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Biomedical subjects

M G Aman

Publications and source records attributed to M G Aman.

At least 37 records · Page 2Linked to original sources
PubMed1992

Behavior of children with seizures. Comparison with norms and effect of seizure type.

Scores for 112 children aged 6 to 12 years, with well-controlled seizures and of average or higher IQ, were compared for problem behavior with established norms. As assessed on the Conners' Teacher Rating Scale, the group with seizures was comparable to the normative group on two subscales and superior on two others. In contrast, parents of children in the seizure group rated them as significantly worse on all six subscales of the Revised Behavior Problem Checklist. In a larger group of 133 children with seizures, from which this sample was selected, the relationship of age, sex, and seizure type to behavior problems was examined. Subjects with partial seizures were rated as slightly more aggressive and antisocial than those with generalized seizures. Findings were discussed in regard to differences in perception of behavior by parents and teachers and the possible relevance of seizure type to the expression of behavior problems.

Adolescent↗
PubMed1991

Prediction of clinical response in children taking methylphenidate.

Twenty-six children having Attention Deficit Hyperactivity Disorder were tested before and after treatment with methylphenidate. In addition to standardized parent and teacher rating scales, each child was assessed on a variety of psychomotor tests with an emphasis on attentional constructs. Relatively few of the performance tests, administered prior to medication, predicted clinical response to medication. However, chronological age and performance on a memory distraction task and on the Graduated Holes Task (Kløve, 1963) were moderately correlated with clinical outcome. Using stepwise multiple regression analyses to predict outcome, age and the psychomotor tasks predicted about 50% of outcome variance. There was virtually no relationship between clinical change and change on the performance tests. Findings are discussed with respect to results from previous prediction studies, theoretical models of drug response, and clinical management.

Attention↗
PubMed1991

Clinical effects of methylphenidate and thioridazine in intellectually subaverage children.

Thirty children with subaverage IQs and psychiatric diagnoses of attention deficit disorder and/or or conduct disorder took part in a double-blind study of placebo, methylphenidate, and thioridazine, which were given for 3 weeks each. The results showed a consistent and highly significant effect of methylphenidate in reducing teacher ratings of problem behavior. Parent ratings showed no behavioral effects for the group as a whole. An attentional model of stimulant drug response was used to divide subjects according to a cognitive maturity domain presumed to reflect selective attention. When divided according to breadth of attention, mental age, and IQ level, higher functioning subjects were found to show a generally favorable response to methylphenidate on both teacher and parent rating scales, whereas children of low functional level typically showed an adverse or indifferent response. The present data suggest that mental age and IQ may be important determinants of drug response; below a given level, there was a greatly reduced likelihood of responding positively. Clinical response to thioridazine was substantially less than the response to methylphenidate, with significant improvements confined to conduct and hyperactivity problems on teacher ratings.

Adolescent↗
PubMed1991

Methylphenidate and thioridazine in the treatment of intellectually subaverage children: effects on cognitive-motor performance.

Twenty-seven children (or smaller subgroups depending upon task difficulty and subject ability) with subaverage IQs took part in a double-blind, placebo-controlled, cross-over study of methylphenidate (0.4 mg/kg/day) and thioridazine (1.75 mg/kg/day). The children were tested for IQ performance, breadth of attention, and performance on a series of electronically controlled cognitive-motor tests. Methylphenidate improved accuracy on a memory task, reduced omission errors on an attentional task, and reduced seat movements on two tasks. Thioridazine failed to have any deleterious effects on IQ performance when subjects received reinforcers for correct answers. Thioridazine at the given dose did not adversely affect performance on any of the cognitive-motor performance tests. Methylphenidate appears likely to enhance sustained attention and motivation in appropriately selected children with mild developmental delays, whereas thioridazine at this modest dose does not appear to impair performance on most psychomotor tests.

Adolescent↗
PubMed1990

Considerations in the use of psychotropic drugs in elderly mentally retarded persons.

Elderly people tend to be large consumers of medication in general and psychotropic drugs in particular. Sedative/hypnotics, anxiolytics, antidepressants, and neuroleptic drugs tend to be the most commonly used psychotropic medications among elderly people who are not developmentally disabled. These drugs are probably commonly employed among elderly mentally retarded people as well, although the rank order of use probably differs. A number of physiological changes which accompany greater age are described and the impact on pharmacokinetic variables outlined. Other factors associated with aging, which influence drug actions, are also outlined. The net effect appears to be that most drugs are more potent, more toxic, or longer lasting among the elderly. Data are also presented on tardive dyskinesia insofar as aging is concerned. This is followed by overall conclusions and some suggested guidelines for the use of these drugs in older mentally retarded persons.

Aged↗
PubMed1990

Knowledge, attitudes, and happiness of nurses working with gerontological patients.

