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PubMed2006

Clinical features of body dysmorphic disorder in adolescents and adults.

Body dysmorphic disorder (BDD) usually begins during adolescence, but its clinical features have received little investigation in this age group. Two hundred individuals with BDD (36 adolescents; 164 adults) completed interviewer-administered and self-report measures. Adolescents were preoccupied with numerous aspects of their appearance, most often their skin, hair, and stomach. Among the adolescents, 94.3% reported moderate, severe, or extreme distress due to BDD, 80.6% had a history of suicidal ideation, and 44.4% had attempted suicide. Adolescents experienced high rates and levels of impairment in school, work, and other aspects of psychosocial functioning. Adolescents and adults were comparable on most variables, although adolescents had significantly more delusional BDD beliefs and a higher lifetime rate of suicide attempts. Thus, adolescents with BDD have high levels of distress and rates of functional impairment, suicidal ideation, and suicide attempts. BDD's clinical features in adolescents appear largely similar to those in adults.

Adolescent↗
PubMed1988

Pediatric Symptom Checklist: screening school-age children for psychosocial dysfunction.

The Pediatric Symptom Checklist (PSC) is a 35-item screening questionnaire that is completed by parents and designed to help pediatricians in outpatient practice identify school-age children with difficulties in psychosocial functioning. The current study assessed the validity of the PSC by screening 300 children in two pediatric practices, a middle-class group practice and an urban health maintenance organization. Validity was established by comparing the results of PSC screening of 48 children with in-depth interview assessments and pediatricians' ratings. Results indicate that the PSC has a specificity of 0.68 and a sensitivity of 0.95. The screening process was well accepted by parents and pediatricians. Several children whose pediatricians' ratings had indicated adequate functioning were identified by the PSC as having substantial psychosocial dysfunction and requiring further evaluation.

Child↗
PubMed1987

The relative value of screening instruments in adolescence.

The phase of development that equips a child to become an adult is a period of transition. To date no instrument has become established as the routine screening measure for this age group in the same way as the Rutter B2 Scale has in children. During a major population study of adolescent functioning, the pupils drawn from four comprehensive schools were used to compare the validity of several screening measures in this age group. The results show that screen instruments tend to be behaviour specific and that antisocial and neurotic behaviour are relatively sex specific. The Rutter Malaise Inventory had the highest correlation with the psychiatrist's diagnosis of neurotic disorder, although the General Health Questionnaire also proved to be reasonably efficient. The antisocial subscale of the Rutter B2 Scale showed the best correlation with the psychiatrist's diagnosis of conduct disorder.

Adolescent↗
PubMed1985

An outbreak of food-borne enterotoxigenic Escherichia coli diarrhoea in England.

An outbreak of diarrhoea with abdominal pain occurred among members of the staff of a school and their guests after a social function at which a cold buffet was served. Sixty people attended the function and 43 subsequently completed questionnaires. Of these, 27 had diarrhoea. The median incubation period was 36 h and the range 12-66 h. Food history analysis showed an association between diarrhoea and eating curried turkey mayonnaise. Stool specimens from 13 of those who developed diarrhoea were examined: Escherichia coli 06.H16 (producing heat-stable and heat-labile enterotoxins) was found in nine specimens and E. coli 027.H20 (producing heat-stable enterotoxin) in 11 specimens. Eight patients had both strains and only one was negative for enterotoxigenic E. coli. Food samples were not available for examination. Enterotoxigenic E. coli should be considered as a possible cause in well-defined outbreaks of food-borne diarrhoea with abdominal pain.

Abdomen↗
PubMed2004

Response disinhibition may be explained as an extinction deficit in an animal model of attention-deficit/hyperactivity disorder (ADHD).

Attention-deficit/hyperactivity disorder (ADHD) is a disorder affecting between 2 and 12% of grade-school children disturbing social, academic, and occupational functioning. Problems related to social adjustment and functioning and/or psychiatric problems will exist in 50-70% of adolescents and young adults diagnosed with ADHD as children. It has been suggested that altered reinforcement and extinction processes may cause the symptoms of ADHD. The present study investigated extinction processes in spontaneously hypertensive rats (SHR), possibly the best-validated animal model of ADHD. Extinction was tested after either a variable interval (VI) or a fixed interval (FI) schedule of reinforcement with and without the presence of a conditioned reinforcer (light in the water cubicle). The results indicate a slower extinction process in the SHR compared to the normal controls, especially during the initial transition from scheduled reinforcement to extinction. Also, more responses were retained in the SHR during the later part of extinction. The extinction deficit in the SHR may be linked to reinforcer unpredictability and the presence of conditioned reinforcers, and may explain response disinhibition seen in children with ADHD.

