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PubMed1992

The role of fathers in child and adolescent psychopathology: make room for daddy.

This review summarizes research concerning the relation between paternal factors and child and adolescent psychopathology. When compared with mothers, fathers continue to be dramatically underrepresented in developmental research on psychopathology. However, findings from studies of children of clinically referred fathers and nonreferred samples of children and their fathers indicate that there is substantial association between paternal characteristics and child and adolescent psychopathology. Findings from studies of fathers of clinically referred children are stronger for fathers' effects on children's externalizing than internalizing problems. In most cases the degree of risk associated with paternal psychopathology is comparable to that associated with maternal psychopathology. Evidence indicates that the presence of paternal psychopathology is a sufficient but not necessary condition for child or adolescent psychopathology.

Adolescent↗
PubMed1999

Child and adolescent psychopathology as risk factors for subsequent tobacco use.

A growing body of research suggests that a number of types of psychopathology that occur during childhood and adolescence are also associated with an increased risk for tobacco use. This paper assesses the relationship between several types of child and adolescent psychopathology and subsequent tobacco use. The types of psychopathology that are discussed include 'externalizing' disorders such as conduct problems and attention-deficit/hyperactivity disorder (ADHD), and 'internalizing' disorders such as depression and anxiety disorders. The strongest evidence for connections between child and adolescent psychopathology and subsequent tobacco use is for conduct problems, ADHD, and depression. There is much weaker support for a connection between anxiety disorders and tobacco use. The relationships between conduct problems and ADHD (which frequently co-occur) and subsequent tobacco use are quite robust. Possible explanations of the relationships between conduct problems, ADHD, and tobacco use are presented. There appears to be a bidirectional relationship between depression and tobacco use; i.e., each has a comparable probability of preceding the other. Areas of particular importance are: (a) the effects of various psychopathologies on various aspects of tobacco use; (b) the role of comorbid psychopathologies; (c) identification of protective factors; (d) the effects of moderators (e.g., gender, ethnicity); (e) mechanisms and processes ('active ingredients') associated with various psychopathologies; (f) implications for intervention; and (g) possible cohort effects.

Adolescent↗
PubMedDate not supplied

Akathisia and exacerbation of psychopathology: a preliminary report.

Akathisia has previously been reported to exacerbate psychopathology and to be associated with noncompliance, suicidality, and violence. One previous study found brisk decrements in psychopathology after acute treatment of akathisia with intramuscular biperiden. This study assessed changes in akathisia and psychopathology in 19 patients after separate one-day treatments with intramuscular benztropine and oral propranolol. Benztropine and propranolol led to clinically meaningful and statistically significant decrements in ratings of subjective and objective measures of akathisia and in psychopathology scores. Changes in psychopathology correlated significantly with changes in subjective measures of akathisia after benztropine and with subjective and objective measures of akathisia after propranolol. Changes in akathisia accounted for 9%-42% of the variance in changes in psychopathology. After treatment, statistically significant decrements in Brief Psychiatric Rating Scale (BPRS) positive symptoms were noted, and individual items not directly related to the akathisia syndrome, such as conceptual disorganization, hallucinatory behavior, and unusual thought content declined, although not significantly. These findings, taken together with the results of a similar previous study, indicate that the effect of akathisia in exacerbating psychopathology is large. If suspected, akathisia should be treated promptly.

Adrenergic beta-Antagonists↗
PubMed1983

Validity of the Minnesota Multiphasic Personality Inventory (MMPI) to psychopathology in patients with epilepsy.

Information regarding the sensitivity of the Minnesota Multiphasic Personality Inventory (MMPI) to psychopathology and the meaning of MMPI elevations in neurological patients, particularly in those with epilepsy, is of both theoretical and clinical concern. Such information has a particular relevance to the temporal lobe epilepsy-psychopathology controversy. In order to investigate evidence for increased psychopathology as a function of complex partial seizures (temporal lobe epilepsy in the old nomenclature), three groups of epilepsy patients differing in seizure type were compared on the MMPI. No supportive evidence was present for such an association. Second, the sensitivity of the MMPI to psychopathology was examined by comparing three groups of epilepsy patients differing in history of psychiatric problems. The results clearly indicated that the MMPI is sensitive to psychopathology in patients with epilepsy. Finally, the Sc scale was examined in relation to items descriptive of "disease-related experiences" and the psychiatric implications of endorsing such items. About one third of the items were identified as descriptive of "real experiences." Nevertheless, patients with psychiatric histories endorsed more of such items. In conclusion, the MMPI appears to be sensitive to psychopathology in epilepsy. Therefore, insensitivity of this instrument cannot be advanced as an explanation for the results of many studies that have not supported the temporal lobe epilepsy-psychopathology controversy.

