[Future family medicine in the United States of America].
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Four classes of emotionally disturbed (ED) children (20 boys and 6 girls, age: M = 8.1 yr) were exposed to six aggressive and six control cartoons. Treatment effects were assessed using direct observations of five categories of behavior during lunch and recess for baseline and the two cartoon conditions. The results revealed significantly more nonphysical aggression following the control cartoons than during baseline across setting and more physical aggression following the control cartoons relative to the aggressive cartoon and baseline conditions in the recess setting. The findings are discussed with regard to their clinical implications and comparability with other field experiments.
Evidence for the role of androgens in the male aggressive and sexual behavior is reviewed. Medroxyprogesterone acetate (MPA; Provera, Upjohn) has a marked antiandrogen property; it is effective in lowering the testosterone level and controlling certain otherwise intractable sex deviations. The finding in 6 patients treated for sex deviation are summarized. The effects of MPA in the treatment of 11 temporal lobe epileptics and 5 other patients with severe angry-aggressive behavior disorder are reported. Most temporal lobe epileptics responded well to MPA. Weight gain and earlier sleep were consistent side effects. The values of plasma testosterone, serum luteinizing hormone, and urinary 17-ketosteroids were decreased by the treatment. Four patients were XYY individuals with lack of control over their sexual-aggressive or angry-aggressive impulses.
A dichotic listening test was employed to test the hypothesis that behavior disorders might have an abnormal laterality patterns of cerebral function. Eighteen behavior disorder out-patients of the psychiatry department at an university hospital and seventeen normal subjects were requested to recall dichotically presented words. The results showed that compared with the normal controls, the subjects with behavior disorders yielded less prominent right ear advantage, lesser response ear alternations, but better overall performances. The results do not support the hypothesis of the left hemisphere dysfunction in behavior disorders but suggest the possibility of the right hemisphere dysfunction.
The importance of two factors--the age at which a consistent pattern of heavy alcohol use was established and the duration of problem drinking--was compared in 70 alcoholic outpatients (21 women) using the Alcohol Use Inventory (AUI). Alcoholics who began heavy drinking at age 20 or below reported significantly greater social role maladaptation, more loss of behavioral control when drinking, greater severity of alcoholism, more severe alcoholic deterioration, and more frequent psychoperceptual withdrawal symptoms (delirium tremens) than later-onset alcoholics. Age of onset was consistently a better correlate of these alcoholic patterns than the duration of heavy drinking. Despite the 9.7-year mean difference between the groups with short- and long-term durations of heavy drinking, no significant differences on their AUI scores were found. These data suggest that the hypothesis that steady, excessive alcohol consumption at a young age may have more deleterious effects on the future social, interpersonal, cognitive and physical functioning of an alcoholic than the duration of excessive alcohol intake deserves further investigation.
Using prospective longitudinal data from the Christchurch Health and Development Study, this paper examines the extent to which early onset, life course persistent and adolescent limited antisocial behavior problems place young people at risk of violent and unsatisfactory romantic relationships in early adulthood. Results revealed the presence of clear linear associations between the developmental timing of antisocial behavior and later partnership risks, with these risks including partner violence perpetration and victimization, interpartner conflict, and increased ambivalence about the relationship. Young people with childhood onset antisocial behavior problems reported higher rates of partnership difficulties than young people with adolescent limited antisocial behavior problems, while those with adolescent limited antisocial behavior reported higher levels of partnership difficulties than young people without a history of antisocial behavior problems. These associations persisted even after extensive control for a range of social, family, and individual factors that were correlated with the timing of antisocial behavior. Results highlight the importance of distinguishing between early and late onset antisocial behavior, and provide further support for existing life course models of the development of antisocial behavior problems in children and adolescents.
