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PubMed1990

A context analysis of contingent teacher attention.

The present two-experiment study compared the relationship between on-task student behavior and three measures of contingent teacher attention: total amount, contingent amount, and proportion of the total amount contingent on the target behavior. Toward this goal, a real-time observational system was developed for assessing multiple categories of teacher attention contingent upon a variety of student behavior categories. Using this system, observational data were collected in a self-contained classroom for a mentally retarded adolescent (Experiment 1) and in a remedial summer school classroom for a regular first-grade student (Experiment 2). Results from the two experiments showed the proportional measure of contingent teacher attention to account for nearly five times more variance in time on-task than contingent amount. These findings are discussed in terms of the importance of concurrently available teacher attention in the functional analysis of classroom behavior.

Adolescent↗
PubMed2006

[KES--training for parents of children with conduct behaviour problems].

Conduct behaviour problems are the most frequent problems in childhood and adolescence. They make special demands on parenting. Possible causes for the emergence and maintenance of this distinctive features can be summarized in a bio-psychosocial disturbance model. The parental educating behaviour is thereby usually not the cause of the childlike behaviour problems, but can stabilize initial behaviour problems. Parenting trainings are therefore considered as an effective possibility of intervention and prevention of childlike behaviour disturbances. In this article contents and effectiveness of the "Kompetenztraining für Eltern sozial auffälliger und aufmerksamkeitsgestörter Kinder (KES)" (Lauth a. Heubeck 2005) are to be represented. The KES is a secondary preventive parenting training, which is offered as an intensive short time intervention and accomplished in groups. The contents of the training fit with the individual problems of parents' everyday educating situations. In the available study this training is operate in three variants in order to examine differential training effects apart from the general effectiveness. The results show a general effectiveness of the KES. Burdens in family educating situations can be reduced likewise the experienced stress in the family. The results also indicate, that the parents of the group with behaviour exercises seems to benefit most from the training. They do not only speak about their problems (alternative treatment) or get suggestions for changes in the educating behaviour (group without behaviour exercises). They are also requested to practice the connected skills in the form of role plays and homework to be able to transfer into everyday life.

Adolescent↗
PubMed2006

Personality strengths in adolescence and decreased risk of developing mental health problems in early adulthood.

The aim of this study was to investigate whether personality strengths during adolescence are associated with decreased risk of developing psychiatric disorders, educational or occupational problems, violent or criminal behaviors, and interpersonal difficulties during early adulthood. A representative community sample of 688 mothers from upstate New York and their offspring was interviewed in the period of 1985-1986 (mean offspring age = 16 years) and in that of 1991-1993 (mean offspring age = 22 years). Results showed that youths with numerous personality strengths at the mean age of 16 years were at a decreased risk of developing psychiatric disorders, educational and occupational problems, interpersonal difficulties, and criminal behaviors at the mean age of 22 years. These associations remained significant after controlling for age, sex, socioeconomic status, verbal intelligence, preexisting psychiatric disorders, and corresponding problems at the mean age of 16 years. Although youths with fewer personality strengths who experienced numerous stressful events were at elevated risk of developing psychiatric disorders during early adulthood, those with a higher number of personality strengths at the mean age of 16 years did not share this vulnerability. We conclude that personality strengths during adolescence may contribute to a decreased risk of developing a wide range of adverse outcomes during early adulthood. Systematic evaluation of character strengths may improve the clinical assessment of adolescents.

Adolescent↗
PubMed2004

[Stalking: problems in differentiation between aberrant social behaviour and mental disorders].

The concept "stalking" refers to willful, malicious, and repeated following or harassment of another person that threatens her or his security. Although there is nothing new about the occurrence of this conduct it has been discussed in psychiatry more intensely in recent years. As a result there are a few attempts at classification, without any claim of general validity. Patterns of stalking behaviour reflect a wide spectrum from aggressive actions in the course of conflicts in a relationship to schizophrenia. Thus, it is not adequate to classify this as a psychiatric disorder per se. Thorough diagnostic assessments are mandatory before introducing legal measures, whereas if these are omitted, the term "mental disorder" may be inappropriately used in a wider sense. This may entail unfavourable consequences to be discussed in this paper.

Adult↗
PubMed2001

The assessment of the situational specificity of children's problems behaviour in peer-peer context.

