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PubMed2006

Antibrain antibodies in children with autism and their unaffected siblings.

Serum autoantibodies to human brain, identified by ELISA and Western immunoblotting, were evaluated in 29 children with autism spectrum disorder (22 with autistic disorder), 9 non-autistic siblings and 13 controls. More autistic subjects than controls had bands at 100 kDa in caudate, putamen and prefrontal cortex (p<0.01) as well as larger peak heights of bands at 73 kDa in the cerebellum and cingulate gyrus. Both autistic disorder subjects and their matched non-autistic siblings had denser bands (peak height and/or area under the curve) at 73 kDa in the cerebellum and cingulate gyrus than did controls (p<0.01). Results suggest that children with autistic disorder and their siblings exhibit differences compared to controls in autoimmune reactivity to specific epitopes located in distinct brain regions.

Autistic Disorder↗
PubMed2003

Researching the pathophysiology of pediatric bipolar disorder.

We suggest that the core feature of bipolar disorder (BPD) is marked state fluctuations. The pathophysiology of switches into depressed, irritable, and extreme positive valence states requires study, with the latter deserving particular focus because it represents a pathognomonic feature of BPD in both adults and children. Hypotheses regarding the pathophysiology of pediatric BPD must account for these marked state fluctuations as well as for specific developmental aspects of the illness. These developmental aspects include marked irritability (in addition to euphoria and depression) and very rapid cycles, along with high rates of attention-deficit/hyperactivity disorder. We review research on neural mechanisms underlying positive valence states and state regulation, focusing on those data relevant to BPD and to development. Researchers are beginning to explore the response of manic patients and control subjects to positive affective stimuli, and considerable research in both nonhuman primates and humans has focused on the cortico-limbic-striatal circuits mediating responses to rewarding stimuli. In control subjects, positive affect affects cognition, and data indicate that prefrontal electroencephalogram asymmetry may differ between control subjects with consistently positive affect and those with more negative affect; however, this latter generalization may not apply to adolescents. With regard to the pathophysiology of state switching in pediatric BPD, data in control subjects indicating that attention regulation plays a role in emotion regulation may be germane. In addition, research detailing physiologic and psychological responses to negative emotional stimuli in bipolar patients and control subjects may increase our understanding of the mechanisms underlying both irritability and rapid cycling seen in children with BPD. Potential foci for research on the pathophysiology of pediatric BPD include reactivity to standardized positive and negative emotional stimuli, and the interaction between emotion regulation and attentional processes.

Adolescent↗
PubMed1999

A longitudinal study of interparental conflict, emotional and behavioral reactivity, and preschoolers' adjustment problems among low-income families.

Researchers have begun to develop models that explain the processes by which interparental conflict impacts children's adjustment. The present study tested a model based on emotional security theory. The longitudinal relations among interparental conflict, boys' reactions to conflict, and internalizing and externalizing problems were examined in a sample of 129 mother-son dyads from low-income, 2-parent families from the time sons were age 2 to 5. Results indicated that children exposed to interparental conflict were more likely to have concurrent and later behavior problems and that patterns of interparental conflict across time made unique contributions in predicting later problems. Children's emotional reactivity in response to conflict had no direct relation to interparental conflict and only modest relations to behavior problems. However, interparental conflict and reactivity factors interacted to predict behavior problems at ages 3 1/2 and 5. Thus, some support was demonstrated for emotional reactivity as a moderator in the development of young children's behavior problems.

Adaptation, Psychological↗
PubMed2006

Social behavior and cortisol reactivity in children with fragile X syndrome.

OBJECTIVE: To examine the association between limbic-hypothalamic-pituitary-adrenal (L-HPA) axis reactivity and social behavior in children with fragile X syndrome (FXS). METHOD: Salivary cortisol changes and concurrent anxiety-related behaviors consistent with the behavioral phenotype of FXS were measured in 90 children with the fragile X full mutation and their 90 unaffected siblings during a social challenge task in the home. RESULTS: Boys and girls with FXS demonstrated more gaze aversion, task avoidance, behavioral signs of distress, and poorer vocal quality than the unaffected siblings. Multiple regression analyses showed that after accounting for effects of IQ, gender, age, quality of the home environment, and basal cortisol level, cortisol reactivity to the task was significantly associated with social gaze in children with FXS. The most gaze-aversive children with FXS had cortisol reductions, whereas those with more eye contact demonstrated the most cortisol reactivity. Unaffected siblings demonstrated an opposite pattern in which less eye contact was associated with increased cortisol reactivity. CONCLUSIONS: Results of the study suggest a unique relation between abnormal gaze behavior and L-HPA mediated stress reactivity in FXS.

