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Results for “Disruptive, Impulse Control, and Conduct Disorders”

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At least 19 recordsLinked to original sources
PubMed2004

Response inhibition in children with conduct disorder and borderline intellectual functioning.

The aim of the study was to investigate impulse control in children with conduct disorder (CD) plus borderline intellectual functioning (BIF), in children with BIF-only, and in a control group with a normal IQ. For this purpose, a Go-No-Go test with varying inter-stimulus-intervals was used. The group CD plus BIF made more errors of commission than the group with BIF only. Therefore, it was concluded that poor impulse control in the group CD plus BIF was associated with CD, not with IQ level. Poor impulse control in the group CD plus BIF was independent of the presentation rate of the stimuli.

Child↗
PubMed2006

Measuring impulsivity in adolescents with serious substance and conduct problems.

Adolescents with substance use and conduct disorders have high rates of aggression and attention deficit hyperactivity disorder (ADHD), all of which have been characterized in part by impulsivity. Developing measures that capture impulsivity behaviorally and correlate with self-reported impulsivity has been difficult. One promising behavioral measure, however, is a variant of the continuous performance test, the Immediate Memory Test/Delayed Memory Test (IMT/DMT). The authors showed significant group differences between adolescents in treatment for serious substance and conduct problems and community controls on impulsivity measures, both behavioral and self-report, as well as on aggression and problem behavior measures. Furthermore, the IMT/DMT correlated significantly with self-reported impulsivity. In summary, the IMT/DMT may be an effective behavioral measure of impulsivity in adolescents.

Adolescent↗
PubMed2001

Acute effects of D-fenfluramine on simultaneous measures of aggressive escape and impulsive responses of adult males with and without a history of conduct disorder.

RATIONALE: The role of serotonin in human aggression was evaluated by administering D-fenfluramine and comparing the effects on laboratory measures of aggression, escape and impulsivity among subjects with and without a history of conduct disorder. METHODS: Ten male subjects with a history of criminal behavior participated in experimental sessions that measured aggressive and impulsive responses. Five subjects had a history of childhood conduct disorder (CD+) and five control subjects did not. Aggression was measured using the Point Subtraction Aggression Paradigm (PSAP), which provides subjects with an aggressive, escape and monetary reinforced response options. Impulsive responses were measured using a paradigm that gives subjects choices between small rewards after short delays versus larger rewards after long delays. RESULTS: Acute doses (0.1, 0.2 and 0.4 mg/kg) of D-fenfluramine produced significant decreases in aggressive responses in CD+ subjects and large decreases in escape responses for CD+ subjects and smaller decreases for control subjects. Impulsive responses were decreased slightly and monetary reinforced responses were not changed in either group. Decreases in aggressive responses were not selective, since escape responses were also decreased, but such effects could not be attributed to a non-specific sedative action because monetary reinforced responses were increased and reaction times were decreased, indicative of central nervous system stimulation. CONCLUSIONS: Release of serotonin by D-fenfluramine is the possible mechanism for reductions in aggressive responses. These results are consistent with a large body of data linking reduced serotonin function and aggressive behavior.

Adult↗
PubMed2000

The importance of callous-unemotional traits for extending the concept of psychopathy to children.

This study focused on the use of callous-unemotional (CU) traits to identify a subgroup of children with both attention deficit/hyperactivity disorder (ADHD) and a conduct problem diagnosis (oppositional defiant disorder [ODD] or conduct disorder [CD] who show characteristics similar to adults with psychopathy. In a clinic-referred sample of children aged 6 to 13 years (N = 154), those with diagnoses of both ADHD and ODD/CD were divided on the basis of teacher ratings of CU traits. Children high on these traits showed features typically associated with psychopathy, such as a lack of fearfulness and a reward-dominant response style. Furthermore, children with CU traits seemed less distressed by their behavior problems. These findings are consistent with research on adults showing that impulsivity and antisocial behavior alone are insufficient to document persons who fit the construct of psychopathy.

Black or African American↗
PubMed2000

Long-term sequelae of prefrontal cortex damage acquired in early childhood.

Frontal lobe dysfunction is often invoked as a contributing factor in developmental disorders characterized by chronic maladaptive behavior, but interpretation of relevant neuropsychological findings has been hampered by the limited information available regarding the consequences of focal prefrontal damage early in life. We describe here the long-term behavioral and cognitive sequelae of damage to prefrontal cortex in two young adult patients who had sustained their brain damage prior to 16 months of age. In the context of normal neurological examinations, both cases had remarkable histories of impaired decision making, behavioral dyscontrol, social defects, and abnormal emotion. Performances were primarily normal on a broad range of neuropsychological measures (intellect, memory, language, academic achievement, visual perception, and visuoconstruction), but selective impairments of executive function were evident. Early dysfunction in the prefrontal region may result in severe and chronic social maladjustment despite largely normal cognitive abilities. These findings can help inform neuropsychological evaluation of patients with possible prefrontal dysfunction in the setting of developmental disabilities or early brain trauma.

