders working in social enterprises improve social and work outcomes (i.e., motivation, skills and productivity), and reduce the perception of being stigmatized. Working in a social enterprise enhances working social skills, which leads to a perception of higher productivity and, consequently, the perception of being discriminated against and stigmatized is reduced. Social enterprise provides a context in which people with mental disorders reach a sense of work-related and social competence. This sense of competence helps them to reduce perceived stigma, which is a crucial step toward social inclusion. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  12. A classification of psychological factors leading to violent behavior in posttraumatic stress disorder.

    Science.gov (United States)

    Silva, J A; Derecho, D V; Leong, G B; Weinstock, R; Ferrari, M M

    2001-03-01

    Posttraumatic stress disorder has long been linked to violent behavior. However, the exact nature of that association remains poorly characterized due to the limitations of knowledge in the area of phenomenology, contextual factors, the biology, and the nature of the aggression involved in the disorder. A clear understanding of the genesis of violence in posttraumatic stress disorder can be helpful to those involved in assessing psychiatric-legal issues relevant to the disorder and in its therapeutic management. In this article, we review the potential psychological links between posttraumatic stress disorder secondary to combat exposure and violent behavior and suggest a tentative classification of the main psychological causes of violence in that syndrome.

  13. Stigma, social anxiety, and illness severity in bipolar disorder: Implications for treatment.

    Science.gov (United States)

    Levy, Boaz; Tsoy, Elena; Brodt, Madeline; Petrosyan, Karen; Malloy, Mary

    2015-02-01

    Studies indicate that comorbid anxiety disorders predict a more severe course of illness in bipolar disorder (BD). The relatively high prevalence of social anxiety in BD points to the potential role that socio-cultural factors, such as stigma, play in exacerbating the progression of this disorder. Stigma creates social anxiety in affected individuals because it essentially forces them into a vulnerable social status that is marked by public disgrace. Although the etiology of debilitating social anxiety in BD may involve multiple factors, stigma deserves particular clinical attention because research in this area indicates that it is common and its internalization is associated with poor outcome. We conducted a literature review using search terms related to stigma, social anxiety, bipolar disorder, illness severity, and outcomes. The electronic databases searched included PsychINFO, PubMed, JSTOR, and EBSCOhost Academic Search Complete with limits set to include articles published in English. The literature indicates that internalized stigma often triggers the core psychological experiences of social anxiety and is highly correlated with clinical and functional outcome in BD. On a psychological level, internalized stigma and social anxiety can create distress that triggers symptoms of BD. From a biological perspective, stigma constitutes a chronic psychosocial stressor that may interact with the pathophysiology of BD in inflammatory ways. The connection between stigma and social anxiety, and their combined effects on people with BD, carries important implications for psychiatric care. To obtain an accurate clinical formulation, initial evaluations may seek to examine stigma-related experiences and determine their relationship to anxiety symptoms and psychosocial functioning. In addition, direct interventions for reducing the ill effects of stigma in BD deserve clinical attention, because they may carry the potential to enhance outcomes.

  14. Psychiatric, behavioral, and attitudinal correlates of avoidant and obsessive-compulsive personality pathology in patients with binge-eating disorder.

    Science.gov (United States)

    Becker, Daniel F; Masheb, Robin M; White, Marney A; Grilo, Carlos M

    2010-01-01

    We examined correlates of avoidant and obsessive-compulsive personality pathology--with respect to psychiatric comorbidity, eating disorder psychopathology, and associated psychologic factors--in patients with binge-eating disorder (BED). Three hundred forty-seven treatment-seeking patients who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), research criteria for BED were reliably assessed with semistructured interviews to evaluate DSM-IV Axis I disorders, personality disorders, and behavioral and attitudinal features of eating disorder psychopathology. Fifteen percent of subjects had avoidant personality disorder features, 12% had obsessive-compulsive personality disorder features, 8% had features of both disorders, and 66% had features of neither. These groups differed significantly in the frequencies of depressive and anxiety disorders, as well as on measures of psychologic functioning (negative/depressive affect and self-esteem) and eating disorder attitudes (shape and weight concerns). There were no group differences on measures of eating behaviors. The avoidant and obsessive-compulsive groups had more psychiatric comorbidity than the group without these personality features but less than the combined group. The group without these features scored significantly lower than all other groups on negative/depressive affect and significantly higher than the avoidant and combined groups on self-esteem. The combined group had the greatest severity on shape and weight concerns. Avoidant and obsessive-compulsive personality features are common in patients with BED. Among BED patients, these forms of personality psychopathology--separately and in combination--are associated with clinically meaningful diagnostic, psychologic, and attitudinal differences. These findings have implications for the psychopathologic relationship between BED and personality psychopathology and may also have implications for assessment and treatment. Copyright

  15. Survey of premenstrual symptom severity and impairment in Korean adolescents: premenstrual dysphoric disorder, subthreshold premenstrual dysphoric disorder and premenstrual syndrome.

