An item response analysis of the motor and behavioral subscales of the unified Huntington's disease rating scale in huntington disease gene expansion carriers.

PubMed

Vaccarino, Anthony L; Anderson, Karen; Borowsky, Beth; Duff, Kevin; Giuliano, Joseph; Guttman, Mark; Ho, Aileen K; Orth, Michael; Paulsen, Jane S; Sills, Terrence; van Kammen, Daniel P; Evans, Kenneth R

2011-04-01

Although the Unified Huntington's Disease Rating Scale (UHDRS) is widely used in the assessment of Huntington disease (HD), the ability of individual items to discriminate individual differences in motor or behavioral manifestations has not been extensively studied in HD gene expansion carriers without a motor-defined clinical diagnosis (ie, prodromal-HD or prHD). To elucidate the relationship between scores on individual motor and behavioral UHDRS items and total score for each subscale, a nonparametric item response analysis was performed on retrospective data from 2 multicenter longitudinal studies. Motor and behavioral assessments were supplied for 737 prHD individuals with data from 2114 visits (PREDICT-HD) and 686 HD individuals with data from 1482 visits (REGISTRY). Option characteristic curves were generated for UHDRS subscale items in relation to their subscale score. In prHD, overall severity of motor signs was low, and participants had scores of 2 or above on very few items. In HD, motor items that assessed ocular pursuit, saccade initiation, finger tapping, tandem walking, and to a lesser extent, saccade velocity, dysarthria, tongue protrusion, pronation/supination, Luria, bradykinesia, choreas, gait, and balance on the retropulsion test were found to discriminate individual differences across a broad range of motor severity. In prHD, depressed mood, anxiety, and irritable behavior demonstrated good discriminative properties. In HD, depressed mood demonstrated a good relationship with the overall behavioral score. These data suggest that at least some UHDRS items appear to have utility across a broad range of severity, although many items demonstrate problematic features. Copyright © 2011 Movement Disorder Society.

Combination Therapy with Cholinesterase Inhibitors and Memantine for Alzheimer’s Disease: A Systematic Review and Meta-Analysis

PubMed Central

Kishi, Taro; Iwata, Nakao

2015-01-01

Background: We performed an updated meta-analysis of randomized controlled trials of combination therapy with cholinesterase inhibitors and memantine in patients with Alzheimer’s disease. Methods: We reviewed cognitive function, activities of daily living, behavioral disturbance, global assessment, discontinuation rate, and individual side effects. Results: Seven studies (total n=2182) were identified. Combination therapy significantly affected behavioral disturbance scores (standardized mean difference=−0.13), activity of daily living scores (standardized mean difference=−0.10), and global assessment scores (standardized mean difference=−0.15). In addition, cognitive function scores (standardized mean difference=−0.13, P=.06) exhibited favorable trends with combination therapy. The effects of combination therapy were more significant in the moderate-to-severe Alzheimer’s disease subgroup in terms of all efficacy outcome scores. The discontinuation rate was similar in both groups, and there were no significant differences in individual side effects. Conclusions: Combination therapy was beneficial for the treatment of moderate-to-severe Alzheimer’s disease in terms of cognition, behavioral disturbances, activities of daily living, and global assessment was well tolerated. PMID:25548104

Combination therapy with cholinesterase inhibitors and memantine for Alzheimer's disease: a systematic review and meta-analysis.

PubMed

Matsunaga, Shinji; Kishi, Taro; Iwata, Nakao

2014-12-28

We performed an updated meta-analysis of randomized controlled trials of combination therapy with cholinesterase inhibitors and memantine in patients with Alzheimer's disease. We reviewed cognitive function, activities of daily living, behavioral disturbance, global assessment, discontinuation rate, and individual side effects. Seven studies (total n=2182) were identified. Combination therapy significantly affected behavioral disturbance scores (standardized mean difference=-0.13), activity of daily living scores (standardized mean difference=-0.10), and global assessment scores (standardized mean difference=-0.15). In addition, cognitive function scores (standardized mean difference=-0.13, P=.06) exhibited favorable trends with combination therapy. The effects of combination therapy were more significant in the moderate-to-severe Alzheimer's disease subgroup in terms of all efficacy outcome scores. The discontinuation rate was similar in both groups, and there were no significant differences in individual side effects. Combination therapy was beneficial for the treatment of moderate-to-severe Alzheimer's disease in terms of cognition, behavioral disturbances, activities of daily living, and global assessment was well tolerated. © The Author 2015. Published by Oxford University Press on behalf of CINP.

Severity of the aggression/anxiety-depression/attention child behavior checklist profile discriminates between different levels of deficits in emotional regulation in youth with attention-deficit hyperactivity disorder.

PubMed

Biederman, Joseph; Petty, Carter R; Day, Helen; Goldin, Rachel L; Spencer, Thomas; Faraone, Stephen V; Surman, Craig B H; Wozniak, Janet

2012-04-01

We examined whether severity scores (1 SD vs 2 SDs) of a unique profile of the Child Behavior Checklist (CBCL) consisting of the Anxiety/Depression, Aggression, and Attention (AAA) scales would help differentiate levels of deficits in children with attention-deficit hyperactivity disorder (ADHD). Subjects were 197 children with ADHD and 224 without ADHD. We defined deficient emotional self-regulation (DESR) as an aggregate cutoff score of >180 but <210 (1 SD) on the AAA scales of the CBCL (CBCL-DESR) and Severe Dysregulation as an aggregate cutoff score of ≥210 on the same scales (CBCL-Severe Dysregulation). All subjects were assessed with structured diagnostic interviews and a range of functional measures. Thirty-six percent of children with ADHD had a positive CBCL-DESR profile versus 2% of controls (p < .001) and 19% had a positive CBCL-Severe Dysregulation profile versus 0% of controls (p < .001). The subjects positive for the CBCL-Severe Dysregulation profile differed selectively from those with the CBCL-DESR profile in having higher rates of unipolar and bipolar mood disorders, oppositional defiant and conduct disorders, psychiatric hospitalization at both baseline and follow-up assessments, and a higher rate of the CBCL-Severe Dysregulation in siblings. In contrast, the CBCL-DESR was associated with higher rates of comorbid disruptive behavior, anxiety disorders, and impaired interpersonal functioning compared with other ADHD children. Severity scores of the AAA CBCL profiles can help distinguish 2 groups of emotional regulation problems in children with ADHD.

Social desirability response tendencies in psychiatric inpatient children.

PubMed

Mabe, P A; Treiber, F A

1989-03-01

This study examined the substantive features of children's social desirability (SD) tendencies that could influence the nature and severity of psychopathology. Examinations of substantive features of SD responding in an inpatient child psychiatry unit (N = 76) suggested that higher scores on the Children's Social Desirability questionnaire were associated strongly with (1) lower mental age; (2) higher scores on self-reported social competence; (3) lower scores on self-reported anger; and (4) lower scores on parent-reported externalization behavioral disturbance. Results were interpreted as suggesting that SD responding for child inpatients may reflect a mixed picture of negative features of cognitive and social immaturity that could affect adversely their ability to judge their own and others' social behavior and of positive features of less external behavioral disturbance and more prosocial attitudes and behaviors.

The relationship of motor skills and adaptive behavior skills in young children with autism spectrum disorders

PubMed Central

MacDonald, Megan; Lord, Catherine; Ulrich, Dale

2015-01-01

Objective To determine the relationship of motor skills and the core behaviors of young children with autism, social affective skills and repetitive behaviors, as indicated through the calibrated autism severity scores. Design The univariate GLM tested the relationship of gross and fine motor skills measured by the gross motor scale and the fine motor scale of the MSEL with autism symptomology as measured by calibrated autism severity scores. Setting Majority of the data collected took place in an autism clinic. Participants A cohort of 159 young children with ASD (n=110), PDD-NOS (n=26) and non-ASD (developmental delay, n=23) between the ages of 12–33 months were recruited from early intervention studies and clinical referrals. Children with non-ASD (developmental delay) were included in this study to provide a range of scores indicted through calibrated autism severity. Interventions Not applicable. Main Outcome Measures The primary outcome measures in this study were calibrated autism severity scores. Results Fine motor skills and gross motor skills significantly predicted calibrated autism severity (p < 0.01). Children with weaker motor skills displayed higher levels of calibrated autism severity. Conclusions The fine and gross motor skills are significantly related to autism symptomology. There is more to focus on and new avenues to explore in the realm of discovering how to implement early intervention and rehabilitation for young children with autism and motor skills need to be a part of the discussion. PMID:25774214

The interactions between religion, religiosity, religious delusion/hallucination, and treatment-seeking behavior among schizophrenic patients in Taiwan.

PubMed

Huang, Charles Lung-Cheng; Shang, Chi-Yung; Shieh, Ming-Shien; Lin, Hsin-Nan; Su, Jin Chung-Jen

2011-05-30

Religion could influence the psychopathology, treatment-seeking behavior, and treatment outcome in schizophrenia, but the associations between these factors have never been explored thoroughly, and the data in Han-Chinese society are scarcer still. The current study recruited 55 schizophrenic patients to explore the relationship between religion, psychopathology with religious content, treatment-seeking behavior, and outcome. Subjects with religious delusions/hallucinations had lower scores on functioning and higher scores on religiosity. The higher religiosity scores were correlated with older age, longer duration of illness, religious affiliation, lower preference of psychiatric treatment, lower functioning score, and delusion/hallucination. As to treatment-seeking behavior, patients with religious affiliation showed less preference toward psychiatric treatment. Individuals with religious delusion/hallucination were more likely to receive magico-religious healing and not to be satisfied with psychiatric treatment. A more positive view of psychiatric treatment was predicted by lower religiosity score, higher satisfaction with psychiatric treatment, and lower years of education. The religiosity level seems not directly related to clinical severity, but it seems to be a better predictor of religious delusions/hallucinations than religious affiliation status. Patients with religious delusions/hallucinations did not necessarily have more severe psychopathology. There are different profiles associated with religious affiliation/religiosity and religious delusions/hallucinations in relation to treatment-seeking behavior among schizophrenia patients in Han-Chinese society. Copyright © 2010 Elsevier Ltd. All rights reserved.

Type A Behavior Pattern, Impulsiveness, Risk Propensity, and Empathy as Predictors of Dyspnea and Number of Infections in Men with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study.

PubMed

Witusik, Andrzej; Mokros, Łukasz; Kuna, Piotr; Nowakowska-Domagała, Katarzyna; Antczak, Adam; Pietras, Tadeusz

2018-06-06

BACKGROUND Stress and psychological factors can induce dyspnea in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to assess selected elements of the clinical presentation of COPD in the context of the severity of type A pattern of behavior, impulsiveness, and tendency for empathy. MATERIAL AND METHODS This was a cross-sectional study. The study group consisted of 179 men with COPD and the control group consisted of 31 healthy male smokers. In all patients, the number of infectious exacerbations over the past year, the result on the dyspnea scale (MRC), and the FEV1-to- predicted FEV1 ratio was assessed. The A pattern of behavior was measured using the Type A scale. To measure impulsivity, risk propensity, and empathy, the IVE impulsivity questionnaire was used. RESULTS An increase in the number of infectious exacerbations was associated with an increased score on the Type A scale, an increase in risk propensity, and a decrease in impulsivity score. Increased severity of dyspnea was associated with an increase in Type A behavior pattern score and an increase in the risk propensity score. CONCLUSIONS Type A behavior pattern and risk propensity are independent predictors of the number of infections in the last year and of the subjective severity of dyspnea among men with COPD and healthy male smokers.

Binge Eating, But Not Other Disordered Eating Symptoms, Is a Significant Contributor of Binge Drinking Severity: Findings from a Cross-Sectional Study among French Students.

PubMed

Rolland, Benjamin; Naassila, Mickael; Duffau, Céline; Houchi, Hakim; Gierski, Fabien; André, Judith

2017-01-01

Many studies have suggested the co-occurrence of eating disorders and alcohol use disorders but in which extent binge eating (BE) and other disordered eating symptoms (DES) are associated with the severity of binge drinking (BD) remains unknown. We conducted a online cross-sectional study among 1,872 French students. Participants were asked their age, gender, tobacco and cannabis use status. They completed the Alcohol Use Questionnaire (AUQ), Eating Disorder Examination Questionnaire (EDE-Q), and UPPS impulsive behavior questionnaire. BD score was calculated using the AUQ. Three items of the EDE-Q were used to construct a BE score. The predictors of the BD score were determined using a linear regression model. Our results showed that the BE score was correlated with the BD score (β 0 = 0.051 ± 0.022; p = 0.019), but no other DES was associated with BD, including purging behaviors. The severity of BD was also correlated with younger age, male gender, tobacco and cannabis use, and with the 'positive urgency,' 'premeditation,' and 'sensation seeking' UPPS subscores ( R 2 of the model: 25%). Within DES, BE appeared as an independent determinant of the BD severity. This is in line with the recent hypothesis that BE is not a subtype of DES, but more a general vulnerability factor of emotional dysregulation, which could be shared by different behavioral and addictive disorders.

Behavior predictors of language development over 2 years in children with autism spectrum disorders.

PubMed

Bopp, Karen D; Mirenda, Pat; Zumbo, Bruno D

2009-10-01

This exploratory study examined predictive relationships between 5 types of behaviors and the trajectories of vocabulary and language development in young children with autism over 2 years. Participants were 69 children with autism assessed using standardized measures prior to the initiation of early intervention (T1) and 6 months (T2), 12 months (T3), and 24 months (T4) later. Growth curve modeling examined the extent to which behaviors at T1 and changes in behaviors between T1 and T2 predicted changes in development from T1 to T4. Regardless of T1 nonverbal IQ and autism severity, high scores for inattentive behaviors at T1 predicted lower rates of change in vocabulary production and language comprehension over 2 years. High scores for social unresponsiveness at T1 predicted lower rates of change in vocabulary comprehension and production and in language comprehension over 2 years. Scores for insistence on sameness behaviors, repetitive stereotypic motor behaviors, and acting-out behaviors at T1 did not predict the rate of change of any child measure over 2 years beyond differences accounted for by T1 autism severity and nonverbal IQ status. The results are discussed with regard to their implications for early intervention and understanding the complex factors that affect developmental outcomes.

Sleep Problems and Their Relationship to Maladaptive Behavior Severity in Psychiatrically Hospitalized Children with Autism Spectrum Disorder (ASD).

PubMed

Sannar, Elise M; Palka, Tamara; Beresford, Carol; Peura, Christine; Kaplan, Desmond; Verdi, Mary; Siegel, Matthew; Kaplan, Shir; Grados, Marco

2017-10-30

We examined the relationship between sleep duration and awakenings to Aberrant Behavior Checklist-Community (ABC-C) and Autism Diagnostic Observation Schedule (ADOS-2) scores in hospitalized youth with ASD and behavioral disturbance. Participants included 106 patients with a stay of at least 10 nights. Sleep in the hospital was recorded by staff observation. Higher scores on the ABC-C (irritability, stereotypy, and hyperactivity subscales) at admission were significantly associated with fewer minutes slept during the last five nights of hospitalization. There was no association between total awakenings and ABC-C scores or ADOS-2 comparison scores. Improved understanding of the relationship between sleep quality and maladaptive behavior in this challenging cohort of patients with ASD is vital to the definition and design of future effective interventions.

The assessment of fetal brain function in fetuses with ventrikulomegaly: the role of the KANET test.

PubMed

Talic, Amira; Kurjak, Asim; Stanojevic, Milan; Honemeyer, Ulrich; Badreldeen, Ahmed; DiRenzo, Gian Carlo

2012-08-01

To assess differences in fetal behavior in both normal fetuses and fetuses with cerebral ventriculomegaly (VM). In a period of eighteen months, in a longitudinal prospective cohort study, Kurjak Antenatal NeuorogicalTest (KANET) was applied to assess fetal behavior in both normal pregnancies and pregnancies with cerebral VM using four-dimensional ultrasound (4D US). According to the degree of enlargement of the ventricles, VM was divided into three groups: mild, moderate and severe. Moreover fetuses with isolated VM were separated from those with additional abnormalities. According to the KANET, fetuses with scores ≥ 14 were considered normal, those with scores 6-13 borderline and abnormal if the score was ≤ 5. Differences between two groups were examined by Fisher's exact test. Differences within the subgroups were examined by Kruskal-Wallis test and contingency table test. KANET scores in normal pregnancies and pregnancies with VM showed statistically significant differences. Most of the abnormal KANET scores as well as most of the borderline-scores were found among the fetuses with severe VM associated with additional abnormalities. There were no statistically significant differences between the control group and the groups with isolated and mild and /or moderate VM. Evaluation of the fetal behavior in fetuses with cerebral VM using KANET test has the potential to detect fetuses with abnormal behavior, and to add the dimension of CNS function to the morphological criteria of VM. Long-term postnatal neurodevelopmental follow-up should confirm the data from prenatal investigation of fetal behavior.

Comorbid symptomatology moderates response to risperidone, stimulant, and parent training in children with severe aggression, disruptive behavior disorder, and attention-deficit/hyperactivity disorder.

PubMed

Farmer, Cristan A; Brown, Nicole V; Gadow, Kenneth D; Arnold, L Eugene; Kolko, David G; Findling, Robert L; Molina, Brooke S G; Buchan-Page, Kristin A; Rice, Robert R; Bangalore, Srihari S; Bukstein, Oscar; Rundberg-Rivera, E Victoria; McNamara, Nora; Aman, Michael G

2015-04-01

In this study, we evaluated parent and child characteristics as predictors and moderators of response in the four-site Treatment of Severe Childhood Aggression (TOSCA) study. A total of 168 children with severe aggression, disruptive behavior disorder, and attention-deficit/hyperactivity disorder (ADHD) were enrolled in a 9-week trial of basic treatment (n=84, stimulant+parent training+placebo) versus augmented treatment (n=84, stimulant+parent training+risperidone). In the initial report, augmented treatment surpassed basic treatment in reducing the primary outcome of disruptive behavior (D-Total) scores. In the current study, we evaluated parent (income, education, family functioning, employment) and child variables (intelligence quotient [IQ], aggression type, comorbid symptomatology) as predictors or moderators, using linear mixed models and the MacArthur guidelines. Higher scores on ADHD symptom severity and callous/unemotional traits predicted better outcome on D-Total regardless of treatment assignment. Two moderators of D-Total were found: Higher anger/irritability symptoms and lower mania scores were associated with faster response, although not better overall effect at endpoint, in the augmented but not the basic group. Several variables moderated response on secondary outcomes (ADHD severity and prosocial behavior), and were characterized by faster response, although not better outcome, in the augmented but not in the basic group. Maternal education moderated outcome on the measure of positive social behavior; children of mothers with less education benefited more from augmented treatment relative to basic than those with more education. Although these findings require validation, they tentatively suggest that augmented treatment works equally well across the entire sample. Nevertheless, certain child characteristics may be useful indicators for the speed of response to augmented treatment.

Free-play behavior of atypical children: an approach to assessment.

PubMed

Clune, C; Paolella, J M; Foley, J M

1979-03-01

Children's free-play behavior and its relationship to IQ and usefulness in assessing severely disturbed children were investigated. The results indicated that (1) the play of 100 normal children scored for quality and time generally yielded significant positive correlations with Binet and WPPSI IQs; (2) the correlations remained the same when verbalizations were deleted from the play protocols; (3) the play scores for 16 severely disturbed boys significantly differentiated two subgroups differing in degree of pathology, showed significant improvement from the pre- to posttreatment periods, and indicated pretreatment scores were significantly and positively correlated with improvement assessed by observer ratings in a 2-year follow-up. Implications for the use of this measure in assessment and the role of play in development were discussed.

Adapting Educational Measurement to the Demands of Test-Based Accountability

ERIC Educational Resources Information Center

Koretz, Daniel

2015-01-01

Accountability has become a primary function of large-scale testing in the United States. The pressure on educators to raise scores is vastly greater than it was several decades ago. Research has shown that high-stakes testing can generate behavioral responses that inflate scores, often severely. I argue that because of these responses, using…

Impulsivity profiles in pathological slot machine gamblers.

PubMed

Aragay, Núria; Barrios, Maite; Ramirez-Gendrau, Isabel; Garcia-Caballero, Anna; Garrido, Gemma; Ramos-Grille, Irene; Galindo, Yésika; Martin-Dombrowski, Jonatan; Vallès, Vicenç

2018-05-01

In gambling disorder (GD), impulsivity has been related with severity, treatment outcome and a greater dropout rate. The aim of the study is to obtain an empirical classification of GD patients based on their impulsivity and compare the resulting groups in terms of sociodemographic, clinical and gambling behavior variables. 126 patients with slot machine GD attending the Pathological Gambling Unit between 2013 and 2016 were included. The UPPS-P Impulsive Behavior Scale was used to assess impulsivity, and the severity of past-year gambling behavior was established with the Screen for Gambling problems questionnaire (NODS). Depression and anxiety symptoms and executive function were also assessed. A two-step cluster analysis was carried out to determine impulsivity profiles. According to the UPPS-P data, two clusters were generated. Cluster 1 showed the highest scores on all the UPPS-P subscales, whereas patients from cluster 2 exhibited only high scores on two UPPS-P subscales: Negative Urgency and Lack of premeditation. Additionally, patients on cluster 1 were younger and showed significantly higher scores on the Beck Depression Inventory and on the State-Trait Anxiety Inventory questionnaires, worse emotional regulation and executive functioning, and reported more psychiatric comorbidity compared to patients in cluster 2. With regard to gambling behavior, cluster 1 patients had significantly higher NODS scores and a higher percentage presented active gambling behavior at treatment start than in cluster 2. We found two impulsivity subtypes of slot machine gamblers. Patients with high impulsivity showed more severe gambling behavior, more clinical psychopathology and worse emotional regulation and executive functioning than those with lower levels of impulsivity. These two different clinical profiles may require different therapeutic approaches. Copyright © 2018 Elsevier Inc. All rights reserved.

Disregulated Alcohol-Related Behavior among College Drinkers: Associations with Protective Behaviors, Personality, and Drinking Motives

ERIC Educational Resources Information Center

Isaak, Matthew I.; Perkins, David R.; Labatut, Tiffany R.

2011-01-01

Objective: This study investigated the psychometric properties of the Disregulated Alcohol-Related Behaviors Inventory (DARBI), a measure of harmful alcohol-related behavior, and the relationship between protective behavior use and scores on the DARBI and several other measures. Participants: Participants were 281 undergraduate volunteers (60%…

Tic Severity and Treatment in Children: The Effect of Comorbid Attention Deficit Hyperactivity Disorder and Obsessive Compulsive Behaviors.

PubMed

Pringsheim, Tamara

2017-12-01

While attention deficit hyperactivity disorder (ADHD) and obsessive compulsive disorder have been shown to have major impacts on quality of life in individuals with Tourette syndrome, there is comparatively little data on how the presence of these comorbidities influence tic severity and treatment. 114 children (mean age 10.25 years) were extensively clinically phenotyped at a single specialty clinic. While there was no difference in Yale Global Tic Severity Scale (YGTSS) scores in children with versus without ADHD, children with obsessive compulsive behaviors had significantly higher YGTSS scores (p = 0.008). There was a significant correlation between YGTSS scores and age (r = 0.344, p < 0.001). Children with ADHD were more likely to be treated for their tics within the first two years of diagnosis (OR 3.51, p = 0.009). As tic severity does not appear to be greater in children with ADHD, this association may relate to greater overall psychosocial impairment in children with this comorbidity.

Prone positioning reduces severe pushing behavior: three case studies.

PubMed

Fujino, Yuji; Amimoto, Kazu; Sugimoto, Satoshi; Fukata, Kazuhiro; Inoue, Masahide; Takahashi, Hidetoshi; Makita, Shigeru

2016-09-01

[Purpose] Pushing behavior is classically described as a disorder of body orientation in the coronal plane. Most interventions for pushing behavior have focused on correcting the deviation in vertical perception. However, pushing behavior seems to involve erroneous movements associated with excessive motor output by the non-paretic limbs and trunk. The present study aimed to inhibit muscular hyper-activity by placing the non-paretic limbs and trunk in the prone position. [Subjects and Methods] The subjects of the present study were 3 acute stroke patients with severe pushing behavior. The study consisted of the following 3 phases: baseline, intervention, and follow-up. In addition to conventional therapy, patients received relaxation therapy in the prone position for 10 minutes a day over 2 days. The severity of pushing behavior was assessed using the scale for contraversive pushing, and truncal balance was evaluated using the trunk control test. These assessments were performed before and after the baseline phase, and after the intervention and follow-up phases. [Results] At the baseline phase, both scores were poor. Both scores improved after the intervention and follow-up phases, and all the patients could sit independently. [Conclusion] Relaxation therapy in the prone position might ameliorate pushing behavior and impaired truncal balance.

[Addiction and personality traits: sensation seeking, anhedonia, impulsivity].

PubMed

Sarramon, C; Verdoux, H; Schmitt, L; Bourgeois, M

1999-01-01

This study presents the evaluation of three dimensional traits of personality (Sensation Seeking, Anhedonia, Impulsivity) among 65 patients admitted in a psychiatric ward, with or without addictive behaviors. Our objective is to establish that these personality traits are commun to all addictive behaviors and to test the hypothesis that high scores on the three scales are linked to a greater probability of presenting with addictive behaviors. The two most frequent types of addiction were alcoholism and drug abuse. The subjects presenting with one or several addictive behaviors had higher average scores on the three scales. Our results printed in the same direction for the subjects having shown an addictive behavior in their past history. The risk to present with an addictive behavior increased with the total scores of these self-report questionnaires. There was a significant relationship between 3 sub-dimensions on the Sensation Seeking Scale and addictive behavior. Each time sub-scores of boredom susceptibility, disinhibition and thrill and adventure rise by one, the risk to present with an addictive behavior is multiplied by 1.4 for the first two and by 1.3 for the third one. Subjects with high scores on the anhedonia and impulsivity scales respectively show a risk multiplied by 1.6 and 3.3 of developing an addictive behavior. These results of this transverse study confirm the link between addiction behavior and these three personality traits.

Factorial and Hierarchical Cluster Analysis of the Adaptive Behavior Scales (Part I & II) in a Population of Older People (50 Years +) with Severe Intellectual Impairment (Mental Handicap).

ERIC Educational Resources Information Center

Moss, S. C.; Hogg, J.

1990-01-01

Principal components analysis was employed on the Adaptive Behavior Scales with scores of 122 older (mean age 63.5) individuals with severe intellectual impairment living in England. The study found the structure of adaptive skills and interpersonal maladaptive behaviors similar to that found for younger retarded adults. Two factors, personal…

Maladaptive behaviour in Prader-Willi syndrome in adult life.

PubMed

Clarke, D J; Boer, H; Chung, M C; Sturmey, P; Webb, T

1996-04-01

Thirty adults with Prader-Willi syndrome (PWS) were compared with 30 adults with non-specific learning disability matched for age, sex and severity of mental retardation. Maladaptive behaviour was assessed with the Aberrant Behavior Checklist (ABC), a 58-item structured interview which rates behaviours from 0 (not a problem) to 3 (severe problem) and which yields five factors (I) irritability, agitation; (II) lethargy, withdrawal; (III) stereotypic behavior; (IV) hyperactivity, non-compliance; and (V) inappropriate speech). The PWS sample had significantly higher factor I (P < 0.001) and factor V (P < 0.05) scores. The PWS sample had mean scores above 1 for 17 ABC items; the contrast subjects had no mean scores above 1. The factor I scores for the PWS sample were similar to those of inpatients in hospital facilities for adults with mental retardation and mental illness or severely challenging behaviour. The results support previous work, and extend it by suggesting that temper tantrums, self-injury, impulsiveness, lability of mood, inactivity and repetitive speech are characteristic behaviours in PWS in adult life. Studies of the reasons for heterogeneity in behaviour are now needed.

Shorter sleep duration is associated with social impairment and comorbidities in ASD.

PubMed

Veatch, Olivia J; Sutcliffe, James S; Warren, Zachary E; Keenan, Brendan T; Potter, Melissa H; Malow, Beth A

2017-07-01

Sleep disturbance, particularly insomnia, is common in children with autism spectrum disorders (ASD). Furthermore, disturbed sleep affects core symptoms and other related comorbidities. Understanding the causes and consequences of sleep disturbances in children with ASD is an important step toward mitigating these symptoms. To better understand the connection between sleep duration and ASD severity, we analyzed ASD-related symptoms using the Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule (ADOS), IQ scores, and parent reports of the average amount of time slept per night that were available in the medical histories of 2,714 children with ASD in the Simons Simplex Collection (SSC). The mean (SD) sleep duration was 555 minutes. Sleep duration and severity of core ASD symptoms were negatively correlated, and sleep duration and IQ scores were positively correlated. Regression results indicated that more severe social impairment, primarily a failure to develop peer relationships, is the core symptom most strongly associated with short sleep duration. Furthermore, increased severity for numerous maladaptive behaviors assessed on the Child Behavior Checklist, as well as reports of attention deficit disorder, depressive disorder, and obsessive compulsive disorder were associated with short sleep duration. Severity scores for social/communication impairment and restricted and repetitive behaviors (RRB) were increased, and IQ scores were decreased, for children reported to sleep ≤420 minutes per night (lower 5th percentile) compared to children sleeping ≥660 minutes (upper 95th percentile). Our results indicate that reduced amounts of sleep are related to more severe symptoms in children with ASD. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1221-1238. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Child behavior checklist dysregulation profile in children with disruptive behavior disorders: A longitudinal study.

PubMed

Masi, Gabriele; Pisano, Simone; Milone, Annarita; Muratori, Pietro

2015-11-01

A Child Behavior Checklist (CBCL) profile defined as Dysregulation Profile (DP) (scores 2 standard deviations or more in anxiety/depression, aggression, attention subscales) has been correlated to poor emotional and behavioral self-regulation. The clinical meaning and the prognostic implications of CBCL-DP are still debated, although it seems associated with severe psychopathology and poor adjustment. In the present study, we used the CBCL-DP score to examine the adolescent outcomes (psychiatric diagnosis, substance use, psychiatric hospitalization) in 80 referred children with disruptive behavior disorders -DBD- (Oppositional Defiant Disorder or conduct disorder), aged 8-9 years, 72 males (90%) and 8 females (10%), followed-up until the age of 14-15 years. Children with higher score on the CBCL-DP profile were at increased risk for presenting ADHD and mood disorders in adolescence. While ADHD in adolescence was predicted also by an ADHD diagnosis during childhood, CBCL-DP score was the only significant predictor of a mood disorder at 14-15 years. On the contrary, CBCL-DP score was not associated with a higher risk of conduct disorder, substance use and hospitalizations in adolescence. A cost-effective and reliable diagnostic measure such as the CBCL may be a part of the diagnostic procedure aimed to capture these at-risk children, to monitor their natural history up to adolescence, and to prevent the risk of a full-blown mood disorder. The small sample size and a selection bias of severe patients with DBD limit the generalization of the findings. Copyright © 2015 Elsevier B.V. All rights reserved.

The Relations of Cognitive, Behavioral, and Physical Activity Variables to Depression Severity in Traumatic Brain Injury: Reanalysis of Data From a Randomized Controlled Trial.

PubMed

Bombardier, Charles H; Fann, Jesse R; Ludman, Evette J; Vannoy, Steven D; Dyer, Joshua R; Barber, Jason K; Temkin, Nancy R

To explore the relations of cognitive, behavioral, and physical activity variables to depression severity among people with traumatic brain injury (TBI) undergoing a depression treatment trial. Community. Adults (N = 88) who sustained complicated mild to severe TBI within the past 10 years, met criteria for major depressive disorder, and completed study measures. Randomized controlled trial. Participants were randomized to cognitive-behavioral therapy (n = 58) or usual care (n = 42). Outcomes were measured at baseline and 16 weeks. We combined the groups and used regressions to explore the relations among theoretical variables and depression outcomes. Depression severity was measured with the Hamilton Depression Rating Scale and Symptom Checklist-20. Theory-based measures were the Dysfunctional Attitudes Scale (DAS), Automatic Thoughts Questionnaire (ATQ), Environmental Rewards Observation Scale (EROS), and the International Physical Activity Questionnaire (IPAQ). Compared with non-TBI norms, baseline DAS and ATQ scores were high and EROS and IPAQ scores were low. All outcomes improved from baseline to 16 weeks except the DAS. The ATQ was an independent predictor of baseline depression. An increase in EROS scores was correlated with decreased depression. Increasing participation in meaningful roles and pleasant activities may be a promising approach to treating depression after TBI.

Wider stall space affects behavior, lesion scores, and productivity of gestating sows.

