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PubMed2002

Assessing personality traits of individuals with mental retardation.

Psychometric properties for a new instrument, the EZ-Personality Questionnaire designed to assess the functioning of students with cultural-familial mental retardation, are presented. The analysis of data from 661 participants yielded a 37-item, seven-scale instrument that confirmed the five hypothesized factors of Positive Reaction Tendency, Negative Reaction Tendency, Effectance Motivation, Expectancy of Success, and Outerdirectedness and identified two additional factors of Curiosity/Creativity and Obedience. Separate studies were conducted to establish the concurrent and construct validity of the instrument. Reliability was examined through split-half and test-retest analyses. All psychometric indices were within acceptable levels, resulting in an instrument with potential applications in research, education, and clinical settings.

Adolescent↗
PubMedDate not supplied

The Motivation Assessment Scale: reliability and construct validity across three topographies of behavior.

The psychometric properties of the Motivation Assessment Scale (MAS) were examined. Specifically, reliability, internal consistency, and construct validity were estimated using 90 ratings of different problem behaviors among 86 individuals with mental retardation. Data were analyzed under conditions of (a) three topographies of problem behavior and (b) two methods of calculation. Although reliability and internal consistency were generally poor, the results depended upon the above conditions. Factor analysis revealed that the four factors of the MAS differed from the subscale structure obtained in this study, proposed by the authors of the MAS. Thus, the construct validity of this scale was ambiguous. It is concluded that the MAS should be employed in conjunction with other instruments to assess the functional characteristics of problem behavior with individuals who have mental retardation.

Group Homes↗
PubMed1977

The human platelet. A diagnostic and research tool for the study of biogenic amines in psychiatric and neurologic disorders.

Comparison of the properties of blood platelets and serotonergic synaptosomes suggests that the human platelet can serve as an appropriate model for the transport, metabolism, and release of serotonin (5-HT) by CNS serotonergic neurons. The study of blood 5-HT levels and platelet 5-HT pharmacodynamics in patients with a variety of psychiatric and neurologic disorders has generated interesting leads into possible abnormalities of CNS 5-HT neurons in these patients. This article reviews the experimental evidence, which uses the human platelet model to investigate neurotransmitter-related abnormalities in Down syndrome, mental retardation, infantile autism, hyperactivity syndromes (minimal brain dysfunction), schizophrenia, affective disorders, Duchenne muscular dystrophy, Parkinson disease, Huntington chorea, and migraine headaches.

Affective Symptoms↗
PubMed1988

Psychometric properties of the Social Training Achievement Record (the STAR profile).

Seven hundred and sixty-eight Social Training Achievement Records were collected independently in two settings during routine assessment of mentally handicapped people, mostly adults in hospital. All scales and total scores were highly internally consistent. Factor analysis on one sample yielded two factors named General Adaptive Behaviour and Community and Equipment Skills. This factor structure was replicated on the second sample. This factor solution is highly similar to that reported for the Adaptive Behavior Scale (Nihira, 1976). Two new scales were derived on the basis of these factor analyses which were also highly internally consistent. Parallel forms of these scales were also satisfactorily developed. Total scores and scores on the two new scales were adequate in routine clinical practice and showed good concurrent and criterion group validities. Reliabilities of individual items were less satisfactory. Suggestions for future developments of this scale are made.

Achievement↗
PubMed1987

Relation between CT patterns, clinical findings and etiological factors in children born at term, affected by congenital hemiparesis.

In order to examine if specific findings from CT correlate with specific clinical or neurological findings, 30 children, 5 to 16 years old, born at term, affected by congenital hemiparesis without intellectual impairment, were submitted to neurofunctional and psychological assessment and examined by CT. 28 of the 30 children had pathological CT. Two morphological CT patterns were found: A) Cavity in the cortex and underlying subcortical white matter (11 cases); B) Unilateral ventricular enlargement and paraventricular lesions (17 cases). CT was normal in two cases. In our children, born at term, no statistical correlation between CT patterns and anamnestic data was found as described in other studies, although in the patients with cortical-subcortical lesions, there was a slight prevalence of a history of perinatal complications, and in the patients with paraventricular lesions there was an uneventful history or abnormal pregnancy history. The relation between specific CT patterns (type A and B) and specific clinical dysfunction is not statistically evident, (unless for astereognosis and type A CT pattern). However, the patients with cortical-subcortical lesions showed a slight prevalence of a lower function of the impaired hand, and a higher percentage of an I.Q. of less than 90, than the group with unilateral ventricular enlargement. No relation was found between CT lesional pattern and epilepsy. The absence of correlation between morphological aspects and clinical findings could be explained by the complexity of structural changes and remodelling properties of the central nervous system, following prenatal and perinatal brain damage.