Adult↗
PubMed1994

Psychopathology and cognitive decline in dementia.

This study investigated the correlation between the degree and quality of cognitive impairment and the presence and degree of severity of psychopathology. Sixty-four demented outpatients were rated for cognition by the Mental Status Questionnaire and for psychopathology by the BEHAVE-AD Reisberg questionnaire. A statistical analysis of the correlations between the cognitive and psychopathological parameters was performed. The study indicated a high rate of psychopathology (as high as 83% of the patients). No significant correlation was found between the cognitive grading score and the presence of psychopathology, except in the space of declined spatial orientation and the occurrence of hallucinations. Psychopathology is a common phenomenon occurring in the course of dementia in the form of Alzheimer's disease or multi-infarct dementia. There is a certain increase in the degree of psychopathology that correlated with cognitive impairment. The high correlation between impaired spatial orientation and the presence of hallucinations seems to point to a common neuropathological substrate.

Aged↗
PubMed1997

Discriminating borderline from antisocial personality disorder in male patients based on psychopathology patterns and type of hostility.

Dimensions of psychopathology and patterns of hostility, as well as the relationship of hostility to psychopathology, were studied in 85 male young adults: 41 with borderline personality disorder (BPD) and 44 with antisocial personality disorder (APD). Diagnoses were based on DSM-III. The following instruments were also used: Brief Psychiatric Rating Scale, Hamilton Depression Rating scale, State-Trait Anxiety Inventory, and Hostility and Direction of Hostility Questionnaire. BPD patients compared with APD patients showed higher levels of overall psychopathology and depression, whereas both groups had equally high anxiety. Total hostility was quite high in both groups. However, BPD patients had more introverted hostility and APD patients had more extroverted hostility. In BPD patients, introverted hostility was related to overall psychopathology, depression, and trait anxiety, whereas in APD patients, no significant relationship of any type of hostility to various dimensions of psychopathology was observed. In conclusion, when comprehensively assessed, BPD patients can be discriminated from APD patients based on certain dimensions of psychopathology and differences in the direction of their hostility. Moreover, the relationship between psychopathology and hostility patterns suggests that the direction of patients' hostility plays an important role in the development of disorder-specific symptomatology.

Adult↗
PubMed1999

[Subjective quality of life of schizophrenic patients. Effect of treatment setting, psychopathology and extrapyramidal motor drug effects].

OBJECTIVE: In a cross-sectional study in 79 schizophrenic patients the quality of life (QOL) of a group of community-based patients under supervision of an outpatient unit (n = 47) and a group of long-stay patients in an inpatient rehabilitation centre in the same area (n = 32) was compared. METHODS: The patients' QOL was evaluated using the Lancashire Quality of Life Profile. Moreover psychopathology and extrapyramidal-motoric side-effects were assessed. RESULTS: Long-stay patients had a more distinct psychopathological symptomatology and more severe side-effects than community-based patients. After adjustment for psychopathology and side-effects, the subjective QOL of long-stay patients was significantly reduced in two out of eight life domains: housing and leisure activities. While psychopathology was negatively correlated with QOL, a subgroup with very marked psychopathology showed unexpectedly high QOL ratings. CONCLUSIONS: Results suggest that psychopathology is a stronger predictor of subjective QOL than side-effects and treatment setting. Patients with very distinct psychopathology probably use lower standards than others when evaluating their QOL which should be taken into consideration when analysing this type of data.

Adult↗
PubMed2001

[Obesity in children and adolescents, mental disorders and familial psychopathology].

