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PubMed1990

Who are the dually diagnosed?

The evaluation of mental health problems among persons with mental retardation is complicated by difficulties in diagnosis as well as by system variables that may also determine who will be assigned a dual diagnosis. In this study a state data base of 78,603 individuals with mental retardation receiving state services was examined. The relations of observed behavior problems, other characteristics of the individual, and residential placement patterns to the likelihood of being given a dual diagnosis were examined. Extrapunitive maladaptive behaviors, cognitive abilities, and social skills were associated with diagnoses of mental health problems among persons with mental retardation. The different perspectives from which these results could be interpreted were discussed.

Adolescent↗
PubMed2000

The children's Social Behavior Questionnaire for milder variants of PDD problems: evaluation of the psychometric characteristics.

The Children's Social Behavior Questionnaire (CSBQ) contains items referring to behavior problems seen in children with milder variants of PDD. Data of large samples of children diagnosed as having high-functioning autism, PDDNOS, ADHD, and other child-psychiatric disorders were gathered. Besides the CSBQ, parents completed the Autism Behavior Checklist (ABC) and the Child Behavior Checklist (CBCL). The data provided the basis for scale construction of the CSBQ, a comparison of the CSBQ scales with other instruments and a comparison of groups on scores on the CSBQ. The 5 scales obtained referred to Acting-out behaviors, Social Contact problems, Social Insight problems, Anxious/Rigid behaviors and Stereotypical behaviors. Results show that the CSBQ has good psychometric qualities with respect to both reliability and validity. A comparison of the different groups showed that significant group differences were found on all scales. In general, the autism group received the highest scores, followed by the PDDNOS group and the ADHD group. Exceptions were on the Acting-out scale, where the ADHD group scored highest and on the Social Insight scale, where no significant difference was found between the PDDNOS group and the ADHD group. Implications of the results and suggestions for further research are discussed.

Adolescent↗
PubMed2006

Hyperlexia in Spanish-speaking children: report of 2 cases from Colombia, South America.

Hyperlexia is a condition rarely reported in Spanish-speaking children, characterized by the ability to recognize written words without formal training. We present two unrelated autistic children with hyperlexia from Colombia (South America) who were followed for 8 years with formal neuropsychological evaluations of language, motor skills, visual perception, attention and behavior. Both children taught themselves to read before 5 years of age but showed minimal comprehension; both displayed obsessional reading and difficulties in social skills and attention. Brain CT scans were normal. Hyperlexia has been associated with hyperactivation of the left superior temporal cortex; we conclude that the orthographic route is a probable mechanism for the development of hyperlexia.

Adolescent↗
PubMed1994

Treatment strategies for patients with dysexecutive syndromes.

Patients with prefrontal behavioral syndromes (dysexecutive, disinhibited, and apathetic) present a significant therapeutic challenge that demands the integration of psychopharmacologic, behavioral, and systemic interventions. Unfortunately, the behavioral disturbances of such patients are frequently misinterpreted and therefore inadequately treated. This article describes the various strategies that are available to the clinician in treating patients with prefrontal deficits.

Brain Damage, Chronic↗
PubMed1998

Social role functioning by adolescents with psychiatric disorders.

OBJECTIVE: To identify aspects of social role functioning that are impaired in adolescents with specific psychiatric disorders in order to improve the psychiatric taxonomy and clinical knowledge base. METHOD: Adolescents in four urban public schools were screened for mental health problems. Structured psychiatric interviews (National Institute of Mental Health Diagnostic Interview Schedule for Children Version 2.2) with 288 adolescents and their mothers were used to identify youths with psychiatric disorders, and 10 aspects of social role functioning were assessed. Aspects of social role functioning that discriminated between youths with and without psychiatric disorders and between those with emotional disorders and those with disruptive disorders were identified for boys and for girls. RESULTS: Boys with any type of disorder and all youths with disruptive disorders had significant, consistent impairment in academic performance and several other areas of functioning. Youths with emotional disorders, especially girls, demonstrated impairment in social activity participation and peer acceptance, but girls with disorders were not as consistently different from those without as were the boys with emotional disorders. CONCLUSIONS: Role functioning differs in important ways between youths with and without psychiatric disorders and between girls and boys with disorders. The results underscore the importance of investigating observable aspects of role behavior in order to improve the timely detection and effective management of psychiatric disorders in youth.

Adolescent↗
PubMed1991

Effects of self-management training and reinforcement on the transfer of improved conduct in the absence of supervision.