Adolescent↗
PubMed1990

Attentional functioning and relational learning.

Stimulus properties such as similarity-dissimilarity and novelty-familiarity are inherently relational and are embedded in ubiquitous stimulus contexts. Children with mental retardation and young children without mental retardation are particularly prone to failure on relational tasks such as oddity and match-to-sample (Greenfield, 1985; Soraci et al., in press). Converging evidence from a number of studies suggest that a critical factor in the performance discrepancies between these and other children is a differential sensitivity to relational information. In these studies relational characteristics of stimulus arrays were enhanced in order to facilitate performances on such relational tasks. Findings indicate the theoretical and practical significance of perceptually based interventions that induce rapid discrimination learning.

Attention↗
PubMed2005

The psychometric properties of the Vineland Adaptive Behavior Scales in children and adolescents with mental retardation.

The psychometric properties of the Vineland Adaptive Behavior Scales Survey Form were studied in a total population of children and adolescents with MR, and in the specific levels of functioning (n=826, age 4-18 years). The original division into (sub)domains, as assigned by the authors, was replicated in the total population and in the mild and moderate levels of functioning. In the severe and profound levels of functioning the structure was less well recognized. The reliability of the instrument proved to be good in the total population and the subgroups. The construct validity was high in all groups. The implications of these findings are discussed with respect to the usefulness of the Vineland for the population with MR.

Adaptation, Psychological↗
PubMedDate not supplied

A behavioral diagnostic paradigm for integrating behavior-analytic and psychopharmacological interventions for people with a dual diagnosis.

Aberrant behaviors exhibited by people with developmental disabilities have been well documented. Often, psychotropic medications, especially neuroleptics, have been used to control behaviors such as self-injury, physical aggression, property destruction, and hyperactivity. Serious side effects of these medications have occurred, resulting in litigation and regulation of their use by courts, surveyors, and accrediting bodies. Rules and regulations have been developed requiring that behaviors/symptoms necessitating that medication usage be clearly delineated, that behavior programs be developed and implemented to reduce need, and that the interdisciplinary team approach be used to monitor effectiveness of interventions. Currently, little guidance exists on how behavioral and psychopharmacological interventions should be applied or combined. This paper presents a paradigm for integrating behavior-analytic and psychopharmacological treatment interventions in the treatment of persons with developmental disabilities that meets applicable standards. Our model is consistent with the least restrictive, yet effective treatment philosophy. Implications for research and treatment are presented.

Behavior Therapy↗
PubMed1996

The Community Living Attitudes Scale, Mental Retardation Form: development and psychometric properties.

We described the development and psychometric properties of the Community Living Attitudes Scale, Mental Retardation Form (CLAS-MR), a 40-item measure based on the input of self-advocates and focused on contemporary community living philosophies. The CLAS-MR, which consists of four subscales that tap attitudes about people with mental retardation, demonstrated acceptable internal consistency, retest reliability, and construct validity with samples of 104 college students and 283 community members. Using data from a sample of 355 staff members from community agencies, we confirmed the factor structure of the measure. Given the importance of attitudes toward persons with mental retardation in policy making and community inclusion, the CLAS-MR can help chronicle the diffusion of the new paradigm of empowered community living for persons with mental retardation.

Activities of Daily Living↗
PubMed2003

The psychometric properties of the Multi-Dimensional Observation Scale for Elderly Subjects (MOSES) in middle aged and older populations of people with mental retardation.

OBJECTIVE: To assess the internal consistency, inter-scale correlations and factor structure of the MOSES with older adults with mental retardation. METHOD: A series of outpatients with mental retardation were assessed with the MOSES. 163 middle aged and older adults with mental retardation living in community settings participated. RESULTS: The subscales and total scale of the Multi-Dimension Observation Scale for Elderly Subjects (MOSES) were highly internally consistent. The pattern of correlations between the five scales was very similar to that reported by Dalton et al. (1999). The results of a factor analysis using varimax rotation indicated a three-factor structure corresponding to adaptive behavior, externalizing and internalizing maladaptive behaviors. CONCLUSIONS: The MOSES appears to be was a psychometrically adequate instrument to screen older adults with mental retardation.

Activities of Daily Living↗
PubMed2000

The oral assessment in Down syndrome questionnaire (OADS): development of an instrument to evaluate oral health problems in individuals with Down syndrome.