    Science.gov (United States)

    Yang, Jaewon; Joe, Sook-Haeng; Lee, Moon-Soo; Kim, Seung-Hyun; Jung, In-Kwa

    2014-06-01

    The aims of the study were to examine the prevalence of premenstrual dysphoric disorder (PMDD), subthreshold PMDD and premenstrual syndrome (PMS) among adolescents, and to assess the nature of symptoms and the impact on daily life functions, especially for PMDD and subthreshold PMDD. A cross-sectional survey was conducted among adolescents from an urban area. Participants included 984 girls divided into the following four groups, using a premenstrual symptoms screening tool: PMDD, subthreshold PMDD, moderate/severe PMS and no/mild PMS. An Adolescent Mental Problem Questionnaire, Center for Epidemiological Studies-Depression Scale, revised Children's Manifest Anxiety Scale, and a menstrual information questionnaire were also used. Sixty-three (6.76%) of the subjects met the criteria for PMDD and 58 (6.2%) were subthreshold PMDD. The subthreshold PMDD group included 79.3% who met the symptom criteria for PMDD, but their impairment was moderate, and 21.7% who were falling short by the number of symptoms for PMDD diagnosis, though reporting severe impairment. The symptom intensity and frequency of the subthreshold PMDD subjects were similar to those in subjects with PMDD. In these two groups, 69% had moderate to severe physical symptoms. Psychiatric problems, including depression and anxiety, were higher in the PMDD and subthreshold PMDD groups than in the moderate/severe PMS and no/mild PMS group. In total, 20% of adolescents reported suffering from distressing premenstrual symptoms, and girls with PMDD and subthreshold PMDD were very similar in their symptom severity and characteristics. Prospective daily charting is needed to confirm the accurate diagnosis and management of PMDD. Copyright © 2012 Wiley Publishing Asia Pty Ltd.

  16. The DSM-5 Levels of Personality Functioning and Severity of Iranian Patients With Antisocial and Borderline Personality Disorders.

    Science.gov (United States)

    Amini, Mehdi; Pourshahbaz, Abbas; Mohammadkhani, Parvaneh; Khodaie Ardakani, Mohammad Reza; Lotfi, Mozhgan

    2015-08-01

    Fundamental problems with Personality Disorders (PD) diagnostic system in the previous version of DSM, led to the revision of DSM. Therefore, a multidimensional system has been proposed for diagnosis of personality disorder features in DSM-5. In the dimensional approach of DSM-5, personality disorders diagnosis is based on levels of personality functioning (Criteria A) and personality trait domains (Criteria B). The purpose of this study was firstly, to examine the DSM-5 levels of personality functioning in antisocial and borderline personality disorders, and second, to explore which levels of personality functioning in patients with antisocial and borderline personality disorders can better predicted severity than others. This study had a cross sectional design. The participants consisted of 252 individuals with antisocial (n = 122) and borderline personality disorders (n = 130). They were recruited from Tehran prisoners, and clinical psychology and psychiatry centers of Razi and Taleghani Hospitals, Tehran, Iran. The sample was selected based on judgmental sampling. The SCID-II-PQ, SCID-II and DSM-5 levels of personality functioning were used to diagnose and assess personality disorders. The data were analyzed by correlation and multiple regression analysis. All statistical analyses were performed using the SPSS 16 software. Firstly, it was found that DSM-5 levels of personality functioning have a strong correlation with antisocial and borderline personality symptoms, specially intimacy and self-directedness (P antisocial personality disorder severity (P personality disorder severity, as well (P personality functioning are a significant predictor of personality disorders severity. The results partially confirm existing studies.