OBJECTIVE: The purpose of this study was to evaluate the type and frequency of psychopathological disorders observed in obese children and adolescents. We also looked for a correlation between psychic disorders in the obese children, the degree of obesity and paternal psychopathology. PATIENTS AND METHODS: The study group included 84 obese children and adolescents aged 5 to 16 years (mean age 10.9 +/- 2.8 years). There were 55 girls and 29 boys. The z-score expressing deviation from the ideal body mass index (IMC) varied from +2 to +10.6 (mean 4 + 1.9). Psychopathological disorders observed in these obese patients were compared in children and adolescents with insulin-dependent diabetes mellitus. The standard diagnostic interview (K-SADS PL) and self-administered questionnaires (Sielberger STAIC-Trait for anxiety and CDI for depression in children or CBCL or GHQ for their parents) were also used to evaluate psychic disorders. RESULTS: More than half of the obese children (47 out of 84) had a DSM-IV diagnosis, often involving anxiety (n = 28). The rate of internalized and externalized psychopathological disorders (measured by STAIC-Trait and CBCL) was higher in the obese children than in the diabetics. The children's psychopathological disorders were more marked if their parents were perturbed, particularly when their mother had an internalized disorder. No correlation was found between the degree obesity and psychopathological disorders in the obese children and adolescents. CONCLUSION: Our findings show the frequency of mental disorders in obese children and point out the importance of parental psychopathology. This underlines the usefulness of a pedopsychiatric approach implicating the entire family for therapeutic management of these patients.

Adolescent↗
PubMed1998

Developmental psychopathology, personality, and temperament: reflections on recent behavioral genetics research.

Personality, temperament, and psychopathology were until recently largely distinct areas of study, each of which emphasized partitioning of heritable and environmental variance. The emergence of the paradigm of developmental psychopathology along with application of multivariate biometric models to behavioral genetic data has defined a second phase of research in these domains. Integrated research has begun to map dimensional liability-threshold models of psychopathology and to evaluate empirically the categorical versus dimensional etiology of traits and disorders. An interesting pattern in the data is that psychopathology is probably not merely an extreme of temperament or personality in many cases. Variations in temperament and personality are now known to be heavily influenced by additive genetic and nonshared environmental factors and to exhibit stable or increasing heritability across development. This pattern holds for some measures of psychopathology but not for others. For example, shared environment effects and decreasing heritability influence much adolescent psychopathology, and comorbid problems in young children appear to be due in part to shared environment effects. Other recent biometric work on the central problem of comorbidity in psychopathology suggests that shared genetic covariation accounts for some specific comorbidities but not others. A third phase of research is now underway, featuring study of specific molecular gene mechanisms by means of linkage and association studies in relation to behavioral phenotypes. Complementary integration of discoveries from biometric behavioral studies and molecular studies is expected to be the norm for the near future.

Adult↗
PubMed1997

Individual psychopathology relative to reports of unwanted sexual experiences as predictor of a bulimic eating pattern.

OBJECTIVE: The goal of this study was to determine whether family and individual psychopathology mediate the relationship between unwanted sexual experiences and bulimic eating behavior. METHOD: Sixty-one women diagnosed with bulimia nervosa and 92 women students and university staff who had never met critia for an eating disorder completed standardized questionnaires on eating behavior, sexual abuse, individual psychopathology, and family psychopathology. RESULTS: Linear regression showed bulimic eating behavior to be significantly related to sexual abuse (beta = .40; p < .0001; R2 = 8.9%). However, multiple regression analyses with family and individual psychopathology as independent variables in addition to sexual abuse showed only individual psychopathology to predict significantly abnormal eating behavior (beta = .53, p < .0001; overall R2 = 49.6%). Specifically, depressive symptoms, suicidality, and impulsive behavior, but not substance abuse, were the components of individual psychopathology most directly associated with bulimia. DISCUSSION: The findings suggest that the primary focus in treatment should not be the traumatic events themselves, but their long-term consequences for the individual.

Adolescent↗
PubMed1995

Issues in the taxonomy of psychopathology in mental retardation.

Several factors appear to impede the development of a valid taxonomy of psychopathology in children and adolescents with mental retardation. These include (a) the lack of a widely accepted definition of psychopathology in mental retardation, (b) disagreement on the nature of the relationship between mental retardation and psychopathology, and (c) insufficient evidence for the reliability and validity of current DSM or ICD systems in this population. In this article, we offer a definition of psychopathology in children with mental retardation; review concepts of the relationship between psychopathology and mental retardation; argue that in moving toward a valid taxonomy factors to be considered should include data from multivariate studies, findings related to behavior phenotypes, and diagnostic considerations with stereotypic behavior and self-injury, organic brain syndromes and pervasive developmental disorders. Finally, we outline a research strategy that may serve as a useful framework for developing a valid taxonomy of psychopathology in this population.