Adult↗
PubMed1995

Correlation of suicidal and violent behavior in different diagnostic categories in hospitalized adolescent patients.

OBJECTIVE: To determine the relative importance of aggression and depression in adolescent suicide within different diagnostic categories. METHOD: One hundred sixty-three consecutive admissions to an adolescent psychiatric inpatient unit were assessed using a semistructure diagnostic instrument, the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Scores for depression, suicidal behaviors, and violent behaviors were calculated from this assessment. RESULTS: Anorexia nervosa and conduct disorder patients had the highest suicidal behavior scores. In addition, patients with conduct disorder were significantly more violent than patients with major depressive disorder, and scores on the Violent Behavior Scale correlated with suicidal symptoms but not with depressive symptoms. CONCLUSION: Aggression may be as important in some kinds of suicidal behaviors as is depression. Thus it seems that there are hypothetically at least two types of suicidal behaviors during adolescence: a wish to die (depression) and a wish not to be here for a time (impulse control). The first type of suicidal behavior characterizes that seen in disorders with prominent depression such as major depressive disorder and anorexia nervosa, and the second characterizes disorders of impulse control such as conduct disorder.

Adolescent↗
PubMed2005

Callous-unemotional traits in predicting the severity and stability of conduct problems and delinquency.

The current study tests whether the presence of callous-unemotional (CU) traits designates a group of children with conduct problems who show an especially severe and chronic pattern of conduct problems and delinquency. Ninety-eight children who were selected from a large community screening of school children in grades 3, 4, 6 and 7 were followed across four yearly assessments. Children with conduct problems who also showed CU traits exhibited the highest rates of conduct problems, self-reported delinquency, and police contacts across the four years of the study. In fact, this group accounted for at least half of all of the police contacts reported in the sample across the last three waves of data collection. In contrast, children with conduct problems who did not show CU traits continued to show higher rates of conduct problems across the follow-up assessments compared to non-conduct problem children. However, they did not show higher rates of self-reported delinquency than non-conduct problem children. In fact, the second highest rate of self-reported delinquency in the sample was found for the group of children who were high on CU traits but without conduct problems at the start of the study.

Affect↗
PubMed1985

Diagnosis and childhood firesetting.

This paper presents findings on the relationship of childhood firesetting and DSM-III diagnosis in a representative sample of child psychiatric outpatients (N = 204). Childhood firesetting and the DSM-III diagnosis of conduct disorder are strongly related; they show a significant interaction effect with lessened competence as measured by activities and increased externalizing (undercontrolled) behavior.

Ambulatory Care↗
PubMed2001

Effects of prenatal exposure to marijuana.

QUESTION: I am treating a 27-year-old woman who is now in her 10th week of pregnancy. She smokes marijuana two to three times a week, but does not use other drugs. She also smokes 20 cigarettes a day. I am concerned about the effects of marijuana exposure on her baby. ANSWER: It is not always possible to isolate the effect of marijuana exposure from other possible confounders on pregnancy outcome. Although marijuana is not an established human teratogen, recent well conducted studies suggest it might have subtle negative effects on neurobehavioural outcomes, including sleep disturbances, impaired visual problem solving, hyperactivity, impassivity, inattention, and increased delinquency.

Adolescent↗
PubMed1989

Psychiatric syndromes in adolescent substance abusers.

Conduct disorder, major depressive episode, and the combination of attention deficit, hyperactivity, and impulse disorder were the most prevalent diagnoses after detoxification among 57 adolescents consecutively referred to an inpatient facility for treatment of substance abuse and other concurrent psychiatric disorders.

Adolescent↗
PubMedDate not supplied

[A rare and little-known method of elaborating the loss of the object in melancholia].