PubMed

Salak-Johnson, J L; DeDecker, A E; Levitin, H A; McGarry, B M

2015-10-01

Limited space allowance within the standard gestation stall is an important welfare concern because it restricts the ability of the sow to make postural adjustments and hinders her ability to perform natural behaviors. Therefore, we evaluated the impacts of increasing stall space and/or providing sows the freedom to access a small pen area on sow well-being using multiple welfare metrics. A total of 96 primi- and multiparous crossbred sows were randomly assigned in groups of 4 sows/treatment across 8 replicates to 1 of 3 stall treatments (TRT): standard stall (CTL; dimensions: 61 by 216 cm), width-adjustable stall (flex stall [FLX]; dimensions: adjustable width of 56 to 79 cm by 216 cm), or an individual walk-in/lock-in stall with access to a small communal open-pen area at the rear of the stall (free-access stall [FAS]; dimensions: 69 by 226 cm). Lesion scores, behavior, and immune and productivity traits were measured at various gestational days throughout the study. Total lesion scores were greatest for sows in FAS and least for sows in FLX ( < 0.001). Higher-parity sows in FAS had the most severe lesion scores (TRT × parity, < 0.0001) and scores were greatest at all gestational days (TRT × day, < 0.05). Regardless of parity, sows in FLX had the least severe scores ( < 0.0001). As pregnancy progressed, lesion scores increased among sows in CTL ( < 0.05). Sow BW and backfat (BF) were greater for sows in FLX and FAS ( < 0.05), and BCS and BF were greater for parity 1 and 2 sows in FAS than the same parity sows in CTL (TRT × parity, < 0.05). Duration and frequency of some postural behaviors and sham chew behavior were affected by TRT ( < 0.05) and time of day (TRT × day, < 0.05). These data indicate that adequate stall space, especially late in gestation, may improve the well-being of higher-parity and heavier-bodied gestating sows as assessed by changes in postural behaviors, lesion severity scores, and other sow traits. Moreover, compromised welfare measures found among sows in various stall environments may be partly attributed to the specific constraints of each stall system such as restricted stall space in CTL, insufficient floor space in the open-pen area of the FAS system, and gate design of the FLX (e.g., direction of bars and feeder space). These results also indicate that parity and gestational day are additional factors that may exacerbate the effects of restricted stall space or insufficient pen space, further compromising sow well-being.

Kinship and nonrelative foster care: the effect of placement type on child well-being.

PubMed

Font, Sarah A

2014-01-01

This study uses a national sample of 1,215 children, ages 6-17, who spent some time in formal kinship or nonrelative foster care to identify the effect of placement type on academic achievement, behavior, and health. Several identification strategies are used to reduce selection bias, including ordinary least squares, change score models, propensity score weighting, and instrumental variables regression. The results consistently estimate a negative effect of kin placements on reading scores, but kin placements appear to have no effect on child health, and findings on children's math and cognitive skills test scores and behavioral problems are mixed. Estimated declines in both academic achievement and behavioral problems are concentrated among children who are lower functioning at baseline. © 2014 The Author. Child Development © 2014 Society for Research in Child Development, Inc.

Prone positioning reduces severe pushing behavior: three case studies

PubMed Central

Fujino, Yuji; Amimoto, Kazu; Sugimoto, Satoshi; Fukata, Kazuhiro; Inoue, Masahide; Takahashi, Hidetoshi; Makita, Shigeru

2016-01-01

[Purpose] Pushing behavior is classically described as a disorder of body orientation in the coronal plane. Most interventions for pushing behavior have focused on correcting the deviation in vertical perception. However, pushing behavior seems to involve erroneous movements associated with excessive motor output by the non-paretic limbs and trunk. The present study aimed to inhibit muscular hyper-activity by placing the non-paretic limbs and trunk in the prone position. [Subjects and Methods] The subjects of the present study were 3 acute stroke patients with severe pushing behavior. The study consisted of the following 3 phases: baseline, intervention, and follow-up. In addition to conventional therapy, patients received relaxation therapy in the prone position for 10 minutes a day over 2 days. The severity of pushing behavior was assessed using the scale for contraversive pushing, and truncal balance was evaluated using the trunk control test. These assessments were performed before and after the baseline phase, and after the intervention and follow-up phases. [Results] At the baseline phase, both scores were poor. Both scores improved after the intervention and follow-up phases, and all the patients could sit independently. [Conclusion] Relaxation therapy in the prone position might ameliorate pushing behavior and impaired truncal balance. PMID:27799722

Chewing and spitting out food as a compensatory behavior in patients with eating disorders.

PubMed

Song, Youn Joo; Lee, Jung-Hyun; Jung, Young-Chul

2015-10-01

Recent studies suggest that chewing and spitting out food may be associated with severe eating-related pathology. The purpose of this study was to investigate the relationship between chewing and spitting, and other symptoms of eating disorders. We hypothesized that patients who chew and spit as a compensatory behavior have more severe eating-related pathology than patients who have never engaged in chewing and spitting behavior. We divided 359 patients with eating disorders into two groups according to whether they engaged in chewing and spitting as a compensatory behavior to lose weight or not. After comparing eating-related pathology between the two groups, we examined factors associated with pathologic eating behaviors using logistic regression analysis. Among our 359 participants, 24.5% reported having engaged in chewing and spitting as a compensatory behavior. The chewing and spitting (CHSP+) group showed more severe eating disorder symptoms and suicidal behaviors. This group also had significantly higher scores on subscales that measured drive for thinness, bulimia, and impulse regulation on the EDI-2, Food Craving Questionnaire, Body Shape Questionnaire, Beck Depression Inventory, Beck Anxiety Inventory, and Maudsley Obsessive Compulsive Inventory. Chewing and spitting is a common compensatory behavior among patients with eating disorders and is associated with more-pathologic eating behaviors and higher scores on psychometric tests. Copyright © 2015 Elsevier Inc. All rights reserved.

Longitudinal Trajectories of Aberrant Behavior in Fragile X Syndrome

PubMed Central

Hustyi, Kristin M.; Hall, Scott S.; Jo, Booil; Lightbody, Amy A.; Reiss, Allan L.

2016-01-01

The Aberrant Behavior Checklist—Community (ABC-C; Aman, Burrow, & Wolford, 1995) has been increasingly adopted as a primary tool for measuring behavioral change in clinical trials for individuals with fragile X syndrome (FXS). To our knowledge, however, no study has documented the longitudinal trajectory of aberrant behaviors in individuals with FXS using the ABC-C. As part of a larger longitudinal study, we examined scores obtained on the ABC-C subscales for 124 children and adolescents (64 males, 60 females) with FXS who had two or more assessments (average interval between assessments was approximately 4 years). Concomitant changes in age-equivalent scores on the Vineland Adaptive Behavior Scales (VABS) were also examined. As expected for an X-linked genetic disorder, males with FXS obtained significantly higher scores on all subscales of the ABC-C and significantly lower age-equivalent scores on the VABS than females with FXS. In both males and females with FXS, scores on the Irritability/Agitation and Hyperactivity/Noncompliance subscales of the ABC-C decreased significantly with age, with little to no change occurring over time on the Lethargy/Social Withdrawal, Stereotypic Behavior, and Inappropriate Speech subscales. The decrease in scores on the Hyperactivity/Noncompliance domain was significantly greater for males than for females. In both males and females, age-equivalent scores on the VABS increased significantly over this developmental period. These results establish a basis upon which to evaluate long-term outcomes from intervention-based research. However, longitudinal direct observational studies are needed to establish whether the severity of problem behavior actually decreases over time in this population. PMID:25129200

Further Evidence that Severe Scores in the Aggression/Anxiety-Depression/Attention Subscales of Child Behavior Checklist (Severe Dysregulation Profile) Can Screen for Bipolar Disorder Symptomatology: A Conditional Probability Analysis

PubMed Central

Uchida, Mai; Faraone, Stephen V; Martelon, MaryKate; Kenworthy, Tara; Woodworth, K Yvonne; Spencer, Thomas; Wozniak, Janet; Biederman, Joseph

2014-01-01

Background Previous work shows that children with high scores (2 SD, combined score ≥ 210) on the Attention Problems, Aggressive Behavior, and Anxious-Depressed (A-A-A) subscales of the Child Behavior Checklist (CBCL) are more likely than other children to meet criteria for bipolar (BP)-I disorder. However, the utility of this profile as a screening tool has remained unclear. Methods We compared 140 patients with pediatric BP-I disorder, 83 with attention deficit hyperactivity disorder (ADHD), and 114 control subjects. We defined the CBCL-Severe Dysregulation profile as an aggregate cutoff score of ≥ 210 on the A-A-A scales. Patients were assessed with structured diagnostic interviews and functional measures. Results Patients with BP-I disorder were significantly more likely than both control subjects (Odds Ratio [OR]: 173.2; 95% Confidence Interval [CI], 21.2 to 1413.8; P < 0.001) and those with ADHD (OR: 14.6; 95% CI, 6.2 to 34.3; P < 0.001) to have a positive CBCL-Severe Dysregulation profile. Receiver Operating Characteristics analyses showed that the area under the curve for this profile comparing children with BP-I disorder against control subjects and those with ADHD was 99% and 85%, respectively. The corresponding positive predictive values for this profile were 99% and 92% with false positive rates of < 0.2% and 8% for the comparisons with control subjects and patients with ADHD, respectively. Limitations Non-clinician raters administered structured diagnostic interviews, and the sample was referred and largely Caucasian. Conclusions The CBCL-Severe Dysregulation profile can be useful as a screen for BP-I disorder in children in clinical practice. PMID:24882182

Gene expression patterns in four brain areas associate with quantitative measure of estrous behavior in dairy cows.

PubMed

Kommadath, Arun; Woelders, Henri; Beerda, Bonne; Mulder, Herman A; de Wit, Agnes A C; Veerkamp, Roel F; te Pas, Marinus F W; Smits, Mari A

2011-04-19

The decline noticed in several fertility traits of dairy cattle over the past few decades is of major concern. Understanding of the genomic factors underlying fertility, which could have potential applications to improve fertility, is very limited. Here, we aimed to identify and study those genes that associated with a key fertility trait namely estrous behavior, among genes expressed in four bovine brain areas (hippocampus, amygdala, dorsal hypothalamus and ventral hypothalamus), either at the start of estrous cycle, or at mid cycle, or regardless of the phase of cycle. An average heat score was calculated for each of 28 primiparous cows in which estrous behavior was recorded for at least two consecutive estrous cycles starting from 30 days post-partum. Gene expression was then measured in brain tissue samples collected from these cows, 14 of which were sacrificed at the start of estrus and 14 around mid cycle. For each brain area, gene expression was modeled as a function of the orthogonally transformed average heat score values using a Bayesian hierarchical mixed model. Genes whose expression patterns showed significant linear or quadratic relationships with heat scores were identified. These included genes expected to be related to estrous behavior as they influence states like socio-sexual behavior, anxiety, stress and feeding motivation (OXT, AVP, POMC, MCHR1), but also genes whose association with estrous behavior is novel and warrants further investigation. Several genes were identified whose expression levels in the bovine brain associated with the level of expression of estrous behavior. The genes OXT and AVP play major roles in regulating estrous behavior in dairy cows. Genes related to neurotransmission and neuronal plasticity are also involved in estrous regulation, with several genes and processes expressed in mid-cycle probably contributing to proper expression of estrous behavior in the next estrus. Studying these genes and the processes they control improves our understanding of the genomic regulation of estrous behavior expression.

Behavioral Outcomes of Extremely Low Birth Weight Children at Age 8 Years

PubMed Central

Hack, Maureen; Taylor, Hudson G.; Schluchter, Mark; Andreias, Laura; Drotar, Dennis; Klein, Nancy

2011-01-01

Objective To describe the prevalence of behavioral problems and symptomatology suggestive of Autism and Asperger’s disorders at age 8 years among extremely low birth weight (ELBW, <1 kg) children, born 1992 through 1995. Method Parent reports of the behavior of 219 ELBW (mean birth weight, 810 g; gestational age 26 weeks) were compared with 176 normal birth weight children of similar maternal sociodemographic status, sex, and age. Behavior was assessed via the Child Symptom Inventory that includes both Symptom Severity Scores and scores meeting DSM-IV criteria for disorders. Results ELBW compared with normal birth weight children had significantly higher mean Symptom Severity Scores for the inattentive, hyperactive, and combined types of attention-deficit hyperactivity disorder (all p < .001) as well as higher scores for Generalized Anxiety (p < .01) and Autistic (p < .001) and Asperger’s (p < .01) disorders. When DSM-IV criteria were considered, ELBW children also had significantly higher rates of attention-deficit hyperactivity disorder of the inattentive (10% vs 3%, p < .01) and combined (5% vs 0.6%, p < .05) types. Conclusions Attention-deficit hyperactivity disorder, mainly the inattentive type is prevalent among ELBW children. Our findings of an increase in symptoms pertaining to Autistic and Asperger’s disorders at school age agree with recent reports of others during early childhood. Early identification and intervention for these problems might improve child functioning and ameliorate parent and child distress. PMID:19322106

The Balthazar Scales of Adaptive Behavior. Measures of Program Development for the Severely and Profoundly Mentally Retarded. Section 1. Skills of Functional Independence. Part Three: Program Scoring Form.

ERIC Educational Resources Information Center

Balthazar, Earl E.

The scoring form for functional independence skills for the mentally retarded includes a section for recording subjects' demographic characteristics as well as tests used, date administered, and raw score. Other sections provide for a brief description of the program being used, an item scoring sheet for the Eating Scales (dependent feeding,…

Multisensory Stimulation as an Intervention Strategy for Elderly Patients With Severe Dementia: A Pilot Randomized Controlled Trial.

PubMed

Sánchez, Alba; Marante-Moar, M Pilar; Sarabia, Carmen; de Labra, Carmen; Lorenzo, Trinidad; Maseda, Ana; Millán-Calenti, José Carlos

2016-06-01

The objective of this study was to compare the effect of multisensory stimulation environment (MSSE) and one-to-one activity sessions in the symptomatology of elderly individuals with severe dementia. Thirty-two participants were randomly assigned to the following 3 groups: MSSE, activity, and control group. The MSSE and activity groups participated in two 30-minute weekly sessions over 16 weeks. Pre-, mid-, and posttrial; 8-week follow-up behavior; mood; cognitive status; and dementia severity were registered. Patients in the MSSE group demonstrated a significant improvement in the Neuropsychiatric Inventory and Bedford Alzheimer Nursing Severity Scale scores compared with the activity group. Both MSSE and activity groups showed an improvement during the intervention in the Cohen-Mansfield Agitation Inventory aggressive behavior factor and total score, with no significant differences between groups. The MSSE may have better effects on neuropsychiatric symptoms and dementia severity in comparison with one-to-one activity sessions in patients with severe dementia. © The Author(s) 2015.

Application of Bayesian Methods for Detecting Fraudulent Behavior on Tests

ERIC Educational Resources Information Center

Sinharay, Sandip

2018-01-01

Producers and consumers of test scores are increasingly concerned about fraudulent behavior before and during the test. There exist several statistical or psychometric methods for detecting fraudulent behavior on tests. This paper provides a review of the Bayesian approaches among them. Four hitherto-unpublished real data examples are provided to…

Using an Early Skills Assessment to Assess Outcome of Early Intensive Behavioral Intervention for Children with Autism

ERIC Educational Resources Information Center

Parry-Cruwys, Diana

2013-01-01

Intensive behavioral intervention for young children diagnosed with autism can produce large gains in social, cognitive, and language development. Although several studies have identified behaviors that are possible indicators of best outcome, changes in performance are typically measured using norm-referenced standardized scores referencing…

Race/Ethnicity and Family Contact: Toward a Behavioral Measure of Familialism

ERIC Educational Resources Information Center

Comeau, Joseph A.

2012-01-01

Research from several disciplines has found that Latinos in the United States tend to score higher than other groups on measures of familialism. While most studies of Latino familialism use attitudinal measures rather than behavioral ones, I argue that examining behavioral measures of familialism can offer additional insights. This article…

The association between emotional and behavioral problems and gastrointestinal symptoms among children with high-functioning autism.

PubMed

Mazefsky, Carla A; Schreiber, Dana R; Olino, Thomas M; Minshew, Nancy J

2014-07-01

This study investigated the association between gastrointestinal symptoms and a broad set of emotional and behavioral concerns in 95 children with high-functioning autism and IQ scores ≥ 80. Gastrointestinal symptoms were assessed via the Autism Treatment Network's Gastrointestinal Symptom Inventory, and data were gathered on autism symptom severity, adaptive behavior, and multiple internalizing and externalizing problems. The majority (61%) of children had at least one reported gastrointestinal symptom. Emotional and behavioral problems were also common but with a high degree of variability. Children with and without gastrointestinal problems did not differ in autism symptom severity, adaptive behavior, or total internalizing or externalizing problem scores. However, participants with gastrointestinal problems had significantly higher levels of affective problems. This finding is consistent with a small body of research noting a relationship between gastrointestinal problems, irritability, and mood problems in autism spectrum disorder. More research to identify the mechanisms underlying this relationship in autism spectrum disorder is warranted. Future research should include a medical assessment of gastrointestinal concerns, longitudinal design, and participants with a range of autism spectrum disorder severity in order to clarify the directionality of this relationship and to identify factors that may impact heterogeneity in the behavioral manifestation of gastrointestinal concerns. © The Author(s) 2013.

The Autism Diagnostic Observation Schedule, Toddler Module: Standardized Severity Scores

PubMed Central

Esler, Amy N.; Bal, Vanessa Hus; Guthrie, Whitney; Wetherby, Amy; Weismer, Susan Ellis; Lord, Catherine

2016-01-01

Standardized calibrated severity scores (CSS) have been created for Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2) Modules 1–4 as a metric of the relative severity of autism-specific behaviors. Total and domain CSS were created for the Toddler Module to facilitate comparison to other modules. Analyses included 388 children with ASD age 12 to 30 months and were replicated on 435 repeated assessments from 127 children with ASD. Compared to raw scores, associations between total and domain CSS and participant characteristics were reduced in the original sample. Verbal IQ effects on Social Affect-CSS were not reduced in the replication sample. Toddler Module CSS increases comparability of ADOS-2 scores across modules and allows studies of symptom trajectories to extend to earlier ages. PMID:25832801

A Prorating Method for Estimating MMPI-2-RF Scores From MMPI Responses: Examination of Score Fidelity and Illustration of Empirical Utility in the PERSEREC Police Integrity Study Sample.

PubMed

Tarescavage, Anthony M; Corey, David M; Ben-Porath, Yossef S

2016-04-01

The purpose of the current study was to identify Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) correlates of police officer integrity violations and other problem behaviors in an archival database with original MMPI item responses and collateral information regarding integrity violations obtained for 417 male officers. In Study 1, we estimated MMPI-2-RF scores from the MMPI item pool (which includes approximately 80% of the MMPI-2-RF items) in a normative sample, a psychiatric inpatient sample, and a police officer sample, and conducted analyses that demonstrated the comparability of estimated and full scale scores for 41 of the 51 MMPI-2-RF scales. In Study 2, we correlated estimated MMPI-2-RF scores with information about subsequent integrity violations and problem behaviors from the integrity violation data set. Several meaningful associations were obtained, predominately with scales from the emotional, thought, and behavioral dysfunction domains of the MMPI-2-RF. Application of a correction for range restriction yielded substantially improved validity estimates. Finally, we calculated relative risk ratios for the statistically significant findings using cutoffs lower than 65T, which is traditionally used to identify clinically significant elevations, and found several meaningful relative risk ratios. © The Author(s) 2015.

A comparative study of behavioral and psychological symptoms of dementia in patients with Alzheimer's disease and vascular dementia referred to psychogeriatric services in Korea and the U.K.

PubMed

Shah, Ajit; Ellanchenny, Nalini; Suh, Guk-Hee

2005-06-01

There is a paucity of cross-cultural studies of behavioral and psychological symptoms of dementia (BPSD). BPSD were examined in consecutive series of referrals to a psychogeriatric service in Korea and the U.K. using the Behavioral Pathology in Alzheimer's Disease (BEHAVE-AD) rating scale and the Cornell Scale for Depression in Dementia (CSDD). Results were analyzed separately for Alzheimer's disease and vascular dementia. Koreans in both diagnostic groups had lower Mini-mental State Examination (MMSE) scores and higher BEHAVE-AD total and subscale scores for most subscales. In both countries, for both diagnostic groups, the total BEHAVE-AD score and several subscale scores were negatively correlated with the MMSE scores. Logistic regression analysis for Alzheimer's disease revealed that BEHAVE-AD total and most subscale scores independently predicted the country of origin in addition to the MMSE scores predicting the same. These differences in BPSD are most likely explained by the lower MMSE scores in the Korean sample. However, genuine differences in BPSD between the two countries can only be critically examined in a cross-cultural population-based epidemiological study for both diagnostic categories using validated instruments to measure BPSD and controlling for the influence of MMSE score.

A scale for assessing the severity of arousal disorders.

PubMed

Arnulf, Isabelle; Zhang, Bin; Uguccioni, Ginevra; Flamand, Mathilde; Noël de Fontréaux, Alix; Leu-Semenescu, Smaranda; Brion, Agnès

2014-01-01

Arousal disorders may have serious health consequences. To develop a scale assessing the severity of arousal disorders (Paris Arousal Disorders Severity Scale, PADSS). University hospital. Controlled study. Consecutive patients (older than 15 y), with sleepwalking (SW) and/or sleep terrors (ST), subjects with previous SW/ST, normal controls and patients with rapid eye movement sleep behavior disorder. The self-rated scale listed 17 parasomniac behaviors (PADSS-A), assessed their frequency from never to twice or more per night (PADSS-B) and evaluated the consequences (PADSS-C: disturbed sleep, injuries, fatigue, and psychological consequences). The clinimetric properties and face validity of the scale were tested. Half of the 73 patients with SW/ST (more men than women) had injured themselves or others, whereas 15% had concomitant sexsomnia and 23% had amnestic eating behaviors. The total PADSS score (range: 0-50) was 19.4 ± 6.3 (range: 8-36) in this group, 11.7 ± 5.9 in 26 subjects with previous SW/ST, 8.8 ± 3.2 in 26 patients with RBD, and 2.0 ± 3.5 in 53 normal controls (P < 0.05). The PADSS demonstrated high sensitivity (83.6%), specificity (87.8%), internal consistency, and test-retest reliability (0.79). The best cutoff for the total score was at 13/14. Exploratory factor analysis revealed two components: wandering and violence/handling. The complexity of behaviors emerging from N3 sleep (scored on videopolysomnography) positively correlated with scores for the PADSS-total, PADSS-A, PADSS-C, and the "violence/handling" factor. This scale had reasonable psychometric properties and could be used for screening and stratifying patients and for evaluating the effects of treatments.

Relationship between emotional intelligence and organizational citizenship behavior in critical and emergency nurses in south east of Iran.

PubMed

Tofighi, M; Tirgari, B; Fooladvandi, M; Rasouli, F; Jalali, M

2015-01-01

Several factors including emotional intelligence affect the efficiency of people. It seems that organizational behavior of each person is strongly influenced by emotional intelligence. Therefore, the present study is aimed to examine the relationship between emotional intelligence and organizational citizenship behavior in critical and emergency nurses in teaching hospitals supervised by Kerman Medical University in Southeast of Iran. This study employed a descriptive cross sectional design. A census sample consisted of 150 critical and emergency nurses working in teaching hospitals supervised by Kerman Medical University participated in this study. Emotional intelligence and organizational citizenship behavior questionnaire was used to assess nurses' emotional intelligence and organizational citizenship behavior by available sampling method. The results showed that the mean age of the participants was 35 years. Most participants (94%) were females and belonged to the age group of 26-30 years. Overall mean score of organizational citizenship behavior scale was 88.21 (±10.4). In the organizational citizenship behavior categories, altruism mean score was higher than the other mean scores. Overall mean score of emotional intelligence was (121.08 ± 17.56). In the subgroups of emotional intelligence, mean score of the relationship management, was higher than the average of other factors. Pearson's correlation coefficient showed no significant relationship between emotional intelligence and organizational citizenship behavior (p ≥ 0.05). The study suggests that health care managers should organize systematic and dynamic policies and procedures in dealing with emotional intelligence and organizational citizenship behavior to assist critical and emergency nurses.

Suicidal behaviour of Indian patients with obsessive compulsive disorder.

PubMed

Dhyani, Mohan; Trivedi, Jitendra Kumar; Nischal, Anil; Sinha, Pramod Kumar; Verma, Subham

2013-04-01

The chronicity, distress, high rates of comorbidity and varying degree of non response to treatment in Obsessive Compulsive Disorder (OCD) may contribute to suicidal behavior. There is relatively little information on suicidal behavior in OCD subjects. Our study design is Single point non-invasive, cross sectional, clinical study of new and follow up cases. Assessment of Suicidal Behavior in patients of OCD attending the adult Psychiatry O.P.D. of Chatrapati Shahuji Maharaj Medical University (CSMMU) U.P. Lucknow using (DSM-IV) criteria for diagnosis of Obsessive Compulsive Disorder, Structured Clinical Interview for DSM-IV Axis-I disorders, Yale Brown Obsessive Compulsive Rating Scale, Scale for Suicidal Ideation (SSI), Beck's Hopelessness Scale (BHS). Mean standard deviation and t test for independent samples, Pearson's correlation coefficient. Statistically significant differences were seen in the SSI score between the "Clinical" and "Sub-Clinical" cases with Clinical group having higher scores. Value of correlation coefficient between YBOCS score and SSI and BHS score is positive and statistically significant (P<0.01). "Clinical" group of patients had significantly higher scores of suicidal ideation measured by Scale of Suicidal Ideation (SSI). There was a significantly positive correlation between disease severity (YBOCS Score) and degree of suicidal ideation (SIS Score).

A Scale for Assessing the Severity of Arousal Disorders

PubMed Central

Arnulf, Isabelle; Zhang, Bin; Uguccioni, Ginevra; Flamand, Mathilde; Noël de Fontréaux, Alix; Leu-Semenescu, Smaranda; Brion, Agnès

2014-01-01

Background: Arousal disorders may have serious health consequences. Objective: To develop a scale assessing the severity of arousal disorders (Paris Arousal Disorders Severity Scale, PADSS). Setting: University hospital. Design: Controlled study. Participants: Consecutive patients (older than 15 y), with sleepwalking (SW) and/or sleep terrors (ST), subjects with previous SW/ST, normal controls and patients with rapid eye movement sleep behavior disorder. Intervention: The self-rated scale listed 17 parasomniac behaviors (PADSS-A), assessed their frequency from never to twice or more per night (PADSS-B) and evaluated the consequences (PADSS-C: disturbed sleep, injuries, fatigue, and psychological consequences). The clinimetric properties and face validity of the scale were tested. Results: Half of the 73 patients with SW/ST (more men than women) had injured themselves or others, whereas 15% had concomitant sexsomnia and 23% had amnestic eating behaviors. The total PADSS score (range: 0-50) was 19.4 ± 6.3 (range: 8-36) in this group, 11.7 ± 5.9 in 26 subjects with previous SW/ST, 8.8 ± 3.2 in 26 patients with RBD, and 2.0 ± 3.5 in 53 normal controls (P < 0.05). The PADSS demonstrated high sensitivity (83.6%), specificity (87.8%), internal consistency, and test-retest reliability (0.79). The best cutoff for the total score was at 13/14. Exploratory factor analysis revealed two components: wandering and violence/handling. The complexity of behaviors emerging from N3 sleep (scored on videopolysomnography) positively correlated with scores for the PADSS-total, PADSS-A, PADSS-C, and the “violence/handling” factor. Conclusion: This scale had reasonable psychometric properties and could be used for screening and stratifying patients and for evaluating the effects of treatments. Citation: Arnulf I; Zhang B; Uguccioni G; Flamand M; Noël de Fontréaux A; Leu-Semenescu S; Brion A. A scale for assessing the severity of arousal disorders. SLEEP 2014;37(1):127-136. PMID:24470702

The relationship between attentional bias toward safety and driving behavior.

PubMed

Zheng, Tingting; Qu, Weina; Zhang, Kan; Ge, Yan

2016-11-01

As implicit cognitive processes garner more and more importance, studies in the fields of healthy psychology and organizational safety research have focused on attentional bias, a kind of selective allocation of attentional resources in the early stage of cognitive processing. However, few studies have explored the role of attentional bias on driving behavior. This study assessed drivers' attentional bias towards safety-related words (ABS) using the dot-probe paradigm and self-reported daily driving behaviors. The results revealed significant negative correlations between attentional bias scores and several indicators of dangerous driving. Drivers with fewer dangerous driving behaviors showed greater ABS. We also built a significant linear regression model between ABS and the total DDDI score, as well as ABS and the number of accidents. Finally, we discussed the possible mechanism underlying these associations and several limitations of our study. This study opens up a new topic for the exploration of implicit processes in driving safety research. Copyright © 2016 Elsevier Ltd. All rights reserved.

Clinical, Psychopathological, and Personality Characteristics Associated with ADHD among Individuals Seeking Treatment for Gambling Disorder.

PubMed

Aymamí, N; Jiménez-Murcia, S; Granero, R; Ramos-Quiroga, J A; Fernández-Aranda, F; Claes, L; Sauvaget, A; Grall-Bronnec, M; Gómez-Peña, M; Savvidou, L G; Fagundo, A B; del Pino-Gutierrez, A; Moragas, L; Casas, M; Penelo, E; Menchón, J M

2015-01-01

(1) To assess the current presence of ADHD symptoms among patients seeking treatment for gambling disorder; (2) to explore clinical and sociodemographic differences between patients who score high and low on the measure of ADHD symptoms; (3) to analyze whether the presence of ADHD symptoms is associated with more severe psychopathology and with specific personality traits; (4) to analyze the mediating role of ADHD symptoms in the relationship between novelty seeking and gambling severity. A total of 354 consecutive patients were administered an extensive battery assessing gambling behavior, psychopathology, and personality traits. Male and female gamblers did not differ significantly in their mean scores on the ADHD measure. However, younger participants aged 18-35 scored higher. Higher ADHD scores were also associated with greater severity of gambling disorder and more general psychopathology. Regarding personality traits, high persistence and self-directedness were negatively related to ADHD scores, while in women alone a positive correlation was found between ADHD scores and scores on harm avoidance and self-transcendence. The presence of ADHD symptoms in both male and female gambling disorder patients may act as an indicator of the severity of gambling, general psychopathology, and dysfunctional personality traits.

Parenting Stress Related to Behavioral Problems and Disease Severity in Children with Problematic Severe Asthma.

PubMed

Verkleij, Marieke; van de Griendt, Erik-Jonas; Colland, Vivian; van Loey, Nancy; Beelen, Anita; Geenen, Rinie

2015-09-01

Our study examined parenting stress and its association with behavioral problems and disease severity in children with problematic severe asthma. Research participants were 93 children (mean age 13.4 ± 2.7 years) and their parents (86 mothers, 59 fathers). As compared to reference groups analyzed in previous research, scores on the Parenting Stress Index in mothers and fathers of the children with problematic severe asthma were low. Higher parenting stress was associated with higher levels of internalizing and externalizing behavioral problems in children (Child Behavior Checklist). Higher parenting stress in mothers was also associated with higher airway inflammation (FeNO). Thus, although parenting stress was suggested to be low in this group, higher parenting stress, especially in the mother, is associated with more airway inflammation and greater child behavioral problems. This indicates the importance of focusing care in this group on all possible sources of problems, i.e., disease exacerbations and behavioral problems in the child as well as parenting stress.

Shared genetic influences between attention-deficit/hyperactivity disorder (ADHD) traits in children and clinical ADHD.

PubMed

Stergiakouli, Evie; Martin, Joanna; Hamshere, Marian L; Langley, Kate; Evans, David M; St Pourcain, Beate; Timpson, Nicholas J; Owen, Michael J; O'Donovan, Michael; Thapar, Anita; Davey Smith, George

2015-04-01

Twin studies and genome-wide complex trait analysis (GCTA) are not in agreement regarding heritability estimates for behavioral traits in children from the general population. This has sparked a debate on the possible difference in genetic architecture between behavioral traits and psychiatric disorders. In this study, we test whether polygenic risk scores associated with variation in attention-deficit/hyperactivity disorder (ADHD) trait levels in children from the general population predict ADHD diagnostic status and severity in an independent clinical sample. Single nucleotide polymorphisms (SNPs) with p < .5 from a genome-wide association study of ADHD traits in 4,546 children (mean age, 7 years 7 months) from the Avon Longitudinal Study of Parents and Children (ALSPAC; general population sample) were selected to calculate polygenic risk scores in 508 children with an ADHD diagnosis (independent clinical sample) and 5,081 control participants. Polygenic scores were tested for association with case-control status and severity of disorder in the clinical sample. Increased polygenic score for ADHD traits predicted ADHD case-control status (odds ratio = 1.17 [95% CI = 1.08-1.28], p = .0003), higher ADHD symptom severity (β = 0.29 [95% CI = 0.04-0.54], p = 0.02), and symptom domain severity in the clinical sample. This study highlights the relevance of additive genetic variance in ADHD, and provides evidence that shared genetic factors contribute to both behavioral traits in the general population and psychiatric disorders at least in the case of ADHD. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Development and validation of the Alzheimer's prevention beliefs measure in a multi-ethnic cohort-a behavioral theory approach.