OBJECTIVE: To develop a French language instrument whose primary aim is the description of oral health status in Down syndrome (DS) individuals. METHOD: Due to the reduced intellectual capacity in DS individuals, the instrument was designed to be completed by their parents. Items were generated through a literature review plus interviews with relevant professionals and DS parents. Following pilot testing, the 31-item questionnaire was divided into seven domains (access, function, development, signs, pain, disability and a global evaluation of oral health status), and subjected to a psychometric evaluation of internal reliability, test-retest reliability and discriminant validity. Internal reliability was assessed through evaluation of Cronbach's alpha or the Kuder-Richardson-20 value where appropriate. Test-retest reliability was assessed through the evaluation of the intra-class correlation coefficient (ICC) for each domain. Discriminant validity was assessed through evaluations of hypothesised differences in domain scores between different groups of DS individuals by age and between DS and non-DS individuals. The theoretical domain categorisation was empirically evaluated through the generation of inter-item correlation coefficients. RESULTS: Internal reliability coefficients ranged from 0.43 for the disability domain to 0.83 for the function domain, while the domain ICCs ranged from 0.56 to 0.77 for the signs and function domains respectively. For discriminant validity, the domains largely performed as hypothesised. Finally, inter-item correlation coefficients largely supported the proposed domain structure of the questionnaire. CONCLUSION: This investigation of the psychometric properties of a proxy. French language, assessment of oral health problems in the DS population has demonstrated an instrument with good preliminary indicators of reliability and validity.

Child↗
PubMed1979

Attitudinal versus ecological approaches to the characterization of institutional treatment environments.

The relational and discriminative properties of attitudinal and ecological measures of environments were examined within the context of a state hospital for mentally retarted clients. Three hypotheses were advanced, and the results gave substantial support for one of these and partial support for a second: (a) that the correlations between attitudinal and ecological measures should not differ significantly from zero, and (b) that differences among hospital treatment programs and living units should be reflected in ecological but not in attitudinal measures. However, the results did not provide clear confirmation for a third hypothesis: that differences among staff demographic characteristics and employment history should be reflected in attitudinal but not in ecological measures. It was suggested that these background variables may not be appropriate measures of personality-linked attributes.

Attitude of Health Personnel↗
PubMedDate not supplied

The Environmental Rating Scale (ERS): a measure of the quality of the residential environment for adults with autism.

This study used classical test theory to assess the psychometric properties of the Environmental Rating Scale (ERS), a measure specifically designed to assess the treatment programs in residential settings that serve individuals with autism. Results of the confirmatory factor analysis support the presence of a single factor represented by the total score. The reliability of the measure was demonstrated by assessments of the internal consistency, stability, and interrater reliability. Preliminary analysis of the validity of the ERS indicates that this measure discriminates between treatment settings designed specifically for individuals with autism and those designed for other populations of developmentally handicapped clients and family homes. The ERS was also significantly positively correlated with a measure of the caregiver's knowledge about autism and a visitor's global impression of the desirability of the setting as a place to live.

Adolescent↗
PubMed1993

The association between psychiatric diagnoses and severe behavior problems in mental retardation.

To investigate the relationship between psychiatric disorders and severe behavior problems in mental retardation, statewide client databases from developmental disabilities services in California (N = 89,419) and New York (N = 45,683) were analyzed and juxtaposed. The study focussed on nine major DSM-III-R psychiatric categories (or their equivalents), and severe forms of aggressive behavior, property destruction, self-injurious behavior, and stereotyped behavior in individuals 45 years old and younger with mental retardation of all levels of severity. In California, 3.9% had at least one psychiatric diagnosis; in New York, 5.4%. The rate of specific psychiatric diagnoses was variable across states, suggesting local preferences in diagnostic practices. Severe behavior problems occurred in 22.1% in California and in 41.4% in New York. This difference in rates can be attributed in part to different recording criteria for behavior problems. With regard to the association between psychiatric diagnoses and problem behaviors the results were consistent across databases: No compelling correlations were found. This means that neither aggression, self-injury, destruction, nor stereotypies determine whether a person receives a psychiatric diagnosis or not.

Adolescent↗
PubMed1984

Pinazepam: review of pharmacological properties and therapeutic efficacy.