  17. Explorative evaluation of the impact of severe premenstrual disorders on work absenteeism and productivity.

    Science.gov (United States)

    Heinemann, Lothar A J; Minh, Thai Do; Filonenko, Anna; Uhl-Hochgräber, Kerstin

    2010-01-01

    To assess the effects of premenstrual disorders on work productivity and absenteeism in the multinational Impact study. Women aged 15-45 years were screened for suspected premenstrual dysphoric disorders (PMDD) and premenstrual syndrome (PMS) and invited to participate in this web-based study. Based on the Daily Record of Severity of Problems (DRSP) questionnaire, symptoms were assessed prospectively over 2 months. Participants were categorized as having no perceived symptoms/mild PMS or moderate-to-severe PMS/PMDD based on a validated algorithm. Work productivity impairment and absenteeism were assessed retrospectively using the Premenstrual Symptoms Screening Tool (PSST) and a modified version of the Work Productivity and Activity Impairment (WPAI) questionnaire. Work productivity impairment was also assessed prospectively over 2 months using the DRSP questionnaire. Overall 1,477 women started the study-of these, 822 (56%) completed the study as planned and represent the full analysis set. Employed women with moderate-to-severe PMS/PMDD had higher rate of productivity impairment on the modified version of the WPAI questionnaire (values >/=7) relative to those with no perceived symptoms/mild PMS (adjusted odds ratio, 3.12; 95% confidence interval, 1.75-5.57). Similar outcomes were obtained for impairment of working productivity or efficiency using the PSST scale (value 4). The mean number of days on the DRSP with at least moderate reduction in productivity or efficiency in daily routine was higher for women with moderate-to-severe PMS/PMDD (5.6 vs. 1.1). Women with moderate-to-severe PMS/PMDD had a higher rate of absenteeism (>8hours per cycle; 14.2% vs. 6.0%). Moderate-to-severe PMS/PMDD seems to be associated with work productivity impairment and increased absenteeism, and thus poses a potential economic burden. Copyright 2010 Jacobs Institute of Women

  18. Eating behavior, weight problems and eating disorders in 101 long-term survivors of childhood-onset craniopharyngioma.

    Science.gov (United States)

    Hoffmann, Anika; Postma, Frank P; Sterkenburg, Anthe S; Gebhardt, Ursel; Müller, Hermann L

    2015-01-01

    As a result of hypothalamic involvement and/or treatment-related hypothalamic damage, up to 75% of childhood craniopharyngioma patients develop hypothalamic obesity. Eating behavior was analyzed in 101 survivors of childhood craniopharyngioma, recruited from 1980 to 2001 in the HIT-Endo multicenter study, and in 85 body mass index (BMI)-matched healthy controls using the Inventory for Eating Behavior and Weight Problems (IEG) and the Inventory for Eating Disorders (ESI). Severely obese patients (BMI>8 SD; n=9) presented with pathological eating behavior, more weight problems, and eating disorders, as compared to obese (BMI 3-8 SD; n=44) and normal or overweight patients (BMICraniopharyngioma patients with different degrees of obesity showed similar or even less pathological findings as compared to BMI-matched normal controls. Severe obesity is associated with pathological eating behavior/disorders in craniopharyngioma patients. As these disorders are not disease-specific, risk factors for hypothalamic obesity should be the focus of further craniopharyngioma research.

  19. Comparison of treatment outcomes in severe personality disorder patients with or without substance use disorders: a 36-month prospective pragmatic follow-up study

    Directory of Open Access Journals (Sweden)

    Lana F

    2016-06-01

    Full Text Available Fernando Lana,1–3 Carmen Sánchez-Gil,1–3 Núria D Adroher,4,5 Víctor Pérez,1–4 Guillem Feixas,6 Josep Martí-Bonany,1–3 Marta Torrens1–4 1Institute of Neuropsychiatry and Addictions (INAD, Centre Emili Mira and Hospital del Mar, Parc de Salut Mar, Barcelona, Spain; 2Mental Health Research Networking Center (CIBERSAM, Madrid, Spain; 3Department of Psychiatry, Autonomous University of Barcelona, Barcelona, Spain; 4IMIM (Hospital del Mar Medical Research Institute, Barcelona, Spain; 5Public Health and Epidemiology Research Networking Center (CIBERESP, Madrid, Spain; 6Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain Background: Concurrent personality disorder (PD and substance use disorder (SUD are common in clinical practice. However, SUD is the main criterion for study exclusion in most psychotherapeutic studies of PD. As a result, data on treatment outcomes in patients with concurrent PD/SUD are scarce.Methods: The study sample consisted of 51 patients diagnosed with severe PD and admitted for psychotherapeutic treatment as a part of routine mental health care. All patients were diagnosed with PD according to the Structured Clinical Interview for PD. Patients were further assessed (DSM-IV diagnostic criteria to check for the presence of concurrent SUD, with 28 patients diagnosed with both disorders (PD-SUD. These 28 cases were then compared to the 23 patients without SUD (PD-nSUD in terms of psychiatric hospitalizations and psychiatric emergency roo