PubMed

Seifan, Alon; Ganzer, Christine A; Vermeylen, Francoise; Parry, Stephen; Zhu, Jifeng; Lyons, Abigail; Isaacson, Richard; Kim, Sarang

2017-12-01

Understanding health beliefs and how they influence willingness will enable the development of targeted curricula that maximize public engagement in Alzheimer's disease (AD) risk reduction behaviors. Literature on behavioral theory and community input was used to develop and validate a health beliefs survey about AD risk reduction among 428 community-dwelling adults. Principal component analysis was performed to assess internal consistency. Linear regression was performed to identify key predictors of Willingness to engage in AD risk reduction behaviors. The measure as well as the individual scales (Benefits, Barriers, Severity, Susceptibility and Social Norm) were found to be internally consistent. Overall, as Benefits and Barriers scores increased, Willingness scores also increased. Those without prior AD experience or family history had lower willingness scores. Finally, we observed an interaction between age and norms, suggesting that social factors related to AD prevention may differentially affect people of different ages. The Alzheimer Prevention Beliefs Measure provides assessment of several health belief factors related to AD prevention. Age, Family History, Logistical Barriers and total Benefits are significant determinants of willingness to engage in AD risk reduction behaviors, such as seeing a doctor or making a lifestyle change. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Altered Behavioral and Autonomic Pain Responses in Alzheimer’s Disease Are Associated with Dysfunctional Affective, Self-Reflective and Salience Network Resting-State Connectivity

PubMed Central

Beach, Paul A.; Huck, Jonathan T.; Zhu, David C.; Bozoki, Andrea C.

2017-01-01

While pain behaviors are increased in Alzheimer’s disease (AD) patients compared to healthy seniors (HS) across multiple disease stages, autonomic responses are reduced with advancing AD. To better understand the neural mechanisms underlying these phenomena, we undertook a controlled cross-sectional study examining behavioral (Pain Assessment in Advanced Dementia, PAINAD scores) and autonomic (heart rate, HR) pain responses in 24 HS and 20 AD subjects using acute pressure stimuli. Resting-state fMRI was utilized to investigate how group connectivity differences were related to altered pain responses. Pain behaviors (slope of PAINAD score change and mean PAINAD score) were increased in patients vs. controls. Autonomic measures (HR change intercept and mean HR change) were reduced in severe vs. mildly affected AD patients. Group functional connectivity differences associated with greater pain behavior reactivity in patients included: connectivity within a temporal limbic network (TLN) and between the TLN and ventromedial prefrontal cortex (vmPFC); between default mode network (DMN) subcomponents; between the DMN and ventral salience network (vSN). Reduced HR responses within the AD group were associated with connectivity changes within the DMN and vSN—specifically the precuneus and vmPFC. Discriminant classification indicated HR-related connectivity within the vSN to the vmPFC best distinguished AD severity. Thus, altered behavioral and autonomic pain responses in AD reflects dysfunction of networks and structures subserving affective, self-reflective, salience and autonomic regulation. PMID:28959201

Development and evaluation of the Fe-BARQ: A new survey instrument for measuring behavior in domestic cats (Felis s. catus).

PubMed

Duffy, Deborah L; de Moura, Roseana T Diniz; Serpell, James A

2017-08-01

A questionnaire instrument for obtaining quantitative behavioral evaluations of pet cats from cat owners was developed and validated. Exploratory Factor Analysis of 2608 questionnaire responses to 149 behavioral questions/items extracted a total of 23 distinct factors that measured most of the more common dimensions of cat behavior. Seventeen of the 23 factors demonstrated adequate-high internal reliability (Cronbach's alpha=0.712-0.923). Questionnaire validation was accomplished by determining: (a) whether owners' subjective ratings of the severity of their cat's behavior problems were associated with cats' actual scores on expected questionnaire factors, (b) whether expected associations between specific demographic and/or lifestyle characteristics and behavior were confirmed by cats' factor or item scores on the questionnaire, and (c) whether breed rankings based on owner-reported factor scores matched those previously derived from the opinions of experts (veterinarians). The results of these various tests confirmed the overall construct validity of the questionnaire. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Caregiver burden associated with behavioral and psychological symptoms of dementia in elderly people in the local community.

PubMed

Matsumoto, Naomi; Ikeda, Manabu; Fukuhara, Ryuji; Shinagawa, Shunichiro; Ishikawa, Tomohisa; Mori, Takaaki; Toyota, Yasutaka; Matsumoto, Teruhisa; Adachi, Hiroyoshi; Hirono, Nobutsugu; Tanabe, Hirotaka

2007-01-01

Despite many studies about the association between caregiver burden and behavioral and psychological symptoms of dementia (BPSD), there have been no population-based studies to evaluate caregiver burden associated with each BPSD. To evaluate caregiver burden associated with the individual BPSD in elderly people living in the community. The subjects were 67 participants with dementia living with their caregivers (diagnosed in the third Nakayama study): 51 Alzheimer's disease, 5 vascular dementia and 11 other. The Neuropsychiatric Inventory (NPI) and NPI Caregiver Distress Scale (NPI-D) were used to assess subjects' BPSD and related caregiver distress, respectively. In the subjects exhibiting BPSD, aberrant motor behavior had the highest mean NPI score, and depression/dysphoria had the lowest. Agitation/aggression had the highest mean NPI-D score, and euphoria/elation had the lowest. Delusion, agitation/aggression, apathy/indifference, irritability/lability and aberrant motor behavior showed a correlation between the NPI and NPI-D scores. The burden associated with BPSD is different for each symptom and does not always depend on frequency and severity of BPSD. These findings suggest that some symptoms, such as agitation/aggression and irritability/lability, may affect the caregivers significantly, although their frequency and severity are low. Copyright (c) 2007 S. Karger AG, Basel.

Investigation of the Association Between Motor Stereotypy Behavior With Fundamental Movement Skills, Adaptive Functioning, and Autistic Spectrum Disorder Symptomology in Children With Intellectual Disabilities.

PubMed

Powell, Joanne L; Pringle, Lydia; Greig, Matt

2017-02-01

Motor stereotypy behaviors are patterned, coordinated, repetitive behaviors that are particularly evident in those with an autistic spectrum disorder and intellectual disabilities. The extent to which motor stereotypy behavior severity is associated with motor skills and maladaptive behavior, measures of adaptive functioning, along with fundamental movement skills and degree of autistic spectrum disorder symptomology is assessed in this preliminary report. Twelve participants, aged 7 to 16 years, with a reported motor stereotypy behavior and either mild or severe intellectual disability comprising developmental or global delay took part in the study. Spearman rho correlational analysis showed that severity of motor stereotypy behavior was significantly positively correlated with autistic spectrum disorder symptomology ( P = .008) and maladaptive behavior ( P = .008) but not fundamental movement skills ( P > .05). An increase in fundamental movement skills score was associated with a decrease in autistic spectrum disorder symptomology ( P = .01) and an increase in motor skills ( P = .002). This study provides evidence showing a significant relationship between motor stereotypy behavior severity with degree of autistic spectrum disorder symptomology and maladaptive behavior.

Hair Mineral Analysis and Disruptive Behavior in Clinically Normal Young Men.

ERIC Educational Resources Information Center

Struempler, Richard E.; And Others

1985-01-01

Forty young navy recruits were selected for hair mineral analysis on the basis of three criteria: mental test scores, demerits during training, and premature discharge from the navy. Statistical analysis revealed several significant relationships between behavioral criteria and mineral measures. Findings confirmed, in a nonclinical sample, hair…

Application of the Repetitive Behavior Scale-Revised--Italian version--in preschoolers with autism spectrum disorder.

PubMed

Fulceri, Francesca; Narzisi, Antonio; Apicella, Fabio; Balboni, Giulia; Baldini, Sara; Brocchini, Jenny; Domenici, Ilaria; Cerullo, Sonia; Igliozzi, Roberta; Cosenza, Angela; Tancredi, Raffaella; Muratori, Filippo; Calderoni, Sara

2016-01-01

Restricted repetitive and stereotyped patterns of behavior, interests, and activities (RRB) are mandatory features for a diagnosis of Autism Spectrum Disorder (ASD) according to the Diagnostic and Statistical Manual of mental disorders-fifth edition (DSM-5). Despite the strong diagnostic role of RRB, their expressiveness and their relationship with other clinical/demographic features in ASD is not fully elucidated. The Italian version of the Repetitive Behavior Scale-Revised (RBS-R) was applied to a relatively large sample of preschool-aged children with ASD who underwent a comprehensive clinical assessment. The relationship between RRB and sex, age, non-verbal IQ, autism severity, as well as the diagnostic accuracy of the RBS-R were explored. Stereotyped and Ritualistic/Sameness behaviors were the most common RRB in preschoolers with ASD, without widespread differences between males and females. No significant correlations between RRB and chronological age, or non-verbal IQ were detected. The expressiveness of ritualistic/sameness behaviors positively correlated with autism severity, assessed through the Calibrated Severity Score (CSS) derived from the Autism Diagnostic Observation Schedule (ADOS). Receiver Operator Characteristic (ROC) analysis showed high diagnostic accuracy using the Global Rating Score, which represents the judgment of the parents of as the RRB affect the child's life. However, while the Global Rating Score performed well, the remaining subscales did not. This investigation extends the limited research on early pattern and associated features of RRB in young children with ASD. The use of the RBS-R may increase the knowledge of the RRB complexity and variability and in turn improve the diagnostic and therapeutic procedures within the autistic spectrum. Copyright © 2015 Elsevier Ltd. All rights reserved.

Stuttering in English-Mandarin bilingual speakers: the influence of language dominance on stuttering severity.

PubMed

Lim, Valerie P C; Lincoln, Michelle; Chan, Yiong Huak; Onslow, Mark

2008-12-01

English and Mandarin are the 2 most spoken languages in the world, yet it is not known how stuttering manifests in English-Mandarin bilinguals. In this research, the authors investigated whether the severity and type of stuttering is different in English and Mandarin in English-Mandarin bilinguals, and whether this difference was influenced by language dominance. Thirty English-Mandarin bilinguals who stutter (BWS), ages 12-44 years, were categorized into 3 groups (15 English-dominant, 4 Mandarin-dominant, and 11 balanced bilinguals) using a self-report classification tool. Three 10-min conversations in English and Mandarin were assessed by 2 English-Mandarin bilingual clinicians for percent syllables stuttered (%SS), perceived stuttering severity (SEV), and types of stuttering behaviors using the Lidcombe Behavioral Data Language (LBDL; Packman & Onslow, 1998; Teesson, Packman, & Onslow, 2003). English-dominant and Mandarin-dominant BWS exhibited higher %SS and SEV scores in their less dominant language, whereas the scores for the balanced bilinguals were similar for both languages. The difference in the percentage of stutters per LBDL category between English and Mandarin was not markedly different for any bilingual group. Language dominance appeared to influence the severity but not the types of stuttering behaviors in BWS. Clinicians working with BWS need to assess language dominance when diagnosing stuttering severity in bilingual clients.

Psychological factors related to eating disordered behaviors: a study with Portuguese athletes.

PubMed

Silva, Luiz; Gomes, A Rui; Martins, Carla

2011-05-01

This study analyzes eating disordered behaviors in a sample of Portuguese athletes and explores its relationship with some psychological dimensions. Two hundred and ninety nine athletes (153 male, 51.2%) practicing collective (65.2%) or individual sports (34.8%) were included. The assessment protocol included the Eating Disorder Examination Questionnaire (EDE-Q) (Fairburn & Beglin, 1994); the Sport Condition Questionnaire (Bruin et al., 2007; Hall et al., 2007); the Sport Anxiety Scale (Smith et al., 2006); the Task and Ego Orientation in Sport Questionnaire (Duda, 1992; Duda & Whitehead, 1998); the Cognitive Evaluation of Sport-Threat Perceptions (Cruz, 1994; Lazarus, 1991); and the Self-Presentation Exercise Questionnaire (Gammage et al., 2004). Results revealed that: i) no case of clinical significance was detected in the four dimensions of the EDE-Q simultaneously; ii) females scored higher on the EDE-Q Global Score, and athletes with the better sport results scored higher on the Restraint subscale; iii) athletes with a higher desire to weigh less scored higher on the EDE-Q Global Score; iv) athletes with lower scores on EDE-Q displayed more positive results on the psychological measures; v) several psychological dimensions were identified as predictors of eating disordered behaviors. In conclusion, the prevalence of eating disordered behaviors was negligible in this study, yet the relationship of this problem with personal, sport and psychological factors was evident.

Behavioral profile of adults with Prader-Willi syndrome: correlations with individual and environmental variables.

PubMed

Jauregi, Joseba; Laurier, Virginie; Copet, Pierre; Tauber, Maithé; Thuilleaux, Denise

2013-08-06

Maladaptive behavior has been reported as a phenotypical feature in Prader-Willi syndrome (PWS). It severely limits social adaptation and the quality of life of children and adults with the syndrome. Different factors have been linked with the intensity and form of these behavioral disturbances but there is no consensus about the cause. Consequently, there is still controversy regarding management strategies and there is a need for new data. The behavior of 100 adults with PWS attending a dedicated center was assessed using the Developmental Behavior Checklist for Adults (DBC-A) and the PWS-specific Hyperphagia Questionnaire. The DBC-A was completed separately by trained caregivers at the center and relatives or caregivers in a natural setting. Genotype, gender, age, degree of obesity and cognitive impairment were analyzed as variables with a hypothetical influence on behavioral features. Patients showed a relatively high rate of behavioral disturbances other than hyperphagia. Disruptive and social relating were the highest scoring DBC-A subscales whereas anxiety/antisocial and self-absorbed were the lowest. When hospital caregiver and natural caregiver scores were compared, scores for the latter were higher for all subscales except for disruptive and anxiety/antisocial. These effects of institutional management were underlined. In the DBC-A, 22 items have descriptive indications of PWS behavior and were used for further comparisons and correlation analysis. In contrast to previous reports, rates of disturbed behavior were lower in patients with a deletion genotype. However, the behavioral profile was similar for both genotypes. No differences were found in any measurement when comparing type I and type II deletions. The other analyzed variables showed little relevance. Significant rates of behavioral disorders were highlighted and their typology described in a large cohort of adults with PWS. The deletion genotype was related to a lower severity of symptoms. Some major behavioral problems, such as hyperphagia, may be well controlled if living circumstances are adapted to the specific requirements of individuals with PWS.

Behavioral profile of adults with Prader-Willi syndrome: correlations with individual and environmental variables

PubMed Central

2013-01-01

Background Maladaptive behavior has been reported as a phenotypical feature in Prader–Willi syndrome (PWS). It severely limits social adaptation and the quality of life of children and adults with the syndrome. Different factors have been linked with the intensity and form of these behavioral disturbances but there is no consensus about the cause. Consequently, there is still controversy regarding management strategies and there is a need for new data. Methods The behavior of 100 adults with PWS attending a dedicated center was assessed using the Developmental Behavior Checklist for Adults (DBC-A) and the PWS-specific Hyperphagia Questionnaire. The DBC-A was completed separately by trained caregivers at the center and relatives or caregivers in a natural setting. Genotype, gender, age, degree of obesity and cognitive impairment were analyzed as variables with a hypothetical influence on behavioral features. Results Patients showed a relatively high rate of behavioral disturbances other than hyperphagia. Disruptive and social relating were the highest scoring DBC-A subscales whereas anxiety/antisocial and self-absorbed were the lowest. When hospital caregiver and natural caregiver scores were compared, scores for the latter were higher for all subscales except for disruptive and anxiety/antisocial. These effects of institutional management were underlined. In the DBC-A, 22 items have descriptive indications of PWS behavior and were used for further comparisons and correlation analysis. In contrast to previous reports, rates of disturbed behavior were lower in patients with a deletion genotype. However, the behavioral profile was similar for both genotypes. No differences were found in any measurement when comparing type I and type II deletions. The other analyzed variables showed little relevance. Conclusions Significant rates of behavioral disorders were highlighted and their typology described in a large cohort of adults with PWS. The deletion genotype was related to a lower severity of symptoms. Some major behavioral problems, such as hyperphagia, may be well controlled if living circumstances are adapted to the specific requirements of individuals with PWS. PMID:23919902

Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) predictors of police officer problem behavior and collateral self-report test scores.

PubMed

Tarescavage, Anthony M; Fischler, Gary L; Cappo, Bruce M; Hill, David O; Corey, David M; Ben-Porath, Yossef S

2015-03-01

The current study examined the predictive validity of Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008/2011) scores in police officer screenings. We utilized a sample of 712 police officer candidates (82.6% male) from 2 Midwestern police departments. The sample included 426 hired officers, most of whom had supervisor ratings of problem behaviors and human resource records of civilian complaints. With the full sample, we calculated zero-order correlations between MMPI-2-RF scale scores and scale scores from the California Psychological Inventory (Gough, 1956) and Inwald Personality Inventory (Inwald, 2006) by gender. In the hired sample, we correlated MMPI-2-RF scale scores with the outcome data for males only, owing to the relatively small number of hired women. Several scales demonstrated meaningful correlations with the criteria, particularly in the thought dysfunction and behavioral/externalizing dysfunction domains. After applying a correction for range restriction, the correlation coefficient magnitudes were generally in the moderate to large range. The practical implications of these findings were explored by means of risk ratio analyses, which indicated that officers who produced elevations at cutscores lower than the traditionally used 65 T-score level were as much as 10 times more likely than those scoring below the cutoff to exhibit problem behaviors. Overall, the results supported the validity of the MMPI-2-RF in this setting. Implications and limitations of this study are discussed. 2015 APA, all rights reserved

Randomized, single-blind, controlled trial of a specialist behavior therapy team for challenging behavior in adults with intellectual disabilities.

PubMed

Hassiotis, Angela; Robotham, Dan; Canagasabey, Anton; Romeo, Renee; Langridge, Diane; Blizard, Robert; Murad, Shahed; King, Michael

2009-11-01

Community-based specialist behavior therapy teams may be helpful in managing challenging behavior, but evidence of their effectiveness is limited. This study was designed to examine the effectiveness and costs associated with treatment by a specialist behavior therapy team. This was a parallel-group, randomized, single-blind controlled trial carried out in an intellectual disabilities service in England. Participants were 63 male and female service users with mild to severe intellectual disability who presented with challenging behavior. The interventions were standard treatment plus applied behavioral analysis (N=32) and standard treatment only (N=31). The primary outcome measure was challenging behavior, as measured by total and subscale scores on the Aberrant Behavior Checklist 3 and 6 months after randomization. Secondary outcome measures were psychiatric comorbidity assessed at 3 and 6 months using the Psychiatric Assessment Schedule for Adults With a Developmental Disability Checklist (PAS-ADD) and total costs recorded at 6 months. Multilevel modeling was used to compare square root transformations of Aberrant Behavior Checklist scores. Significant differences were found in the transformed total scores on the Aberrant Behavior Checklist (difference=-0.89, 95% CI=-1.74 to -0.04) and transformed lethargy and hyperactivity subscale scores (common intervention effect=-0.56, 95% CI=-0.97 to -0.15). Standard care participants fared worse on the PAS-ADD comorbid organic disorder subscale. There was a clear trend for lower overall costs of the intervention. Use of a specialist behavior therapy team in addition to standard treatment appears to be more effective in improving challenging behavior and may have financial advantages over standard treatment.

[Childhood traumatization, dissociation and nonsuicidal self-injurious behavior in borderline personality disorder].

PubMed

Merza, Katalin; Harmatta, János; Papp, Gábor; Kuritárné Szabó, Ildikó

2017-05-01

Childhood traumatization plays a significant role in the etiology of borderline personality disorder. Studies found a significant association between childhood traumatization, dissociation, and nonsuicidal self-injurious behavior. The aim of our study was to assess dissociation and nonsuicidal self-injury among borderline inpatients and to reveal the association between childhood traumatization, dissociation, and self-injurious behavior. The sample consisted of 80 borderline inpatients and 73 depressed control patients. Childhood traumatization, dissociation and self-injurious behavior were assessed by questionnaires. Borderline patients reported severe and multiplex childhood traumatization. Cumulative trauma score and sexual abuse were the strongest predictors of dissociation. Furthermore, we have found that cumulative trauma score and dissociation were highly predictive of self-injurious behavior. Our results suggest that self-injurious behavior and dissociation in borderline patients can be regarded as indicators of childhood traumatization. Orv Hetil. 2017; 158(19): 740-747.

Clinical, Psychopathological, and Personality Characteristics Associated with ADHD among Individuals Seeking Treatment for Gambling Disorder

PubMed Central

Aymamí, N.; Jiménez-Murcia, S.; Granero, R.; Ramos-Quiroga, J. A.; Fernández-Aranda, F.; Claes, L.; Sauvaget, A.; Grall-Bronnec, M.; Gómez-Peña, M.; Savvidou, L. G.; Fagundo, A. B.; del Pino-Gutierrez, A.; Moragas, L.; Casas, M.; Penelo, E.; Menchón, J. M.

2015-01-01

Objectives. (1) To assess the current presence of ADHD symptoms among patients seeking treatment for gambling disorder; (2) to explore clinical and sociodemographic differences between patients who score high and low on the measure of ADHD symptoms; (3) to analyze whether the presence of ADHD symptoms is associated with more severe psychopathology and with specific personality traits; (4) to analyze the mediating role of ADHD symptoms in the relationship between novelty seeking and gambling severity. Method. A total of 354 consecutive patients were administered an extensive battery assessing gambling behavior, psychopathology, and personality traits. Results. Male and female gamblers did not differ significantly in their mean scores on the ADHD measure. However, younger participants aged 18–35 scored higher. Higher ADHD scores were also associated with greater severity of gambling disorder and more general psychopathology. Regarding personality traits, high persistence and self-directedness were negatively related to ADHD scores, while in women alone a positive correlation was found between ADHD scores and scores on harm avoidance and self-transcendence. Conclusion. The presence of ADHD symptoms in both male and female gambling disorder patients may act as an indicator of the severity of gambling, general psychopathology, and dysfunctional personality traits. PMID:26229967

Lameness Detection in Dairy Cows: Part 1. How to Distinguish between Non-Lame and Lame Cows Based on Differences in Locomotion or Behavior

PubMed Central

Van Nuffel, Annelies; Zwertvaegher, Ingrid; Pluym, Liesbet; Van Weyenberg, Stephanie; Thorup, Vivi M.; Pastell, Matti; Sonck, Bart; Saeys, Wouter

2015-01-01

Simple Summary Scoring cattle for lameness based on changes in locomotion or behavior is essential for farmers to find and treat their lame animals. This review discusses the normal locomotion of cows in order to define abnormal locomotion due to lameness. It furthermore provides an overview of various relevant visual locomotion scoring systems that are currently being used as well as practical considerations when assessing lameness on a commercial farm. Abstract Due to its detrimental effect on cow welfare, health and production, lameness in dairy cows has received quite a lot of attention in the last few decades—not only in terms of prevention and treatment of lameness but also in terms of detection, as early treatment might decrease the number of severely lame cows in the herds as well as decrease the direct and indirect costs associated with lameness cases. Generally, lame cows are detected by the herdsman, hoof trimmer or veterinarian based on abnormal locomotion, abnormal behavior or the presence of hoof lesions during routine trimming. In the scientific literature, several guidelines are proposed to detect lame cows based on visual interpretation of the locomotion of individual cows (i.e., locomotion scoring systems). Researchers and the industry have focused on automating such observations to support the farmer in finding the lame cows in their herds, but until now, such automated systems have rarely been used in commercial herds. This review starts with the description of normal locomotion of cows in order to define ‘abnormal’ locomotion caused by lameness. Cow locomotion (gait and posture) and behavioral features that change when a cow becomes lame are described and linked to the existing visual scoring systems. In addition, the lack of information of normal cow gait and a clear description of ‘abnormal’ gait are discussed. Finally, the different set-ups used during locomotion scoring and their influence on the resulting locomotion scores are evaluated. PMID:26479389

Suggestive Linkage of the Child Behavior Checklist Juvenile Bipolar Disorder Phenotype to 1p21, 6p21, and 8q21

ERIC Educational Resources Information Center

Doyle, Alysa E.; Biederman, Joseph; Ferreira, Manuel A. R.; Wong, Patricia; Smoller, Jordan W.; Faraone, Stephen V.

2010-01-01

Objective: Several studies have documented a profile of elevated scores on the Attention Problems, Aggressive Behavior and Anxious/Depressed scales of the Child Behavior Checklist (CBCL) in youth with bipolar disorder. The sum of these scales, referred to as the CBCL Juvenile Bipolar Disorder (JBD) phenotype, has modest diagnostic utility, and…

A study of the feasibility of Internet administration of a computerized health survey: the headache impact test (HIT).

PubMed

Bayliss, M S; Dewey, J E; Dunlap, I; Batenhorst, A S; Cady, R; Diamond, M L; Sheftell, F

2003-12-01

Headache impact test (HIT) is a precise, practical tool that quantifies the impact of headache on respondents' lives. It is the first widely-available dynamic health assessment (DynHA). Applications of this brief, precise survey include population based screening for disabling headaches, tracking of individual patient scores over time, disease management programs and others. We use data from Internet HIT assessments during the fall of 2000 to (1) evaluate characteristics of respondents and assessments, (2) assess the utility of joint administration of HIT and the SF-8 Health Survey (SF-8) to screen for migraine and depression, and (3) explore associations between HIT scores and subsequent healthcare-related attitudes and behaviors. We analyzed Internet HIT surveys completed between 9/1 and 11/30/2000 (n = 19,195). Subsamples include respondents who also completed (1) a 12-item Internet survey assessing severity, frequency, cause and management of headaches; (2) an e-mail survey measuring healthcare-related behaviors; (3) the SF-8; or (4) the website registration process, providing age and gender data. We used analysis of variance (ANOVA) to evaluate HIT score differences associated with age, gender, headache severity or frequency, and healthcare-related behaviors and attitudes and chi2 tests to assess the prevalence and comorbidity of migraine and depression. Three-quarters of respondents achieved a precise HIT score in < or = 5 items. Most had moderate/severe headaches; 65% had headaches at least monthly. HIT scores were directly related to headache severity and frequency. Most respondents were females, with significantly higher HIT scores than males. Most HIT respondents were between ages 25 and 54 (HIT scores were higher for younger respondents). Sixty four percent screened positive for migraine; 20% for depression. Both conditions were more prevalent among females than males. Comorbid migraine and depression was 50% more prevalent among females and increased with age until age 50. Patients with worse headache impact were more likely to seek care, discuss headaches with their providers and find HIT useful. It is feasible to use Internet-based dynamic assessments to measure health status. These data complement previous results showing that HIT differentiates respondents according to headache characteristics (severity and frequency). HIT plus SF-8 yields a practical screen for migraine and depression in headache patients and may lead to more effective treatment for patients with these conditions. Preliminary findings suggest that the experience of taking HIT on the Internet may motivate headache patients to seek care and discuss headaches with their providers.

Autism Spectrum Disorder in Fragile X Syndrome: A Longitudinal Evaluation

PubMed Central

Hernandez, R. Nick; Feinberg, Rachel L.; Vaurio, Rebecca; Passanante, Natalie M.; Thompson, Richard E.; Kaufmann, Walter E.

2009-01-01

The present study extends our previous work on characterizing the autistic behavior profile of boys with fragile X syndrome (FXS) who meet Diagnostic and Statistical Manual for Mental Disorders, 4th Edition criteria for autism spectrum disorder (ASD) into a longitudinal evaluation of ASD in FXS (FXS+ASD). Specifically, we aimed to determine the stability of the diagnosis and profile of ASD in FXS over time. Through regression models, we also evaluated which autistic and social behaviors and skills were correlates of diagnosis and autistic behavior severity (i.e., Autism Diagnostic Interview-Revised total scores). Finally, we assessed the evolution of cognitive parameters in FXS+ASD. A population of 56 boys (30–88 months at baseline) with FXS was evaluated using measures of autistic, social, and cognitive behaviors and skills at three yearly evaluations. We found that the diagnosis of ASD in FXS was relatively stable over time. Further emphasizing this stability, we found a set of behaviors and skills, particularly those related to peer relationships and adaptive socialization, that differentiated FXS+ASD from the rest of the FXS cohort (FXS+None) and contributed to autistic severity at all time points. Nevertheless, the general improvement in autistic behavior observed in FXS+ASD coupled with the concurrent worsening in FXS+None resulted in less differentiation between the groups over time. Surprisingly, FXS+ASD IQ scores were stable while FXS+None non-verbal IQ scores declined. Our findings indicate that ASD is a distinctive subphenotype in FXS characterized by deficits in complex social interaction, with similarities to ASD in the general population. PMID:19441123

Patient Effort in Traumatic Brain Injury Inpatient Rehabilitation: Course and Associations With Age, Brain Injury Severity, and Time Postinjury

PubMed Central

Seel, Ronald T.; Corrigan, John D.; Dijkers, Marcel P.; Barrett, Ryan S.; Bogner, Jennifer; Smout, Randall J.; Garmoe, William; Horn, Susan D.

2016-01-01

Objective To describe patients' level of effort in occupational, physical, and speech therapy sessions during traumatic brain injury (TBI) inpatient rehabilitation and to evaluate how age, injury severity, cognitive impairment, and time are associated with effort. Design Prospective, multicenter, longitudinal cohort study. Setting Acute TBI rehabilitation programs. Participants Patients (N=1946) receiving 138,555 therapy sessions. Interventions Not applicable. Main Outcome Measures Effort in rehabilitation sessions rated on the Rehabilitation Intensity of Therapy Scale, FIM, Comprehensive Severity Index brain injury severity score, posttraumatic amnesia (PTA), and Agitated Behavior Scale (ABS). Results The Rehabilitation Intensity of Therapy Scale effort ratings in individual therapy sessions closely conformed to a normative distribution for all 3 disciplines. Mean Rehabilitation Intensity of Therapy Scale ratings for patients' therapy sessions were higher in the discharge week than in the admission week (P<.001). For patients who completed 2, 3, or 4 weeks of rehabilitation, differences in effort ratings (P<.001) were observed between 5 subgroups stratified by admission FIM cognitive scores and over time. In linear mixed-effects modeling, age and Comprehensive Severity Index brain injury severity score at admission, days from injury to rehabilitation admission, days from admission, and daily ratings of PTA and ABS score were predictors of level of effort (P<.0001). Conclusions Patients' level of effort can be observed and reliably rated in the TBI inpatient rehabilitation setting using the Rehabilitation Intensity of Therapy Scale. Patients who sustain TBI show varying levels of effort in rehabilitation therapy sessions, with effort tending to increase over the stay. PTA and agitated behavior are primary risk factors that substantially reduce patient effort in therapies. PMID:26212400

Behavioral and emotional problems in a Kuala Lumpur children's home.