In both theory and research the general issue of the extent to which children's problem behaviour is generalised across situations, and to what extent it is situation specific, has been neglected. In the clinical assessment of disordered children, too, little attention has been paid to the specific situations in which these children display their inappropriate behaviour. In this study the Taxonomy of Problematic Social Situations (TOPS) (Dodge, McClaskey, & Feldman, 1985) was employed. This is a questionnaire in which the child's teacher is asked to rate the likelihood of a child responding in an inappropriate manner in a specific situation. Characteristics of TOPS were investigated both in randomly selected normal school children and in boys with a conduct disorder. Four factors appeared to underlie the TOPS scores from 652 randomly selected boys and girls from grades 1 to 6, these being: teachers' scores for the types of problem situation Being Disadvantaged, Coping with Competition, Social Expectations of Peers, and Teacher Expectations. Because of the high internal consistency of the four factors, TOPS was abbreviated to a TOPS-Short Form (18 instead of 44 items). The four-factor model was cross-validated by means of a second sample of 326 boys and girls. A model with only one general problem behaviour factor did not fit the data of both samples. When the four specific factors were added a satisfactory fit resulted. Moreover, it was found that in the first sample 52% of the variance was explained by the general factor, whereas 18% of the variance was explained by the four specific factors together. Thus, the extent to which problem behaviour is situation specific should not be disregarded. In all four types of problem situation, boys showed more inappropriate behaviour than girls. With increasing age, children were rated as being more competent in dealing with the problem situation Being Disadvantaged. Teachers rated the four types of problem situation as more problematic for boys with a conduct disorder (N = 42) than for normal control boys (N = 67). Conduct disordered boys also differed individually in the number of situational types that were problematic for them. With respect to clinical implications, the identification of the particular social context in which a conduct disordered child displays his or her inappropriate behaviour may help refine treatment goals: more adequate social functioning should be aimed at specifically in those situations that are problematic.

Aggression↗
PubMed1994

Clinical symptoms, neurological impairment, and prediction of violence in psychiatric inpatients.

OBJECTIVE: The study sought to identify basic clinical symptoms of violent inpatients and to determine the relationship between these symptoms and two outcome measures: whether violence was persistent or transient, and length of stay on a secure care unit designed to control violent behavior. METHODS: Thirty-eight patients consecutively admitted to the secure care unit were assessed using a quantified neurological scale, the Brief Psychiatric Rating Scale, and a modified version of the Social Participation Rating Scale, which measured participation in unit activities. Because there was considerable overlap among these clinical measures, factor analysis was applied to isolate underlying clinical factors. RESULTS: Factor analysis consistently identified two independent factors at different time points. The first factor, which consisted of various psychiatric symptoms and behavioral abnormalities, was indicative of general impairment. The second factor was bipolar, reflecting a positive association with neurological impairment and a negative association with paranoid symptoms. A differential association between these two factors and the outcome variables was found. Length of stay, a measure of perceived dangerousness, was best predicted by the general impairment factor, whereas persistent violence was predicted primarily by the bipolar factor. CONCLUSIONS: The data confirmed an association between persistent violence and neurological impairment. The study underscores the need for differential treatment of violent behavior in psychiatric inpatients, as different psychopathological processes might be involved.

Adult↗
PubMed2006

Subthalamic stimulation in Parkinson disease: behavior and social adaptation.

BACKGROUND: Bilateral subthalamic high-frequency stimulation significantly improves motor functions in patients with advanced forms of Parkinson disease (PD). This favorable effect contrasts with a growing number of reports that the treatment may result in psychiatric complications. OBJECTIVE: To analyze the presence of behavioral disorders and social maladjustment in PD patients successfully treated with continuous bilateral subthalamic stimulation. DESIGN: Prospective study. SETTING: University hospital. METHODS: Twenty PD patients underwent prospective evaluation for behavioral and personality changes, quality of life, and social functioning, 6 and 24 months after surgery to implant bilateral stimulating electrodes within the subthalamic nucleus. RESULTS: At 6 and 24 months after surgery, parkinsonian motor disability (on-stimulation/off-medication) was improved by 81% and 67%, respectively, and the severity of levodopa-related motor complications was improved by 84% and 70%, respectively. Levodopa-equivalent dosage was decreased by 79% and 66%, respectively; severity of depression was improved by 21% and 33%, respectively; and severity of anxiety was improved by 43% and 64%, respectively. The patients' personality traits were unmodified. Twenty-four months after surgery, the global score for quality of life was improved by 28%, whereas scores for social adjustment remained stable. CONCLUSIONS: Provided that patients with PD are rigorously selected for neurosurgery, subthalamic stimulation (1) improves mood, anxiety, and quality of life; (2) does not result in severe permanent psychiatric disorders or modify patients' personality; and (3) does not ameliorate social adaptation.