Analysis of Variance↗
PubMed2000

Perceptual-motor, visual and cognitive ability in very low birthweight preschool children without neonatal ultrasound abnormalities.

Thirty-six children born preterm with very low birth weight without neonatal brain disorders and normal cerebral ultrasound findings were examined at pre-school age: visual, perceptual motor, attention, behaviour and cognitive assessments were performed in the study group as well as in a control group of term children matched for age, sex and parental educational and occupational status. The results showed a significant lower scoring in perceptual motor skills in the study group, associated with a defect of accuracy in spatial attention and a higher incidence of stereopsis impairment related with perceptual motor disabilities. Behavioural disorders, in terms of emotional maturation and hyperactivity, were significantly more frequent in the study group. To prevent behavioural and learning problems at school, a complete longitudinal assessment including visual functions and perceptual motor abilities seems mandatory in preterm born children, even in the absence of neonatal brain disorders including abnormal cerebral ultrasound findings.

Attention↗
PubMedDate not supplied

Progress and outcomes for children with autism receiving parent-managed intensive interventions.

Parent-managed behavioral interventions for young children with autism are under-researched. We analyzed data from 66 children served by 25 different early intervention consultants. After a mean of 31.6 months of intervention IQ scores had not changed (N = 22). Vineland adaptive behavior scores had increased significantly by 8.9 points (N = 21). No children aged > 72 months attained normal functioning, i.e., IQ > 85 and unassisted mainstream school placement (N = 42). Progress for 60 children across 12 months was found for mental age (5.4 months), adaptive behavior (9.7 months), and language (5.1 months). The interventions did not reproduce results from clinic-based professionally directed programs. The effectiveness of the parent-managed intervention model as it has developed and the adequacy of professional services in that model are discussed.

Autistic Disorder↗
PubMedDate not supplied

Progress and outcomes for children with autism receiving parent-managed intensive interventions.

Parent-managed behavioral interventions for young children with autism are under-researched. We analysed data from 66 children served by 25 different early intervention consultants. After a mean of 31.6 months of intervention, IQ scores had not changed (N = 22). Vineland adaptive behavior scores had increased significantly by 8.9 points (N = 21). No children aged >72 months attained normal functioning, i.e., IQ > 85 and unassisted mainstream school placement (N = 42). Progress for 60 children across 12 months was found for mental age (5.4 months), adaptive behavior (9.7 months), and language (5.1 months). The interventions did not reproduce results from clinic-based professionally directed programs. The effectiveness of the parent-managed intervention model as it has developed and the adequacy of professional services in that model are discussed.

Adaptation, Psychological↗
PubMed2004

Comparison of the effects of fluticasone propionate aqueous nasal spray and loratadine on daytime alertness and performance in children with seasonal allergic rhinitis.

BACKGROUND: Concern has been directed at the relative sedating properties of lipophilic and lipophobic antihistamines, but few studies have sought to determine the comparative benefit of seasonal allergic rhinitis (SAR) treatments in controlling symptoms and consequently improving alertness. OBJECTIVE: To compare the relative contributions of fluticasone propionate aqueous nasal spray and loratadine in enhancing daytime performance in 8- to 17-year-old children. METHODS: All participants had a documented history of SAR, positive response to a skin prick (wheal 3-mm greater than negative control or equal to the positive control) for seasonal aeroallergens, and clinically identifiable symptoms at the time of randomization. Following confirmation during baseline of current SAR symptoms, participants were randomized to 1 of the 2 treatments and returned 2 weeks later for evaluation of symptom control, quality of life, attention, reaction time, and memory. RESULTS: Children in the fluticasone propionate aqueous nasal spray group but not the loratadine group demonstrated improvement in nasal symptoms, nasal quality of life score, and composite verbal memory. No differences were identified on any scores from the Conners Continuous Performance Test. CONCLUSIONS: Treatments that most effectively control SAR symptoms are also likely to provide the greatest benefit to children whose daytime functioning, including their capacity to learn at school, is compromised by their illness.

Administration, Intranasal↗
PubMed2002

A cross-sectional analysis of work-related outcomes in adults with asthma.