PubMed

Abd Rahman, Fairuz Nazri; Mohd Daud, Tuti Iryani; Nik Jaafar, Nik Ruzyanei; Shah, Shamsul Azhar; Tan, Susan Mooi Koon; Wan Ismail, Wan Salwina

2013-08-01

There is a dearth of studies on behavioral and emotional problems in residential care children in Malaysia. This study describes the behavioral and emotional problems in a sample of children in a government residential care home and compares them with their classmates living with their birth parents. A comparative cross-sectional study was carried out where carers from both groups were asked to fill in the translated Bahasa Melayu version of the Child Behavior Check List. Forms for 53 residential care children and 61 classmates were completed. The residential care children had significantly higher scores on the rule-breaking (P < 0.001) and Diagnostic and Statistical Manual of Mental Disorders (DSM) conduct problem subscales (P < 0.001). Residential care children's age significantly correlated with DSM somatic problems (P = 0.03) and post-traumatic stress (P = 0.023). Duration of care was significantly positively correlated with rule-breaking (P = 0.008), DSM conduct problems (P = 0.018) and externalizing scores (P = 0.017). Abuse and neglect cases had higher anxiety and depression scores (P = 0.024). Number of reasons in care positively correlated with several subscales, including total behavioral problem score (P = 0.005). Logistic regression revealed the greater number of reasons for placement a child had was significantly associated with having externalizing scores in the clinical range (P = 0.016). However, after Bonferroni correction, only the initial findings regarding rule-breaking and DSM conduct problem scores remained significant. Challenges exist in managing residential care children in Malaysia, especially regarding externalizing behavior. More studies are required to describe the Malaysian scene. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

Less Structured Movement Patterns Predict Severity of Positive Syndrome, Excitement, and Disorganization

PubMed Central

Walther, Sebastian

2014-01-01

Disorganized behavior is a key symptom of schizophrenia. The objective assessment of disorganized behavior is particularly challenging. Actigraphy has enabled the objective assessment of motor behavior in various settings. Reduced motor activity was associated with negative syndrome scores, but simple motor activity analyses were not informative on other symptom dimensions. The analysis of movement patterns, however, could be more informative for assessing schizophrenia symptom dimensions. Here, we use time series analyses on actigraphic data of 100 schizophrenia spectrum disorder patients. Actigraphy recording intervals were set at 2 s. Data from 2 defined 60-min periods were analyzed, and partial autocorrelations of the actigraphy time series indicated predictability of movements in each individual. Increased positive syndrome scores were associated with reduced predictability of movements but not with the overall amount of movement. Negative syndrome scores were associated with low activity levels but unrelated with predictability of movement. The factors disorganization and excitement were related to movement predictability but emotional distress was not. Thus, the predictability of objectively assessed motor behavior may be a marker of positive symptoms and disorganized behavior. This behavior could become relevant for translational research. PMID:23502433

Outcomes of Integrated Behavioral Health with Primary Care.

PubMed

Balasubramanian, Bijal A; Cohen, Deborah J; Jetelina, Katelyn K; Dickinson, L Miriam; Davis, Melinda; Gunn, Rose; Gowen, Kris; deGruy, Frank V; Miller, Benjamin F; Green, Larry A

2017-01-01

Integrating behavioral health and primary care is beneficial to patients and health systems. However, for integration to be widely adopted, studies demonstrating its benefits in community practices are needed. The objective of this study was to evaluate effect of integrated care, adapted to local contexts, on depression severity and patients' experience of care. This study used a convergent mixed-methods design, merging findings from a quasi-experimental study with patient interviews conducted as part of Advancing Care Together, a community demonstration project that created an innovation incubator for practices implementing evidence-based integration strategies. The study included 475 patients with a 9-item Patient Health Questionnaire (PHQ-9) score ≥10 at baseline, from 5 practices. Statistically significant reductions in mean PHQ-9 scores were observed in all practices, ranging from 2.72 to 6.46 points. Clinically, 50% of patients had a ≥5-point reduction in PHQ-9 score and 32% had a ≥50% reduction. This finding was corroborated by patient interviews that demonstrated positive experiences with behavioral health clinicians and acquiring new skills to cope with adverse situations at work and home. Integrating behavioral health and primary care, when adapted to fit into community practices, reduced depression severity and enhanced patients' experience of care. Integration is a worthwhile investment; clinical leaders, policymakers, and payers should support integration in their communities. © Copyright 2017 by the American Board of Family Medicine.

The prevalence and correlates of severe depression in a cohort of Mexican teachers.

PubMed

Soria-Saucedo, Rene; Lopez-Ridaura, Ruy; Lajous, Martin; Wirtz, Veronika J

2018-07-01

Depression is among the 10 major causes of disability in Mexico. Yet, local contextual factors associated to the disorder remain poorly understood. We measured the impact of several factors on severe depression such as demographics, pharmacotherapy, multimorbidity, and unhealthy behaviors in Mexican teachers. A total of 43,845 Mexican female teachers from 12 Mexican states answered the Patient Health Questionnaire (PHQ9). Data were part the Mexican Teacher's Cohort prospective study, the largest ongoing cohort study in Latin America. Unadjusted and adjusted estimates assessed the impact of several contextual factors between severe versus mild-no depression cases. In total 7026 teachers (16%) had a PHQ9 score compatible with severe depression. From them, only 17% received psychotropics, compared to 60% for those with a formal diagnosis. Less than 5% of teachers with PHQ9 scores compatible with severe depression had a formal diagnosis. Adjusted analysis reported higher odds of pharmacotherapy, having ≥ 3 comorbidities, higher levels of couple, family and work stress, fewer hours of vigorous physical activity, higher alcohol consumption, and smoking as risk factors for severe depression. Also, rural residents of northern and center states appeared more severely depressed compared to their urban counterparts. On average, the PHQ9 scores differed by ~ 10 points between severe and mild-no depressed teachers. A cross-sectional design. Also, the study focused on female teachers between ages 25 and 74 years old, reducing the generalizability of the estimates. Under-diagnosis of clinical depression in Mexican teachers is concerning. Unhealthy behavior is associated with severe depression. The information collected in this study represents an opportunity to build prevention mechanisms of depression in high-risk subgroups of female educators and warrants improving access to mental care in Mexico. Copyright © 2018 Elsevier B.V. All rights reserved.

Deficits in facial emotion recognition indicate behavioral changes and impaired self-awareness after moderate to severe traumatic brain injury.

PubMed

Spikman, Jacoba M; Milders, Maarten V; Visser-Keizer, Annemarie C; Westerhof-Evers, Herma J; Herben-Dekker, Meike; van der Naalt, Joukje

2013-01-01

Traumatic brain injury (TBI) is a leading cause of disability, specifically among younger adults. Behavioral changes are common after moderate to severe TBI and have adverse consequences for social and vocational functioning. It is hypothesized that deficits in social cognition, including facial affect recognition, might underlie these behavioral changes. Measurement of behavioral deficits is complicated, because the rating scales used rely on subjective judgement, often lack specificity and many patients provide unrealistically positive reports of their functioning due to impaired self-awareness. Accordingly, it is important to find performance based tests that allow objective and early identification of these problems. In the present study 51 moderate to severe TBI patients in the sub-acute and chronic stage were assessed with a test for emotion recognition (FEEST) and a questionnaire for behavioral problems (DEX) with a self and proxy rated version. Patients performed worse on the total score and on the negative emotion subscores of the FEEST than a matched group of 31 healthy controls. Patients also exhibited significantly more behavioral problems on both the DEX self and proxy rated version, but proxy ratings revealed more severe problems. No significant correlation was found between FEEST scores and DEX self ratings. However, impaired emotion recognition in the patients, and in particular of Sadness and Anger, was significantly correlated with behavioral problems as rated by proxies and with impaired self-awareness. This is the first study to find these associations, strengthening the proposed recognition of social signals as a condition for adequate social functioning. Hence, deficits in emotion recognition can be conceived as markers for behavioral problems and lack of insight in TBI patients. This finding is also of clinical importance since, unlike behavioral problems, emotion recognition can be objectively measured early after injury, allowing for early detection and treatment of these problems.

Noninvasive transcranial focal stimulation via tripolar concentric ring electrodes lessens behavioral seizure activity of recurrent pentylenetetrazole administrations in rats.

PubMed

Makeyev, Oleksandr; Luna-Munguía, Hiram; Rogel-Salazar, Gabriela; Liu, Xiang; Besio, Walter G

2013-05-01

Epilepsy affects approximately 1% of the world population. Antiepileptic drugs are ineffective in approximately 30% of patients and have side effects. We have been developing a noninvasive transcranial focal electrical stimulation with our novel tripolar concentric ring electrodes as an alternative/complementary therapy for seizure control. In this study we demonstrate the effect of focal stimulation on behavioral seizure activity induced by two successive pentylenetetrazole administrations in rats. Seizure onset latency, time of the first behavioral change, duration of seizure, and maximal seizure severity score were studied and compared for focal stimulation treated (n = 9) and control groups (n = 10). First, we demonstrate that no significant difference was found in behavioral activity for focal stimulation treated and control groups after the first pentylenetetrazole administration. Next, comparing first and second pentylenetetrazole administrations, we demonstrate there was a significant change in behavioral activity (time of the first behavioral change) in both groups that was not related to focal stimulation. Finally, we demonstrate focal stimulation provoking a significant change in seizure onset latency, duration of seizure, and maximal seizure severity score. We believe that these results, combined with our previous reports, suggest that transcranial focal stimulation may have an anticonvulsant effect.

Noninvasive transcranial focal stimulation via tripolar concentric ring electrodes lessens behavioral seizure activity of recurrent pentylenetetrazole administrations in rats

PubMed Central

Makeyev, Oleksandr; Luna-Munguía, Hiram; Rogel-Salazar, Gabriela; Liu, Xiang; Besio, Walter G.

2012-01-01

Epilepsy affects approximately one percent of the world population. Antiepileptic drugs are ineffective in approximately 30% of patients and have side effects. We have been developing a noninvasive transcranial focal electrical stimulation with our novel tripolar concentric ring electrodes as an alternative/complementary therapy for seizure control. In this study we demonstrate the effect of focal stimulation on behavioral seizure activity induced by two successive pentylenetetrazole administrations in rats. Seizure onset latency, time of the first behavioral change, duration of seizure, and maximal seizure severity score were studied and compared for focal stimulation treated (n = 9) and control groups (n = 10). First, we demonstrate that no significant difference was found in behavioral activity for focal stimulation treated and control groups after the first pentylenetetrazole administration. Next, comparing first and second pentylenetetrazole administrations, we demonstrate there was a significant change in behavioral activity (time of the first behavioral change) in both groups that was not related to focal stimulation. Finally, we demonstrate focal stimulation provoking a significant change in seizure onset latency, duration of seizure, and maximal seizure severity score. We believe that these results, combined with our previous reports, suggest that transcranial focal stimulation may have an anticonvulsant effect. PMID:22692938

Disciplinary action by medical boards and prior behavior in medical school.

PubMed

Papadakis, Maxine A; Teherani, Arianne; Banach, Mary A; Knettler, Timothy R; Rattner, Susan L; Stern, David T; Veloski, J Jon; Hodgson, Carol S

2005-12-22

Evidence supporting professionalism as a critical measure of competence in medical education is limited. In this case-control study, we investigated the association of disciplinary action against practicing physicians with prior unprofessional behavior in medical school. We also examined the specific types of behavior that are most predictive of disciplinary action against practicing physicians with unprofessional behavior in medical school. The study included 235 graduates of three medical schools who were disciplined by one of 40 state medical boards between 1990 and 2003 (case physicians). The 469 control physicians were matched with the case physicians according to medical school and graduation year. Predictor variables from medical school included the presence or absence of narratives describing unprofessional behavior, grades, standardized-test scores, and demographic characteristics. Narratives were assigned an overall rating for unprofessional behavior. Those that met the threshold for unprofessional behavior were further classified among eight types of behavior and assigned a severity rating (moderate to severe). Disciplinary action by a medical board was strongly associated with prior unprofessional behavior in medical school (odds ratio, 3.0; 95 percent confidence interval, 1.9 to 4.8), for a population attributable risk of disciplinary action of 26 percent. The types of unprofessional behavior most strongly linked with disciplinary action were severe irresponsibility (odds ratio, 8.5; 95 percent confidence interval, 1.8 to 40.1) and severely diminished capacity for self-improvement (odds ratio, 3.1; 95 percent confidence interval, 1.2 to 8.2). Disciplinary action by a medical board was also associated with low scores on the Medical College Admission Test and poor grades in the first two years of medical school (1 percent and 7 percent population attributable risk, respectively), but the association with these variables was less strong than that with unprofessional behavior. In this case-control study, disciplinary action among practicing physicians by medical boards was strongly associated with unprofessional behavior in medical school. Students with the strongest association were those who were described as irresponsible or as having diminished ability to improve their behavior. Professionalism should have a central role in medical academics and throughout one's medical career. Copyright 2005 Massachusetts Medical Society.

Variation in the Early Trajectories of Autism Symptoms Is Related to the Development of Language, Cognition, and Behavior Problems.

PubMed

Visser, Janne C; Rommelse, Nanda N J; Lappenschaar, Martijn; Servatius-Oosterling, Iris J; Greven, Corina U; Buitelaar, Jan K

2017-08-01

The objectives of this study were to model more homogeneous subgroups within autism spectrum disorder (ASD) based on early trajectories of core symptoms; and to further characterize these subgroups in terms of trajectories of language, cognition, co-occurring (attention-deficit/hyperactivity disorder [ADHD]-related) traits and clinical outcome diagnosis. Children (N = 203) referred for possible ASD at ages 1 to 4 years were assessed at three time points at intervals ranging from 9 months to 3 years. Assessments included standardized measures for ASD (Autism Diagnostic Observation Schedule [ADOS]), language (ADOS-language item), nonverbal IQ (NV-IQ; different tests adequate to chronological/mental age), and parent-reported behavioral problems (Infant-Toddler Social and Emotional Assessment, Child Behavior Checklist). Latent-class growth curve analysis with ADOS total scores led to the identification of three main stable and two small improving groups: a severe-stable group (19.5% of sample)-the only group without considerable language improvement-showed persistent low NV-IQ and marked increase in attention problems over time; a moderate-stable group (21.7%) with below-average increasing NV-IQ; and a mild-stable group (48%) with stable-average NV-IQ and the highest scores on ADHD-related traits, whose ASD outcome diagnoses increased despite stable-low ASD scores. Two groups (each 5.4%) improved: one moved from severe to moderate ASD scores, and the other moved from moderate to mild/nonspectrum scores. Both of these groups improved on language, NV-IQ, and ADHD-related traits. Results support the high stability of ASD symptoms into various severity levels, but also highlight the significant contribution of non-ASD domains in defining and explaining the different ASD trajectories. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Performance on the Frontal Assessment Battery is sensitive to frontal lobe damage in stroke patients.

PubMed

Kopp, Bruno; Rösser, Nina; Tabeling, Sandra; Stürenburg, Hans Jörg; de Haan, Bianca; Karnath, Hans-Otto; Wessel, Karl

2013-11-16

The Frontal Assessment Battery (FAB) is a brief battery of six neuropsychological tasks designed to assess frontal lobe function at bedside [Neurology 55:1621-1626, 2000]. The six FAB tasks explore cognitive and behavioral domains that are thought to be under the control of the frontal lobes, most notably conceptualization and abstract reasoning, lexical verbal fluency and mental flexibility, motor programming and executive control of action, self-regulation and resistance to interference, inhibitory control, and environmental autonomy. We examined the sensitivity of performance on the FAB to frontal lobe damage in right-hemisphere-damaged first-ever stroke patients based on voxel-based lesion-behavior mapping. Voxel-based lesion-behavior mapping of FAB performance revealed that the integrity of the right anterior insula (BA13) is crucial for the FAB global composite score, for the FAB conceptualization score, as well as for the FAB inhibitory control score. Furthermore, the FAB conceptualization and mental flexibility scores were sensitive to damage of the right middle frontal gyrus (MFG; BA9). Finally, the FAB inhibitory control score was sensitive to damage of the right inferior frontal gyrus (IFG; BA44/45). These findings indicate that several FAB scores (including composite and item scores) provide valid measures of right hemispheric lateral frontal lobe dysfunction, specifically of focal lesions near the anterior insula, in the MFG and in the IFG.

Performance on the Frontal Assessment Battery is sensitive to frontal lobe damage in stroke patients

PubMed Central

2013-01-01

Background The Frontal Assessment Battery (FAB) is a brief battery of six neuropsychological tasks designed to assess frontal lobe function at bedside [Neurology 55:1621-1626, 2000]. The six FAB tasks explore cognitive and behavioral domains that are thought to be under the control of the frontal lobes, most notably conceptualization and abstract reasoning, lexical verbal fluency and mental flexibility, motor programming and executive control of action, self-regulation and resistance to interference, inhibitory control, and environmental autonomy. Methods We examined the sensitivity of performance on the FAB to frontal lobe damage in right-hemisphere-damaged first-ever stroke patients based on voxel-based lesion-behavior mapping. Results Voxel-based lesion-behavior mapping of FAB performance revealed that the integrity of the right anterior insula (BA13) is crucial for the FAB global composite score, for the FAB conceptualization score, as well as for the FAB inhibitory control score. Furthermore, the FAB conceptualization and mental flexibility scores were sensitive to damage of the right middle frontal gyrus (MFG; BA9). Finally, the FAB inhibitory control score was sensitive to damage of the right inferior frontal gyrus (IFG; BA44/45). Conclusions These findings indicate that several FAB scores (including composite and item scores) provide valid measures of right hemispheric lateral frontal lobe dysfunction, specifically of focal lesions near the anterior insula, in the MFG and in the IFG. PMID:24237624

Timing, duration, and severity of iron deficiency in early development and motor outcomes at 9 months

PubMed Central

Santos, Denise CC; Angulo-Barroso, Rosa M; Li, Ming; Bian, Yang; Sturza, Julie; Richards, Blair; Lozoff, Betsy

2017-01-01

BACKGROUND/OBJECTIVES Poorer motor development is reported in infants with iron deficiency (ID). The role of timing, duration and severity is unclear. We assessed relations between ID timing, duration, and severity and gross motor scores, neurological integrity, and motor behavior quality at 9 months. METHODS Iron status was determined at birth and 9 months in otherwise healthy term Chinese infants. The 9-month motor evaluation included the Peabody Developmental Motor Scale (PDMS-2), Infant Neurological International Battery (INFANIB), and motor quality factor. Motor outcomes were analyzed by ID timing (fetal-neonatal, infancy), duration, and severity. For severity, we also considered maternal iron status. RESULTS Data were available for 1194 infants. Iron status was classified as fetal-neonatal and infancy ID (n=253), fetal-neonatal ID (n=256), infancy ID (n=288), and not ID (n=397). Compared with not ID, infants with fetal-neonatal or infancy ID had lower locomotion scores (effect size ds=0.19, 0.18) and those with ID in both periods (longer duration) had lower locomotion and overall PDMS-2 gross motor scores (ds=0.20, 0.18); ID groups did not differ. More severe ID in late pregnancy was associated with lower INFANIB Vestibular function (p=0.01), and total score (p=0.03). More severe ID in infancy was associated with lower scores for locomotion (p=0.03), overall gross motor (p=0.05). CONCLUSIONS Fetal-neonatal and/or infancy ID was associated with lower overall gross motor development and locomotion test scores at 9 months. Associations with ID severity varied by ID timing: more severe ID in late pregnancy, poorer neurological integrity; more severe ID in infancy, poorer gross motor development. PMID:29235557

A Scoring System to Predict the Severity of Hirschsprung Disease at Diagnosis and Its Correlation With Molecular Genetics.

PubMed

Núñez-Ramos, Raquel; Fernández, Raquel M; González-Velasco, Miguel; Ruiz-Contreras, Jesús; Galán-Gómez, Enrique; Núñez-Núñez, Ramón; Borrego, Salud

2017-01-01

Objectives Hirschsprung disease (HSCR) has a wide range of severity. There are nonsevere forms treated conservatively until surgery and severe forms that require an early stoma and prolonged hospitalization. Our objective was to establish a clinical scoring system to predict the severity of HSCR and to evaluate the possible existence of a clinical-genetic correlation. Methods We carried out a retrospective observational study including all HSCR cases treated in our hospital. The sample was divided into severe and nonsevere disease according to the number of surgical procedures, hospitalization time, and episodes of enterocolitis. The proposed score was applied at diagnosis, and the sensitivity, specificity, and optimal cut-point were determined. We conducted a prospective molecular study of RET, EDNRB, and EDN3 on all patients, as well as SOX10 in Waardenburg Syndrome type 4 forms. Results Among the 42 patients treated between 1983 and 2013, 15 met the severe disease criteria. This group had a higher mean score (13.15 ± 2.36) than the nonsevere group (8.15 ± 2.13; p < 0.001). A score ≥11 had a sensitivity of 87% and a specificity of 81% in detecting the severe cases. Causative mutations were identified in 12 patients, 8 of them in the severe group ( p = 0.015). Most of these mutations (75%) were located in the RET proto-oncogene. Conclusion The proposed scoring system enables the early selection of patients with severe behavior of HSCR. A value ≥11 showed good sensitivity and specificity for this purpose. Causative mutations were identified in more than 50% of patients who met the criteria for severe disease.

Car surfing: case studies of a growing dangerous phenomenon.

PubMed

Clark, Steven; Mangram, Alicia; Dunn, Ernest

2008-03-01

Car surfing is a dangerous new pastime for American youth. Car surfing is an activity that is defined as standing (or lying) on a vehicle while it is being driven. This activity frequently results in severe injuries that often require significant surgical intervention. Despite its destructive nature, however, there are many Internet sites that encourage this behavior and view it as amusing. As a result, car surfing is becoming increasingly popular. We conducted a retrospective chart review of all patients injured as a result of car surfing over the last 4 years at our Urban Level II trauma center. Data collected included Injury Severity Score (ISS), Revised Trauma Score (RTS), age, gender, injury pattern, surgical intervention, and length of stay. Eight car surfers were identified. The average age was 17. The average Revised Trauma Score was 6.8 with an average Injury Severity Score of 16.9. Five patients were admitted to the intensive care unit. Four of these five patients needed to be intubated for ventilatory support. Five of the eight patients had significant intracranial injuries. Two patients had epidural hematomas that required evacuation. Two other patients had subdural hematomas that were treated nonoperatively, and one patient had a subarachnoid hemorrhage that was also treated nonoperatively. Four of the eight patients required surgical intervention. There were no deaths in this study. Car surfing leads to severe injuries that can result in significant morbidity. American youth have access to Internet sites that project this activity as an acceptable behavior. Five of our eight patients had a significant intracranial injury. Trauma surgeons need to be more aware of this injury phenomenon.

The Effect of Hock Injury Laterality and Lameness on Lying Behaviors and Lying Laterality in Holstein Dairy Cows

PubMed Central

Krawczel, Peter D.

2017-01-01

Simple Summary Dairy cattle may experience discomfort in a myriad of ways throughout their life cycle, particularly when sustaining hock injuries or suboptimal locomotion. Lactating dairy cattle divide their lying time equally between left and right sides; however, discomfort experienced during pregnancy or following cannulation can cause a shift in the normal lying laterality. The objective of this study was to determine the effect of hock injuries and lameness on the lying behaviors of dairy cattle, particularly lying laterality. Lying laterality did not differ from the expected 50% (left side lying time) in cattle with hock injuries, lameness, or both. The current results suggest that lying laterality does not differ between varying levels of hock injury or lameness severity. Going forward, further research could determine if lying laterality shifts over the course of the animal developing a hock injury or lameness. Abstract Lactating dairy cattle divide their lying equally between their left side and their right side. However, discomfort, such as pregnancy and cannulation, can cause a cow to shift lying side preference. The objective of this study was to determine the effect of lameness and hock injuries on lying behaviors, particularly lying laterality, of lactating dairy cows. Cows from four commercial farms in eastern Croatia that had lying behavior data, health score data, and production records were used in the study. Health scores including hock injuries and locomotion were collected once per cow. Severely lame cows had greater daily lying time compared to sound cows and moderately lame cows. Overall, cows spent 51.3 ± 1.2% of their daily lying time on the left side. Maximum hock score, locomotion score, hock injury laterality, or parity did not result in lying laterality differing from 50%. PMID:29149044

Abnormal illness behavior and Internet addiction severity: The role of disease conviction, irritability, and alexithymia

PubMed Central

Scimeca, Giuseppe; Bruno, Antonio; Crucitti, Manuela; Conti, Claudio; Quattrone, Diego; Pandolfo, Gianluca; Zoccali, Rocco Antonio; Muscatello, Maria Rosaria Anna

2017-01-01

Background and aims While the association between health anxiety and maladaptive Internet use is a well-established finding, no studies have been performed to examine the possible effect of abnormal illness behavior (AIB). AIB is a maladaptive manner of experiencing, evaluating, or acting in response to health and illness that is disproportionate to evident pathology. The aim of this study was to investigate the association between AIB and Internet addiction (IA) severity in a sample of Italian University students. The possible effect of alexithymia, anxiety, and depression was also taken into account. Methods Participants were 115 men and 163 women (mean age = 23.62 ± 4.38 years); AIB was measured via the Illness Behavior Questionnaire (IBQ), and IA severity by the Internet Addiction Test (IAT). Results The most powerful IBQ factor predicting IA severity scores was disease conviction. Irritability was the only emotional IBQ factor associated with IA severity. Nevertheless, disease conviction and alexithymia remained the only significant predictors of IAT scores when hierarchical regression analysis was executed. Discussion and conclusions Our results support previous findings showing that those characterized by health anxiety are more prone to an excessive and maladaptive use of Internet. Moreover, this study showed that irritability was the only emotional aspect of AIB predicting IA severity. This finding is consistent with the cognitive model of hypochondria, which states that cognitive factors (dysfunctional beliefs and assumptions) play a major role in the explanation of this psychopathological condition. PMID:28245678

A MAOA gene*cocaine severity interaction on impulsivity and neuropsychological measures of orbitofrontal dysfunction: preliminary results.

PubMed

Verdejo-García, Antonio; Albein-Urios, Natalia; Molina, Esther; Ching-López, Ana; Martínez-González, José M; Gutiérrez, Blanca

2013-11-01

Based on previous evidence of a MAOA gene*cocaine use interaction on orbitofrontal cortex volume attrition, we tested whether the MAOA low activity variant and cocaine use severity are interactively associated with impulsivity and behavioral indices of orbitofrontal dysfunction: emotion recognition and decision-making. 72 cocaine dependent individuals and 52 non-drug using controls (including healthy individuals and problem gamblers) were genotyped for the MAOA gene and tested using the UPPS-P Impulsive Behavior Scale, the Iowa Gambling Task and the Ekman's Facial Emotions Recognition Test. To test the main hypothesis, we conducted hierarchical multiple regression analyses including three sets of predictors: (1) age, (2) MAOA genotype and severity of cocaine use, and (3) the interaction between MAOA genotype and severity of cocaine use. UPPS-P, Ekman Test and Iowa Gambling Task's scores were the outcome measures. We computed the statistical significance of the prediction change yielded by each consecutive set, with 'a priori' interest in the MAOA*cocaine severity interaction. We found significant effects of the MAOA gene*cocaine use severity interaction on the emotion recognition scores and the UPPS-P's dimensions of Positive Urgency and Sensation Seeking: Low activity carriers with higher cocaine exposure had poorer emotion recognition and higher Positive Urgency and Sensation Seeking. Cocaine users carrying the MAOA low activity show a greater impact of cocaine use on impulsivity and behavioral measures of orbitofrontal cortex dysfunction. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Abnormal illness behavior and Internet addiction severity: The role of disease conviction, irritability, and alexithymia.

PubMed

Scimeca, Giuseppe; Bruno, Antonio; Crucitti, Manuela; Conti, Claudio; Quattrone, Diego; Pandolfo, Gianluca; Zoccali, Rocco Antonio; Muscatello, Maria Rosaria Anna

2017-03-01

Background and aims While the association between health anxiety and maladaptive Internet use is a well-established finding, no studies have been performed to examine the possible effect of abnormal illness behavior (AIB). AIB is a maladaptive manner of experiencing, evaluating, or acting in response to health and illness that is disproportionate to evident pathology. The aim of this study was to investigate the association between AIB and Internet addiction (IA) severity in a sample of Italian University students. The possible effect of alexithymia, anxiety, and depression was also taken into account. Methods Participants were 115 men and 163 women (mean age = 23.62 ± 4.38 years); AIB was measured via the Illness Behavior Questionnaire (IBQ), and IA severity by the Internet Addiction Test (IAT). Results The most powerful IBQ factor predicting IA severity scores was disease conviction. Irritability was the only emotional IBQ factor associated with IA severity. Nevertheless, disease conviction and alexithymia remained the only significant predictors of IAT scores when hierarchical regression analysis was executed. Discussion and conclusions Our results support previous findings showing that those characterized by health anxiety are more prone to an excessive and maladaptive use of Internet. Moreover, this study showed that irritability was the only emotional aspect of AIB predicting IA severity. This finding is consistent with the cognitive model of hypochondria, which states that cognitive factors (dysfunctional beliefs and assumptions) play a major role in the explanation of this psychopathological condition.

Comprehensive behavioral-motivational nutrition education improves depressive symptoms following bariatric surgery: a randomized, controlled trial of obese Hispanic Americans.

PubMed

Petasne Nijamkin, Monica; Campa, Adriana; Samiri Nijamkin, Shani; Sosa, Jorge

2013-01-01

To evaluate the effect of 2 post-bariatric support interventions on depressive symptoms of Hispanic Americans treated with gastric bypass for morbid or severe obesity. Prospective randomized, controlled trial conducted in a laparoscopic institution. During the Phase 1 clinical trial (from preoperative evaluation to 6 months after surgery), all participants received standard care. During Phase 2 (6-12 months after surgery), participants were randomly assigned to receive either standard care (n = 72) or comprehensive support (n = 72). Comprehensive group participants received 6 educational sessions focused on behavior change strategies and motivation with nutrition counseling. Depression scores and weight change over time. Independent samples t tests and regression analysis assessed relationships among depression scores and excess weight loss. Participants receiving behavioral-motivational intervention scored significantly lower on Beck's Depression Inventory questionnaire scores than those receiving standard care. For those with depressive symptoms at randomization, 24% of participants who received the comprehensive intervention reported no depressive symptoms at 12 months after surgery, compared with 6% of those who received standard care (P < .001). Patients' depressive mood improvement was significantly and positively associated with excess weight loss and attendance at educational sessions (P < .001). Findings support the importance of post-bariatric comprehensive behavioral-motivational nutrition education for decreasing risk for depression and improving weight loss. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Deletion 2q37 syndrome: Cognitive-behavioral trajectories and autistic features related to breakpoint and deletion size.

PubMed

Fisch, Gene S; Falk, Rena E; Carey, John C; Imitola, Jaime; Sederberg, Maria; Caravalho, Karen S; South, Sarah

2016-09-01

Subtelomeric deletions have been reported in ∼2.5% of individuals with developmental disabilities. Subtelomeric deletion 2q37 has been detected in many individuals diagnosed with intellectual disabilities (ID) and autism spectrum disorders (ASD). Previously, genotype-phenotype correspondences were examined for their relationship to breakpoints 37.1, 37.2, or 37.3. Our purpose was to ascertain whether there were phenotypic differences at these breakpoints, elucidate the cognitive-behavioral phenotype in del2q37, and examine the genotype-phenotype association in the deletion with respect to cognitive-behavioral profiles and ASD. We administered a comprehensive cognitive-behavioral battery to nine children diagnosed with del 2q37, ages 3.9-17.75 years. ID for five tested with the Stanford-Binet (4th Edition) (SBFE) ranged from severe to mild [IQ Range: 36-59]. Adaptive behavior scores from the Vineland Adaptive Behavior Scale (VABS) were much below adequate levels (DQ Range: floor value ["19"] to 55). Autism scores from the Child Autism Rating Scale (CARS) ranged from 22 [non-autistic] to 56 [extremely autistic]; 5/8 [63%] children received scores on the autism spectrum. Participants with the largest deletions, 10.1 and 9.5 Mb, attained the highest IQ and DQ scores while those with the smallest deletions, 7.9 and 6.6 Mb, made the lowest IQ and DQ scores. No association between deletion breakpoint and phenotype were found. Assessment of the various deleted regions suggested histone deacetylase 4 gene (HDAC4) was a likely candidate gene for ASD in our sample. However, two earlier reports found no association between HDAC4 haploinsufficiency and ASD. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Risperidone for the core symptom domains of autism: results from the study by the autism network of the research units on pediatric psychopharmacology.