The instruction, maintenance, and transfer of training of social skills of 3 seriously emotionally disturbed adolescents were accomplished by a self-management training and reinforcement package. During baseline sessions these students, who were covertly filmed in their classroom, averaged over 90% off-task or socially inappropriate behavior while their teacher was out of the room. They showed similar behaviors when walking between classes, unattended by their teacher. Treatment was introduced in the classroom and consisted of social skills and self-management training and reinforcement. Treatment procedures included instruction, modeling, and role playing of social skills, as well as self-assessment, self-recording, and self-reinforcement for correct approximations of these skills. After 5 weeks of training, all subjects demonstrated substantial improvements in the classroom during the teacher's absence and when distracted by other students; however, transfer of social skills did not occur to the between-class setting until students were given explicit instruction to initiate self-managing procedures in this setting.

Adolescent↗
PubMed2001

Rages and refusals. Managing the many faces of adolescent anxiety.

OBJECTIVE: To provide family physicians with a practical approach to recognition, assessment, and treatment of adolescent anxiety disorders complicated by avoidance or oppositional behaviour. QUALITY OF EVIDENCE: Current literature was searched via MEDLINE using the MeSH headings Anxiety and Anxiety Disorders, focusing on epidemiology, clinical presentations in adolescence, and both pharmacologic and nonpharmacologic treatment. In addition, internationally accepted diagnostic criteria, current practice guidelines, and recent textbooks by recognized experts were reviewed. Research evidence and consensus recommendations were integrated with a practical approach developed in a provincial mood and anxiety disorders clinic. MAIN FINDINGS: Anxiety disorders are common in adolescents, with estimated prevalence of at least 10%. Substance abuse and avoiding school are common complications, and irritability with behavioural and rage problems can interfere with effective management. Current controlled research is examining the effectiveness of serotonergic medications known to benefit panic disorder, social phobia, and generalized anxiety in adults. While cognitive and behavioural treatments are effective for some child and adolescent anxiety disorders, they can be difficult to administer, and a supportive and psychoeducational approach could be as effective for those who refuse to go to school. CONCLUSION: Family physicians' awareness of the role of anxiety in adolescent school avoidance and in intense, oppositional emotional reactions at home can lead to more specific assessment and therapeutic intervention. Practical management strategies are recommended.

Adolescent↗
PubMed1975

Changing diagnosis of childhood psychosis.

The case findings of thirty-three children given a diagnosis of psychosis during hospitalization in the '50s and '60s were reviewed and rediagnosed in 1973. Childhood schizophrenia was the original diagnosis in 58% of the cases but was the rediagnosis in only 18% of those same cases. Chronic brain syndrome with various reactions (psychotic reaction, nonpsychotic behavioral reaction, and mental retardation and autism) was the diagnosis in 27% of the cases, originally, but was given to 67% of the cases on rediagnosis. One-third of the children originally diagnosed as psychotic were rediagnosed as nonpsychotic. Approximately two-thirds of the children were nonpsychotic according to the DeMyer-Churchill guidelines.

Autistic Disorder↗
PubMed1998

Premorbid personality traits in Alzheimer's disease: do they predispose to noncognitive behavioral symptoms?

The purpose of this study was to examine whether premorbid personality traits predispose to noncognitive symptoms in Alzheimer's disease (AD). The Munich Personality Test was used to evaluate caregivers' perception of personality prior to symptom onset in 56 outpatients with probable AD. Caregivers also completed the "mood" and "disturbed behavior" scales of the Nurses' Observation Scale for Geriatric Patients. A neuropsychiatrist rated depressive symptoms on the Cornell Scale for Depression and the occurrence of personality change in four domains according to ICD-10. Under statistical control of confounding variables, results showed a moderate association between (high) premorbid neuroticism, subsequent troublesome behavior, and personality change, on the one hand, and (low) frustration tolerance and depression, on the other. Premorbid personality traits may indeed predispose to subsequent noncognitive symptoms in AD.

Aged↗
PubMed1986

Treatment of psychiatric morbidity in the mentally retarded adult.

302 mentally retarded (MR) adults, representative of the total Danish MR population were surveyed for present psychiatric treatment and care. The care was generally satisfactory with the majority living under good conditions and provided with a fairly sufficient level of training and occupational therapy. The psychopharmacological treatment was balanced and performed after modern principles. However, more elaborate psychiatric treatment approaches, such as psychotherapy and behavioural therapy, were only used in very few cases, despite the obvious need. A brief review is given and a guide to the literature on psychiatric treatment in the field of mental retardation.

Adult↗