Activities of Daily Living↗
PubMed1993

Disorganized infant attachment classification and maternal psychosocial problems as predictors of hostile-aggressive behavior in the preschool classroom.

This study of 62 low-income families examined the relation between maternal and infant measures assessed at 18 months infant age and child behavior problems at age 5 as rated by preschool teachers. The infancy assessments included measures of mother-infant interaction, maternal psychosocial problems, infant cognitive development, and infant attachment security, including the disorganized/disoriented classification. The strongest single predictor of deviant levels of hostile behavior toward peers in the classroom was earlier disorganized/disoriented attachment status, with 71% of hostile preschoolers classified as disorganized in their attachment relationships in infancy. Maternal psychosocial problems independently predicted hostile aggression in preschool and combined additively with infant attachment security in prediction. Results are discussed in relation to the asymmetry of forward and backward prediction that characterized the findings and in relation to the potential significance of disorganized attachment behavior as a precursor to later maladaptation.

Aggression↗
PubMed1986

Problem patients in a psychiatric inpatient setting. An explorative study.

A total of 26 psychiatric inpatients (5.8% of all admissions) in an intensive treatment unit were identified as problem patients by nursing personnel. Reasons for such identification were behavioral pathology of the patient, difficulties of the staff in the relationship with the patient, and insufficient therapeutic progress, and the use of inappropriate therapeutic methods. Compared with a control group, the problem patients were psychotics or personality disorders. They presented more behavioral pathology, were prescribed more medication, and experienced decisively longer hospitalizations, although they profited less from their hospitalization. Follow-up investigation revealed that the majority did not earn their own living, otherwise they were no more poorly socially adapted than the discharged controls. The suicide proneness of problem patients was high. In the treatment of these patients the necessity of adapting the therapeutic standards and expectations is of the utmost importance.

Adult↗
PubMed1997

Evaluation of brain injury related behavioral disturbances in community mental health centers.

As a result of improved emergency trauma services, more individuals suffering a traumatic brain injury are surviving. Unfortunately, most of these survivors suffer chronic neuropsychiatric sequelae related to both the brain damage and the psychosocial impact of the injury on self-esteem, self-image, primary role, and vocational function. Current community supports are often inadequate to deal with the complex array of neurologic and psychiatric difficulties. This article outlines common features of brain injury, explores the link between these features and the common neuropsychiatric sequelae of brain injury, and suggests some principles helpful in the evaluation of the behaviorally challenged brain injured patient.

Adult↗
PubMed1988

Troublesome and disruptive behaviors in dementia. Relationships to diagnosis and disease severity.

Patients with dementia often manifest troublesome and disruptive behaviors in addition to intellectual impairments. This study evaluated behavioral disturbances in 126 demented patients examined sequentially, using questionnaires administered to primary caregivers to quantify the types and severity of behavioral disturbances. Eighty-three percent of the patients exhibited one or more of the targeted behaviors. The most common troublesome and disruptive behaviors clustered into three categories: aggressive, ideational, and vegetative. The prevalence and severity of the behaviors increased with global severity of dementia, but did not differ in either frequency or type when patients with three diagnoses were compared: Alzheimer's disease (AD), multi-infarct dementia (MID), and mixed AD and MID (MIX). The occurrence and severity of the target behaviors correlated modestly with the severity of dementia. Impairments of mental status correlated weakly with only a single troublesome and disruptive behavior--assaultiveness. These results suggest that troublesome and disruptive behaviors are a very frequent component of dementing disorders, are related to disease severity, and parallel (but are probably not determined by) intellectual deficit.

Adult↗
PubMed2004

Emotional, social, and behavioral functioning of children with sickle cell disease and comparison peers.

This research examined the emotional, social, and behavioral functioning of children with sickle cell disease (SCD) and classroom comparison peers from the perspective of primary and secondary caregivers. It was hypothesized that children with SCD would have more internalizing (emotional) and social problems and fewer externalizing (behavioral) problems than comparison peers. Caregivers of 70 children with SCD and 67 comparison peers completed the Child Behavior Checklist (CBCL) during visits to the children's homes. Relative to comparison peers, children with SCD were perceived by primary caregivers as having more total and internalizing problems and less total competence. Additionally, significantly more children with SCD exceeded clinical cutoffs on the CBCL. While caregivers of children with SCD perceive these children to be at a slightly elevated risk for problems across multiple domains, a significant number of children with SCD have problems in the clinical range. The authors recommend that vigorous screening programs for mental health problems should be included in the routine care of children with SCD, and programs of psychosocial intervention research should be implemented to ameliorate problems for the children at greatest risk.

Adolescent↗