Most of the nurses surveyed reported that they worked with the elderly because of a special interest in this population, and the majority (88%) indicated that they were "usually or always" satisfied with their work. The aspects of care most frequently identified by respondents as unrewarding were behavioral and psychosocial problems caused by their patients. When questioned about changes that would lead to greater job satisfaction, the most frequent response was a need for more time to interact with patients. The majority of nurses defined old age in terms of functional loss. In planning for future nursing needs of elderly people, the majority of respondents felt there was a need for more domiciliary services so that elderly people can receive assistance in their own homes.

Aged↗
PubMed1989

Review of fenfluramine in the treatment of the developmental disabilities.

Fenfluramine, a serotonin reducing agent, has been the subject of intense research effort in recent years. A variety of biochemical studies summarized suggest that some autistic children and many nonautistic severely retarded individuals have elevated blood serotonin concentrations. The research on fenfluramine's clinical efficacy is thoroughly reviewed from a methodological perspective. All studies assessing the drug's effects on blood serotonin have observed reductions in whole blood serotonin to about 50% of baseline concentrations. Although there were early reports of drug enhancement of IQ, there is no good evidence that this is the case. However, there are data to suggest that fenfluramine may enhance social relatedness, reduce stereotypic behavior, lessen overactivity, and improve attention span in some autistic children, although these results do not appear consistently across studies. The animal literature on the neurotoxicity of fenfluramine is reviewed, and a number of limitations in this research are identified that raise questions about its relevance to the pharmacotherapy of children.

Attention Deficit Disorder with Hyperactivity↗
PubMed1989

Haloperidol treatment with chronically medicated residents: dose effects on clinical behavior and reinforcement contingencies.

Twenty residents, most of whom had previously received neuroleptic maintenance therapy, were assessed in a double blind, placebo-controlled, cross-over study of haloperidol. Haloperidol was administered in standardized doses of .025 and .05 mg/kg/day, for 3 weeks each. Clinical changes were confined to a slight reduction in ratings of stereotypic behavior and an increase in gross-motor activity under the high dose. Under reinforcement conditions, there was a marked tendency for instruction following performance to improve under the high dose condition. Subjects were divided according to degree of stereotypic behavior. Those with initially high levels of stereotypy tended to show a significantly more favorable response to haloperidol than did those with low levels of stereotypy.

Adolescent↗
PubMed1988

Thioridazine dose effects with reference to stereotypic behavior in mentally retarded residents.

Eleven residents receiving long-term thioridazine treatment were studied while receiving their previous dose, standardized low and high doses (1.25 and 2.50 mg/kg per day), and placebo conditions. For theoretical reasons, subjects were also classified by degree of stereotypic behavior on the Fairview Problem Behavior Checklist (Barron & Sandman, 1983). Ratings of hyperactivity and self-injury were significantly lower during the higher as compared with the lower dose condition. Subjects classified as in the high-stereotypy group had significantly and substantially higher levels of maladaptive behavior on several other clinical variables. When all four drug conditions were compared, no significant drug effects were detected. However, high-stereotypy subjects responded significantly better to the drug than low-stereotypy subjects on ratings of Lethargy/Social Withdrawal and Hyperactivity on the Aberrant Behavior Checklist (Aman, Singh, Stewart, & Field, 1985a). The findings were related to previous dosage research and the literature on stereotypic behavior.

Dose-Response Relationship, Drug↗
PubMed1988

The psychopathology instrument for mentally retarded adults: psychometric characteristics, factor structure, and relationship to subject characteristics.

The self-report and a modified informant version of the Psychopathology Instrument for Mentally Retarded Adults (PIMRA) was used to assess 160 mentally retarded adults. Statistics relating to the instrument's internal consistency and test-retest reliability were calculated. The effects of demographic variables were analyzed and the factor structure of the instrument was examined. Of the psychometric statistics examined, only the item-total correlations were as robust as in the original reports. Significant relationships between PIMRA scores and age, sex, and level of mental retardation were found, but there was no significant effect due to residential setting (institution versus community). The factor structure for both versions of the PIMRA was similar to that in the initial reports.

Adolescent↗
PubMed1987

The effects of essential fatty acid supplementation by Efamol in hyperactive children.

