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Results for “Child Behavior Disorders”

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PubMed1976

Toward reducing behavior problems in autistic children.

A historical perspective was presented, attempting to trace how some clinical concepts and working assumptions, effective in the past, had drifted out of relationship with social changes, and were now considered by many as being myths. These included the assumption that developmental deviations such as autism were primarily normal responses to family stress and that autism primarily involved the child's social withdrawal from a hostile environment. In this paper some relationships between such myth beliefs and parental difficulties in managing their autistic child were identified. Specific management difficulties were distinguished from general ones. The latter manifest themselves in parental confusion, inappropriate expectations, and social role diffusion. Suggestions were made for helping parental management through changing treatment structures from traditional procedures.

Attitude of Health Personnel↗
PubMed1994

DSM-IV field trials for the disruptive behavior disorders: symptom utility estimates.

OBJECTIVE: We tested the predictive utility of symptoms for proposed DSM-IV definitions of the disruptive behavior disorders using indices corrected for symptom and diagnosis base rates. METHOD: The field trials sample consisted of 440 clinic-referred youths who were consecutive referrals to a heterogeneous group of mental health clinics. Multiple informants were interviewed to determine the presence of symptoms and diagnoses. RESULTS: Some symptoms which were either not in DSM-III or DSM-III-R, or were modifications of DSM-III-R symptoms, had greater diagnostic efficiency than did several existing symptoms. Symptom utility estimates were generally similar for different ages and genders, although some interesting age and sex trends emerged for a few symptoms. CONCLUSIONS: The results supported the inclusion of more restricted definitions of "lying" and "truancy" to increase their association with a conduct disorder diagnosis and they supported the elimination of "swearing" in the oppositional defiant disorder criteria. In addition to their relevance for developing optimal criteria for DSM-IV, these results can aid DSM-IV users by providing a useful guide to the relative efficiency of individual symptoms based on data from a large heterogeneous clinic population.

Adolescent↗
PubMed2005

How to differentiate bipolar disorder from attention deficit hyperactivity disorder and other common psychiatric disorders: a guide for clinicians.

Bipolar disorder in children often is confused with attention deficit disorder, substance-induced mood disorder, oppositional defiant disorder, and conduct disorder. It is not uncommon for some of these disorders to be comorbid with pediatric bipolar disorder. This article provides the reader with a review of the existing literature on differentiating these illnesses and recognizing the phenomenology of each disorder as it pertains to a psychiatric diagnostic work-up of a child. Clinically helpful overlapping and unique characteristics of each disorder are discussed and a practical approach to differentiate these disorders is provided.

Adolescent↗
PubMed1990

Oppositional disorder in children: a validation study comparing conduct disorder, oppositional disorder and normal control children.

Subjects with oppositional disorder (OD, N = 21) and conduct disorder (CD, N = 22) were compared with normal controls (NC, N = 20) to determine whether OD is a distinct disorder. OD subjects exhibited high rates of associated attention deficit, emotional and learning disorders. Compared with NC, OD subjects had high rates of problems in social relationships and came from families characterized by marital fights, dysfunction, and paternal psychopathology. Compared with CD, OD was less often characterized by undersocialization and separations from fathers and more often characterized by dissatisfaction in the marital relationship. These results suggest that OD is a variant of CD rather than of normality.

Achievement↗
PubMed1992

Parenting stress among families of children with attention deficit hyperactivity disorder.

Prior research has shown that parenting stress levels can be quite high among families of children with attention deficit hyperactivity disorder (ADHD). This study investigated the degree to which such stress was related not only to the child's ADHD, but also to various other child, parent, and family-environment circumstances. Multimethod assessments were conducted on 104 clinic-referred children with ADHD. Data collected from these subjects were entered into hierarchical multiple-regression analyses, utilizing the Parenting Stress Index as the criterion. The results showed that the child and parent characteristics accounted for a substantial portion of the variance in overall parenting stress. The child's oppositional-defiant behavior and maternal psychopathology were especially potent predictors. The severity of the child's ADHD, the child's health status, and maternal health status also emerged as significant predictors. These findings are discussed in terms of their impact upon the clinical management of children with ADHD.

