Commentary: a look at ourselves in the mirror.
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Efficiency, Organizational↗
Biomedical subjects
William G Kronenberger
Publications and source records attributed to William G Kronenberger.
Media violence exposure and executive functioning in aggressive and control adolescents.
The relationship between media violence exposure and executive functioning was investigated in samples of adolescents with no psychiatric diagnosis or with a history of aggressive-disruptive behavior. Age-, gender-, and IQ-matched samples of adolescents who had no Diagnostic and Statistical Manual of Mental Disorders-fourth edition (DSM-IV; American Psychiatric Association, 1994) diagnosis (N = 27) and of adolescents who had DSM-IV Disruptive Behavior Disorder diagnoses (N = 27) completed measures of media violence exposure and tests of executive functioning. Moderate to strong relationships were found between higher amounts of media violence exposure and deficits in self-report, parent-report, and laboratory-based measures of executive functioning. A significant diagnosis by media violence exposure interaction effect was found for Conners' Continuous Performance Test scores, such that the media violence exposure-executive functioning relationship was stronger for adolescents who had Disruptive Behavior Disorder diagnoses. Results indicate that media violence exposure is related to poorer executive functioning, and this relationship may be stronger for adolescents who have a history of aggressive-disruptive behavior.
Adolescent↗
Childhood epilepsy, attention problems, and ADHD: review and practical considerations.
Children with epilepsy have a significant risk for problems with attention and/or attention deficit hyperactivity disorder. Clinical studies suggest a prevalence of 30% to 40%. Inattention is more common than hyperactivity and impulsivity. Additional central nervous system dysfunction and intractable seizures are major risk factors. Treatment should include psychoeducational interventions and medication. Stimulant drugs are safe and effective in children with epilepsy and currently are first-line agents for treatment of attention problems in this population.
Attention↗
Investigator ratings of ADHD symptoms during a randomized, placebo-controlled trial of atomoxetine: a comparison of parents and teachers as informants.
This study compared investigator ratings of ADHD symptoms based on interviews with parents and teachers during a doubleblind, placebo-controlled study of atomoxetine. Investigators completed the ADHD Rating Scale: Investigator (ADHDRS-I) based on separate semistructured interviews with the primary caretaker and teacher of the participant. Interviews were conducted at Visits 2 to 7 during a double-blind treatment protocol comparing atomoxetine (N= 10) and placebo (N= 6). Both parent and teacher-based ratings were sensitive to change in ADHD symptoms with atomoxetine treatment. Parent-based assessment differentiated significantly between treatment with atomoxetine and placebo, whereas teacher-based assessment was less sensitive to change. Parents and teachers showed good agreement on change in ADHDRS-I scores. Investigator ratings based on parent- and teacher-report were sensitive to change in symptoms of ADHD during treatment with atomoxetine. Despite good agreement between parent- and teacher-based ratings of symptom change, parent-based ADHD symptom ratings are more sensitive to symptom change.
Atomoxetine Hydrochloride↗
Attention-deficit/hyperactivity disorder in children and adolescents.
ADHD is a common developmental disorder frequently associated with additional neurologic and psychiatric disorders. Stimulant medication is an effective first-line therapy for most children with ADHD. Current research is defining the genetic and neurobiologic basis for this disorder.
Adolescent↗
Learning disorders.
Three broad areas of LDs are recognized in the DSM-IV (RD, mathematics disorder, and disorder of written expression), and many atypical LDs (such as NVLD) also may be found in children with academic underachievement. These disorders are defined by a significant discrepancy between a child's intellectual (learning) ability and specific area of academic achievement, based on individual psychologic testing. Interventions for these disorders begin with careful evaluation and testing, followed by meetings at the school and development of an IEP. The recommendations of the IEP are performed in the school setting, whereas additional interventions may be sought at private learning clinics. Specific treatments for RD have been well defined, whereas those for other LDs must be tailored to match the strengths and weaknesses of the child. Although it is rare for individuals to completely outgrow the academic weaknesses characteristic of an LD, their performance in the area of weakness often can be improved markedly with appropriate interventions.
Attention Deficit Disorder with Hyperactivity↗
Inpatient pediatric consultation-liaison: a case-controlled study.
OBJECTIVE: To conduct a prospective case-controlled study of pediatric inpatients referred for consultation in a tertiary care children's medical center. METHOD: Referrals (n = 104) were matched with nonreferrals (n = 104) for age (4 to 18 years), gender, and illness type/severity and completed parent- and self-report (dependent on age) behavioral rating scales to assess for adjustment/functioning. Nurses completed in-hospital ratings of behavioral/adjustment difficulties. Goal attainment and satisfaction ratings were obtained from the referring physicians, parents/guardians, and the consultant. RESULTS: Referrals exhibited more behavior/adjustment/coping difficulties than nonreferrals by parent, nurse, and self report. Frequently employed interventions included coping-strategies intervention, cognitive and behavioral therapies, and case management. Referring physician and consultant ratings of goal attainment were high, as were physician ratings of satisfaction and parent/guardian ratings of overall helpfulness. CONCLUSIONS: Pediatric inpatients referred by their physicians had significantly more internalizing and externalizing disturbances than their nonreferred hospitalized peers. Many of the behavioral and adjustment problems that lead to in-hospital consultation referral were evident in global behavior difficulties prior to hospitalization. Referring pediatricians, parents/guardians, and consultants rate the outcome as benefiting the patients via assisting in the overall management of their health concerns, coping, and adjustment.
Adaptation, Psychological↗
Assessment of response to clinical hypnosis: development of the Hypnotic State Assessment Questionnaire.
This study describes the development and preliminary psychometric properties of a scale for measuring hypnotic response in clinical hypnosis sessions. The Hypnotic State Assessment Questionnaire (HSAQ), a brief, multidimensional measure of hypnotic response during clinical sessions of hypnosis, is intended to facilitate supervision of hypnosis trainees and to document subjects' response in clinical hypnosis sessions. Results indicate that most HSAQ subscales have good interrater and internal consistency reliability. Furthermore, HSAQ observations correlated with post-hypnotic behaviors and subjective experiences of hypnosis. Use of the HSAQ in hypnosis training settings allows supervisors to obtain standardized data describing hypnosis sessions conducted by trainees. This data may also be used to document clinical response for record keeping or research.
Humans↗
Media violence exposure and frontal lobe activation measured by functional magnetic resonance imaging in aggressive and nonaggressive adolescents.
OBJECTIVE: To understand better the relation between media violence exposure, brain functioning, and trait aggression, this study investigated the association between media violence exposure and brain activation as measured by functional magnetic resonance imaging (fMRI) in groups of normal adolescents and adolescents with disruptive behavior disorder (DBD) with aggressive features. METHODS: Seventy-one participants underwent neuropsychologic evaluation and assessment of exposure to violent media. Subjects also were evaluated with fMRI while performing a counting Stroop (CS) task. RESULTS: Frontal lobe activation was reduced in aggressive subjects compared with control subjects. In addition, differences in frontal lobe activation were associated with differences in media violence exposure. Specifically, activation during performance of the CS in control subjects with high media violence exposure resembled that seen in DBD subjects. CONCLUSIONS: Our findings suggest that media violence exposure may be associated with alterations in brain functioning whether or not trait aggression is present.
Adolescent↗