PubMed

McDougle, Christopher J; Scahill, Lawrence; Aman, Michael G; McCracken, James T; Tierney, Elaine; Davies, Mark; Arnold, L Eugene; Posey, David J; Martin, Andrès; Ghuman, Jaswinder K; Shah, Bhavik; Chuang, Shirley Z; Swiezy, Naomi B; Gonzalez, Nilda M; Hollway, Jill; Koenig, Kathleen; McGough, James J; Ritz, Louise; Vitiello, Benedetto

2005-06-01

Risperidone has been found efficacious for decreasing severe tantrums, aggression, and self-injurious behavior in children and adolescents with autistic disorder (autism). The authors report on whether risperidone improves the core symptoms of autism, social and communication impairment and repetitive and stereotyped behavior. The database from an 8-week double-blind, placebo-controlled trial (N=101) and 16-week open-label continuation study (N=63) of risperidone for children and adolescents with autism was used to test for drug effects on secondary outcome measures: scores on the Ritvo-Freeman Real Life Rating Scale, the Children's Yale-Brown Obsessive Compulsive Scale, and the maladaptive behavior domain of the Vineland Adaptive Behavior Scales. Compared to placebo, risperidone led to a significantly greater reduction in the overall score on the Ritvo-Freeman Real Life Rating Scale, as well as the scores on the subscales for sensory motor behaviors (subscale I), affectual reactions (subscale III), and sensory responses (subscale IV). No statistically significant difference was observed, however, on the subscale for social relatedness (subscale II) or language (subscale V). Risperidone also resulted in significantly greater reductions in scores on the Children's Yale-Brown Obsessive Compulsive Scale and Vineland maladaptive behavior domain. This pattern of treatment response was maintained for 6 months. Risperidone led to significant improvements in the restricted, repetitive, and stereotyped patterns of behavior, interests, and activities of autistic children but did not significantly change their deficit in social interaction and communication. Further research is necessary to develop effective treatments for the core social and communicative impairments of autism.

Monte Carlo simulation of expert judgments on human errors in chemical analysis--a case study of ICP-MS.

PubMed

Kuselman, Ilya; Pennecchi, Francesca; Epstein, Malka; Fajgelj, Ales; Ellison, Stephen L R

2014-12-01

Monte Carlo simulation of expert judgments on human errors in a chemical analysis was used for determination of distributions of the error quantification scores (scores of likelihood and severity, and scores of effectiveness of a laboratory quality system in prevention of the errors). The simulation was based on modeling of an expert behavior: confident, reasonably doubting and irresolute expert judgments were taken into account by means of different probability mass functions (pmfs). As a case study, 36 scenarios of human errors which may occur in elemental analysis of geological samples by ICP-MS were examined. Characteristics of the score distributions for three pmfs of an expert behavior were compared. Variability of the scores, as standard deviation of the simulated score values from the distribution mean, was used for assessment of the score robustness. A range of the score values, calculated directly from elicited data and simulated by a Monte Carlo method for different pmfs, was also discussed from the robustness point of view. It was shown that robustness of the scores, obtained in the case study, can be assessed as satisfactory for the quality risk management and improvement of a laboratory quality system against human errors. Copyright © 2014 Elsevier B.V. All rights reserved.

Relationships between nutrition-related knowledge, self-efficacy, and behavior for fifth grade students attending Title I and non-Title I schools.

PubMed

Hall, Elisha; Chai, Weiwen; Albrecht, Julie A

2016-01-01

The Social Cognitive Theory (SCT) is a widely used theory for nutrition education programming. Better understanding the relationships between knowledge, self-efficacy, and behavior among children of various income levels can help to form and improve nutrition programs, particularly for socioeconomically disadvantaged youth. The purpose of this study was to determine the relationships between knowledge, self-efficacy, and behavior among fifth grade students attending Title I (≥40% of students receiving free or reduced school meals) and non-Title I schools (<40% of students receiving free or reduced school meals). A validated survey was completed by 55 fifth grade students from Title I and 122 from non-Title I schools. Differences in knowledge, self-efficacy, and behavior scores between groups were assessed using t test and adjusted for variations between participating schools. Regression analysis was used to determine the relationships between knowledge, self-efficacy, and behavior. In adjusted models, the Title I group had significantly lower scores on several knowledge items and summary knowledge (P = 0.04). The Title I group had significantly lower scores on several behavior variables including intakes of fruits (P = 0.02), vegetables (P = 0.0005), whole grains (P = 0.0003), and lean protein (P = 0.047), physical activity (P = 0.002) and summary behavior (P = 0.001). However the Title I group scored higher on self-efficacy for meal planning (P = 0.04) and choosing healthy snacks (P = 0.036). Both self-efficacy (β = 0.70, P < 0.0001) and knowledge (β = 0.35, P = 0.002) strongly predicted behavior; however, only self-efficacy remained significant in the Title I group (self-efficacy, β = 0.82, P = 0.0003; knowledge, β = 0.11, P = 0.59). Results demonstrate disparities in nutrition knowledge and behavior outcomes between students surveyed from Title I and non-Title I schools, suggesting more resources may be necessary for lower income populations. Findings suggest that future nutrition interventions should focus on facilitating the improvement of children's self-efficacy. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effects of Rotigotine on REM Sleep Behavior Disorder in Parkinson Disease.

PubMed

Wang, Yan; Yang, Yuechang; Wu, Huijuan; Lan, Danmei; Chen, Ying; Zhao, Zhongxin

2016-10-15

REM sleep behavior disorder (RBD) is a common manifestation of Parkinson disease (PD). In this study, we assessed the effects of rotigotine transdermal patch on RBD features in patients with PD. In this prospective open-label study, eleven PD patients with untreated RBD were administered rotigotine patches for up to seven months to ameliorate their parkinsonism. The severities of their RBD symptoms before and after rotigotine therapy were evaluated through patient and bed partner interviews, a validated evaluation scale (REM sleep behavior disorder questionnaire-Hong Kong, RBDQ-HK), and blinded assessments based on video-polysomnographic (VPSG) measure. Rotigotine improved parkinsonism and subjective sleep quality in PD patients with RBD. The RBDQ-HK total score, especially the Factor 2 score, was decreased, which demonstrated that the subjective severity of RBD symptoms was improved after rotigotine treatment, especially the frequency and severity of abnormal RBD-related motor behaviors. The VPSG analyses showed that the total sleep time (TST) and stage 1% were increased and that the PLMS index was decreased. However, no differences in the RBD-related sleep measures were observed. The improved RBD symptoms and VPSG measures of PD patients in this study (TST, stage 1%, and PLMS index) suggest that, in PD, rotigotine may partially improve RBD-related symptoms. Rotigotine should be considered to be an optional drug for the treatment of RBD symptoms in PD. © 2016 American Academy of Sleep Medicine

Mobile Phone Sensor Correlates of Depressive Symptom Severity in Daily-Life Behavior: An Exploratory Study.

PubMed

Saeb, Sohrab; Zhang, Mi; Karr, Christopher J; Schueller, Stephen M; Corden, Marya E; Kording, Konrad P; Mohr, David C

2015-07-15

Depression is a common, burdensome, often recurring mental health disorder that frequently goes undetected and untreated. Mobile phones are ubiquitous and have an increasingly large complement of sensors that can potentially be useful in monitoring behavioral patterns that might be indicative of depressive symptoms. The objective of this study was to explore the detection of daily-life behavioral markers using mobile phone global positioning systems (GPS) and usage sensors, and their use in identifying depressive symptom severity. A total of 40 adult participants were recruited from the general community to carry a mobile phone with a sensor data acquisition app (Purple Robot) for 2 weeks. Of these participants, 28 had sufficient sensor data received to conduct analysis. At the beginning of the 2-week period, participants completed a self-reported depression survey (PHQ-9). Behavioral features were developed and extracted from GPS location and phone usage data. A number of features from GPS data were related to depressive symptom severity, including circadian movement (regularity in 24-hour rhythm; r=-.63, P=.005), normalized entropy (mobility between favorite locations; r=-.58, P=.012), and location variance (GPS mobility independent of location; r=-.58, P=.012). Phone usage features, usage duration, and usage frequency were also correlated (r=.54, P=.011, and r=.52, P=.015, respectively). Using the normalized entropy feature and a classifier that distinguished participants with depressive symptoms (PHQ-9 score ≥5) from those without (PHQ-9 score <5), we achieved an accuracy of 86.5%. Furthermore, a regression model that used the same feature to estimate the participants' PHQ-9 scores obtained an average error of 23.5%. Features extracted from mobile phone sensor data, including GPS and phone usage, provided behavioral markers that were strongly related to depressive symptom severity. While these findings must be replicated in a larger study among participants with confirmed clinical symptoms, they suggest that phone sensors offer numerous clinical opportunities, including continuous monitoring of at-risk populations with little patient burden and interventions that can provide just-in-time outreach.

Mobile Phone Sensor Correlates of Depressive Symptom Severity in Daily-Life Behavior: An Exploratory Study

PubMed Central

Saeb, Sohrab; Zhang, Mi; Karr, Christopher J; Schueller, Stephen M; Corden, Marya E; Kording, Konrad P

2015-01-01

Background Depression is a common, burdensome, often recurring mental health disorder that frequently goes undetected and untreated. Mobile phones are ubiquitous and have an increasingly large complement of sensors that can potentially be useful in monitoring behavioral patterns that might be indicative of depressive symptoms. Objective The objective of this study was to explore the detection of daily-life behavioral markers using mobile phone global positioning systems (GPS) and usage sensors, and their use in identifying depressive symptom severity. Methods A total of 40 adult participants were recruited from the general community to carry a mobile phone with a sensor data acquisition app (Purple Robot) for 2 weeks. Of these participants, 28 had sufficient sensor data received to conduct analysis. At the beginning of the 2-week period, participants completed a self-reported depression survey (PHQ-9). Behavioral features were developed and extracted from GPS location and phone usage data. Results A number of features from GPS data were related to depressive symptom severity, including circadian movement (regularity in 24-hour rhythm; r=-.63, P=.005), normalized entropy (mobility between favorite locations; r=-.58, P=.012), and location variance (GPS mobility independent of location; r=-.58, P=.012). Phone usage features, usage duration, and usage frequency were also correlated (r=.54, P=.011, and r=.52, P=.015, respectively). Using the normalized entropy feature and a classifier that distinguished participants with depressive symptoms (PHQ-9 score ≥5) from those without (PHQ-9 score <5), we achieved an accuracy of 86.5%. Furthermore, a regression model that used the same feature to estimate the participants’ PHQ-9 scores obtained an average error of 23.5%. Conclusions Features extracted from mobile phone sensor data, including GPS and phone usage, provided behavioral markers that were strongly related to depressive symptom severity. While these findings must be replicated in a larger study among participants with confirmed clinical symptoms, they suggest that phone sensors offer numerous clinical opportunities, including continuous monitoring of at-risk populations with little patient burden and interventions that can provide just-in-time outreach. PMID:26180009

The severity of attention deficit hyperactivity symptoms and its relationship with lifetime substance use and psychological variables among 10th grade students in Istanbul.

PubMed

Evren, Cuneyt; Dalbudak, Ercan; Evren, Bilge; Can, Yesim; Umut, Gokhan

2014-10-01

The aim of this study was to determine the severity of attention deficit hyperactivity symptoms (ADHS) and related psychological and behavioral variables among 10th grade students in Istanbul/Turkey. Cross-sectional online self-report survey conducted in 45 schools in 15 districts Istanbul. The questionnaire included sections about demographic data and use of substances including tobacco, alcohol and drugs. Also ADHS, depression, anxiety, anger and sensation seeking subscales of Psychological Screening Test for Adolescents (PSTA) were used. The analyses were conducted based on the 4938 subjects. Mean ADHS score was higher in females and among those with a lifetime use of tobacco, alcohol and drug, and having self-harming behavior and suicidal thoughts. ADHS score was correlated with depression, anxiety, anger and sensation seeking scores. In univariate covariance analysis (ANCOVA); depression, anxiety, anger, sensation seeking, lifetime alcohol use and suicidal thoughts predicted the severity of ADHS. The findings suggest that, since ADHS is associated with depression, anxiety, anger, sensation seeking, lifetime alcohol use and suicidal thoughts among 10th grade students, clinicians should screen suicidality and comorbid psychiatric symptoms routinely in adolescents with ADHS. Copyright © 2014 Elsevier Inc. All rights reserved.

Differences in mental health among young adults with borderline personality symptoms of various severities.

PubMed

Lu, Wei-Hsin; Wang, Peng-Wei; Ko, Chih-Hung; Hsiao, Ray C; Liu, Tai-Ling; Yen, Cheng-Fang

2018-04-01

This study examined the differences in mental health and behavioral problems among young adults with borderline personality symptoms of various severities. 500 college students participated in this study. Borderline personality symptoms were evaluated using the Taiwanese version of the Borderline Symptom List (BSL-23). Mental health problems were assessed using the Symptom Checklist-90-Revised Scale. Suicidality and other behavioral problems were assessed using questions from the epidemiological version of the Kiddie Schedule for Affective Disorders and Schizophrenia and BSL-23 Supplement. According to the distribution of BSL-23 scores at the 25th, 50th, and 75th percentiles, the participants were divided into 4 groups: No/Mild, Moderate, Severe, and Profound. Analysis of variance and the chi-square test were used to compare mental health and behavioral problems among the 4 groups. All mental health problems differed significantly among the 4 groups. The severity of nearly all mental health problems increased with that of borderline personality symptoms. The proportions of most behavioral problems differed significantly among the 4 groups. The Profound group was more likely to have behavioral problems than the other 3 groups. Young adults who had more severe borderline personality symptoms had more severe mental health and behavioral problems. Copyright © 2017. Published by Elsevier B.V.

Influence of timing and dose of thyroid hormone replacement on mental, psychomotor, and behavioral development in children with congenital hypothyroidism.

PubMed

Bongers-Schokking, Jacoba J; de Muinck Keizer-Schrama, Sabine M P F

2005-12-01

To evaluate the influence of initial and postinitial treatment factors on cognitive, psychomotor, and psychological outcome in schoolchildren with congenital hypothyroidism (CH). We studied 45 patients (19 with severe CH and 26 with mild CH) and 37 control children by correlating initial and postinitial treatment factors (free thyroxine and thyroid-stimulating hormone [TSH] concentrations, and the percentage of overtreatment and undertreatment periods) with the results of neuropsychological tests and behavior (as reported on the Teacher Report Form [TRF]). The global IQ of the children with CH was comparable to that of the controls; visuomotor and verbal scores were lower, and total TRF scores were higher. Ethnic group, previous development, and overtreatment predicted IQ and verbal scores, with higher scores seen for the overtreated patients than for the control children and those patients who had not been overtreated. As initial treatment was less satisfactory, total TRF scores were higher. Our study suggests that initial and postinitial suboptimal treatment of CH leads to abnormalities in IQ and specific fields. Overtreatment may advance cognitive development in 5-1/2- to 7-year-olds. Suboptimal initial treatment may lead to behavioral problems. We recommend that TSH concentrations be maintained within the normal range in patients with CH.

Bullying Victimization and Perpetration and Their Correlates in Adolescents Clinically Diagnosed With ADHD.

PubMed

Chou, Wen-Jiun; Liu, Tai-Ling; Yang, Pinchen; Yen, Cheng-Fang; Hu, Huei-Fan

2018-01-01

To examine the prevalence rates of bullying involvement and their correlates in adolescents diagnosed with ADHD in Taiwan. Bullying involvement, family and ADHD characteristics, the levels of behavioral inhibition system (BIS) and behavioral approach system (BAS), and psychiatric comorbidity were assessed in 287 adolescents with ADHD. The multiple regression analysis was used to examine the correlate of bullying victimization and perpetration. The prevalence rates of the pure victims, pure perpetrators, and victim-perpetrators were 14.6%, 8.4%, and 5.6%, respectively. Young age, a high BIS score, autism spectrum disorders, and low satisfaction with family relationships were associated with severe bullying victimization. A high score of fun seeking on the BAS and low satisfaction with family relationships were associated with severe bullying perpetration. A high proportion of adolescents with ADHD are involved in bullying. Multiple factors are associated with bullying involvement in adolescents with ADHD.

Evaluation of early childhood social-communication difficulties in children born preterm using the Quantitative Checklist for Autism in Toddlers.

PubMed

Wong, Hilary S; Huertas-Ceballos, Angela; Cowan, Frances M; Modi, Neena

2014-01-01

To characterize early childhood social-communication skills and autistic traits in children born very preterm using the Quantitative Checklist for Autism in Toddlers (Q-CHAT) and explore neonatal and sociodemographic factors associated with Q-CHAT scores. Parents of children born before 30 weeks gestation and enrolled in a study evaluating routinely collected neurodevelopmental data between the post-menstrual ages of 20 and 28 months were invited to complete the Q-CHAT questionnaire. Children with severe neurosensory disabilities and cerebral palsy were excluded. Participants received neurodevelopmental assessments using the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III). Q-CHAT scores of this preterm cohort were compared with published general population scores. The association between Bayley-III cognitive and language scores and neonatal and sociodemographic factors with Q-CHAT scores were examined. Q-CHAT questionnaires were completed from 141 participants. At a mean post-menstrual age of 24 months, the Q-CHAT scores of the preterm cohort (mean 33.7, SD 8.3) were significantly higher than published general population scores (mean 26.7; SD 7.8), indicating greater social-communication difficulty and autistic behavior. Preterm children received higher scores, particularly in the categories of restricted, repetitive, stereotyped behavior, communication, and sensory abnormalities. Lower Bayley-III language scores and non-white ethnicity were associated with higher Q-CHAT scores. Preterm children display greater social-communication difficulty and autistic behavior than the general population in early childhood as assessed by the Q-CHAT. The implications for longer-term outcome will be important to assess. Copyright © 2014 Mosby, Inc. All rights reserved.

Effect of OROS methylphenidate on encopresis in children with attention-deficit/hyperactivity disorder.

PubMed

Yılmaz, Savaş; Bilgiç, Ayhan; Hergüner, Sabri

2014-04-01

Although encopresis shows a high rate of comorbidity in patients with attention-deficit/hyperactivity disorder (ADHD), the etiologic origin of this relationship and the effect of ADHD drugs on encopresis are unclear. In this chart review, we explored the effect of OROS long-acting methylphenidate (MPH) treatment on encopresis in children with ADHD. We also evaluated the relationship between the clinical variables of ADHD and encopresis. The sample consisted of 21 children and adolescents (20 boys and 1 girl) with encopresis and coexisting ADHD 7-15 years of age. Their clinical characteristics and baseline (visit 1) and end of the second months' (visit 2) Conners' Parent Rating Scale (CPRS) subscores were recorded. Retrospective clinician determinations were made using the Clinical Global Impressions-Severity subscale (CGI-S) for encopresis severity and the Clinical Global Impressions-Improvement subscale (CGI-I) for encopresis response. According to the CGI-I, 14 subjects (71.4 %) showed much or very much improvement in their encopresis at the second visit. All of the CPRS scores showed a significant reduction during the second visit. No association was found between the CGI-I score and the changes in any of the CPRS scores. Baseline oppositional defiant disorder (ODD) and conduct disorder (CD) scores were correlated with the CGI-S score; however, no association was found between core ADHD symptom severity and the CGI-S score. With regard to the encopresis outcome, the baseline CD score was negatively correlated with the CGI-I score, and the baseline ODD score was prone to show a negative correlation with the CGI-I score. These results suggest that coexisting behavioral problems may be a vulnerability factor based on the severity of encopresis, and that MPH treatment may have a positive effect on encopresis in children and adolescents with ADHD.

A disease specific questionnaire for assessing behavior in individuals with Prader-Willi syndrome.

PubMed

Avrahamy, Hamutal; Pollak, Yehuda; Shriki-Tal, Liron; Genstil, Larry; Hirsch, Harry J; Gross-Tsur, Varda; Benarroch, Fortu

2015-04-01

Prader-Willi syndrome (PWS) is a genetic multisystem disorder with various medical, cognitive, behavioral and psychiatric problems. PWS is caused by the lack of expression of paternal genes on chromosome 15q2-q13 due to a deletion (70-75%), uniparental disomy (25-30%) or imprinting center defect (<5%). The common PWS behavioral and psychiatric characteristics are very typical in all ethnicities and were reported worldwide. Still, each individual has a specific profile of these common traits and the severity of his or her symptoms varies over time. Behavioral problems are the most important factor affecting the quality of life of both the individuals and their families. There is a need for a standardized tool to assess the specific behavioral profile of each individual and its present severity, in order to enable physicians to tailor the specific treatment needed and assist in a more accurate clinical follow up. To the best of our knowledge no such a tool has been standardized and published. We developed, based on the literature (mainly Forster and Gourash's paradigm) and our clinical experience, a 37 item disease specific questionnaire, the "PWS Behavioral Questionnaire" (PWSBQ) for assessing behavior in PWS patients. The purpose of the present study was to validate this tool in the entire adolescent and adult PWS population in Israel. The PWSBQ focuses on five major domains-abnormal emotional regulation, food-seeking related behavior, lack of flexibility, oppositional behavior and interpersonal problems and lastly body related behaviors. Caregivers of all Hebrew speaking individuals with PWS over the age of 12 years attending the Israeli national multidisciplinary PWS clinic were recruited. Of the 54 eligible individuals, 53 participated. They were interviewed with the PWSBQ and in addition filled the "Hyperphagia Questionnaire" and the "Child Behavioral Checklist" (CBCL). After verifying the questionnaire's content validity, all items on the PWSBQ were analyzed for internal reliability by calculating Cronbach's α. Criterion validity was evaluated by correlation testing with regard to the Hyperphagia Questionnaire and CBCL. In order to assess the questionnaire's interpretability, the correlation between the PWSBQ and the "Clinical Global Impression" (CGI) scores was evaluated. The PWSBQ total score was positively correlated with both the CBCL total score and the CGI score (0.662 and 0.549, p<0.001 respectively). Of the five domains, four had acceptable internal reliability (excluding the body related behaviors domain, which was thus removed from the total score). Criterion validity was established for the four domains remaining in the statistical analysis (abnormal emotional regulation, food seeking related behavior, lack of flexibility and oppositional behavior and interpersonal problems). Our findings suggest that the PWSBQ is a valid and reliable tool for the assessment of current behavioral problems among individuals with PWS. Although further research is needed in order to verify PWSBQ's ability to identify changes in the behavioral status of a given individual, it can now be used both in research and in a clinical setting, enabling the physician to plan the most suitable treatment based on the current behavioral status. Copyright © 2014 Elsevier Inc. All rights reserved.

Physical exercise, vegetable and fruit intake and health-related quality of life in Chinese breast cancer survivors: a cross-sectional study.

PubMed

Gong, Xiao-Huan; Wang, Ji-Wei; Li, Jiang; Chen, Xue-Fen; Sun, Li; Yuan, Zheng-Ping; Yu, Jin-Ming

2017-06-01

Breast cancer has long-term effects on health-related quality of life (HRQOL) of cancer survivors after treatment. Few research studies have focused on the association between health behaviors and HRQOL of Chinese breast cancer survivors (BCS). The aim of this study was to examine the separate and combined influence of physical exercise, vegetable and fruit intake on health-related quality of life of BCS. A cross-sectional study was conducted among BCS from April to July 2013, in Shanghai, China. Data were collected using a self-reported questionnaire, which included questions about basic socio-demographic characteristics, health conditions and treatments, health behaviors and HRQOL. HRQOL was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core30 (EORTC QLQ-C30) simplified Chinese V3.0 version and the Functional Assessment of Cancer Therapy-General (FACT-G) simplified Chinese 4th version. Multiple linear regression models were performed to estimate the effects of physical exercise, vegetable and fruit intake as well as the effects of health behavior patterns on HRQOL adjusting for potential confounding variables. Exercisers reported significantly higher scores in most HRQOL dimensions than non-exercisers. Participants who ate more than 250 g of vegetables reported significantly higher scores in most HRQOL dimensions than participants who ate equal or less than 250 g of vegetables. Participants who ate fruit every day reported significantly higher scores in all HRQOL dimensions than those who did not eat fruit every day (P Adjusted  ≤ 0.032), except symptom subscales. All subscale scores and total scores of HRQOL, except symptom subscales, were positively associated with the number of adopted healthy lifestyle behaviors (P Trend  ≤ 0.003). Compared to participants who adopted only one healthy behavior, participants who adopted two or three healthy behaviors both reported significantly higher HRQOL scores. Physical exercise, enough vegetable and fruit intake are positively associated with HRQOL of BCS. BCS who adopted several healthy behaviors simultaneously had better HRQOL than one healthy behavior alone. Healthy behaviors, including engagement in exercise, proper diet, especially comprehensive lifestyle behavior interventions, should be valued in improving HRQOL of BCS.

Predictors of anxiety in early-stage Parkinson's disease - Results from the first two years of a prospective cohort study.

PubMed

Rutten, Sonja; van der Ven, Peter M; Weintraub, Daniel; Pontone, Gregory M; Leentjens, Albert F G; Berendse, Henk W; van der Werf, Ysbrand D; van den Heuvel, Odile A

2017-10-01

Anxiety has a negative impact on daily functioning and quality of life in patients with Parkinson's disease (PD). This study aims at assessing which sociodemographic and clinical characteristics predict the course of anxiety in early PD. The participants of this two-year prospective cohort study were recently diagnosed PD patients not receiving psychiatric medications or dopamine replacement therapy at baseline. Assessments were performed annually after baseline. The primary outcome measure was anxiety, as measured with the State-Trait Anxiety Inventory (STAI). Covariates were age, gender, family history, striatal dopamine transporter binding ratios, and severity of motor and non-motor features of PD at baseline. Data were analyzed using a mixed model analysis. Inclusion criteria were met by 306 subjects. An increase in STAI total score was predicted by older age, lower score on the Montreal Cognitive Assessment, and the presence of a probable REM-sleep behavior disorder (RBD) at baseline. A decrease in STAI total score over time was predicted by a higher baseline score on the 15-item Geriatric Depression Scale, compulsive behavior at baseline and a family history of PD. More severe baseline anxiety was associated with compulsive behavior and depressive symptoms. These symptoms had a parallel course, showing a decrease over time. An increase in anxiety was predicted by older age, worse cognitive functioning and the presence of RBD. Our findings, when replicated in a sample of PD patients in a more advanced disease stage, could provide starting points for prevention of anxiety in PD patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Music therapy assessment for severely emotionally disturbed children: a pilot study.

PubMed

Layman, Deborah L; Hussey, David L; Laing, Sarah J

2002-01-01

The purpose of this study was to pilot a music therapy assessment instrument for severely emotionally disturbed children. The subjects in this pilot were 20 children, 13 male and 7 female, at a residential treatment center in Cleveland, Ohio. After conducting an extensive literature review, the authors developed a music therapy assessment instrument measuring 4 relevant domains: behavioral/social functioning, emotional responsiveness, language/communication abilities, and music skills. Responses were coded into 3 categories: defensive/withdrawn, target behavior, and disruptive/intrusive. Results demonstrated that subjects displayed significantly more behaviors in the disruptive/intrusive domain. High inter-rater reliability scores of 91.5% for percent agreement and .808 for Cohen's kappa were achieved utilizing this assessment instrument.

Impact of Frontal Lobe Function and Behavioral Changes on Health-Related Quality of Life in Patients with Parkinson's Disease: A Cross-Sectional Study from Southwest China.

PubMed

Guo, Xiaoyan; Song, Wei; Chen, Ke; Chen, Xueping; Zheng, Zhenzhen; Cao, Bei; Huang, Rui; Zhao, Bi; Wu, Ying; Shang, Hui-Fang

2015-01-01

Cognitive impairment may negatively impact the health-related quality of life (HRQoL) in patients with Parkinson's disease (PD). However, information on the effects of frontal lobe function and behavior changes on the HRQoL of the Chinese PD population is limited. Studies on the associations among frontal lobe function, behavioral changes and the HRQoL may help optimize the treatment and improve the HRQoL of PD patients. A total of 309 PD patients were evaluated using the Frontal Assessment Battery, the Frontal Behavioral Inventory (FBI) and the PD Questionnaire 39-item version (PDQ-39). Patients with worse frontal lobe function were older (p < 0.001), had longer disease durations (p = 0.002), higher Unified Parkinson's Disease Rating Scale part III (UPDRS-III) scores (p < 0.001) and higher Hoehn and Yahr (H-Y) stages (p = 0.001), and exhibited significantly higher PDQ-39 summary index (SI; p = 0.001) compared with those who had better frontal lobe function. In addition, the disease duration (p = 0.008), UPDRS-III scores (p < 0.001), H-Y stage (p < 0.001), PDQ-39 SI and scores for each domain of the PDQ-39 (p < 0.001) were higher as the severity of frontal behavioral changes increased. The total FBI score (p < 0.001) was positively correlated with the PDQ-39 SI. Frontal behavioral changes were closely associated with poor HRQoL in Chinese PD patients. © 2015 S. Karger AG, Basel.

Feasibility and effectiveness of narrative exposure therapy and cognitive behavioral therapy in a context of ongoing violence in South Africa.

PubMed

Hinsberger, Martina; Holtzhausen, Leon; Sommer, Jessica; Kaminer, Debra; Elbert, Thomas; Seedat, Soraya; Wilker, Sarah; Crombach, Anselm; Weierstall, Roland

2017-05-01

In an observer-blinded intervention trial, we tested the reduction of posttraumatic stress symptoms, aggressive attitude, and behavior in young males living in a context of ongoing community and gang violence by means of (a) forensic offender rehabilitation narrative exposure therapy (FORNET), and (b) the cognitive-behavioral intervention "Thinking for a Change" (TFAC). A waiting list served as the control condition. A total of 39 young men were included in the data analysis: 15 completed FORNET, 11 underwent cognitive-behavioral therapy (CBT), and 13 were on a waiting list for later treatment. The primary efficacy endpoints were the PTSD Symptom Scale-Interview (PSS-I) severity score, the Appetitive Aggression Scale (AAS) score, and the number of perpetrated violent event types 8 months (on average) after treatment. Only in the sample receiving FORNET were posttraumatic stress disorder (PTSD) scores significantly reduced at the first follow-up (Cohen's d = -0.97) and significantly different from those of the control group (Cohen's d = -1.03). The changes in scores for appetitive aggression and perpetrated events were not significant for any of the treatment conditions. The study shows that trauma-focused treatment can reduce the psychological symptoms of posttraumatic stress even for individuals living under unsafe conditions in low-income urban communities. However, achieving changes in violent behavior within a context of ongoing violence may require more than the treatment of trauma-related suffering, confrontation with one's offenses, or cognitive-behavioral interventions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Functional assessment in vocational rehabilitation: a systematic approach to diagnosis and goal setting.

PubMed

Crewe, N M; Athelstan, G T

1981-07-01

The Functional Assessment Inventory (FAI) has been developed for diagnostic use in vocational rehabilitation. This study involved field testing and initial validation of the Inventory as a diagnostic tool. Thirty vocational rehabilitation counselors administered the Inventory to 351 clients. Factor analysis identified 8 scales: Cognitive Function, Motor Function, Personality and Behavior. Vocational Qualifications, Medical Condition, Vision, Hearing, and Economic Disincentives. Content and concurrent validity of the Inventory were assessed by comparing the scores of clients grounded by medical diagnosis and by relating scores to counselors' judgments of severity of disability and employability. Clients with various primary disabilities appeared to differ from one another on the factor scales and on individual items in predictable ways. Total Functional Limitations scores were highly correlated with counselors' ratings of severity of disability and employability.

Psychometric properties of the Italian version of the Cognitive Reserve Scale (I-CRS).

PubMed

Altieri, Manuela; Siciliano, Mattia; Pappacena, Simona; Roldán-Tapia, María Dolores; Trojano, Luigi; Santangelo, Gabriella

2018-05-04

The original definition of cognitive reserve (CR) refers to the individual differences in cognitive performance after a brain damage or pathology. Several proxies were proposed to evaluate CR (education, occupational attainment, premorbid IQ, leisure activities). Recently, some scales were developed to measure CR taking into account several cognitively stimulating activities. The aim of this study is to adapt the Cognitive Reserve Scale (I-CRS) for the Italian population and to explore its psychometric properties. I-CRS was administered to 547 healthy participants, ranging from 18 to 89 years old, along with neuropsychological and behavioral scales to evaluate cognitive functioning, depressive symptoms, and apathy. Cronbach's α, corrected item-total correlations, and the inter-item correlation matrix were calculated to evaluate the psychometric properties of the scale. Linear regression analysis was performed to build a correction grid of the I-CRS according to demographic variables. Correlational analyses were performed to explore the relationships between I-CRS and neuropsychological and behavioral scales. We found that age, sex, and education influenced the I-CRS score. Young adults and adults obtained higher I-CRS scores than elderly adults; women and participants with high educational attainment scored higher on I-CRS than men and participants with low education. I-CRS score correlated poorly with cognitive and depression scale scores, but moderately with apathy scale scores. I-CRS showed good psychometric properties and seemed to be a useful tool to assess CR in every adult life stage. Moreover, our findings suggest that apathy rather than depressive symptoms may interfere with the building of CR across the lifespan.

Description of Adults Seeking Hearing Help for the First Time According to Two Health Behavior Change Approaches: Transtheoretical Model (Stages of Change) and Health Belief Model.