Child↗
PubMed1999

Parents anticipating misbehaviour: an observational study of strategies parents use to prevent conflict with behaviour problem children.

Research on the role of parenting styles in the development of disruptive behaviour problems has focused primarily on how parents handle conflict once it has occurred. This home observational study examined strategies used by 52 mothers to prevent conflict with 3-year-olds. It was predicted that mothers of children with behaviour problems would use fewer "positive" strategies to resolve conflict, and would use reactive rather than pre-emptive strategies. Results showed frequency of positive strategies did not differ between the groups. Mothers of children with behaviour problems were less likely to use pre-emptive, and more likely to use reactive, strategies. Further analysis showed child conduct problems, rather than other characteristics, best discriminated pre-emptive from reactive strategy users. Follow-up of a subsample found that reactive strategies at age 3 predicted age 5 behaviour problems, even after controlling for age 3 behaviour problems.

Attitude↗
PubMed1991

[Panarteritis nodosa with secondary hyperaldosteronism involving renal arterioles].

A case of a 6 year old girl with angiographically and bioptically verified systemic polyarteritis nodosa is reported. Secondary hyperaldosteronism due to involvement of small and medium-sized renal arteries caused severe hypertension and left ventricular hypertrophy, and together with abdominal complaints, loss of weight, livedo reticularis and elevated titers of streptococcal antibodies formed the clinical pattern of the disease. It may be assumed, that there is a correlation between the recurrent streptococcal infections and the development of systemic polyarteritis nodosa by hypersensitivity or disordered immunologic reactivity. Therapy and short time follow up is reported. For treatment of hypertension an angiotensin converting encyme inhibitor was used, which immediately slowed down the maximal stimulated plasmarenin-angiotensin system.

Aldosterone↗
PubMed1976

[Antibodies against the Epstein-Barr virus, capsid antigen in children with malignant neoplasms (author's transl)].

Sera from children were tested for antibodies to viral capsid antigens of Epstein-Barr virus. The method applied was the indirect immunofluorescence test. 25 sera from healthy donors were titrated as controls. In 14 patients with acute lymphocytic leukemia we found low levels, a tiny little girl with chronic myelocytic leukemia (?) AND THREE CHILDREN.WITH LYMPHOPROLIFERATIVE DISORDERS SHOWed highly increased serological reactivities. Investigated children with other kinds of tumours did not serologically differ significantly from the control group. Further investigations should clarify the role of this infectious agent.

Age Factors↗
PubMed2002

[Functional gastralgia].

Psychiatric and psychological examinations of 100 patients (80 females and 20 males) with functional gastralgia (ICD-10 diagnosis F45.31) have been conducted. In all the cases, the disease developed in chronic stress in persons with higher anxiety inclined to mild anxious and depressive reactions. Four stages of the disease development were described: reactive (neurotic) depression, psychosomatic reactions, psychosomatic cycles (mono- and polysystemic) and psychopathization. Development of psychosomatic personality was expressed as hypochondriac type.

Adolescent↗
PubMed2003

Clinical phenomenology of episodic rage in children with Tourette syndrome.

OBJECTIVE: Episodic rage of unknown etiology causes significant morbidity in children with Tourette's syndrome (TS). Using modified Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for intermittent explosive disorder (IED), we developed a screen and symptom questionnaire to explore rage attack phenomenology and to preliminarily investigate whether symptom clusters can identify clinical subgroups of TS children with rage attacks. METHODS: 48 children with TS between ages 7 and 17 years consecutively presenting with rage attacks completed the Rage Attacks Screen and Questionnaire. Data was subjected to factor analysis. Cluster analytic procedures were used to identify clinical subgroups. RESULTS: Final cluster solution revealed four homogeneous subgroups of TS children with rage who were differentiated by predominant clinical characteristics: specific urge resolution, environmentally secure reactivity, nonspecific urge resolution or labile nonresolving. CONCLUSION: Episodic rage in TS has stereotypic features, but diverse and complex etiologies. Identifying particular symptom clusters may facilitate improved treatment strategies.

Adolescent↗
PubMed1988

Secondary generalized epilepsy in childhood: EEG patterns and correlation with responsiveness to benzodiazepines or ACTH (preliminary note).