The author presents a fully detailed report of the observation of two economically secure young women who were caught shop-lifting in a large department store; one woman was apprehended while suffering from depression, the other was caught just prior to the onset of a depressive episode. It is hoped that the details referred here may contribute to the insufficient data published on this subject up to the present. It is important to note that the thefts committed by these patients show the typical characteristics of "impulsive behavior". Furthermore, the impulse to steal may appear in various psychiatric conditions. Therefore, the author first considered the hypothesis that these thefts may have been computed during an acute dysthymic psychosis. Epilepsy was ruled out in both cases based on anamnestic data, electroencephalographic findings and, even after the administration of a pharmacological trigger, no epileptic symptoms appeared. These negative results prompted the author to propose a psychosemeiogenetic rapport between the depressive conditions and the thefts. Considering basic information regarding the psychodynamic of impulsive behavior in general, and that manifested in the course of melancholia in particular, the author confronts the problem of the psychosemeiogenesis of the impulsive to steal in the depressed patient. In order to understand this problem, the author proposes several interpretative hypotheses (equivalence of suicide or "parasuicide" according to Deshaies; attempt to give a concrete reason for the "feeling of guilt"; conduct to symbolically compensate the loss of the "object"). Following an in-depth, critical discussion, the author concludes that the "parasuicide" hypothesis is most accurate in the case of the first patient, whereas "compensation" more adequately explains the second. In conclusion, the interest that these cases present in the forensic medical sphere is also brought to light.

Depressive Disorder↗
PubMed2006

"Missing links" in borderline personality disorder: loss of neural synchrony relates to lack of emotion regulation and impulse control.

OBJECTIVE: Symptoms of borderline personality disorder (BPD) may reflect distinct breakdowns in the integration of posterior and frontal brain networks. We used a high temporal resolution measure (40-Hz gamma phase synchrony) of brain activity to examine the connectivity of brain function in BPD. METHODS: Unmedicated patients with BPD (n = 15) and age-and sex-matched healthy control subjects (n = 15) undertook a task requiring discrimination of salient from background tones. In response to salient stimuli, the magnitude and latency of peak gamma phase synchrony for early (0-150 ms post stimulus) and late (250-500 ms post stimulus) phases were calculated for frontal and posterior regions and for left and right hemispheres. We recorded skin conductance responses (SCRs) and reaction time (RT) simultaneously to examine the contribution of arousal and performance. RESULTS: Compared with controls, patients with BPD had a significant delay in early posterior gamma synchrony and a reduction in right hemisphere late gamma synchrony in response to salient stimuli. Both SCR onset and RT were also delayed in BPD, but independently from differences in synchrony. The delay in posterior synchrony was associated with cognitive symptoms, and reduced right hemisphere synchrony was associated with impulsivity. CONCLUSIONS: These findings suggest that distinct impairments in the functional connectivity of neural systems for orienting to salient input underlie core dimensions of cognitive disturbance and poor impulse control in BPD.

Adult↗
PubMed2003

Impulsivity and prefrontal hypometabolism in borderline personality disorder.

Prefrontal hypoperfusion and decreased glucose uptake in the prefrontal cortex (PFC) are found in violent criminal offenders, murderers and aggressive psychiatric patients. These abnormalities may be independent of diagnosis and associated with impulsive-aggression as a personality trait. Impulsive-aggression is a clinical characteristic of borderline personality disorder (BPD) where it is associated with assaultive and suicidal behaviors. We conducted FDG-PET studies in 13 non-depressed, impulsive female subjects with BPD and 9 healthy controls to look for abnormalities in glucose metabolism in areas of the PFC associated with regulation of impulsive behavior. Statistical Parametric Mapping-99 (SPM99) was used to analyze the PET data with Hamilton depression scores as covariate. Significant reductions in FDG uptake in BPD subjects relative to healthy controls were found bilaterally in medial orbital frontal cortex, including Brodmann's areas 9, 10 and 11. There were no significant areas of increased uptake in BPD subjects compared to control subjects. Covarying for measures of impulsivity or impulsive-aggression rendered insignificant the differences between groups. Decreased glucose uptake in medial orbital frontal cortex may be associated with diminished regulation of impulsive behavior in BPD.

Adult↗
PubMed1992

EEG and evoked potentials in episodic-dyscontrol syndrome.

The neurophysiologic correlates of explosive rage and violence are uncertain and controversial. We recorded 17-channel electroencephalograms (EEGs), brainstem auditory-evoked potentials (BAEPs), and long-latency auditory-event-related potentials (AEPs) in 23 patients with impulsive, aggressive and violent behavior satisfying criteria for episodic-dyscontrol syndrome. Most patients also satisfied criteria for intermittent explosive disorder, although some had had conduct disorders in childhood or had previously used psychoactive substances. Sixteen of 23 patients had normal EEGs, while 7 had diffuse or focal slowing not ascribable to drowsiness or the effects of medication. They differed significantly from 20 age-matched patients with headaches, of whom 1 had an abnormal EEG (chi 2 = 4.68, p < 0.05), and from 24 depressed patients, all of whose EEGs were normal (chi 2 = 4.83, p < 0.05). Patients and normal control subjects did not differ in BAEP latencies. N100 and P160 AEP amplitudes were lower in episodic-dyscontrol patients than in control, but the difference was not significant. These findings suggest that non-specific cerebral dysfunction and EEG changes may be associated with disordered impulse or behavior control. Episodic dyscontrol may be associated with other evidence of minimal brain dysfunction.