PubMed

Saunders, Gabrielle H; Frederick, Melissa T; Silverman, ShienPei C; Nielsen, Claus; Laplante-Lévesque, Ariane

2016-01-01

Several models of health behavior change are commonly used in health psychology. This study applied the constructs delineated by two models-the transtheoretical model (in which readiness for health behavior change can be described with the stages of precontemplation, contemplation and action) and the health belief model (in which susceptibility, severity, benefits, barriers, self-efficacy, and cues to action are thought to determine likelihood of health behavior change)-to adults seeking hearing help for the first time. One hundred eighty-two participants (mean age: 69.5 years) were recruited following an initial hearing assessment by an audiologist. Participants' mean four-frequency pure-tone average was 35.4 dB HL, with 25.8% having no hearing impairment, 50.5% having a slight impairment, and 23.1% having a moderate or severe impairment using the World Health Organization definition of hearing loss. Participants' hearing-related attitudes and beliefs toward hearing health behaviors were examined using the University of Rhode Island Change Assessment (URICA) and the health beliefs questionnaire (HBQ), which assess the constructs of the transtheoretical model and the health belief model, respectively. Participants also provided demographic information, and completed the hearing handicap inventory (HHI) to assess participation restrictions, and the psychosocial impact of hearing loss (PIHL) to assess the extent to which hearing impacts competence, self-esteem, and adaptability. Degree of hearing impairment was associated with participation restrictions, perceived competence, self-esteem and adaptability, and attitudes and beliefs measured by the URICA and the HBQ. As degree of impairment increased, participation restrictions measured by the HHI, and impacts of hearing loss, as measured by the PIHL, increased. The majority of first-time help seekers in this study were in the action stage of change. Furthermore, relative to individuals with less hearing impairment, individuals with more hearing impairment were at more advanced stages of change as measured by the URICA (i.e., higher contemplation and action scores relative to their precontemplation score), and they perceived fewer barriers and more susceptibility, severity, benefits and cues to action as measured by the HBQ. Multiple regression analyses showed participation restrictions (HHI scores) to be a highly significant predictor of stages of change explaining 30% to 37% of the variance, as were duration of hearing difficulty, and perceived benefits, severity, self-efficacy and cues to action assessed by the HBQ. The main predictors of stages of change in first-time help seekers were reported participation restrictions and duration of hearing difficulty, with constructs from the health belief model also explaining some of the variance in stages of change scores. The transtheoretical model and the health belief model are valuable for understanding hearing health behaviors and can be applied when developing interventions to promote help seeking.

Academic Achievement and Physical Activity: A Meta-analysis.

PubMed

Álvarez-Bueno, Celia; Pesce, Caterina; Cavero-Redondo, Iván; Sánchez-López, Mairena; Garrido-Miguel, Miriam; Martínez-Vizcaíno, Vicente

2017-12-01

The effect of physical activity (PA) on different areas of academic achievement and classroom behaviors and how different characteristics of PA interventions could modify the effect remain unclear. The objective was twofold: (1) to assess the effect of PA interventions on academic achievement and classroom behaviors in childhood and (2) to determine the characteristics of individuals and PA programs that enhance academic performance. We identified studies from the database inception to October 16, 2016. We selected intervention studies aimed at examining the effect of exercise on academic achievement and classroom behaviors at developmental age. Random-effects models were used to calculate pooled effect size for all primary outcomes (language- and mathematics-related skills, reading, composite score, and time in on-task behavior). Positive values represent a direct relationship between PA programs and academic achievement scores or on-task behaviors. A total of 26 studies (10 205 children, aged from 4 to 13) were included. Pooled effect size (95% confidence interval) estimates were as follows: (1) 0.16 (-0.06 to 0.37) for language-related skills; (2) 0.21 (0.09 to 0.33) for mathematics-related skills; (3) 0.13 (0.02 to 0.24) for reading; (4) 0.26 (0.07 to 0.45) for composite scores; and (5) 0.77 (0.22 to 1.32) for time in on-task behaviors. Limitations included the variety of tools used to measure academic achievement and the limited number of studies that reported the effect of after-school PA interventions. PA, especially physical education, improves classroom behaviors and benefits several aspects of academic achievement, especially mathematics-related skills, reading, and composite scores in youth. Copyright © 2017 by the American Academy of Pediatrics.

Elucidating X chromosome influences on Attention Deficit Hyperactivity Disorder and executive function.

PubMed

Green, Tamar; Bade Shrestha, Sharon; Chromik, Lindsay C; Rutledge, Keetan; Pennington, Bruce F; Hong, David S; Reiss, Allan L

2015-09-01

To identify distinct behavioral and cognitive profiles associated with ADHD in Turner syndrome (TS), relative to idiopathic ADHD and neurotypical controls, in order to elucidate X-linked influences contributing to ADHD. We used a multilevel-model approach to compare 49 girls with TS to 37 neurotypical females, aged 5-12, on established measures of behavior (BASC-2) and neurocognitive function (NEPSY). We further compared girls with TS to BASC-2 and NEPSY age-matched reference data obtained from children with idiopathic ADHD. Within the TS group, 51% scored at or above the "at-risk" range for ADHD-associated behaviors on the BASC-2 (TS/+ADHD). The BASC-2 behavioral profile in this TS/+ADHD-subgroup was comparable to a reference group of boys with ADHD with respect to attentional problems and hyperactivity. However, the TS/+ADHD-subgroup had significantly higher hyperactivity scores relative to a reference sample of girls with ADHD (p = 0.016). The behavioral profile in TS was associated with significantly lower attention and executive function scores on the NEPSY relative to neurotypical controls (p = 0.015); but was comparable to scores from a reference sample of children with idiopathic ADHD. Deficits in attention and executive function were not observed in girls with TS having low levels of ADHD-associated behavior (TS/-ADHD). ADHD-associated behavioral and cognitive problems in TS are prevalent and comparable in severity to those found in children with idiopathic ADHD. The ADHD phenotype in TS also appears relatively independent of cognitive features typically associated with TS, like visuospatial weaknesses. These findings suggest that X-linked haploinsufficiency and downstream biological effects contribute to increased risk for ADHD. Copyright © 2015 Elsevier Ltd. All rights reserved.

[The link between aggressive behavior and depression in adolescence. A cross-sectional study conducted in the psychiatric emergency unit at the Sainte-Anne hospital].

PubMed

Benarous, X; Guedj, M J; Braitman, A; Gallois, E; Lana, P

2014-12-01

The link between depression and aggressive behavior in adults has been found in many studies. In adolescents, this relationship is still controversial. Several studies point out that irritability is a key symptom in adolescent depressed. Few studies have analyzed precisely the kind of aggressive behavior. This study sets out to assess the relationship between aggressive behavior and depressive affects in adolescents. We also pay attention in this population to hopelessness feelings, anxiety, global functioning and the type of aggressive behavior. This is a descriptive and observational cross-sectional study. Data was collected from 49 successive adolescents admitted for a 24-hour evaluation in the emergency department of the Sainte-Anne psychiatric hospital. The inclusion period was from February to April 2012, with age limits between 15 and 18. For each patient, the clinician completed with the parents or other caregivers the Modified Overt Aggressive Scale (MOAS) searching for existence of aggressive behavior in the week prior to the consultation. The population was divided into two groups: P- group when the MOAS score was < 3 and the P+ group when the MOAS score was ≥ 3. The Global Assessment of Functioning Scale and Adolescent Depression Rating Scale for clinicians (ADRSc) were also completed. Each patient completed the self-report Buss-Perry Aggression Questionnaire (QA), the Beck Hopelessness scale and the Adolescent Depression Rating Scale for patients (ADRSp). Forty-nine adolescents with a median age of 16 years and 4 months participated. The first reason for consultation was depressive symptoms, followed by disruptive behavior. The analysis was conducted on 39 questionnaires. The demographic profile of the two groups was similar. We did not find any significant difference between the groups P+ and P- on ADRSc scores and secondary criteria. However, we found higher scores in the QA in the more depressed patient, especially a higher hostility score in this sample. In the subgroup analysis: as expected self-aggressive behavior was associated with a higher depression score, more hospitalization and a poor global functioning score. Surprisingly, the patients who showed physical aggression against others had a better prognosis and lower depression scores. The study did not conclude on the link between aggressive behavior and depression in this population. The adolescent hostility appears more characteristic of depression compared to other dimensions of aggressivity (anger, verbal aggression, physical aggression) in adolescents. Physical aggression against others appeared not only less typical in depression but was also associated with a better global functioning. Clinicians should pay particular attention to the kind of aggressive behavior in clinical evaluations of adolescents in an emergency context. Copyright © 2014 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Effects of Rotigotine on REM Sleep Behavior Disorder in Parkinson Disease

PubMed Central

Wang, Yan; Yang, Yuechang; Wu, Huijuan; Lan, Danmei; Chen, Ying; Zhao, Zhongxin

2016-01-01

Study Objectives: REM sleep behavior disorder (RBD) is a common manifestation of Parkinson disease (PD). In this study, we assessed the effects of rotigotine transdermal patch on RBD features in patients with PD. Methods: In this prospective open-label study, eleven PD patients with untreated RBD were administered rotigotine patches for up to seven months to ameliorate their parkinsonism. The severities of their RBD symptoms before and after rotigotine therapy were evaluated through patient and bed partner interviews, a validated evaluation scale (REM sleep behavior disorder questionnaire-Hong Kong, RBDQ-HK), and blinded assessments based on video-polysomnographic (VPSG) measure. Results: Rotigotine improved parkinsonism and subjective sleep quality in PD patients with RBD. The RBDQ-HK total score, especially the Factor 2 score, was decreased, which demonstrated that the subjective severity of RBD symptoms was improved after rotigotine treatment, especially the frequency and severity of abnormal RBD-related motor behaviors. The VPSG analyses showed that the total sleep time (TST) and stage 1% were increased and that the PLMS index was decreased. However, no differences in the RBD-related sleep measures were observed. Conclusions: The improved RBD symptoms and VPSG measures of PD patients in this study (TST, stage 1%, and PLMS index) suggest that, in PD, rotigotine may partially improve RBD-related symptoms. Rotigotine should be considered to be an optional drug for the treatment of RBD symptoms in PD. Citation: Wang Y, Yang Y, Wu H, Lan D, Chen Y, Zhao Z. Effects of rotigotine on REM sleep behavior disorder in Parkinson disease. J Clin Sleep Med 2016;12(10):1403–1409. PMID:27568909

A Mixed Methods Examination of Sleep Throughout the Alcohol Recovery Process Grounded in the Social Cognitive Theory: The Role of Self-Efficacy and Craving.

PubMed

Brooks, Alyssa T; Krumlauf, Michael; Beck, Kenneth H; Fryer, Craig S; Yang, Li; Ramchandani, Vijay A; Wallen, Gwenyth R

2018-03-01

Sleep disturbances can accompany alcohol use disorders during various phases of the disease. This analysis utilized a mixed methods approach to assess whether sleep-related beliefs and/or behavior of individuals who are alcohol dependent were associated with sleep quality both pre- and postdischarge from a clinical research facility providing inpatient alcohol rehabilitation treatment. Individuals with higher self-efficacy for sleep (SE-S) reported better sleep quality at both time points. Individuals with fewer dysfunctional beliefs about sleep had poorer sleep quality at both time points. Individuals with higher unhealthy sleep-related safety behaviors had poorer sleep quality at both time points. In a linear regression model, only the difference in SE-S scores from pre- to postdischarge (β = -.396, p = .01) and the postdischarge Penn Alcohol Craving Score (β = .283, p = .019) significantly predicted the change in sleep quality. Thus, those whose SE-S scores increased and those with lower postdischarge craving scores were more likely to experience a decrease on Pittsburgh Sleep Quality Index scores from pre- to postdischarge even after controlling for covariates. References to behavior or personal factors were often discussed during the qualitative interviews in tandem with the environment. Participants reported both (1) self-medicating anxiety with alcohol and (2) self-medicating the inability to fall asleep with alcohol. Given the success of behavioral sleep interventions in various populations and the unique potential contributions of mixed methods approaches to examine sleep and alcohol use, assessing sleep-related cognitions and behaviors of individuals with severe alcohol use disorders may be important in understanding sleep quality and subsequent relapse.

Cognitive reserve as a moderator of responsiveness to an online problem-solving intervention for adolescents with complicated mild to severe traumatic brain injury

PubMed Central

Karver, Christine L.; Wade, Shari L.; Cassedy, Amy; Taylor, H. Gerry; Brown, Tanya M.; Kirkwood, Michael W.; Stancin, Terry

2013-01-01

Children and adolescents with traumatic brain injury (TBI) often experience behavior difficulties that may arise from problem-solving deficits and impaired self-regulation. However, little is known about the relationship of neurocognitive ability to post-TBI behavioral recovery. To address this question, we examined whether verbal intelligence, as estimated by Vocabulary scores from the Wechsler Abbreviated Scale of Intelligence, predicted improvements in behavior and executive functioning following a problem-solving intervention for adolescents with TBI. 132 adolescents with complicated mild to serve TBI were randomly assigned to a 6 month web-based problem-solving intervention (CAPS; n = 65) or to an internet resource comparison (IRC; n = 67) group. Vocabulary moderated the association between treatment group and improvements in meta-cognitive abilities. Examination of the mean estimates indicated that for those with lower Vocabulary scores, pre-intervention Metacognition Index scores from the Behavior Rating Inventory of Executive Function (BRIEF) did not differ between the groups, but post-intervention scores were significantly lower (more improved) for those in the CAPS group. These findings suggest that low verbal intelligence was associated with greater improvements in executive functioning following the CAPS intervention and that verbal intelligence may have an important role in response to intervention for TBI. Understanding predictors of responsiveness to interventions allows clinicians to tailor treatments to individuals, thus improving efficacy. PMID:23710617

Dementia in the movies: the clinical picture.

PubMed

Gerritsen, Debby L; Kuin, Yolande; Nijboer, Jessika

2014-01-01

Visual media influence the general public's perceptions and attitudes regarding people with mental conditions. This qualitative study investigates the depiction accuracy of dementia's clinical features in motion pictures. Using the search terms 'dementia', 'Alzheimer's disease' and 'senility' movies with release dates between January 2000 and March 2012 were sought on the Internet Movie Database. Based on four selection criteria 23 movies were included. Independently, three researchers watched all movies, scored symptoms, capacities, and behaviors. Scores were discussed and refined during consensus meetings, resulting in a taxonomy of clinical features. Various features are found, most often cognitive symptoms. Behavioral features are also shown - retiring behavior more than agitation - and various emotions, but physical symptoms are rarely depicted. Capacities are infrequently presented and are unrealistic in several of the movies. The clinical picture of dementia portrayed in fictional movies is mild and may be misleading.

Characteristics of stereotypic movement disorder and self-injurious behavior assessed with the Diagnostic Assessment for the Severely Handicapped (DASH-II).

PubMed

Matson, J L; Hamilton, M; Duncan, D; Bamburg, J; Smiroldo, B; Anderson, S; Baglio, C

1997-01-01

The first experiment involved 143 individuals with severe and profound mental retardation. Individuals with Stereotypic Movement Disorder, Self-Injurious Behavior (SIB), and Stereotypic movement disorder with self-injurious behavior as assessed by the Diagnostic Assessment for the Severely Handicapped-II DASH-II were validated against Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV; American Psychiatric Association, 1994) criteria. In a second study DASH-II scores for 1480 individuals with severe and profound mental retardation were compared on demographic variables, core and associated features of each disorder. Characteristics of persons in each group were reviewed. Persons with profound mental retardation were more likely to evince stereotypies or self-injury compared to their severely impaired counterparts. Also, those with stereotypies were more likely to present with Pervasive Developmental Disorder (PDD)/autism, organicity, and eating disorders, while persons with SIB were more likely to evince sleep, sexual, and eating disorders.

Minnesota multiphasic personality inventory-2 restructured form (MMPI-2-RF) scale score differences in bariatric surgery candidates diagnosed with binge eating disorder versus BMI-matched controls.

PubMed

Marek, Ryan J; Ben-Porath, Yossef S; Ashton, Kathleen; Heinberg, Leslie J

2014-04-01

Binge Eating Disorder (BED) is among the most common psychiatric disorders in bariatric surgery candidates. The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) is a broadband, psychological test that includes measures of emotional and behavioral dysfunction, which have been associated with BED behaviors in bariatric surgery candidates; however these studies have lacked appropriate controls. In the current study, we compared MMPI-2-RF scale scores of bariatric surgery patients diagnosed with BED (BED+) with BMI-matched controls without BED (BED-). Three-hundred and seven BED+ participants (72.64% female and 67.87% Caucasian; mean BMI of 51.36 kg/m(2) [SD = 11.94]) were drawn from a large, database (N = 1304). Three-hundred and seven BED- participants were matched on BMI and demographics (72.64% female, 68.63% Caucasian, and mean BMI of 51.30 kg/m(2) [SD = 11.70]). The BED+ group scored significantly higher on measures of Demoralization, Low Positive Emotions, and Dysfunctional Negative Emotions and scored lower on measures of Antisocial Behaviors, reflecting behavioral constraint. Optimal T-Score cutoffs were below the traditional 65 T score for several MMPI-2-RF scales. MMPI-2-RF externalizing measures also added incrementally to differentiating between the groups beyond the Binge Eating Scale (BES). BED+ individuals produced greater elevations on a number of MMPI-2-RF internalizing scales and externalizing scales. Use of the test in conjunction with a clinical interview and other self-report data can further aid the clinician in guiding patients to appropriate treatment to optimize outcome. Copyright © 2013 Wiley Periodicals, Inc.

Treating laryngopharyngeal reflux: Evaluation of an anti-reflux program with comparison to medications.

PubMed

Yang, Jin; Dehom, Salem; Sanders, Stephanie; Murry, Thomas; Krishna, Priya; Crawley, Brianna K

To determine if an anti-reflux induction program relieves laryngopharyngeal reflux (LPR) symptoms more effectively than medication and behavioral changes alone. Retrospective study. Tertiary care academic center. A database was populated with patients treated for LPR. Patients were included in the study group if they completed a two-week anti-reflux program (diet, alkaline water, medications, behavioral modifications). Patients were included in the control group if they completed anti-reflux medications and behavioral modifications only. Patients completed the voice handicap index (VHI), reflux symptom index (RSI), cough severity index (CSI), dyspnea index (DI) and eating assessment tool (EAT-10) surveys and underwent laryngoscopy for examination and reflux finding score (RFS) quantification. Of 105 study group patients, 96 (91%) reported subjective improvement in their LPR symptoms after an average 32-day first follow-up and their RSI and CSI scores improved significantly. No significant differences were found in VHI, DI, or EAT-10 scores. Fifteen study patients who had previously failed adequate high-dose medication trials reported improvement and their CSI and EAT-10 scores improved significantly. Ninety-five percent of patients with a chief complaint of cough reported improvement and their CSI scores improved significantly from 12.3 to 8.2. Among 81 controls, only 39 (48%) patients reported improvement after an average 62-day first follow-up. Their RSI scores did not significantly change. The anti-reflux program yielded rapid and substantial results for a large cohort of patients with LPR. It compared favorably with medication and behavioral modification alone. It was effective in improving cough and treating patients who had previously failed medications alone. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects on agitation with rivastigmine patch monotherapy and combination therapy with memantine in mild to moderate Alzheimer's disease: a multicenter 24-week prospective randomized open-label study (the Korean EXelon Patch and combination with mEmantine Comparative Trial study).

PubMed

Yoon, Soo J; Choi, Seong H; Na, Hae R; Park, Kyung-Won; Kim, Eun-Joo; Han, Hyun J; Lee, Jae-Hong; Shim, Young S; Na, Duk L

2017-03-01

Memantine is known to be effective in the treatment of the behavioral symptoms of dementia, especially agitation in moderate to severe Alzheimer's disease (AD). However, memantine and rivastigmine patch combination therapy has not been well studied in determining treatment effectiveness with mild to moderate AD patients. This was a multicenter, 24-week, prospective, randomized, open-label study design. A total 147 AD patients with Mini-Mental State Examination scores from 10 to 20 were randomly assigned to rivastigmine patch monotherapy and combination therapy with memantine groups. Agitation symptoms, using the Korean Version of the Cohen Mansfield Agitation Inventory were evaluated at baseline and at study end. Suppression and emergence of agitation symptoms were also evaluated. We carried out factor analyses to evaluate the interrelationship of agitation symptoms and to investigate treatment response in these symptoms. Factor analyses showed two symptom clusters: factor A - aggressive agitated behaviors - versus factor B - non-aggressive agitated behaviors. The rivastigmine patch monotherapy group showed significantly decreased factor B scores and had a tendency of decreased Korean Version of the Cohen Mansfield Agitation Inventory total scores and factor A scores. Conversely, the combination therapy group showed significantly increased Korean Version of the Cohen Mansfield Agitation Inventory total scores and factor B scores. Neither monotherapy nor combination therapy reduced the emergence of new agitation symptoms. In this trial of mild to moderate AD patients, the rivastigmine patch monotherapy group experienced a reduction of non-aggressive agitated behaviors. However, combination therapy with memantine did not show any benefit on the agitation associated with mild to moderate AD. Geriatr Gerontol Int 2017; 17: 494-499. © 2016 Japan Geriatrics Society.

A Conditional Cash Transfer Program in the Philippines Reduces Severe Stunting.

PubMed

Kandpal, Eeshani; Alderman, Harold; Friedman, Jed; Filmer, Deon; Onishi, Junko; Avalos, Jorge

2016-09-01

Pantawid, a conditional cash transfer (CCT) program in the Philippines, provided grants conditioned on health-related behaviors for children aged 0-5 y and schooling for those aged 10-14 y. We investigated whether Pantawid improved anthropometric measurements in children aged 6-36 mo. We estimated cross-sectional intention-to-treat effects using a 2011 cluster-randomized trial across 130 villages-65 treated and 65 control-with data collected after 31 mo of implementation. Anthropometry characteristics were measured for 241 children in treated areas and 244 children in control areas. Health service use for children aged 6-36 mo and dietary intake for those aged 6-60 mo also were measured. Outcome variables were height-for-age z scores (HAZs) and weight-for-age z scores (WAZs), stunting, severe stunting, underweight, and severely underweight. Impact also was assessed on perinatal care, institutional delivery, presence of skilled birth attendant, breastfeeding practices, immunization, growth monitoring and deworming, care-seeking, and children's intake of protein-rich foods. Pantawid was associated with a significant reduction in severe stunting [<-3 SD from WHO standards for healthy children; β = -10.2 percentage points (95% CI -18.8, -1.6 percentage points); P = 0.020] as well as a marginally significant increase in HAZs [β = 0.284 SDs (95% CI -0.033, 0.602 SDs); P = 0.08]. WAZs, stunting, underweight, and severely underweight status did not change. Concomitantly, several measures of health-seeking behavior increased significantly. To our knowledge, Pantawid is one of few CCT programs worldwide that significantly reduced severe stunting in children aged 6-36 mo; changes in key parenting practices, including children's intake of protein-rich foods and care-seeking behavior, were concurrent. © 2016 American Society for Nutrition.

Characteristics of Executive Functioning in a Small Sample of Children With Tourette Syndrome.

PubMed

Schwam, Dina M; King, Tricia Z; Greenberg, Daphne

2015-01-01

Tourette syndrome (TS) is a disorder that involves at least one vocal tic and two or more motor tics; however, associated symptoms of obsessive-compulsive disorder (OCD) and attention-deficit disorder or attention-deficit hyperactivity disorder (ADHD) are common. Many children with TS exhibit educational difficulties and one possible explanation may be deficits in executive functioning. The focus of this study was to look at the severity of symptoms often associated with TS (tics and OCD and ADHD symptoms) and its potential relationship with the Behavior Rating Inventory of Executive Function (BRIEF) Parent Form in 11 children diagnosed with TS aged 8 to 14 years old. The parent of the child completed the BRIEF along with symptom measures evaluating tics, OCD behaviors, and ADHD symptoms. Despite relatively low mean scores on the symptom measures and just a few children exhibiting clinically significant scores on the BRIEF indexes, at least half the children exhibited abnormal scores on the Working Memory, Inhibit, and Shift subscales of the BRIEF. Varying patterns of relationships were found on the BRIEF subscales for each symptom severity scale. Results suggest that the BRIEF may be useful in determining the specific areas of difficulty in a population with variable symptomatology.

[The Relationship between Violence and Clinical Features, Insight and Cognitive Functions in Patients with Schizophrenia].

PubMed

Köşger, Ferdi; Eşsizoğlu, Altan; Sönmez, İpek; Güleç, Gülcan; Genek, Müge; Akarsu, Özlem

2016-01-01

We aimed to investigate the predictive factors of violent behavior in schizophrenia and the relationship between violent behavior and insight and cognitive functions in this study. 68 patients diagnosed with schizophrenia were separated into two groups; with a history of violent behavior (n = 30) and without (n = 38). Both group swere administered the Positiveand Negative Syndrome Scale (PANSS), Buss-Perry Aggression Questionnaire, Schedule for Assessing the Three Components of Insight, California Verbal Learning Test (CVLT), Trail Making Test, Wisconsin Card Sorting Test, and Stroop Test. Male gender, the number of hospitalizations, incompliance with the treatment, alcohol and substance abuse, the number of suicide attempts, the mean score of PANSS positive symptoms, PANSS general symptoms and PANSS total were significantly higher in patients with schizophrenia with a history of violent behavior, compared to non-violent group. Long delayed response subsection of CVLT mean score was lower in patients with violent behavior. Incompliance with the treatment (OR:5.927, p=0.041), alcohol and substance abuse (OR:21.089, p=0.000), and PANSS total score (OR:1.053, p=0.011)were identified as predictive factors of violent behavior in patients with schizophrenia. Lack of insight and executive function impairment are the core symptoms of schizophrenia and not seems to be associated with violent behavior in patients with schizophrenia. Impairment of memory may be associated with violent behavior in patients with schizophrenia. Incompliance with treatment, alcohol and substance abuse, and the severity of positive symptoms are important factors in predicting violence behavior in patients with schizophrenia.

The relationship between safety climate and recent accidents: behavioral learning and cognitive attributions.

PubMed

Desai, Vinit M; Roberts, Karlene H; Ciavarelli, Anthony P

2006-01-01

The association between accidents and subsequent work unit safety perceptions was assessed to address cognitive and behavioral changes following accidents. Many studies attempt to predict accident rates using measures of work unit safety, but effects vary considerably. Conversely, this study examined whether recent accidents may be positively associated with work unit safety perceptions, as suggested by behavioral learning mechanisms (increases in safety investments following accidents) or cognitive mechanisms (defensive attributions regarding accident causality). Lagged squadron-level accident experience was correlated with work unit safety perceptions obtained through a 61-question safety climate survey administered to 6,361 individuals in U.S. Navy flight squadrons. Positive associations between minor or intermediately severe accidents and future safety climate scores were found, although no effect was found for major accidents. We suggest that accident history should be considered when examining work unit safety perceptions because recent accidents may be associated with higher safety climate scores. We did not find that this varies systematically with accident severity, and longitudinal research on additional samples is needed to further test this possibility. This research may be used to refine measurement of work unit safety and to examine impacts of accidents or safety violations on workers' cognitive processes and group behavioral changes.

A description of disordered eating behaviors in Latino males

PubMed Central

Reyes-Rodríguez, Mae Lynn; Sala, Margarita; Von Holle, Ann; Unikel, Claudia; Bulik, Cynthia M.; Cámara-Fuentes, Luis; Suárez-Torres, Alba

2011-01-01

Objective To explore disordered eating and eating disorders (ED) in Latino males. Participants 722 male college students from a larger prevalence study conducted in the University of Puerto Rico (UPR) system. Method Participants were selected from a list of sections of required courses for first-year students on each campus. Self report instruments were used to explore ED symptoms (EAT-26 & BULIT-26) and depression (BDI). Results Overall, 2.26% scored above the cut-off point on the BULIT-R and 5.08% score above the cut-off point on the EAT-26. Of the males, 4.43% reported sufficient frequency and severity to approximate DSM-IV criteria for BN. Depression symptomatology was found in those who scored above the cut-off point on both instruments of ED. Conclusion College health practitioners should be aware of disordered eating in Latino males and include them in efforts to detect disordered eating behaviors in college students. PMID:21308586

Mediators and treatment matching in behavior therapy, cognitive therapy and cognitive behavior therapy for chronic insomnia.

PubMed

Harvey, Allison G; Dong, Lu; Bélanger, Lynda; Morin, Charles M

2017-10-01

To examine the mediators and the potential of treatment matching to improve outcome for cognitive behavior therapy (CBT) for insomnia. Participants were 188 adults (117 women; Mage = 47.4 years, SD = 12.6) meeting the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; text rev.; DSM-IV-TR; American Psychiatric Association [APA], 2000) diagnostic criteria for chronic insomnia (Mduration: 14.5 years, SD: 12.8). Participants were randomized to behavior therapy (BT; n = 63), cognitive therapy (CT; n = 65), or CBT (n = 60). The outcome measure was the Insomnia Severity Index (ISI). Hypothesized BT mediators were sleep-incompatible behaviors, bedtime variability (BTv), risetime variability (RTv) and time in bed (TIB). Hypothesized CT mediators were worry, unhelpful beliefs, and monitoring for sleep-related threat. The behavioral processes mediated outcome for BT but not CT. The cognitive processes mediated outcome in both BT and CT. The subgroup scoring high on both behavioral and cognitive processes had a marginally significant better outcome if they received CBT relative to BT or CT. The subgroup scoring relatively high on behavioral but low on cognitive processes and received BT or CBT did not differ from those who received CT. The subgroup scoring relatively high on cognitive but low on behavioral processes and received CT or CBT did not differ from those who received BT. The behavioral mediators were specific to BT relative to CT. The cognitive mediators were significant for both BT and CT outcomes. Patients exhibiting high levels of both behavioral and cognitive processes achieve better outcome if they receive CBT relative to BT or CT alone. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Correlations of diffusion tensor imaging values and symptom scores in patients with schizophrenia.

PubMed

Michael, Andrew M; Calhoun, Vince D; Pearlson, Godfrey D; Baum, Stefi A; Caprihan, Arvind

2008-01-01

Abnormalities in white matter (WM) brain regions are attributed as a possible biomarker for schizophrenia (SZ). Diffusion tensor imaging (DTI) is used to capture WM tracts. Psychometric tests that evaluate the severity of symptoms of SZ are clinically used in the diagnosis process. In this study we investigate the correlates of scalar DTI measures, such as fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity with behavioral test scores. The correlations were found by different schemes: mean correlation with WM atlas regions and multiple regression of DTI values with test scores. The corpus callosum, superior longitudinal fasciculus right and inferior longitudinal fasciculus left were found to be having high correlations with test scores.

A Tele-Behavioral Health Intervention to Reduce Depression, Anxiety, and Stress and Improve Diabetes Self-Management.

PubMed

Mochari-Greenberger, Heidi; Vue, Lee; Luka, Andi; Peters, Aimee; Pande, Reena L

2016-08-01

Depression is prevalent among individuals with diabetes and associated with suboptimal self-management. Little is known about the feasibility and potential impact of tele-behavioral therapy to improve depressive symptoms and self-management among diabetes patients. This was a retrospective observational study of consecutive graduates enrolled in a national 8-week diabetes behavioral telehealth program between August 1, 2014, and January 31, 2015 (N = 466; mean age 56.8 ± 5.0 years; 56% female). Participant characteristics (demographics, comorbidities) were obtained by standardized questionnaire. Depression, anxiety, and stress symptoms (DASS; validated Depression Anxiety and Stress Scale 21 survey), and glucose self-testing frequency and values (point-of-care monitor) were measured at program start and completion. Changes in DASS severity and glucose self-testing frequency were assessed by chi-square tests. Changes in DASS and blood glucose levels were evaluated by paired t-tests. At baseline, approximately one in three participants had elevated depression (32%), anxiety (33%), or stress (31%) scores. Significant reductions in average DASS, depression (-8.8), anxiety (-6.9), and stress (-9.9), scores were observed at graduation among those with elevated baseline scores (p < 0.0001); most (≥80%) improved to less severe depression, anxiety, or stress categories. Improved glucose self-testing frequency (69% vs. 60% tested ≥once per week; p = 0.0005) and significant reductions in mean morning glucose levels (-12.3 mg/dL; p = 0.0002) were observed from baseline to graduation. Participants with normal versus non-normal depression scores were more likely to have lower (

Being Small for Gestational Age: Does it Matter for the Neurodevelopment of Premature Infants? A Cohort Study.