BACKGROUND: Asthma is a disease with physical symptoms that can impair a person's functioning to the point of interfering with school, work, and social activities. OBJECTIVE: Describe how disease (asthma) and patient characteristics affect perceived work performance and absenteeism. METHODS: Using a cross-sectional study design, 369 adults with asthma from a managed care organization responded to a mailed questionnaire which included a perceived work performance scale (WPS) and an item assessing absenteeism. Analysis consisted of psychometric testing of the scale (internal consistency and construct validity); trend observation of influence of perceived and symptom-derived severity on WPS and absenteeism distribution; and regression analysis to examine the relationship between patient/disease characteristics and the work-related outcomes. RESULTS: The mean WPS score was 88.0 +/- 16.2 (of a possible 100), with a Cronbach's alpha of 0.79. Most respondents (84.7%) did not miss any work in the previous 4 weeks. WPS scores declined and the percentage of respondent absenteeism increased as perceived and symptom-derived severity worsened. The regression model for WPS produced an adjusted R2 of 0.32 and included the number of other illnesses, health beliefs, race, income, and perceived and symptom-derived asthma severity. The regression model for absenteeism included number of other illnesses, race, health beliefs, and symptom-derived severity. Perceived work performance and absenteeism are outcomes measures that are distinctive and complementary. CONCLUSIONS: Disease severity, race, income, and health beliefs also contribute and should be considered in health services research related to asthma.

Absenteeism↗
PubMed2002

Children with ADHD and motor dysfunction compared with children with ADHD only.

The purpose of this study was to identify group differences in children with attention-deficit-hyperactivity disorder and motor dysfunction (ADHD-MD) and ADHD only, and to evaluate the medication responsiveness of ADHD-MD. Sixty-three children (49 males and 14 females; mean age 9 years 10 months, SD 2 years 10 months) underwent a triple blind, placebo-controlled crossover study evaluating two dose levels of methylphenidate (0.3 mg/kg and 0.5 mg/kg [DOSAGE ERROR CORRECTED], twice daily) and placebo. Forty-nine trials were completed. Nineteen were children with ADHD-MD, 44 had ADHD only. Behavior and functioning were assessed at home and at school. Treatment effects were assessed using the Abbreviated Symptom Questionnaire for Parents and Teachers. Children with ADHD-MD were more likely to have severe ADHD-combined type and other neurodevelopmental and behavioral problems. Both groups of children had a linear dose response to medication (placebo, low, high) and there was no evidence of a group by dose interaction or an overall group effect at home or school. The lack of group effect suggests that these children responded to medication like the other subgroups.

Attention Deficit Disorder with Hyperactivity↗
PubMed2002

Risk and promotive effects in the explanation of persistent serious delinquency in boys.

Risk and promotive effects were investigated as predictors of persistent serious delinquency in male participants of the Pittsburgh Youth Study (R. Loeber, D. P. Farrington, M. Stouthamer-Loeber, & W. B. van Kammen, 1998), living in different neighborhoods. Participants were studied over ages 13-19 years for the oldest sample and 7-13 years for the youngest sample. Risk and promotive effects were studied in 6 domains: child behavior, child attitudes, school and leisure activities, peer behaviors, family functioning, and demographics. Regression models improved when promotive effects were included with risk effects in predicting persistent serious delinquency. Disadvantaged neighborhoods, compared with better neighborhoods, had a higher prevalence of risk effects and a lower prevalence of promotive effects. However, predictive relations between risk and promotive effects and persistent serious delinquency were linear and similar across neighborhood socioeconomic status.

Adolescent↗
PubMed2004

The structure of working memory from 4 to 15 years of age.

The structure of working memory and its development across the childhood years were investigated in children 4-15 years of age. The children were given multiple assessments of each component of the A. D. Baddeley and G. Hitch (1974) working memory model. Broadly similar linear functions characterized performance on all measures as a function of age. From 6 years onward, a model consisting of 3 distinct but correlated factors corresponding to the working memory model provided a good fit to the data. The results indicate that the basic modular structure of working memory is present from 6 years of age and possibly earlier, with each component undergoing sizable expansion in functional capacity throughout the early and middle school years to adolescence.

Adolescent↗
PubMed2004

Enduring effects of prenatal cocaine exposure on selective attention and reactivity to errors: evidence from an animal model.