Adolescent↗
PubMed2003

Psychopathological dimensions in first-episode psychoses. From the trunk to the branches and leaves.

BACKGROUND: Dimensional frameworks for structuring psychopathology have been formulated in recent years to overcome classification problems of categorical approaches. However, few studies have addressed the dilemma of hierarchy within symptoms or dimensions in psychosis. METHODS: This study was designed to examine the hierarchical structure of psychopathological dimensions in first episode psychosis. The sample consisted of 94 first-episode patients psychosis. An exhaustive psychopathological assessment was carried out using the AMDP-system. Consecutive principal component analyses of AMDP symptoms, determining 'a priori' the number of factors to be extracted, were carried out. RESULTS: Following the track of the resulting factor analyses, a 'vertical hierarchical' framework was achieved. Our schema organized dimensions in a series of echelons in which lower tiers are subsumed as subsets of those assigned to higher ranks. In addition, a final model comprising 10 dimensions provided an 'horizontal' and multidimensional structure comprising all relevant psychopathological dimensions in first-episode psychosis. CONCLUSIONS: This study confirmed to a great extent the existence of a hierarchical organization within psychopathological dimensions in 'first-episode' psychosis. The present 'hierarchical and multidimensional' model of psychopathological dimensions allows for selection of the level of complexity of 'candidate phenotypes' to use in neurobiological research of psychosis.

Adult↗
PubMed2006

Psychopathological symptoms, social skills, and personality traits: a study with adolescents.

The purpose of this study is two-fold: (a) to study the concomitant relationships between psychopathological symptoms, cooperation, social skills, and other personality traits; and (b) to identify the predictive variables of psychopathological symptoms. The sample consists of 322 adolescents aged 14 to 17 years old. This study uses correlational methodology. In order to assess psychopathological symptoms, cooperation, social skills, and personality traits, the following scales are used: the Symptom Checklist (SCL-90-R; Derogatis, 1983), the Cooperativeness Scale (CS; Rigby, Cox, and Black, 1997), the MESSY social skills scale (Matson, Rotatori, and Helsel, 1983), and the TPT Personality Test (Corral, Pamos, Pereña, and& Seisdedos, 2002). Pearson coefficients suggest that adolescents with many psychopathological symptoms have low levels of cooperative behaviors and social skills. They also score high in inappropriate assertiveness, impulsiveness, overconfidence, and jealousy-withdrawal and have low levels of emotional stability, sociability, and responsibility. Through multiple regression analyses, the following variables were identified as predictors of psychopathological symptoms: jealousy-withdrawal, low social integration, impulsiveness, and low self-concept. The role played by intervention programs promoting socio-emotional development to prevent psychopathological symptoms and enhance mental health is discussed.

Adolescent↗
PubMed2001

Specificity of relations between children's control-related beliefs and internalizing and externalizing psychopathology.

The authors examined the specificity of the relation between 3 types of control-related beliefs and internalizing and externalizing psychopathology in a sample of 290 clinic-referred children aged 7 to 17 years. Self-reported beliefs about control (the capacity to cause an intended outcome), contingency (the degree to which a desired outcome can be controlled by a relevant behavior), and competence (an individual's ability to produce the relevant behavior) across 3 domains (academic, behavioral, and social) showed more specific relations with psychopathology than have been previously reported. Among children with externalizing psychopathology, internalizing psychopathology may be specifically associated with increased self-critical awareness about their conduct; externalizing psychopathology may attenuate the specific negative relation between internalizing psychopathology and control-related beliefs in the social domain.

Adolescent↗
PubMed2001

[How far is psychopathology still meaningful for the treatment of schizophrenia?].