Acoustic Stimulation↗
PubMed2003

Impulsivity, gender, and response to fenfluramine challenge in borderline personality disorder.

Behavioral impulsivity in borderline personality disorder (BPD) is associated with indices of diminished central serotonergic function, independent of suicidal behavior, depression or alcohol use disorder. Many of these studies have been conducted among males in specialized settings. Studies of BPD females, who constitute the majority of BPD patients, are generally conducted in community settings and report inconsistent findings. We studied gender differences in behavioral impulsivity and the prolactin response to D,L-fenfluramine (FEN) in BPD subjects in a community setting. A FEN challenge study was conducted with 64 BPD subjects (20 male, 44 female), and 57 controls (36 male, 21 female). Axis I and II disorders, including BPD, and suicidal histories were assessed by structured interviews. Controls were free of Axis I and II disorders. Impulsivity and aggression were assessed by the Buss-Durkee Hostility Inventory, Barratt Impulsiveness Scale, Minnesota Multiphasic Personality Inventory-Psychopathic Deviate subscale, and the Brown-Goodwin Lifetime History of Aggression. Male, but not female, BPD subjects had significantly diminished prolactin responses compared to controls. Impulsivity and aggression each predicted prolactin responses. A significant effect of BPD diagnosis on prolactin response was eliminated when impulsivity was co-varied. Impulsivity and aggression were inversely related to delta-prolactin and peak-prolactin responses among male but not female subjects. Gender differences in central serotonergic function may contribute to variations in impulsivity in BPD.

Adult↗
PubMed2005

Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication.

BACKGROUND: Little is known about the general population prevalence or severity of DSM-IV mental disorders. OBJECTIVE: To estimate 12-month prevalence, severity, and comorbidity of DSM-IV anxiety, mood, impulse control, and substance disorders in the recently completed US National Comorbidity Survey Replication. DESIGN AND SETTING: Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using a fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview. PARTICIPANTS: Nine thousand two hundred eighty-two English-speaking respondents 18 years and older. MAIN OUTCOME MEASURES: Twelve-month DSM-IV disorders. RESULTS: Twelve-month prevalence estimates were anxiety, 18.1%; mood, 9.5%; impulse control, 8.9%; substance, 3.8%; and any disorder, 26.2%. Of 12-month cases, 22.3% were classified as serious; 37.3%, moderate; and 40.4%, mild. Fifty-five percent carried only a single diagnosis; 22%, 2 diagnoses; and 23%, 3 or more diagnoses. Latent class analysis detected 7 multivariate disorder classes, including 3 highly comorbid classes representing 7% of the population. CONCLUSION: Although mental disorders are widespread, serious cases are concentrated among a relatively small proportion of cases with high comorbidity.

Adolescent↗
PubMed2006

Coexisting psychiatric disorders in a New Zealand outpatient alcohol and other drug clinical population.

OBJECTIVE: To describe the extent of psychiatric disorder and mental health service utilization in a representative outpatient alcohol and other drug (AOD) treatment sample in New Zealand. METHOD: A total of 105 patients were randomly recruited from two outpatient AOD treatment services in New Zealand and completed a diagnostic interview within the first 2 months of treatment. Axis I psychiatric diagnoses were made using the computerized Composite International Diagnostic Interview (CIDI-Auto), and were supplemented by the South Oaks Gambling Scale (SOGS) and the conduct disorder and antisocial personality disorder section of the Diagnostic Interview for Genetic Studies (DIGS). RESULTS: Seventy-four per cent of the sample had a current non-substance or gambling axis I disorder, with a lifetime rate of 90%. The most commonly diagnosed of these coexisting psychiatric disorders were major depressive episode (34%), social phobia (31%) and posttraumatic stress disorder (31%). Past contact with mental health services was common, while contact at the time of baseline assessment was uncommon. CONCLUSIONS: Coexisting psychiatric disorder was the rule and not the exception in this sample. AOD patients are clearly part of the larger population of mental health patients. AOD services need to be capable of comprehensive assessment and treatment planning, which includes coexisting psychiatric disorders, and should work toward better integration with other mental health services.

Adolescent↗