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AIMS: This review considers, from a theoretical clinical point of view, several interview based instruments used in the areas of neuropsychology, psychology and psychiatry that have been designed to evaluate the associated symptoms in several diagnostic categories or types in the different editions of the Diagnostic and statistical manual of mental disorders. DEVELOPMENT: The study of psychopathology, especially in children and adolescents, has one prior requisite: a thorough knowledge of how categorical disorders are organised by axes and the reason for the groups of symptoms and their variations located in each criterion. Consequently, in order to perform a diagnosis in child psychopathology, different criteria have to be fulfilled, according to the presence of the different disorders associated with a particular pathology, and the different evaluation tools provide a multiple approach that allows the behavioural problems to be evaluated. CONCLUSIONS: We currently have a series of diagnostic instruments available that are recommended for individual clinical study and can be applied both by parents and by teachers. The need then arises to research into whether the symptoms reported by parents and teachers have similar characteristics or whether, to the contrary, there are differences in the behaviour observed in distinct contexts, which would require a further analysis of the contextual particularities the patient moves in.
The term stalking describes a pattern of behavior in which the victim is pursued, pestered and threatened. In many cases, the stalker resorts to physical violence, and may even commit murder. In the German-speaking areas, the phenomenon is to date not much discussed in the psychiatric and psychological literature, despite the fact that it is a widespread occurrence. While stalkers are diagnosed as suffering from schizophrenia and/or narcissistic as well as borderline disorders, victims have no typical "victim personality". They do, however, respond to stalking with anxiety, depression and post-traumatic stress disorders, which need to be recognized and treated.
The Eating Disorders Center (EDC), is a clinical-research project of the Mental Research Institute (MRI) centered in the study and treatment of Anorexia Nervosa (Self Starvation), Bulimia (binge-eating and purging) and weight/diet obsessions/compulsions. This paper presents: a) A brief description of the Center, both in its research and clinical aspects. The clinical program is centered in the application of the MRI's brief interactional approach to the treatment of eating disorders. The research project is being developed. b) A definition of terms, taken from the Statistical Manual of Mental Disorders (DSM III) and how these eating disorders have shown an increase in recent years. c) A brief discussion of theories of etiology and maintenance in the field of eating disorders. This point includes the perspective on eating disorders of several theoretical models, and how we believe that it is the societal model the one that can account for the recent increase of eating disorders.
Stalking is an old behavior, but a new crime. The author has reviewed what is currently known about the epidemiology, demography, psychiatry, psychology, pursuits and outcomes, threatening communications, violence, and clinical risk management of stalking cases. But this "dark heart of romantic pursuit" (p 7) extends beyond the paradigm of science and is often an aggressive and aberrant expression of unrequited love. In 1579, John Lyly wrote "As the best wine doth make the sharpest vinegar, so the deepest love turneth to the deadliest hate" (Euphues: The Anatomy of Wit).
This paper reviews the role of orbitofrontal cortex (OFC) lesions in antisocial behaviors and the adequacy of a strict OFC account of antisocial disorders where there is no evidence of lesion. Neurocognitive accounts of antisocial behaviors are extended beyond the OFC. Several methodological shortcomings specific to this neuroscience approach to antisocial behavior are identified. A developmental approach is advocated to chart the developmental sequences of impaired brain development and of the various comorbid states typically seen in antisocial disorders.
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This paper reviews and evaluates a set of studies that utilize dynamic systems (DS) principles, and in two cases dynamic systems methods, for predicting antisocial development and other behavioral outcomes. I suggest that the emphasis of DS approaches on process and nonlinear causation is very different from the emphasis in developmental psychopathology on prediction, yet the marriage of these approaches is necessary to capture the complex interactions that give rise to problematic trajectories. The studies reviewed do indeed uncover predictive relations that would have been difficult to conceptualize or impossible to find using more traditional strategies. In discussing these studies. I suggest DS interpretations of emerging individual differences, phase-specific change, sleeper effects, mediating variables, and behavioral rigidity versus malleability, in the context of developmental prediction. I also discuss the advantages of moving from DS concepts to DS methods in clinical-developmental research.