PubMed

Bickle Graz, Myriam; Tolsa, Jean-François; Fischer Fumeaux, Céline Julie

2015-01-01

Whether being small for gestational age (SGA) increases the risk of adverse neurodevelopmental outcome in premature infants remains controversial. to study the impact of SGA (birthweight < percentile 10) on cognition, behavior, neurodevelopmental impairment and use of therapy at 5 years old. This population-based prospective cohort included infants born before 32 weeks of gestation. Cognition was evaluated with the K-ABC, and behavior with the Strengths and Difficulties Questionnaire (SDQ). Primary outcomes were cognitive and behavioral scores, as well as neurodevelopmental impairment (cognitive score < 2SD, hearing loss, blindness, or cerebral palsy). The need of therapy, an indirect indicator of neurodevelopmental impairment, was a secondary outcome. Linear and logistic regression models were used to analyze the association of SGA with neurodevelopment. 342/515 (76%) premature infants were assessed. SGA was significantly associated with hyperactivity scores of the SDQ (coefficient 0.81, p < 0.04), but not with cognitive scores, neurodevelopmental impairment or the need of therapy. Gestational age, socio-economic status, and major brain lesions were associated with cognitive outcome in the univariate and multivariate model, whereas asphyxia, sepsis and bronchopulmonary dysplasia were associated in the univariate model only. Severe impairment was associated with fetal tobacco exposition, asphyxia, gestational age and major brain lesions. Different neonatal factors were associated with the use of single or multiple therapies: children with one therapy were more likely to have suffered birth asphyxia or necrotizing enterocolitis, whereas the need for several therapies was predicted by major brain lesions. In this large cohort of premature infants, assessed at 5 years old with a complete panel of tests, SGA was associated with hyperactive behavior, but not with cognition, neurodevelopmental impairment or use of therapy. Birthweight <10th percentile alone does not appear to be an independent risk factor of neurodevelopmental adverse outcome in preterm children.

Impulse control disorders in advanced Parkinson's disease with dyskinesia: The ALTHEA study.

PubMed

Biundo, Roberta; Weis, Luca; Abbruzzese, Giovanni; Calandra-Buonaura, Giovanna; Cortelli, Pietro; Jori, Maria Cristina; Lopiano, Leonardo; Marconi, Roberto; Matinella, Angela; Morgante, Francesca; Nicoletti, Alessandra; Tamburini, Tiziano; Tinazzi, Michele; Zappia, Mario; Vorovenci, Ruxandra Julia; Antonini, Angelo

2017-11-01

Impulse control disorders and dyskinesia are common and disabling complications of dopaminergic treatment in Parkinson's disease. They may coexist and are possibly related. The objectives of this study were to assess the frequency and severity of impulse control disorders in Parkinson's disease patients with dyskinesia. The ALTHEA study enrolled 251 Parkinson's disease patients with various degrees of dyskinesia severity from 11 movement disorders centers in Italy. Each patient underwent a comprehensive assessment including Unified Dyskinesia Rating Scale and the Questionnaire for Impulsive Compulsive Disorders in Parkinson Disease-Rating Scale. There was an overall 55% frequency of impulse control disorder and related behaviors (36% were clinically significant). The positive patients were younger at disease diagnosis and onset and had higher Unified Dyskinesia Rating Scale historical and total score (P = 0.001 and P = 0.02, respectively, vs negative). There was an increased frequency of clinically significant impulse control disorders in patients with severe dyskinesia (P = 0.013), a positive correlation between the questionnaire total score and dopamine agonist dose (P = 0.018), and a trend with levodopa dose. More than half of Parkinson's disease patients with dyskinesia have impulse control disorders and related behaviors, which are frequently clinically significant. Dopaminergic therapy total dose is associated with their severity. Clinicians should carefully assess patients with maladaptive behaviors and dyskinesia because they do not properly evaluate their motor and nonmotor status. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

Behavioral and Neural Inhibitory Control Moderates the Effects of Reward Sensitivity on Adolescent Substance Use

PubMed Central

Kim-Spoon, Jungmeen; Deater-Deckard, Kirby; Holmes, Christopher; Lee, Jacob; Chiu, Pearl; King-Casas, Brooks

2016-01-01

The developmental period of adolescence is characterized by increasing incidence of health risk behaviors, including experimenting with drugs and alcohol. We examined how inhibitory control interacts with reward and punishment sensitivity to predict substance use severity and age of onset among early adolescents. The sample was comprised of 157 early adolescents (13-14 years of age, 52% male). Composite scores for behavioral activation system (BAS), behavioral inhibition system (BIS), and substance use severity and onset were computed using adolescents’ questionnaire data, and inhibitory control was assessed based on adolescents’ behavioral performance and brain imaging during the Multiple Source Interference Task (MSIT). Structural equation modeling analyses indicated that for both behavioral performance and neural activity indicators of inhibitory control, high levels of BAS predicted earlier onset of substance use among adolescents with low inhibitory control—but not among adolescents with high inhibitory control. BIS was not related to substance use severity and onset among adolescents. The results support the theoretically hypothesized moderating role of inhibitory control and its associated frontal cortex functioning, and offer new insights into the identification of adolescents with neurobehavioral vulnerabilities to developing maladaptive substance use behaviors. PMID:27580969

Establishing the feasibility of direct observation in the assessment of tics in children with chronic tic disorders.

PubMed

Himle, Michael B; Chang, Susanna; Woods, Douglas W; Pearlman, Amanda; Buzzella, Brian; Bunaciu, Liviu; Piacentini, John C

2006-01-01

Behavior analysis has been at the forefront in establishing effective treatments for children and adults with chronic tic disorders. As is customary in behavior analysis, the efficacy of these treatments has been established using direct-observation assessment methods. Although behavior-analytic treatments have enjoyed acceptance and integration into mainstream health care practices for tic disorders (e.g., psychiatry and neurology), the use of direct observation as a primary assessment tool has been neglected in favor of less objective methods. Hesitation to use direct observation appears to stem largely from concerns about the generalizability of clinic observations to other settings (e.g., home) and a lack of consensus regarding the most appropriate and feasible techniques for conducting and scoring direct observation. The purpose of the current study was to evaluate and establish a reliable, valid, and feasible direct-observation protocol capable of being transported to research and clinical settings. A total of 43 children with tic disorders, collected from two outpatient specialty clinics, were assessed using direct (videotape samples) and indirect (Yale Global Tic Severity Scale; YGTSS) methods. Videotaped observation samples were collected across 3 consecutive weeks and two different settings (clinic and home), were scored using both exact frequency counts and partial-interval coding, and were compared to data from a common indirect measure of tic severity (the YGTSS). In addition, various lengths of videotaped segments were scored to determine the optimal observation length. Results show that (a) clinic-based observations correspond well to home-based observations, (b) brief direct-observation segments scored with time-sampling methods reliably quantified tics, and (c) indirect methods did not consistently correspond with the direct methods.

Impulsive-compulsive behaviors in parkin-associated Parkinson disease

PubMed Central

Fasano, Alfonso; Ginevrino, Monia; Petrucci, Simona; Ricciardi, Lucia; Bove, Francesco; Criscuolo, Chiara; Moccia, Marcello; De Rosa, Anna; Sorbera, Chiara; Bentivoglio, Anna Rita; Barone, Paolo; De Michele, Giuseppe; Pellecchia, Maria Teresa; Valente, Enza Maria

2016-01-01

Objective: The aim of this multicenter, case-control study was to investigate the prevalence and severity of impulsive-compulsive behaviors (ICBs) in a cohort of patients with parkin-associated Parkinson disease (PD) compared to a group of patients without the mutation. Methods: We compared 22 patients with biallelic parkin mutations (parkin-PD) and 26 patients negative for parkin, PINK1, DJ-1, and GBA mutations (PD-NM), matched for age at onset, disease duration, levodopa, and dopamine agonist equivalent daily dose. A semistructured interview was used to diagnose each of the following ICBs: compulsive sexual behavior, compulsive buying, binge eating, punding, hobbyism, and compulsive medication use. The Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease–Rating Scale (QUIP-RS) was adopted to rate ICB severity. Results: Frequency of patients with at least one ICB was comparable between parkin-PD and PD-NM. Nevertheless, when analyzing the distribution of specific ICBs, a higher frequency of compulsive shopping, binge eating, and punding/hobbyism was found in the parkin-PD group. Compared to PD-NM, parkin-PD patients with ICB had younger onset age and higher frequency of smokers; in 5 patients, ICB had predated PD onset. Total and partial (compulsive buying, compulsive sexual behavior, binge eating, hobbyism/punding) QUIP-RS scores were higher in patients with parkin-PD compared to patients with PD-NM. Logistic regression analysis showed that the presence of parkin mutations was associated with smoking status and higher QUIP-RS total score. Conclusions: Our data expand the parkin-associated phenotypic spectrum demonstrating higher frequency and severity of specific ICBs, and suggesting an association between the parkin genotype, smoking status, and ICB severity. PMID:27590295

Impulsive-compulsive behaviors in parkin-associated Parkinson disease.

PubMed

Morgante, Francesca; Fasano, Alfonso; Ginevrino, Monia; Petrucci, Simona; Ricciardi, Lucia; Bove, Francesco; Criscuolo, Chiara; Moccia, Marcello; De Rosa, Anna; Sorbera, Chiara; Bentivoglio, Anna Rita; Barone, Paolo; De Michele, Giuseppe; Pellecchia, Maria Teresa; Valente, Enza Maria

2016-10-04

The aim of this multicenter, case-control study was to investigate the prevalence and severity of impulsive-compulsive behaviors (ICBs) in a cohort of patients with parkin-associated Parkinson disease (PD) compared to a group of patients without the mutation. We compared 22 patients with biallelic parkin mutations (parkin-PD) and 26 patients negative for parkin, PINK1, DJ-1, and GBA mutations (PD-NM), matched for age at onset, disease duration, levodopa, and dopamine agonist equivalent daily dose. A semistructured interview was used to diagnose each of the following ICBs: compulsive sexual behavior, compulsive buying, binge eating, punding, hobbyism, and compulsive medication use. The Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS) was adopted to rate ICB severity. Frequency of patients with at least one ICB was comparable between parkin-PD and PD-NM. Nevertheless, when analyzing the distribution of specific ICBs, a higher frequency of compulsive shopping, binge eating, and punding/hobbyism was found in the parkin-PD group. Compared to PD-NM, parkin-PD patients with ICB had younger onset age and higher frequency of smokers; in 5 patients, ICB had predated PD onset. Total and partial (compulsive buying, compulsive sexual behavior, binge eating, hobbyism/punding) QUIP-RS scores were higher in patients with parkin-PD compared to patients with PD-NM. Logistic regression analysis showed that the presence of parkin mutations was associated with smoking status and higher QUIP-RS total score. Our data expand the parkin-associated phenotypic spectrum demonstrating higher frequency and severity of specific ICBs, and suggesting an association between the parkin genotype, smoking status, and ICB severity. © 2016 American Academy of Neurology.

Study Behaviors and USMLE Step 1 Performance: Implications of a Student Self-Directed Parallel Curriculum.

PubMed

Burk-Rafel, Jesse; Santen, Sally A; Purkiss, Joel

2017-11-01

To determine medical students' study behaviors when preparing for the United States Medical Licensing Examination (USMLE) Step 1, and how these behaviors are associated with Step 1 scores when controlling for likely covariates. The authors distributed a study-behaviors survey in 2014 and 2015 at their institution to two cohorts of medical students who had recently taken Step 1. Demographic and academic data were linked to responses. Descriptive statistics, bivariate correlations, and multiple linear regression analyses were performed. Of 332 medical students, 274 (82.5%) participated. Most students (n = 211; 77.0%) began studying for Step 1 during their preclinical curriculum, increasing their intensity during a protected study period during which they averaged 11.0 hours studying per day (standard deviation [SD] 2.1) over a period of 35.3 days (SD 6.2). Students used numerous third-party resources, including reading an exam-specific 700-page review book on average 2.1 times (SD 0.8) and completing an average of 3,597 practice multiple-choice questions (SD 1,611). Initiating study prior to the designated study period, increased review book usage, and attempting more practice questions were all associated with higher Step 1 scores, even when controlling for Medical College Admission Test scores, preclinical exam performance, and self-identified score goal (adjusted R = 0.56, P < .001). Medical students at one public institution engaged in a self-directed, "parallel" Step 1 curriculum using third-party study resources. Several study behaviors were associated with improved USMLE Step 1 performance, informing both institutional- and student-directed preparation for this high-stakes exam.

The Behavior Problems Inventory-Short Form for individuals with intellectual disabilities: part II: reliability and validity.

PubMed

Rojahn, J; Rowe, E W; Sharber, A C; Hastings, R; Matson, J L; Didden, R; Kroes, D B H; Dumont, E L M

2012-05-01

The Behavior Problems Inventory-01 (BPI-01) is an informant-based behaviour rating instrument for intellectual disabilities (ID) with 49 items and three sub-scales: Self-injurious Behavior, Stereotyped Behavior and Aggressive/Destructive Behavior. The Behavior Problems Inventory-Short Form (BPI-S) is a BPI-01 spin-off with 30 items. The psychometric properties of these two versions of the scale were computed using aggregated archival data from nine different sites in the USA, Wales, England, the Netherlands and Romania with a total of 1122 cases with a BPI-01 total score >0. The internal consistency of the BPI-01 and the BPI-S ranged from fair to excellent with the BPI-01 showing slightly stronger reliability. Construct validity (confirmatory and discriminant) was computed by comparing BPI sub-scale scores with the scores of four other behaviour rating scales (the Aberrant Behavior Checklist, the Diagnostic Assessment for the Severely Handicapped-II, the Nisonger Child Behavior Rating Form and the Inventory for Client and Agency Planning). Strong evidence for confirmatory and discriminant validity was found for both the BPI-01 and the BPI-S. Confirmatory fit indices for the BPI and the BPI-S were comparable and suggesting that the factor structures fit the data well. In summary, both BPI versions were found to be equally sound psychometrically and can be endorsed for future use. However, independent future studies are needed to replicate the psychometrics of the BPI-S with new data. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 Blackwell Publishing Ltd.

The Dysexecutive Questionnaire advanced: item and test score characteristics, 4-factor solution, and severity classification.

PubMed

Bodenburg, Sebastian; Dopslaff, Nina

2008-01-01

The Dysexecutive Questionnaire (DEX, , Behavioral assessment of the dysexecutive syndrome, 1996) is a standardized instrument to measure possible behavioral changes as a result of the dysexecutive syndrome. Although initially intended only as a qualitative instrument, the DEX has also been used increasingly to address quantitative problems. Until now there have not been more fundamental statistical analyses of the questionnaire's testing quality. The present study is based on an unselected sample of 191 patients with acquired brain injury and reports on the data relating to the quality of the items, the reliability and the factorial structure of the DEX. Item 3 displayed too great an item difficulty, whereas item 11 was not sufficiently discriminating. The DEX's reliability in self-rating is r = 0.85. In addition to presenting the statistical values of the tests, a clinical severity classification of the overall scores of the 4 found factors and of the questionnaire as a whole is carried out on the basis of quartile standards.

Manual versus Automated Rodent Behavioral Assessment: Comparing Efficacy and Ease of Bederson and Garcia Neurological Deficit Scores to an Open Field Video-Tracking System.

PubMed

Desland, Fiona A; Afzal, Aqeela; Warraich, Zuha; Mocco, J

2014-01-01

Animal models of stroke have been crucial in advancing our understanding of the pathophysiology of cerebral ischemia. Currently, the standards for determining neurological deficit in rodents are the Bederson and Garcia scales, manual assessments scoring animals based on parameters ranked on a narrow scale of severity. Automated open field analysis of a live-video tracking system that analyzes animal behavior may provide a more sensitive test. Results obtained from the manual Bederson and Garcia scales did not show significant differences between pre- and post-stroke animals in a small cohort. When using the same cohort, however, post-stroke data obtained from automated open field analysis showed significant differences in several parameters. Furthermore, large cohort analysis also demonstrated increased sensitivity with automated open field analysis versus the Bederson and Garcia scales. These early data indicate use of automated open field analysis software may provide a more sensitive assessment when compared to traditional Bederson and Garcia scales.

Psychiatric severity and HIV-risk sexual behaviors among persons with substance use disorders.

PubMed

Majer, John M; Komer, Anne C; Jason, Leonard A

2015-01-01

The relationship between mental illness and human-immunodeficiency virus (HIV)-risk sexual behavior among persons with substance use disorders is not well-established because of differences in assessing psychiatric factors (types, symptoms, severity), substance use (diagnosis, survey responses, past substance use), and HIV-risk sexual behaviors (individual measures, combination of sex/drug use risk behaviors) across studies. This study utilized a more global and dimensional aspect of psychiatric issues (problem severity) to examine the relationship with HIV-risk sexual behaviors and substance use among persons with substance use disorders. Participants included 224 men and 46 women, with a mean age of 40.4 years (SD = 9.5). The most common substances were heroin/opiates, with 41.4% reporting use of these substances (n = 110), while 27.8% reported using cocaine (n = 74) and 12.8% reported using alcohol (n = 34). Of all participants, 39 (14.4%) were identified as having high psychiatric severity (defined using the psychiatric severity score from the Addiction Severity Index), which was used as an indication of probable comorbid psychiatric and substance use disorders. Among these participants likely to have comorbid disorders, hierarchical linear regression was conducted to examine HIV-risk sexual behaviors (number of partners and unprotected sexual behaviors in the past 30 days) in relation to psychiatric severity, substance use, and gender. Gender (women) and psychiatric severity (higher) were significantly related to greater HIV-risk sexual behaviors. After entering gender and substance use into the regression model, psychiatric severity accounted for another 21.9% of the variance in number of partners and 14.1% of the variance in unprotected sexual behaviors. Overall, the models accounted for 55.5% and 15.6% of the variance, respectively. A significant interaction was found for number of partners (but not frequency of unprotected behavior), such that those higher in psychiatric severity and higher in substance use had a greater number of sexual partners. The model including this interaction term accounted for 63.4% of the variance in number of partners. Findings suggest psychiatric severity is an underlying risk factor for HIV-risk sexual behavior among persons with substance use disorders who have various psychiatric comorbidities.

Developing the Pediatric Refractory Epilepsy Questionnaire: a pilot study.

PubMed

Purusothaman, Vaishnavi; Ryther, Robin C C; Bertrand, Mary; Harker, Lisa A; Jeffe, Donna B; Wallendorf, Michael; Smyth, Matthew D; Limbrick, David D

2014-08-01

Up to 14% of children with epilepsy continue to experience seizures despite having appropriate medical therapy and develop medically refractory epilepsy (MRE). Assessing clinical outcomes and therapeutic efficacy in children with MRE undergoing palliative epilepsy surgery has been challenging because of the lack of a quantitative instrument capable of estimating the clinical status of these patients. The ideal instrument would at once consider seizure control, neurodevelopment, caregiver burden, and quality of life. The purpose of this study was to develop and pilot the Pediatric Refractory Epilepsy Questionnaire (PREQ), a quantitative instrument to assess the severity and individual burden of epilepsy in children with MRE undergoing palliative epilepsy treatments. The caregivers of 25 patients with MRE completed the PREQ and the Quality of Life in Childhood Epilepsy (QOLCE) measure and participated in a semistructured interview. Medical records of the patients were reviewed, an Early Childhood Epilepsy Severity Scale (E-CHESS) score was calculated, and a Global Assessment of Severity of Epilepsy (GASE) score was obtained for each patient. The initial PREQ was modified based on the analysis of responses, association with previously validated scales, comments from caregivers, and expertise of the PREQ panelists. Pediatric Refractory Epilepsy Questionnaire subscale scores were calculated based on clinical paradigm and compared with independent measures of seizure severity and quality of life. Significant correlations were observed between the seizure severity subscale and the GASE score (r=0.55) and between the mood subscale and the well-being score (r=0.61) on the QOLCE. Significant correlations were also observed between the caregiver rating of seizure severity and the GASE score (r=0.53), the social activity score (r=0.57), and the behavior score (r=0.43) on the QOLCE. Correlations between the caregiver rating of quality of life and the quality of life score (r=0.58) and the number of AEDs used (r=0.45) were also significant. This pilot study is an initial, critical step in the development of the PREQ. The significant correlations between the PREQ subscales and the external epilepsy severity and quality of life measures lend preliminary support to our hypothesis that the PREQ is assessing the severity of epilepsy along with other important domains, such as mood, neurodevelopment, and quality of life. A larger prospective study of this modified PREQ is currently underway to further develop the PREQ. Copyright © 2014 Elsevier Inc. All rights reserved.

Modification of severe violent and aggressive behavior among psychiatric inpatients through the use of a short-term token economy.

PubMed

Park, Jae Soon; Lee, Kyunghee

2012-12-01

Meager research has been carried out to determine the effectiveness of the token economy among patients behaving violently in mental hospitals. The purpose of this study was to examine the effectiveness of the Short-Term Token Economy (STTE) on violent behavior among chronic psychiatric in-patients. A nonequivalent control group design method was utilized. Participants in an experimental group (n=22) and control group (n=22) took part in this study from January to April, 2008. Observation on aggressive behavior among male in-patients in one hospital as a baseline was made during the week before the behavior modification program and measurement of aggressive behavior was done using the Overt Aggression Scale (OAS), which includes verbal attacks, property damage and physical attacks. The aggressive behavior scores of the experimental group decreased, those of the control group, scores showed an increase after the eight-week behavior modification program utilizing STTE. The results of the study indicate that STTE is effective in reducing the incidence of aggressive behavior among male in-patients in psychiatric hospitals. The outcome of this study should be helpful in reducing the use of coercive measures or psychoactive medication in controlling the violent behavior among in-patients in hospitals.

Prevalence and correlates of psychopathology in children and adolescents evaluated with the strengths and difficulties questionnaire dysregulation profile in a clinical setting.

PubMed

Carballo, Juan José; Serrano-Drozdowskyj, Elena; García Nieto, Rebeca; Díaz de Neira-Hernando, Mónica; Pérez-Fominaya, Margarita; Molina-Pizarro, Cristian Antonio; De León-Martínez, Victoria; Baca-García, Enrique

2014-01-01

The clinical presentation of children and adolescents referred to mental health services is frequently complicated by comorbid and severe affective and behavioral dysregulation. This dysregulation phenotype seems to be an indicator of overall psychopathology, symptom severity and functional impairment. Currently, this phenotype is assessed by the Child Behavior Checklist. However, the widely used Strengths and Difficulties Questionnaire (SDQ) has been recently validated to screen the Dysregulation Profile (SDQ-DP) in clinical settings. The objective of this study was to determine the prevalence and demographic, psychosocial and clinical correlates of the SDQ-DP phenotype in a Spanish clinical sample. In a clinical sample of 623 consecutively referred children and adolescents (4-17 years old), we compared clinical and sociodemographic correlates between subjects who met the SDQ-DP criteria (DP) and those who did not (NO_DP). Sociodemographic data, parent-rated SDQ, Children's Global Assessment Scale, Clinical Global Impression, family Apgar scale and clinical diagnoses were collected by experienced child and adolescent psychiatrists. Overall in our sample, 175 subjects (28.1%) met the SDQ-DP criteria (DP group). Compared with the NO_DP group, the DP subjects had significantly higher scores on internalizing and externalizing psychopathology, problems with peers and overall problems as well as significantly lower scores on prosocial behavior. Clinical diagnoses assigned revealed that DP subjects showed significantly greater psychiatric comorbidity. DP subjects also showed significantly worse family functioning and increased symptom severity and significantly lower scores on psychosocial functioning. A high prevalence of children and adolescents with the dysregulated profile, assessed by the SDQ-DP, was found in our clinical setting. The SDQ-DP may serve as an index of overall psychological severity and functional impairment. In addition, it may indicate family dysfunction. Further research is needed to validate the clinical value of SDQ-DP by examining longitudinal stability, heritability, adult outcome, risk factors and diagnostic correlates. © 2014 S. Karger AG, Basel.

Psychometric validation of the Columbia-Suicide Severity rating scale in Spanish-speaking adolescents.

PubMed

Serrani Azcurra, Daniel

2017-12-30

Adolescent suicide is a major public health issue, and early and accurate detection is of great concern. There are many reliable instruments for this purpose, such as the Columbia-Suicide severity rating scale (C-SSRS), but no validation exists for Spanish speaking Latin American adolescents. To assess psychometric properties and cut-off scores of the C-SSRS in Spanish speaking adolescents. Exploratory assessment with principal component analysis (PCA) and Varimax rotation, and confirmatory analysis (CFA) were performed on two groups with 782 and 834 participants respectively (N=1616). Mean age was 24.8 years. A Receiver operator analysis was applied to distinguish between control and suicide-risk subgroups adolescents. Promax rotation yielded two 10-items factors, for suicide ideation and behavior respectively. C-SSRS was positively correlated with other suicide risk scales, such as Beck Depression Inventory-II, Suicidal Behaviors Questionnaire-Revised, or PHQ-9. Confirmatory factor analysis yielded a two-factor solution as the best goodness of fit model. C-SSRS showed adequate ability to detect suicide risk group with positive predictive value of 68.3%. ROC analyses showed cutoff scores of ≥ 6 and ≥ 4 for suicide ideation and behavior scales respectively. This research offers data supporting psychometric validity and reliability of C-SSRS in nonclinical Spanish-speaking students. Added benefits are flexible scoring and management easiness. This questionnaire yields data on distinct aspects of suicidality, being more parsimonious than separate administration of a bunch of questionnaires.

Psychometric validation of the Columbia-Suicide Severity rating scale in Spanish-speaking adolescents

PubMed Central

2017-01-01

Abstract Introduction: Adolescent suicide is a major public health issue, and early and accurate detection is of great concern. There are many reliable instruments for this purpose, such as the Columbia-Suicide severity rating scale (C-SSRS), but no validation exists for Spanish speaking Latin American adolescents. Objetive: To assess psychometric properties and cut-off scores of the C-SSRS in Spanish speaking adolescents. Methods: Exploratory assessment with principal component analysis (PCA) and Varimax rotation, and confirmatory analysis (CFA) were performed on two groups with 782 and 834 participants respectively (N=1616). Mean age was 24.8 years. A Receiver operator analysis was applied to distinguish between control and suicide-risk subgroups adolescents. Results: Promax rotation yielded two 10-items factors, for suicide ideation and behavior respectively. C-SSRS was positively correlated with other suicide risk scales, such as Beck Depression Inventory-II, Suicidal Behaviors Questionnaire-Revised, or PHQ-9. Confirmatory factor analysis yielded a two-factor solution as the best goodness of fit model. C-SSRS showed adequate ability to detect suicide risk group with positive predictive value of 68.3%. ROC analyses showed cutoff scores of ≥ 6 and ≥ 4 for suicide ideation and behavior scales respectively Conclusion: This research offers data supporting psychometric validity and reliability of C-SSRS in nonclinical Spanish-speaking students. Added benefits are flexible scoring and management easiness. This questionnaire yields data on distinct aspects of suicidality, being more parsimonious than separate administration of a bunch of questionnaires. PMID:29662259

Growing Up After Critical Illness: Verbal, Visual-Spatial, and Working Memory Problems in Neonatal Extracorporeal Membrane Oxygenation Survivors.

PubMed

Madderom, Marlous J; Schiller, Raisa M; Gischler, Saskia J; van Heijst, Arno F J; Tibboel, Dick; Aarsen, Femke K; IJsselstijn, Hanneke

2016-06-01

To assess neuropsychologic outcome in 17- and 18-year-old neonatal extracorporeal membrane oxygenation survivors. A prospective longitudinal follow-up study. Follow-up program at the Erasmus MC-Sophia Children's Hospital in Rotterdam, The Netherlands. Thirty adolescents 17 or 18 years old, treated between 1991 and 1997, underwent neuropsychologic assessment. None. Attention, memory, executive functioning, visual-spatial functions, social-emotional functioning, and behavior were assessed with validated instruments, and data were compared with reference data. Included predictors for analysis of adverse outcome were diagnosis, age at start extracorporeal membrane oxygenation, convulsions, and use of antiepileptics. Adolescents' performance (expressed as mean [SD] z score) was significantly lower than the norm on short-term and long-term verbal memory (z score = -1.40 [1.58], p = 0.016; z score = -1.54 [1.67], p = 0.010, respectively), visual-spatial memory (z score = -1.65 [1.37], p = 0.008; z score = -1.70 [1.23], p = 0.008, respectively), and working memory (32% vs 9% in the norm population). Parents reported more problems for their children regarding organization of materials (z score = -0.60 [0.90]; p = 0.03) and behavior evaluation (z score = -0.53 [0.88]; p = 0.05) on a questionnaire. Patients reported more withdrawn/depressed behavior (z score = -0.47 [0.54]; p = 0.02), somatic complaints (z score = -0.43 [0.48]; p = 0.03), and social problems (z score = -0.41 [0.46]; p = 0.04). Patients reported more positive feelings of self-esteem and an average health status. Adolescents treated with neonatal extracorporeal membrane oxygenation are at risk of verbal, visual-spatial, and working memory problems. Future research should focus on 1) the longitudinal outcome of specific neuropsychologic skills in adolescence and adulthood; 2) identifying risk factors of neuropsychologic dysfunction; 3) evaluating to what extent "severity of illness" is responsible for acquired brain injury; and 4) effects of timely cognitive rehabilitation.

Sleep Complaints as Risk Factor for Suicidal Behavior in Severely Depressed Children and Adolescents.

PubMed

Lopes, Maria-Cecilia; Boronat, Alexandre C; Wang, Yuan-Pang; Fu-I, Lee

2016-11-01

To investigate the association between sleep complaints and suicidal behaviors among severely depressed children and adolescents. The sample was 214 youths (56.1% males, mean age 12.5 years) with diagnosis of DSM-IV major depressive disorder consecutively recruited from a university-based outpatient clinic specialized in mood disorders. The structured interview for children and adolescents was applied to participants. The Children's Depression Rating Scale-revised version-scored the severity of depression, and the Children's Global Assessment Scale assessed the global functioning. Subgroups of patients were compared for psychopathological association by means of logistic regression, in accordance with presence and absence of sleep complaints and suicidality. The frequency of sleep complaints and suicidal behaviors was, respectively, 66.4% and 52.3%, and both symptoms were observed in 37.9% of patients. Initial insomnia was the most frequent manifestation (58%), followed by night awakening (36%), daytime sleepiness (31%), and early awakening (29.9%). Significant association between sleep disturbance and suicidal behavior was found (odds ratio range of 2.3-10.8). Sleep disturbances are potential warning manifestations of suicidal behaviors in depressed youth. Possibly, the severity of the active affective episode likely underlies in both sleep complaints and suicidal behaviors among depressed underage patients. © 2016 The Authors. CNS Neuroscience & Therapeutics Published by John Wiley & Sons Ltd.

Regional Brain Tissue Changes and Associations with Disease Severity in Children with Sleep Disordered Breathing.

PubMed

Horne, Rosemary S C; Roy, Bhaswati; Walter, Lisa M; Biggs, Sarah N; Tamanyan, Knarik; Weichard, Aidan; Nixon, Gillian M; Davey, Margot J; Ditchfield, Michael; Harper, Ronald M; Kumar, Rajesh

2017-12-15

Children with sleep-disordered breathing (SDB) exhibit behavioral, cognitive, and autonomic deficits, suggestive of neural injury. We assessed whether the tissue alterations resulted from acute or chronic processes, and if alterations correlated with disease severity. Brain tissue integrity was examined with mean diffusivity (MD) (3.0-Tesla scanner) in 20 non-snoring controls (mean age±sem, 12.2±0.6y; 10 male) and 18 children with SDB (12.3±0.7y; 11 male). Sleep, cognitive, and behavioral measures were compared between groups following overnight polysomnography using Student's t-tests. Whole-brain MD maps were realigned and averaged, normalized, smoothed, and compared between groups using ANCOVA (covariates; age, gender, and socioeconomic status). Partial correlations were calculated between whole-brain smoothed MD maps and obstructive apnea hypopnea indices (OAHI). Age, gender, and sleep variables did not differ between groups. The SDB group showed higher OAHI, body mass indices, and systolic blood pressure. Significantly reduced MD values (acute changes) appeared in the hippocampus, insula, thalamus, temporal and occipital cortices, and cerebellum, but were increased (chronic damage) in the frontal and prefrontal cortices in the SDB group over controls. Both positive and negative correlations appeared with extent of tissue changes and disease severity. Externalizing and Total Problem Behaviors were significantly higher in SDB children. Verbal, performance and total IQ scores trended lower, and behavioral scores trended higher. Pediatric SDB is accompanied by predominantly acute brain changes in areas that regulate autonomic, cognitive, and mood functions, and chronic changes in frontal cortices essential for behavioral control. Interventions need to be keyed to address acute vs chronic injury. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Risk factors for self-injury, aggression, and stereotyped behavior among young children at risk for intellectual and developmental disabilities.