Pinazepam, a benzodiazepine derivative, differs from other drugs of its class by the presence of an unsaturated bond, the propargyl group, at the N-1 position. Its toxicity is less than that of diazepam. In animals, pinazepam controls anxiety and aggressiveness. This effect seems to be associated with a particularly low hypnotic effect and with a limited impairment of motor coordination. Pinazepam shows less cortical activity at the anxiolytic level than does diazepam on EEG. The drug's mechanism of action primarily involves modification in the region of the limbic system. Extensive pharmacokinetic studies have demonstrated rapid gastrointestinal absorption of pinazepam. The metabolic pathway is N-1 dealkylation and C-3 hydroxylation. In dogs, pinazepam reaches the steady state in one day and its main metabolite, depropargylpinazepam (N-desmethyldiazepam) in six days, thus achieving a much higher blood concentration than the parent drug. In rabbits, a first-pass effect is evident. Both compounds are converted to oxazepam, which is pharmacologically inactive and is eliminated in the urine. Pinazepam and depropargylpinazepam cross the placenta and appear in human milk. In dogs, accumulation could not be demonstrated at the end of treatment with 10 mg of pinazepam for 20 days. All the findings in animals were confirmed in humans. In clinical trials with open or controlled design, pinazepam, compared with diazepam, showed a significant and purely anxiolytic action in patients suffering from anxiety with or without somatic manifestations, particularly in gastrointestinal disorders. Even though it is not a specific hypnotic drug, it seems to help patients in whom the physiological course of the sleep is disturbed. The standard dosage is 10 mg daily, divided in two doses. Pinazepam is well tolerated in humans. About 5% of patients experience mild sedation. Other side effects are infrequent and minor. In the studies there was no evidence of impairment of motor coordination or of intellectual performance. There were no reports of a rebound phenomenon or drug dependence. These findings indicate that pinazepam is a pure anxiolytic agent devoid of hypnotic effect or motor disorders, characteristics that make it a useful drug for daytime use.

Animals↗
PubMed2007

Sequence variants within exon 1 of MECP2 occur in females with mental retardation.

A new splice variant of the Rett syndrome gene, MECP2, was recently identified, that includes coding sequence from exon 1, and is the predominant transcript in the central nervous system. This sequence encodes polyalanine and polyglycine stretches within the N-terminal portion of MeCP2, and may confer novel functional properties to the protein. We screened autism, mental retardation (MR), and control populations for sequence variation within this region, and identified variation in approximately 1% of MR cases screened (N = 1,410). No variants were identified in the autism sample (N = 401). Most of these variants occur within a trinucleotide repeat region and result in change in number of alanine or glycine residues within the repeat stretches. We suggest some of these variants may be a relatively frequent cause of non-specific MR or developmental delay.

Adult↗
PubMed1977

Array properties and conservation of number performance with retarded adolescents and young adults.

A group of 31 institutionalized retarded adolescents responded to 18 conservation of number tasks. Within the range of each row containing 4 to 6 items, there was no significant effect on performance with variations in the total number of items or the numerical difference between rows. Unexpectedly, pre- and posttransformed arrays did not cause significant differences in judgment errors. When significant differences (p less than .01) did appear between transformed and untransformed arrays, it seemed to be due to a one-to-one correspondence existing in one of the arrays and not in the effect of a transformation. The optimal performance under one-to-one correspondence conditions and the observed, orderly decrease in correct responding was explained as a function of the number of contradictions in the stimulus array. The explanation of judgment errors being caused by contradictions between numerosity and length and/or density cues was interpreted within Brainerd's (1973a, 1973b) theory of the development of early number concepts.

Adolescent↗
PubMed2003

New achievements and pharmacotherapeutic approaches to impotence in the elderly.

Erectile dysfunction (ED) has a negative impact on the quality of life of elderly men, but impotence is not an absolute concomitant of aging. Aging changes influencing sexual function in men consist of a decreased capacity to reach arousal by imagination or view, fragility of erection, and an increase in the refractory period. These events may be part of the andropause syndrome, which includes a decrease in intellectual activity, fatigue, depression, decreases in body hair, lean body mass and bone mineral density, accompanied by an increase in weight. As a consequence, the overlap of aging processes, concurrent diseases and social situations to which elderly men are subject, results in the great variability reported in epidemiological studies. In the same way, the complex physiology of erection depends on the social, environmental, or physical context in which it occurs. New achievements in research on intracellular mechanisms of erection and on the neuroendocrinology of aging contribute to better understanding the pathophysiology of ED in the elderly. For example, testosterone declines with age with great interindividual variability, since other hormonal changes are also involved. What currently can be easily identified is the alteration of LH-testosterone feedback alterations, although hormone levels fall in the normal range. Nevertheless, the extent to which age-dependent decline in hormones leads to health problems that may affect the quality of life remains to be clarified. Several concepts on aging-related processes have been challenged, and conditions that were once accepted as physiologically age-related are now thought to lead to medical problems, but until now erectile dysfunction remains underreported, underdiagnosed, and undertreated, especially in the elderly. Nowadays, we are witnessing a rapid growth in available pharmacotherapies, from intracavernous injections of vasoactive drugs, to powerful new oral agents, with differing pharmacological dynamic and kinetic properties. New options for treatment are therefore possible, taking into account both the possibility of changing ineffective drugs and augmenting efficacy by means of synergistic associations. This rich generation of progress is certainly contributing to a better medical approach to sexuality in aging people.

Age Distribution↗