Secondary generalized epilepsy in childhood, characterized by absences or minor motor seizures, occurs in the forms of various syndromes, as defined by current classifications. EEG often shows continuous or subcontinuous paroxysmal activity associated with partly reversible psychomotor or mental regression. The paroxysmal activity can exhibit one of two distinct patterns: "organized" or "disorganized," although intermediate forms are common. The two patterns differ not only morphologically but also in the responsiveness to drug or hormone therapy, reactivity to stimuli, sleep changes and frequency of disordered slow rhythms. These features are illustrated by means of a survey of 10 cases.

Adolescent↗
PubMed1976

[Hypoglycemia. Part 4. General causes, physiological newborn hyperglycemia, hyperglycemia in various illnesses, metabolic deficiency, and metabolic error].

The possible causes for hypoglycemia are discussed in relation to the biochemical and metabolic basis of blood glucose regulation. The functional tests which are important for purposes of differential diagnosis are described in detail. Most cases of clinically important hypoglycemia are based on disfunctions of the regulatory endocrinological mechanisms necessary for prevention of hypoglycemia in the fasting state. The consequence, therefore, is a "starvation hypoglycemia". Ketosis during hypoglycemia is evaluated as a kind of "glucose-sparing-mechanism". It is observed in all cases, where the nutritional glucose supply is not sufficient. The common therapy in typical cases of starvation hypoglycemia is a carbohydrate rich and protein rich nutrition. Additionally, small and frequent meals are required for avoidance of starvation hypoglycemia. Whereas starvation hypoglycemia is frequently seen, so called reactive hypoglycemia is very rare. The following metabolic disorders lead to reactive hypoglycemia: leucinsensitive hypoglycemia, fructose intolerance, galactose intolerance, fructose-1,6-diphosphatase deficiency. Considering these cases special tolerance tests are required. With the usual routine test methods only leucin-sensitive hypoglycemia is diagnosed.

Adult↗
PubMed1985

Electrodermal activity of undersocialized aggressive children: a pilot study.

Electrodermal activity of 11 children with conduct disorder (CD) and 11 normal children were compared during periods of rest, moderate tone and loud bell stimulation. The CD group was best differentiated from controls by lower reactivity to the first bell, while on tonic measures they showed normal values. The electrodermal profile of the CD children thus resembled that of adult sociopaths on phasic measures only. The possibility of using electrodermal measures for predicting outcome and for differential diagnosis is raised.

Acoustic Stimulation↗
PubMed1981

A global psychosomatic study of 16 consecutive patients with ulcerative colitis.

The author reports the results of a global psychosomatic study conducted upon a consecutive series of 16 patients with ulcerative colitis (UC), by means of an anamnestic biographic interview plus a projective test (TAT) in association with the usual clinical research applied. The most significant data deal with: the relationship with parental figures during infancy; the 'changes' in life during the period which preceded the clinical onset of UC; the presence of a latent or manifest depressive condition; the alexithymic characteristics; the lack of 'intermediate sphere'; the correlation between the reactivation of UC and certain environmental situations; the defence mechanisms; the type of object relationship.

Adolescent↗
PubMed1982

[Conforming delusions].

A number of schizophrenic patients with the delusion homogeneous in its contents (conformant delusion) were examined. The results of the examination have shown that the delusion of this type can develop not only simultaneously, by the inter-induction mechanism, but also by way of transfer, suggestion of the delusional idea, i.e. by the type of suggestive psychoses. The leading role in the mechanism of the conformant delusion formation belongs to endogenous factors, and namely, to the regularities of the basic disease development that determine the peculiarities of the time course and outcome of the conformant delusion. A slowly progressing course of the disease without gross negative changes, a tendency to formation of "worshipped" delusional ideas, and formation of acquired reactive lability are the peculiarities of a schizophrenic process which are the "grounds" for conformant delusion formation.

Adolescent↗
PubMed1997

Child and adolescent anxiety disorders and early attachment.

OBJECTIVE: The major aim of this research is to determine whether infants who were anxiously/resistantly attached in infancy develop more anxiety disorders during childhood and adolescence than infants who were securely attached. To test different theories of anxiety disorders, newborn temperament and maternal anxiety were included in multiple regression analyses. METHOD: Infants participated in Ainsworth's Strange Situation Procedure at 12 months of age. The Schedule for Affective Disorders and Schizophrenia for School-Age Children was administered to the 172 children when they reached 17.5 years of age. Maternal anxiety and infant temperament were assessed near the time of birth. RESULTS: The hypothesized relation between anxious/resistant attachment and later anxiety disorders was confirmed. No relations with maternal anxiety and the variables indexing temperament were discovered, except for a composite score of nurses' ratings designed to access "high reactivity," and the Neonatal Behavioral Assessment Scale clusters of newborn range of state and inability to habituate to stimuli. Anxious/resistant attachment continued to significantly predict child/adolescent anxiety disorders, even when entered last, after maternal anxiety and temperament, in multiple regression analyses. CONCLUSION: The attachment relationship appears to play an important role in the development of anxiety disorders. Newborn temperament may also contribute.