Thirty-one children, selected for marked inattention and overactivity, were studied in a double-blind, placebo-controlled crossover study of essential fatty acid (EFA) supplementation. Subjects received the active treatment and placebo conditions for 4 weeks each and were assessed on a variety of cognitive, motor, and standardized rating scale measures. EFA supplementation (evening primrose oil; Efamol) resulted in significantly lower levels of palmitoleic acid (a nonessential fatty acid) and higher concentrations of dihomogammalinolenic acid, an EFA previously found to be deficient in some hyperactive children. Supplementation was also associated with significant changes on two performance tasks and with significant improvement to parent ratings on the subscales designated as Attention Problem and Motor Excess of the Revised Behavior Problem Checklist. However, a variety of eight other psychomotor performance tests and two standardized teacher rating scales failed to indicate treatment effects. When the experiment-wise probability level was set at .05, only 2 of 42 variables showed treatment effects. Baseline EFA concentrations appeared to be unrelated to treatment response. It was concluded that EFA supplementation, as employed here, produces minimal or no improvements in hyperactive children selected without regard to baseline EFA concentrations.

8,11,14-Eicosatrienoic Acid↗
PubMed1987

The relationship between nurse characteristics and perceptions of psychotropic medications in residential facilities for the retarded.

A total of 227 nurses were surveyed regarding their attitudes, perceptions, and knowledge about the use of psychotropic drugs. In general, greater age, male sex, status, and higher qualifications tended to covary and were associated with perception of greater involvement by senior nurses in drug-related decisions, more satisfaction with the level of in-service training, awareness of certain side effects, perception of interdisciplinary decision making as a clinical reality, and the view that psychologists were not influential in medication-related decisions. Those without these characteristics (e.g., females, younger nurses) more often advocated greater use of medical and laboratory tests, ongoing training, and alternatives to drugs. Nurses working in nonambulatory units more often saw senior nursing staff as influential in decisions to stop drug treatment and more often recommended that alternatives to pharmacology be employed. Some tentative conclusions about the dynamics surrounding medication use in these facilities were offered to account for these patterns.

Adolescent↗
PubMed1987

Caregiver perceptions of psychotropic medication in residential facilities.

Direct caregivers (designated as "psychopaedic nurses" in New Zealand) in two public residential facilities were surveyed regarding their perceptions, opinions, and knowledge of psychotropic drugs. Of 276 individuals contacted, 227 (82%) returned usable questionnaires. The results indicated that unit supervisors (charge nurses) and unit doctors were perceived as wielding most influence on decisions regarding psychotropic drugs, whereas caregivers based outside residential units were seen as having little influence. Aggressive/destructive behavior and, to a smaller extent, self-injurious behavior were seen as the most likely problem behaviors to lead to medication use. Subjective measures were generally favored for assessing drug effects although, in a hypothetical "ideal" situation, nurses gave increasing priority to more objective indices. Endorsement of behavior modification as an alternative to pharmacotherapy was generally high. A large majority of these caregivers (85%) expressed dissatisfaction with their training concerning psychotropic drugs. Finally, data were presented on drug topics about which respondents wanted to learn more and about changes they wished to see instated in their facilities. Our principal conclusion was that these data indicate a need for more education on a variety of social, pharmacological, and behavioral issues as they relate to medication use.

Adolescent↗
PubMed1987

Clinical characteristics and serum essential fatty acid levels in hyperactive children.

This study compared 48 hyperactive children with 49 age-and-sex-matched controls. Significantly more hyperactive children had auditory, visual, language, reading, and learning difficulties, and the birth weight of hyperactive children was significantly lower than that of controls (3,058 and 3,410 g, respectively; p less than 0.01). In addition, significantly more hyperactive children had frequent coughs and colds, polydypsia, polyuria, and a serious illness or accident in the past year than controls, but there was no increase in asthma, eczema, or other allergies. Serum essential fatty acid (EFA) levels were measured in 44 hyperactive subjects and 45 controls. The levels of docasahexaenoic, dihomogammalinolenic, and arachidonic acids were significantly lower in hyperactive children than controls (docosahexaenoic: 41.6 and 49.5 micrograms/ml serum respectively, p = 0.045; dihomogammolinolenic: 34.9 and 41.3 micrograms/ml serum, p = 0.007; arachidonic: 127.1 and 147.0 micrograms/ml serum, p = 0.027). These findings have possible therapeutic and diagnostic implications, but further research is needed to attempt to replicate these differences.

8,11,14-Eicosatrienoic Acid↗
PubMed1987

Reliability of the Aberrant Behavior Checklist and the effect of variations in instructions.

Interrater and test-retest reliabilities of the Aberrant Behavior Checklist were compared on the basis of type of instructions to raters. Three nurses in each of three residential units twice rated 28 mentally retarded residents, using one type of rating system, and the ratings were repeated 4 weeks later. The frequency-based instructions resulted in both higher interrater and test-retest reliability coefficients than did the other instructional types. Frequency-based ratings were performed again in another residential unit, but the higher reliabilities were not replicated. Interrater and test-retest reliability correlations varied markedly both across subscales and raters but were comparable to levels derived with other symptom checklists. We concluded that rater characteristics (e.g., motivation) are more powerful variables than are scoring systems.

Hospitals, Psychiatric↗