Adult Long-Evans rats, exposed prenatally to 1 of 4 doses of cocaine (0.0,0.5,1.0, or 3.0 mg/kg iv), were tested on a 3-choice visual attention task with an olfactory distractor presented unpredictably on one third of the trials. The performance of all 3 cocaine-exposed groups was significantly more disrupted than that of controls by the presentation of distractors. Results demonstrate that prenatal cocaine exposure increases susceptibility to distractors, using a task specifically designed to measure this function. In addition, the present study revealed that individuals exposed to cocaine in utero exhibit greater performance disruption after an error than controls, in certain types of tasks. Both areas of dysfunction, impaired selective attention and impaired arousal regulation, have important functional consequences in humans, possibly affecting the school performance and social development of cocaine-exposed children.

Animals↗
PubMed2006

Marital conflict, maternal and paternal parenting, and child adjustment: a test of mediation and moderation.

Parenting was examined as a mediator of associations between marital and child adjustment, and parent gender was examined as a moderator of associations among marital, parental, and child functioning in 226 families with a school-age child (146 boys). Parenting fully mediated associations between marital conflict and child internalizing and externalizing behaviors. Parent gender did not moderate associations when data from the full sample or families with girls only were evaluated. Parent gender did moderate associations when families with boys were evaluated, with the association between marital conflict and parenting stronger for fathers than mothers. A trend suggested fathers' parenting may be more strongly related to internalizing behavior and mothers' parenting may be more strongly related to externalizing behavior in boys.

Adult↗
PubMed1991

Ability, achievement, and adjustment in homeless children.

Homeless 3-12-year-old children residing in city shelters were compared with a matched control group of 45 inner city children in terms of cognitive functioning and emotional-behavioral adjustment. School-age children in both groups did not differ significantly on most measures. Preschool homeless children exhibited slower development and more emotional-behavioral problems than did their domiciled peers, and significantly fewer were enrolled in early childhood programs. The feasibility of evaluating this population on standardized instruments is demonstrated, and implications of the study for social policy are discussed.

Achievement↗
PubMed1983

Sexual fantasy and activity patterns of females with inhibited sexual desire versus normal controls.

Until recent years, female sexual fantasy was generally associated with psychopathology or negative qualities. Sexual fantasy is now regarded by the cognitive-behavioral schools as a normal occurrence serving adaptive functions. No investigation has been made comparing the sexual fantasy and activity patterns of women with a specific sexual dysfunction and women with a satisfactory sexual adjustment. This study compared responses to a fantasy questionnaire completed by 30 women reporting a satisfying sex life and 25 women who came to a sexual dysfunction clinic with a complaint of inhibited sexual desire. This study confirms that females with inhibited sexual desire fantasize less during foreplay, coitus, masturbation and general daydreaming than the controls. The content of fantasies in both groups is similar. The females with inhibited sexual desire do not masturbate less often and do not have fewer orgasms through masturbation than the controls. The females with inhibited sexual desire have fewer orgasms through intercourse alone.

Adolescent↗
PubMed2002

Faecal calprotectin levels in infants with infantile colic, healthy infants, children with inflammatory bowel disease, children with recurrent abdominal pain and healthy children.

UNLABELLED: This study investigated faecal calprotectin concentration, a measure of intestinal inflammation, in infants and children with abdominal pain. Faecal calprotectin was measured by an enzyme-linked immunosorbent assay kit in spot stool samples in 76 infants with typical infantile colic, 7 infants with transient lactose intolerance and 27 healthy infants. All infants were 2-10 wk of age. In addition, 19 children with recurrent abdominal pain (RAP; mean age 11.5 y), 17 with inflammatory bowel disease (IBD; mean age 11.1 y; 10 had Crohn's disease and 7 ulcerative colitis) and 24 healthy children (mean age 5.3 y) were studied. In infants with infantile colic the mean faecal calprotectin concentration was not different from that in healthy infants (278 +/- 105 vs 277 +/- 109 mg kg(-1), p = 0.97) or in infants with transient lactose intolerance (300.3 +/- 124 mg kg(-1), p = 0.60). The calprotectin level was similar in boys and girls and fell significantly with age (p = 0.04). Children with IBD had faecal calprotectin levels (293 +/- 218 mg kg(-1)) much higher than healthy children (40 +/- 28 mg kg(-1), p < 0.0001) and children with RAP without identified organic disease (18 +/- 24 mg kg(-1), p < 0.0001). CONCLUSION: Faecal calprotectin may differentiate between functional abdominal pain and IBD in school-aged children. In young infants high faecal calprotectin levels are normal.

Abdominal Pain↗