Anxiety Disorders↗
PubMed1985

[Borderline neuropsychiatric disorders in purine metabolism disorders in children].

A thorough examination of 410 children with the preliminary diagnosis of neuro-arthritic diathesis revealed a family history of primary disorders of purine metabolism with hyperuricemia (HU) and hyperuricuria (HUK) in combination with borderline neuropsychic disturbances in 150 children. Most of the children (122 of the 150) presented disorders of the neurotic level of reactivity according to the type of systemic and monosystemic neuroses and neurotic reactions in the presence of moderate HU and HUK. The clinical picture in children with the signs of residual-organic cerebral insufficiency (28 of the 150) was predominantly characterized by behavioural abnormalities in conjunction with significant deviations on the part of purine metabolism parameters.

Adolescent↗
PubMed2004

Child- and family-focused cognitive-behavioral therapy for pediatric bipolar disorder: development and preliminary results.

OBJECTIVE: To describe child- and family-focused cognitive-behavioral therapy (CFF-CBT), a new developmentally sensitive psychosocial intervention for pediatric bipolar disorder (PBD) that is intended for use along with medication. CFF-CBT integrates principles of family-focused therapy with those of CBT. The theoretical framework is based on (1). the specific problems of children and families coping with bipolar disorder, (2). a biological theory of excessive reactivity, and (3). the role of environmental stressors in outcome. CFF-CBT actively engages parents and children over 12 hour-long sessions. METHOD: An exploratory investigation was conducted to determine the feasibility of CFF-CBT. Participants included 34 patients with PBD (mean age 11.33 years, SD = 3.06) who were treated with CFF-CBT plus medication in a specialty clinic. Treatment integrity, adherence, and parent satisfaction were assessed. Symptom severity and functioning were evaluated before and after treatment using the severity scales of the Clinical Global Impression Scales for Bipolar Disorder (CGI-BP) and the Children's Global Assessment Scale (CGAS) respectively. RESULTS: On completion of therapy, patients with PBD showed significant reductions in severity scores on all CGI-BP scales and significantly higher CGAS scores compared to pretreatment results. High levels of treatment integrity, adherence, and satisfaction were achieved. CONCLUSIONS: CFF-CBT has a strong theoretical and conceptual foundation and represents a promising approach to the treatment of PBD. Preliminary results support the potential feasibility of the intervention.

Adaptation, Psychological↗
PubMed1995

Altered antioxidant status and increased lipid peroxidation in children with cystic fibrosis.

Cystic fibrosis often combines an infectious pathology with a syndrome of malabsorption, both potentially capable of favoring the deleterious effects of reactive oxygen species. This study was a simultaneous evaluation of the main antioxidant systems dependent on micronutrients and of lipid peroxidation products in 27 children with cystic fibrosis and 17 healthy children. Plasma of cystic fibrosis patients showed very low concentrations of beta-carotene (0.30 +/- 0.2 vs 1.63 +/- 0.5 mumol/g cholesterol, P < 0.0001) and a lower activity of selenium-dependent glutathione peroxidase (263.6 +/- 42 vs 296.9 +/- 57 U/L, P = 0.028). In parallel, the higher plasma concentrations of organic hydroperoxides (171.5 +/- 54.4 vs 122.6 +/- 23.3 mumol/L, P = 0.001) and of thiobarbituric acid reactants (2.9 +/- 0.6 vs 2.4 +/- 0.3 mumol/L, P = 0.004) reflected oxidative stress in this pathology. In addition, in these patients the major substrates of lipoperoxidation were significantly lower, whether they be linoleic acid (2.26 +/- 0.8 vs 3.60 +/- 0.9 mmol/L, P < 0.0001) or arachidonic acid (0.55 +/- 0.2 vs 0.74 +/- 0.2 mmol/L, P = 0.006). These results suggested that nutritional deficiencies resulting from malabsorption could considerably amplify disorders related to toxicity of reactive oxygen species. These nutritional deficits could also be aggravated by the destruction of antioxidant compounds by the inflammatory process.

Adolescent↗