The paper gives reasons for the view that psychopathology has to be not only the fundamental method for clinical psychiatry, but also an essential prerequisite for a rational therapy of schizophrenia and related disorders. Because schizophrenic patients present very different types of psychopathological cross-sectional syndromes, the choice of a distinct neuroleptic or antidepressant compound and their dosage has to be guided along the psychopathological target syndrome. The clinical-therapeutical effects of neuroleptics and antidepressants are above all symptom- (Freyhan) or syndrome-directed. The differentiation of positive and negative symptoms, acute and chronic or residual schizophrenia, or of the prodromal symptoms according to contemporary approaches seems to be not sufficient for the early detection of psychopathological predictors of an impending psychosis and the special indication and choice of a distinct drug and dosing strategy. This is valid for maintenance treatment of patients in remission, for early intervention in the prodromal stages before the first and later psychotic episodes and in preventing relapses. Relapse rates can be reduced by a low dose maintenance therapy with basic symptom oriented early adaptation of the dosage in the prodromes before psychotic remanifestations. Some presuppositions of an effective psychopharmacological and psychological therapy in view of clinical psychopathology (K. Schneider) and the "phenomenological attitude" (K. Jaspers) are outlined. A necessary condition for the secondary as well as for the primary prevention of psychotic episodes is the detailed knowledge of the interindividual different dynamic and cognitive basic symptoms, defined in the Bonn Scale BSABS, that are experiential in kind and not identical with the negative and behavioral "Prodromal and Residual Symptoms" of DSM and ICD-10. The early detection and preventive intervention of schizophrenic psychoses is most likely possible by means of a subtle, descriptive-analytical phenomenology and psychopathology. Also "chronic" patients beyond acute psychoses, e. g. those with persisting pure residues, characterized not by true negative, but by basic symptoms, often respond to distinct atypical neuroleptics and/or antidepressants. The knowledge of the prodromal symptoms and the coping strategies, frequently developed by the patients themselves, is an essential component of a basic symptom oriented psychoeducational concept.

Humans↗
PubMed1997

Psychopathology in infancy.

The first three years of life present unique challenges to the study of psychopathology. We highlight four of the issues in a selective review of the developmental psychopathology of early childhood, including lack of specificity of risk and outcome variables, measurement difficulties, rapid developmental changes and the centrality of the relationship context in early childhood. We also highlight issues relevant to conceptualizations of disorders of infancy, emphasizing especially the need for efforts to validate clinical disorders. We consider two major domains of infant development that we believe are especially relevant to a discussion of psychopathology, namely, regulation of emotion and infant-caregiver attachment. Discussions of these two domains of infant development and their psychopathological extremes allow us to consider conceptualizations of psychopathology from the dual perspectives of developmental psychopathology and clinical disorders. We conclude by suggesting a number of strategies to build upon previous research.

Affective Symptoms↗
PubMed1981

Deficits in neuropsychological functioning and psychopathology in persons with epilepsy: a rejected hypothesis revisited.

Previous investigations have failed to detect a relationship between the adequacy/inadequacy of neuropsychological functioning and psychopathology in persons with epilepsy. It is argued that these results were obtained because of the manner in which the measures of psychopathology, the MMPI, were analyzed. The MMPI data from two recent neuropsychological investigations of epilepsy were analyzed using a technique which has been found to be quite sensitive to various psychopathological categories, i.e., Goldberg's Rules. Comparison of subjects varying in degree of neuropsychological impairment revealed increased psychopathology in the patient groups with more widespread cognitive deficits. It is concluded that there is a relationship between deficits in neuropsychological functioning and psychopathology in epilepsy. This relationship is related to the larger literature of epilepsy and psychopathology.

Epilepsy↗
PubMed2005

General psychopathology is more important for executive functioning than diagnosis.

OBJECTIVE: Impaired executive functioning (EF) has often been reported in patients with major depression or schizophrenia. We hypothesize that the variance in EF is more affected by level of general psychopathology than by diagnosis. METHOD: Forty-three patients with major depression and 47 with schizophrenia were included. EF was measured with Wisconsin Card Sorting Test, Stroop Colour Word Test, Paced Auditory Serial Addition Test, Digits Backwards and Controlled Oral Word Association Test. The level of general psychopathology was measured with Brief Psychiatric Rating Scale - Expanded and Positive and Negative Syndrome Scale, the General psychopathology subscale. RESULTS: The level of general psychopathology predicted more of the variance in EF than diagnosis. In multivariate analyses, the effect of general psychopathology on EF was more robust for adjustment for diagnosis than vice versa. CONCLUSION: Future research on cognitive functioning in psychiatric patients should include level of general psychopathology to avoid overemphasising effects of diagnoses.

Adult↗