Aggression↗
PubMed1990

Aggressive children in a day treatment program: changed outcome and possible explanations.

An earlier study (Gabel, Finn & Ahmad, 1988) of severely disturbed children treated in a day hospital program, found that outcome was particularly poor for children with preadmission histories of severe aggressive/destructive behavior. The study reported here compares the outcome in a more recent group of children treated in the same setting with the earlier group's outcome. The recent group of children, like the earlier one, was made up of youngsters who were often from dysfunctional and abusive families. Outcome for aggressive children, including aggressive children with histories of suspected child abuse/maltreatment, was significantly improved. Possible reasons for this improvement in outcome in terms of programmatic changes that had occurred are discussed.

Aggression↗
PubMed1989

Cognitive-behavioral therapy and relationship therapy in the treatment of children referred for antisocial behavior.

The present study evaluated alternative treatments for children (N = 112, ages 7-13) referred for severe antisocial behavior. Children were randomly assigned to one of three treatments: problem-solving skills training (PSST), problem-solving skills training with in vivo practice (PSST-P), which included therapeutically planned activities to extend training to settings outside of treatment, or client-centered relationship therapy (RT). PSST and PSST-P children showed significantly greater reductions in antisocial behavior and overall behavior problems, and greater increases in prosocial behavior than RT children. These effects were evident on measures obtained immediately after treatment and at a 1-year follow-up, and on measures of child performance at home and at school. PSST-P children showed greater changes than PSST children on measures of functioning at school at posttreatment, but these differences were no longer evident at follow-up. Children in both PSST conditions showed significant reductions in deviant behavior and improvements in prosocial behavior from pretreatment to follow-up, whereas RT children tended to remain at their pretreatment level of functioning. Notwithstanding the significant improvements, comparisons with nonclinic (normative) samples revealed that the majority of youth remained outside of the normal range of deviant behavior. Possible directions for improving treatment for antisocial youth are highlighted.

Adolescent↗
PubMed2007

Generalized anxiety disorder and depression: childhood risk factors in a birth cohort followed to age 32.

BACKGROUND: The close association between generalized anxiety disorder (GAD) and major depressive disorder (MDD) prompts questions about how to characterize them in future diagnostic systems. We tested whether risk factors for MDD and GAD are similar or different. METHOD: The representative 1972-73 Dunedin birth cohort of 1037 males and females was followed to age 32 with 96% retention. Adult GAD and MDD were diagnosed at ages 18, 21, 26, and 32 years, and juvenile anxiety/depression were also taken into account. Thirteen prospective risk measures indexed domains of family history, adverse family environment, childhood behavior, and adolescent self-esteem and personality traits. RESULTS: Co-morbid MDD+GAD was antedated by highly elevated risk factors broadly across all domains. MDD+GAD was further characterized by the earliest onset, most recurrence, and greatest use of mental health services and medication. Pure GAD had levels of risk factors similar to the elevated levels for co-morbid MDD+GAD; generally, pure MDD did not. Pure GAD had risks during childhood not shared by pure MDD, in domains of adverse family environment (low SES, somewhat more maltreatment) and childhood behavior (internalizing problems, conduct problems, somewhat more inhibited temperament). Pure MDD had risks not shared by pure GAD, in domains of family history (of depression) and personality (low positive emotionality). CONCLUSIONS: Specific antecedent risk factors for pure adult MDD versus GAD may suggest partly different etiological pathways. That GAD and co-morbid MDD+GAD share many risk markers suggests that the presence of GAD may signal a pathway toward relatively more severe internalizing disorder.

Adolescent↗
PubMed1983

Auditory brain stem responses and cortical auditory-evoked potentials in difficult-to-test children.

Brain-stem-evoked responses (BERs) and cortical auditory-evoked potentials (AEP) were recorded in 24 children showing severe behavioral disorders. BER testing always requires sedation if not general anesthesia. This allowed us to perform precise acoustic impedance measurements, and thus to find 3 glue ears. The electrophysiological tests revealed whether there was sensorineural deafness, which was cared for if necessary. Finally, when the BERs were normal, we evaluated the modifications in the cortical AEP, in relation to a clinical classification closely related to that of the DSM III of the American Academy of Psychiatry.

Adolescent↗