PubMed

Schroeder, Stephen R; Marquis, Janet G; Reese, R Matthew; Richman, David M; Mayo-Ortega, Liliana; Oyama-Ganiko, Rosa; LeBlanc, Judith; Brady, Nancy; Butler, Merlin G; Johnson, Tiffany; Lawrence, Linda

2014-07-01

Before the 1990s, research on the early identification and prevention of severe behavior disorders (SBDs), such as aggression, self-injury, and stereotyped behavior, among young children with intellectual and developmental disabilities (IDD), was mostly done with children 3 years or older. More recent work suggests that signs of SBDs may occur as early as 6 months in some infants. The present study combined a cross-sectional and longitudinal approach to examine SBDs in 180 young children aged 4-48 months recruited through mass screening, then receiving an interdisciplinary evaluation and six-month follow-ups for one year. Twelve potential risk factors related to SBDs were examined. Eight of these risk factors, including age, gender, diagnosis, intellectual and communication levels, visual impairment, parent education, family income, were differentially related to scores for Aggression, SIB, and Stereotyped Behavior subscales on the Behavior Problems Inventory (BPI-01) at initial interdisciplinary evaluation. BPI-01 scores decreased over the year for 57% of the children and increased for 43%. The amount of decrease on each BPI-01 subscale varied with age, gender, and diagnosis.

Frontal lobe function and behavioral changes in amyotrophic lateral sclerosis: a study from Southwest China.

PubMed

Wei, QianQian; Chen, XuePing; Zheng, ZhenZhen; Huang, Rui; Guo, XiaoYan; Cao, Bei; Zhao, Bi; Shang, Hui-Fang

2014-12-01

Despite growing interest, the frequency and characteristics of frontal lobe functional and behavioral deficits in Chinese people with amyotrophic lateral sclerosis (ALS), as well as their impact on the survival of ALS patients, remain unknown. The Chinese version of the frontal assessment battery (FAB) and frontal behavioral inventory (FBI) were used to evaluate 126 sporadic ALS patients and 50 healthy controls. The prevalence of frontal lobe dysfunction was 32.5%. The most notable impairment domain of the FAB was lexical fluency (30.7%). The binary logistic regression model revealed that an onset age older than 45 years (OR 5.976, P = 0.002) and a lower educational level (OR 0.858, P = 0.002) were potential determinants of an abnormal FAB. Based on the FBI score, 46.0% of patients showed varied degrees of frontal behavioral changes. The most common impaired neurobehavioral domains were irritability (25.4%), logopenia (20.6%) and apathy (19.0%). The binary logistic regression model revealed that the ALS Functional Rating Scale-Revised scale score (OR 0.127, P = 0.001) was a potential determinant of an abnormal FBI. Frontal functional impairment and the severity of frontal behavioral changes were not associated with the survival status or the progression of ALS by the cox proportional hazard model and multivariate regression analyses, respectively. Frontal lobe dysfunction and frontal behavioral changes are common in Chinese ALS patients. Frontal lobe dysfunction may be related to the onset age and educational level. The severity of frontal behavioral changes may be associated with the ALSFRS-R. However, the frontal functional impairment and the frontal behavioral changes do not worsen the progression or survival of ALS.

Severity of unilateral spatial neglect is an independent predictor of functional outcome after acute inpatient rehabilitation in individuals with right hemispheric stroke.

PubMed

Di Monaco, Marco; Schintu, Selene; Dotta, Manuela; Barba, Sonia; Tappero, Rosa; Gindri, Patrizia

2011-08-01

To investigate the relationship between severity of unilateral spatial neglect (USN) and functional recovery in activities of daily living after a right-hemisphere stroke. Observational study. Rehabilitation hospital in Italy. We investigated 107 of 131 inpatients with right-hemisphere stroke who were consecutively admitted to our rehabilitation hospital. Not applicable. To assess USN severity, conventional and nonconventional Behavioral Inattention Tests (BITs) were performed at admission to inpatient rehabilitation at a median of 19 days after stroke occurrence. FIM was performed both on admission to and discharge from inpatient rehabilitation to assess functional autonomy. FIM efficiency (improvement of FIM score per day of stay length) and FIM effectiveness (proportion of potential improvement achieved) were calculated. Fifty-four (50.5%) of the 107 patients were affected by USN. In these 54 patients, both conventional and nonconventional BIT scores were significantly correlated with FIM scores assessed at discharge from rehabilitation: ρ values were .385 (P=.004) and .396 (P=.003), respectively. After adjustment for 7 potential confounders, including FIM scores before rehabilitation, we found a significant positive association between either conventional or nonconventional BIT scores and FIM scores after rehabilitation (r=.276, P=.047 and r=.296, P=.033, respectively), FIM efficiency (r=.315, P=.022 and r=.307, P=.025, respectively), and FIM effectiveness (r=.371, P=.006 and r=.306, P=.026, respectively). Data support the independent prognostic role of USN severity assessed at admission to inpatient rehabilitation after a right-hemisphere stroke. Models aimed at predicting the functional outcome in stroke survivors may benefit from inclusion of USN severity. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

[Influence of educational status, burn area and coping behaviors on the complication of psychological disorders in severely burned patients].

PubMed

Cheng, Hua; Li, Xiao-jian; Cao, Wen-juan; Chen, Li-ying; Zhang, Zhi; Liu, Zhi-he; Yi, Xian-feng; Lai, Wen

2013-04-01

To discuss how the educational status, burn area and coping behaviors influence the psychological disorders in severely burned patients. Sixty-four severely burned patients hospitalized in Guangzhou Red Cross Hospital, Guangdong Provincial Work Injury Rehabilitation Center, and Guangdong General Hospital were enrolled with cluster random sampling method. Data of their demography and situation of burns were collected. Then their coping behavior, psychological disorders including anxiety, depression and post-traumatic stress disorder (PTSD) plus its core symptoms of flashback, avoidance, and hypervigilance were assessed by medical coping modes questionnaire, self-rating anxiety scale (SAS), self-rating depression scale (SDS), PTSD checklist-civilian version (PCL-C) respectively. Correlation was analyzed between demography, burn area, coping behavior and psychological disorders. The predictive powers of educational status, burn area and coping behaviors on the psychological disorders were analyzed. The qualitative variables were assigned values. Data were processed with t test, Spearman rank correlation analysis, and multiple linear regression analysis. (1) The patients scored (19.0 ± 3.4) points in confrontation coping behavior, which showed no statistically significant difference from the domestic norm score (19.5 ± 3.8) points (t = -1.13, P > 0.05). The patients scored (16.6 ± 2.4) and (11.0 ± 2.2) points in avoidance and resignation coping behaviors, which were significantly higher than the domestic norm score (14.4 ± 3.0), (8.8 ± 3.2) points (with t values respectively 7.06 and 7.76, P values both below 0.01). The patients' standard score of SAS, SDS, PCL-C were (50 ± 11), (54 ± 11), and (38 ± 12) points. Respectively 89.1% (57/64), 60.9% (39/64), 46.9% (30/64) of the patients showed anxiety, depression, and PTSD symptoms. (2) Four independent variables: age, gender, marital status, and time after burns, were correlated with the psychological disorders, but the correlativity was not statistically significant (with rs values from -0.089 to 0.245, P values all above 0.05). Educational status was significantly negatively correlated with anxiety, depression, PTSD and its core symptoms of flashback, avoidance (with rs values from -0.361 to -0.253, P values all below 0.05). Educational status was negatively correlated with hypervigilance, but the correlativity was not statistically significant (rs = -0.187, P > 0.05). Burn area was significantly positively correlated with the psychological disorders (with rs values from 0.306 to 0.478, P values all below 0.05). Confrontation coping behavior was positively correlated with the psychological disorders, but the correlativity was not statistically significant (with rs values from 0.121 to 0.550, P values all above 0.05). Avoidance coping behavior was correlated with the psychological disorders, but the correlativity was not statistically significant (with rs values from -0.144 to 0.193, P values all above 0.05). Resignation coping behavior was significantly positively correlated with the psychological disorder (with rs values from 0.377 to 0.596, P values all below 0.01). (3) Educational status had predictive power on the anxiety, PTSD and flash back symptoms of patients (with t values from -2.19 to -2.02, P values all below 0.05), but not on depression, avoidance and hypervigilance (with t values from -1.95 to -0.99, P values all above 0.05). Burn area had no predictive power on the psychological disorders (with t values from 0.55 to 1.78, P values all above 0.05). Resignation coping behavior had predictive power on the psychological disorders (with t values from 3.10 to 6.46, P values below 0.01). Confrontation and avoidance coping behaviors had no predictive power on the psychological disorders (with t values from 0.46 to 2.32 and -0.89 and 1.75 respectively, P values all above 0.05). The severely burned patients with lower educational status, larger burn area, and the more frequently adapted resignation coping behavior are more likely to suffer from anxiety, depression, and PTSD.

Assessing fears of preschool children with nighttime fears by a parent version of the fear survey schedule for preschool children.

PubMed

Kushnir, Jonathan; Gothelf, Doron; Sadeh, Avi

2015-01-01

Although excessive fears are common in preschool children, validated assessment tools for this age are lacking. Our aim was to modify and provide preliminary evidence of the utility of a preschoolers' fear screening tool, a parent-reported Fear Survey Schedule for Preschool Children (FSS-PC). 109 Israeli preschool children (aged 4-6 years) with chronic night time fears (NF) and 30 healthy children (controls) participated. The FSS-PC analysis included: 1) internal reliability, 2) correlations between FSS-PC scores and Child Behavior Checklist (CBCL) measures, 3) differences between NF and a comparison sample of FSS-PC scores, and 4) FSS-PC sensitivity in detecting change in NF following an intervention for NF. There were low-to-medium positive correlations between the FSS-PC scores and several internalizing scales of the CBCL measures. FSS-PC scores in the NF group were significantly higher than the control children's score. FSS-PC scores had adequate internal reliability and were also sensitive for detecting significant changes in fear levels following behavioral interventions. Unique cultural and environmental circumstances and specific study group. This new version of the FSS-PC may provide clinicians with a novel and useful screening tool for early assessment of fear- and anxiety-related phenomena of preschool children.

Overactive bladder symptom severity, bother, help-seeking behavior, and quality of life in patients with type 2 diabetes: a path analysis.

PubMed

Xu, Dongjuan; Zhao, Meng; Huang, Liqun; Wang, Kefang

2018-01-02

This study aimed to investigate the relationships among overactive bladder (OAB) symptom severity, bother, help-seeking behavior, and quality of life (QOL) in patients with type 2 diabetes. A total of 127 diabetic patients, aged at least 18 years, with overactive bladder from a hospital in Shandong Province, China, were recruited for this study. Symptom severity, bother, and quality of life were assessed using the Overactive Bladder Symptom Score (OABSS), Patient Perception of Bladder Condition (PPBC), and Overactive Bladder Questionnaire Short Form (OAB-q SF), respectively. Help-seeking behavior was assessed by asking patients whether they consulted health care professionals or received treatment for their bladder problems. A two-step path analysis was performed to analyze the data. OAB symptom severity was directly associated with lower levels of QOL, and the strength of this association was no longer significant when taking bother and help-seeking behavior into account. Bother increased with OAB symptom severity, and patients with bothersome OAB tended to have lower levels of QOL. Moreover, bother increased help-seeking behavior; however, patients who sought help tended to have lower levels of QOL. Our findings highlight the role of bother and help-seeking behavior in the relationship between OAB symptom severity and QOL. To improve a patient's QOL, health care providers should focus not only on symptom bother but also on dysfunctional help-seeking patterns.

Discovering Your Personality: A Group Exercise in Personal Sensemaking

ERIC Educational Resources Information Center

Anderson, Marc H.

2008-01-01

Personality affects a wide variety of issues in organizational behavior, human resource management, and strategic management. Instructors teaching personality often have students take personality tests and then give them their scores. This passive approach to giving test feedback suffers from several weaknesses dealing with distinct perceptual…

Development and validation of the Pediatric Anesthesia Behavior score--an objective measure of behavior during induction of anesthesia.

PubMed

Beringer, Richard M; Greenwood, Rosemary; Kilpatrick, Nicky

2014-02-01

Measuring perioperative behavior changes requires validated objective rating scales. We developed a simple score for children's behavior during induction of anesthesia (Pediatric Anesthesia Behavior score) and assessed its reliability, concurrent validity, and predictive validity. Data were collected as part of a wider observational study of perioperative behavior changes in children undergoing general anesthesia for elective dental extractions. One-hundred and two healthy children aged 2-12 were recruited. Previously validated behavioral scales were used as follows: the modified Yale Preoperative Anxiety Scale (m-YPAS); the induction compliance checklist (ICC); the Pediatric Anesthesia Emergence Delirium scale (PAED); and the Post-Hospitalization Behavior Questionnaire (PHBQ). Pediatric Anesthesia Behavior (PAB) score was independently measured by two investigators, to allow assessment of interobserver reliability. Concurrent validity was assessed by examining the correlation between the PAB score, the m-YPAS, and the ICC. Predictive validity was assessed by examining the association between the PAB score, the PAED scale, and the PHBQ. The PAB score correlated strongly with both the m-YPAS (P < 0.001) and the ICC (P < 0.001). PAB score was significantly associated with the PAED score (P = 0.031) and with the PHBQ (P = 0.034). Two independent investigators recorded identical PAB scores for 94% of children and overall, there was close agreement between scores (Kappa coefficient of 0.886 [P < 0.001]). The PAB score is simple to use and may predict which children are at increased risk of developing postoperative behavioral disturbance. This study provides evidence for its reliability and validity. © 2013 John Wiley & Sons Ltd.

The Trauma of Commercial Sexual Exploitation of Youth: A Comparison of CSE Victims to Sexual Abuse Victims in a Clinical Sample.

PubMed

Cole, Jennifer; Sprang, Ginny; Lee, Robert; Cohen, Judith

2016-01-01

This study examined the demographic features, trauma profiles, clinical severity indicators, problem behaviors, and service utilization characteristics of youth victims of commercial sexual exploitation (CSE) compared with a matched sample of sexually abused/assaulted youth who were not exploited in commercial sex. Secondary data analysis and propensity score matching were used to select a sample of 215 help-seeking youth who were exploited in prostitution (n = 43) or who were sexually abused/assaulted but not exploited in prostitution (n = 172) from the National Child Traumatic Stress Network Core Data Set (NCTSN CDS). Propensity Score Matching was used to select a comparison sample based on age, race, ethnicity, and primary residence. Statistically significant differences were noted between the groups on standardized (e.g., UCLA Posttraumatic Stress Disorder Reaction Index [PTSD-RI], Child Behavior Checklist [CBCL]) and other measures of emotional and behavioral problems (e.g., avoidance and hyperarousal symptoms, dissociation, truancy, running away, conduct disorder, sexualized behaviors, and substance abuse). This study provides useful insight into the symptom and service utilization profiles of youth exploited in commercial sex as compared with youth with other types of sexually exploitive experiences. Targeted screening and event-sensitive measures are recommended to more accurately identify youth exploited in commercial sex. More research is needed to determine if and what modifications to trauma therapies may be required to address the more severe symptomatology and behavior problems associated with youth exploited in commercial sex. © The Author(s) 2014.

The efficacy of Internet-based cognitive behavioral therapy for severely fatigued survivors of breast cancer compared with care as usual: A randomized controlled trial.

PubMed

Abrahams, Harriët J G; Gielissen, Marieke F M; Donders, Rogier R T; Goedendorp, Martine M; van der Wouw, Agnes J; Verhagen, Constans A H H V M; Knoop, Hans

2017-10-01

Severe fatigue is a common and distressing symptom affecting approximately one in four survivors of breast cancer. The current study examined the efficacy of Internet-based cognitive behavioral therapy (ICBT) for severe fatigue in survivors of breast cancer compared with care as usual (CAU). The authors conducted a parallel-group randomized controlled trial. Severely fatigued, disease-free survivors of breast cancer who had completed cancer treatment at least 3 months previously were eligible. Participants were randomly allocated to ICBT or CAU using computer-generated stratified block randomization. The primary outcome of fatigue severity was assessed at baseline and after 6 months, as were the secondary outcomes of functional impairment, psychological distress, and quality of life. Statistical effects were tested with analyses of covariance (intention-to-treat analysis). Participants were recruited between January 2014 and March 2016 and assigned to ICBT (66 patients) or CAU (66 patients). Compared with the participants who had received CAU, those who had received ICBT reported lower fatigue scores at 6 months (mean difference [Δ], 11.5; 95% confidence interval [95% CI], 7.7-15.3) and a large effect size (Cohen d = 1.0), with the majority of patients (73%) demonstrating clinically significant improvement. ICBT also was found to lead to lower functional impairment (Δ, 297.8; 95% CI, 145.5-450.1) and psychological distress scores (Δ, 5.7; 95% CI, 3.4-7.9) and higher quality-of-life scores (Δ, 11.7; 95% CI, 5.8-17.7) compared with CAU, with medium to large effect sizes (Cohen d = 0.6-0.8). ICBT appears to be effective in reducing severe fatigue and related symptoms and meets the current need for easy accessible and more efficient evidence-based treatment options for severely fatigued survivors of breast cancer. Cancer 2017;123:3825-34. © 2017 American Cancer Society. © 2017 American Cancer Society.

Relationship between basic protective health behaviours and health related quality of life in Greek urban hospital employees.

PubMed

Tountas, Yannis; Manios, Yannis; Dimitrakaki, Christine; Tzavara, Chara

2007-01-01

The study aimed to explore the association between the presence of several protective health behaviors and physical and mental wellbeing/functioning among healthy hospital employees in Greece. A randomly selected representative sample of 395 employees working in seven hospitals, both public and private, within the wider region of Athens participated in the study. Participants were assigned to the following professional categories: administrative, auxiliary and technical personnel, medical doctors and nurses. Four basic protective health behaviors were examined: following the Mediterranean diet, exercising, no smoking and moderate alcohol drinking. Employees' health related quality of life was assessed with the self-administered SF-36 generic health status measure. Technical and administrative hospital personnel reported more healthy behaviors than medical and auxiliary personnel. There was an increased likelihood of scoring higher in almost all SF-36 Physical health subscales in the accumulation of the above four protective heath behaviors. In terms of mental health, even the presence of two or more protective health behaviors significantly increase the score on most SF-36 Mental health subscales. Results indicate that the protective role of basic health behaviors extends beyond physical health to mental wellbeing.

Impact of Behavioral Symptoms in Dementia Patients on Depression in Daughter and Daughter-in-Law Caregivers.

PubMed

Lee, Juwon; Sohn, Bo Kyung; Lee, Hyunjoo; Seong, Sujeong; Park, Soowon; Lee, Jun-Young

2017-01-01

One caregiver relationship that has been neglected in caregiver depression research is the daughter-in-law. Compared with Western countries, in which those who are closer in familial relationships such as the spouse or child usually take care of the patient, in many Asian countries, the daughter-in-law often assumes the caretaker role. However, not much research has been done on how this relationship may result in different caregiver outcomes. We sought to identify whether the association between patient characteristics and caregiver depressive symptoms differs according to the familial relationship between caregiver and patient. Ninety-five daughter (n = 47) and daughter-in-law (n = 48) caregivers of dementia patients were asked to report their own depressive symptoms and patient behavioral symptoms. Patients' cognitive abilities, daily activities, and global dementia ratings were obtained. Hierarchical linear regression was employed to determine predictors of depressive symptoms. Daughters-in-law had marginally higher depressive scores. After adjusting for caregiver and patient characteristics, in both groups, greater dependency in activities of daily living and more severe and frequent behavioral symptoms predicted higher caregiver depressive scores. However, greater severity and frequency of behavioral symptoms predicted depression to a greater degree in daughters compared with daughters-in-law. Although behavioral symptoms predicted depression in both caregiver groups, the association was much stronger for daughters. This suggests that the emotional relationship between the daughter and patient exacerbates the negative effect of behavioral symptoms on caregiver depression. The familial relationship between the caregiver and dementia patient should be considered in managing caregiver stress.

Impact of psychiatric and social characteristics on HIV sexual risk behavior in Puerto Rican women with severe mental illness.

PubMed

Heaphy, Emily Lenore Goldman; Loue, Sana; Sajatovic, Martha; Tisch, Daniel J

2010-11-01

Latinos in the United States have been identified as a high-risk group for depression, anxiety, and substance abuse. HIV/AIDS has disproportionately impacted Latinos. Review findings suggest that HIV-risk behaviors among persons with severe mental illness (SMI) are influenced by a multitude of factors including psychiatric illness, cognitive-behavioral factors, substance use, childhood abuse, and social relationships. To examine the impact of psychiatric and social correlates of HIV sexual risk behavior in Puerto Rican women with SMI. Data collected longitudinally (from 2002 to 2005) in semi-structured interviews and from non-continuous participant observation was analyzed using a cross-sectional design. Bivariate associations between predictor variables and sexual risk behaviors were examined using binary and ordinal logistic regression. Linear regression was used to examine the association between significant predictor variables and the total number of risk behaviors the women engaged in during the 6 months prior to baseline. Just over one-third (35.9%) of the study population (N = 53) was diagnosed with bipolar disorder and GAF scores ranged from 30 to 80 with a median score of 60. Participants ranged in age from 18 to 50 years (M = 32.6 ± 8.7), three-fourths reported a history of either sexual or physical abuse or of both in childhood, and one-fourth had abused substances in their lifetimes. Bivariate analyses indicated that psychiatric and social factors were differentially associated with sexual risk behaviors. Multivariate linear regression models showed that suffering from increased severity of psychiatric symptoms and factors and living below the poverty line are predictive of engagement in a greater number of HIV sexual risk behaviors. Puerto Rican women with SMI are at high risk for HIV infection and are in need of targeted sexual risk reduction interventions that simultaneously address substance abuse prevention and treatment, childhood abuse, and the indirect effects associated with SMI such as living in poverty. Mental health programs should address risk behavior among adults with SMI in the context of specific symptomatology and comorbidities.

Personality and antisocial behavior in children and adolescents: an enquiry into Eysenck's and Gray's theories.

PubMed

Fonseca, A C; Yule, W

1995-12-01

Two studies were conducted to test the hypotheses derived from Eysenck's and Gray's theories of personality regarding antisocial behavior. For this purpose the Eysenck Personality Questionnaire (Junior) (EPQ-Junior) and a card task aimed at measuring sensitivity to reward were used in each of the studies. The first study compared a group of juvenile delinquents with a group of nondelinquents and the second study compared a group of severely conduct-disordered children with a group of normal children. The results did not support Eysenck's claim that delinquents score higher than their normal counterparts on extraversion, neuroticism, and psychoticism. Some support was found for the hypothesis derived from Gray's theory: Children and adolescents with severe antisocial behavior were more sensitive to rewards than their normal counterparts.

A Brief Prenatal Intervention of Behavioral Change to Reduce the Risk of Maternal Cytomegalovirus: A Randomized Controlled Trial.

PubMed

Hughes, Brenna L; Gans, Kim M; Raker, Christina; Hipolito, Evelyn R; Rouse, Dwight J

2017-10-01

To estimate the effects of a brief prenatal behavioral intervention on risk behaviors for maternal cytomegalovirus (CMV) infection. Women were screened with CMV serology during prenatal care before 20 weeks of gestation and followed for at least 10 weeks. Women without serologic evidence of primary CMV infection were approached. Participants were apprised of serostatus and then randomized 2:1 to either a brief behavioral intervention during their prenatal care visit or to standard care (a brochure). The 7- to 10-minute in-office intervention included a video and hygiene education using motivational interviewing. Participants were then given a reminder calendar to take home and weekly text message reminders. The primary outcome was change in behavioral compliance score on a scale of 0-100. Secondary outcomes included process evaluation and domains of behavior change. A sample size of 180 participants was planned to compare the behavioral compliance score change of at least 15% between intervention and control groups with 80% power and 2.5% two-sided α. From April 2013 to October 2014, 197 women were randomized. One hundred eighty-seven (96%) had outcome data available. Mean gestational age at screening and randomization was 9 4/7 and 13 6/7 weeks of gestation, respectively. Primary outcome assessment occurred at a mean of 28 4/7 weeks of gestation. Baseline behavioral compliance scores increased modestly in the intervention group (mean: 7-point increase from 80.7 to 87.7, 95% CI 2.4-5.9) compared with the comparison group (mean: 4-point increase from 79.7 to 84.1, 95% CI 5.9-8.4; mean difference in change score: 3.0, 95% CI, 0.8-5.2; P=.007). Those in the intervention group reported change in risk perception related to perceived severity and susceptibility, self-efficacy, and perceived norms (P<.05 for all). A brief behavioral intervention delivered in the prenatal care setting was modestly effective at changing behaviors related to CMV infection risk. ClinicalTrials.gov, NCT01819519.

Associations Between Adverse Childhood Experiences and ADHD Diagnosis and Severity.

PubMed

Brown, Nicole M; Brown, Suzette N; Briggs, Rahil D; Germán, Miguelina; Belamarich, Peter F; Oyeku, Suzette O

Although identifying adverse childhood experiences (ACEs) among children with behavioral disorders is an important step in providing targeted therapy and support, little is known about the burden of ACEs among children with attention deficit-hyperactivity disorder (ADHD). We described the prevalence of ACEs in children with and without ADHD, and examined associations between ACE type, ACE score, and ADHD diagnosis and severity. Using the 2011 to 2012 National Survey of Children's Health, we identified children aged 4 to 17 years whose parents indicated presence and severity of ADHD, and their child's exposure to 9 ACEs. Multivariate logistic regression was used to estimate associations between ACEs, ACE score, and parent-reported ADHD and ADHD severity, adjusted for sociodemographic characteristics. In our sample (N = 76,227, representing 58,029,495 children), children with ADHD had a higher prevalence of each ACE compared with children without ADHD. Children who experienced socioeconomic hardship (adjusted odds ratio [aOR], 1.39; 95% confidence interval [CI], 1.21-1.59), divorce (aOR, 1.34; 95% CI, 1.16-1.55), familial mental illness (aOR, 1.55; 95% CI, 1.26-1.90), neighborhood violence (aOR, 1.47; 95% CI, 1.23-1.75), and incarceration (aOR, 1.39; 95% CI, 1.12-1.72) were more likely to have ADHD. A graded relationship was observed between ACE score and ADHD. Children with ACE scores of 2, 3, and ≥4 were significantly more likely to have moderate to severe ADHD. Children with ADHD have higher ACE exposure compared with children without ADHD. There was a significant association between ACE score, ADHD, and moderate to severe ADHD. Efforts to improve ADHD assessment and management should consider routinely evaluating for ACEs. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT zones in defining levels of severity among out-patients with alcohol dependence in the COMBINE study.

PubMed

Donovan, Dennis M; Kivlahan, Daniel R; Doyle, Suzanne R; Longabaugh, Richard; Greenfield, Shelly F

2006-12-01

To examine among alcohol-dependent out-patient clients the concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) total score and 'zones' suggested by the World Health Organization for defining levels of severity of alcohol use problems. Participants were classified into AUDIT zones (AUDIT total score = 8-15, 16-19, 20-40) and compared on measures of demographics, treatment goals, alcohol consumption, alcohol-related consequences, severity of dependence, physiological dependence, tolerance, withdrawal and biomarkers of alcohol use. Eleven out-patient academic clinical research centers across the United States. Participants Alcohol dependent individuals (n = 1335) entering out-patient treatment in the Combined Pharmacotherapies and Behavioral Interventions (COMBINE) study. The AUDIT was administered as part of an initial screening. Baseline measures used for concurrent validation included the Structured Clinical Interview for Diagnostic and Statistical Manual, 4th edition (DSM-IV) Disorders, the Alcohol Dependence Scale, the Drinker Inventory of Consequences, the Obsessive-Compulsive Drinking Scale, the University of Rhode Island Change Assessment, the Thoughts about Abstinence Scale, the Form-90, %carbohydrate-deficient transferrin and gamma-glutamyl transferase. Findings Indicators of severity of dependence and alcohol-related problems increased linearly with total score and differed significantly across AUDIT zones. The highest zone, with scores of 20 and above, was markedly different with respect to severity from the other two zones and members of this group endorsed an abstinence goal more strongly. The AUDIT total score is a brief measure that appears to provide an index of severity of dependence in a sample of alcohol-dependent individuals seeking out-patient treatment, extending its potential utility beyond its more traditional role as a screening instrument in general populations.

Negative Emotions and Behaviors are Markers of Breakup Distress

ERIC Educational Resources Information Center

Field, Tiffany; Diego, Miguel; Pelaez, Martha; Deeds, Osvelia; Delgado, Jeanette

2013-01-01

Method: University students who experienced a recent romantic breakup were given several self-report measures and were then divided into high versus low breakup distress groups. Results: The high breakup distress versus the low breakup distress groups had higher scores on negative emotions scales including depression, anxiety and anger and…

Dimensionality of Upper Elementary Mathematics Instruction: Exploring Factors across Two Observational Instruments

ERIC Educational Resources Information Center

Blazar, David; Braslow, David; Charalambous, Charalambos Y.

2015-01-01

Over the past several years, research teams have developed observational instruments to measure the quality of teachers' instructional practices. Instruments such as Framework for Teaching (FFT) and the Classroom Assessment Scoring System (CLASS) assess general teaching practices, including student-teacher interactions, behavior management, and…

Development and Validation of a Quantitative Measure of Adaptive Behaviors in Women With Pelvic Floor Disorders.

PubMed

Wei, John T; Dunn, Rodney; Nygaard, Ingrid; Burgio, Kathryn; Lukacz, Emily S; Markland, Alayne; Wren, Patricia A; Brubaker, Linda; Barber, Matthew D; Jelovsek, J Eric; Spino, Cathie; Meikle, Susie; Janz, Nancy

To establish validity for the Pelvic Floor Disorders Network (PFDN) self-administered Adaptive Behavior Index (ABI) and to assess whether ABI assesses known discordance between severity of pelvic floor symptoms and self-reported bother. In addition to the ABI questionnaire, participants in 1 of 6 Pelvic Floor Disorders Network trials completed condition-specific measures of pretreatment symptom severity (including Pelvic Floor Distress Inventory; PFDI) and health-related quality of life (Pelvic Floor Impact Questionnaire; PFIQ). The final survey was developed from an iterative process using subject and expert endorsement, factor analyses, and response distributions. Domains were created using a development cohort (n = 304 women), reliability and validity were established using a validation cohort (n = 596 women), and test-retest reliability was assessed (n = 111 women). Factor analyses supported an 11-item avoidance domain and a 6-item hygiene domain. Cronbach' alphas were 0.88 and 0.68, respectively. Test-retest reliability was 0.84 for both domains. Construct validity was demonstrated in correlations between the ABI domains and baseline PFDI and PFIQ (r values, 0.43-0.79 with all P values <0.0001). Moreover, the ABI accounted for 8% to 26% of unexplained variance between the symptoms severity measure and the impact on health related quality of life. After treatment, avoidance domain scores improved for urinary and fecal incontinence groups and hygiene scores improved for the fecal incontinence group. The ABI is a reliable and valid measure in women with pelvic floor disorders. Adaptive behaviors account in part for discordance between pelvic floor symptom severity and bother.

Exposure to prenatal life events stress is associated with masculinized play behavior in girls

PubMed Central

Barrett, Emily S.; Redmon, J. Bruce; Wang, Christina; Sparks, Amy; Swan, Shanna H.

2014-01-01

Previous research has shown that prenatal exposure to endocrine-disrupting chemicals can alter children’s neurodevelopment, including sex-typed behavior, and that it can do so in different ways in males and females. Non-chemical exposures, including psychosocial stress, may disrupt the prenatal hormonal milieu as well. To date, only one published study has prospectively examined the relationship between exposure to prenatal stress and gender-specific play behavior during childhood, finding masculinized play behavior in girls who experienced high prenatal life events stress, but no associations in boys. Here we examine this question in a second prospective cohort from the Study for Future Families. Pregnant women completed questionnaires on stressful life events during pregnancy, and those who reported one or more events were considered “stressed”. Families were recontacted several years later (mean age of index child: 4.9 years), and mothers completed a questionnaire including the validated Preschool Activities Inventory (PSAI), which measures sexually dimorphic play behavior. In sex-stratified analyses, after adjusting for child’s age, parental attitudes towards gender-atypical play, age and sex of siblings, and other relevant covariates, girls (n=72) exposed to prenatal life events stress had higher scores on the PSAI masculine sub-scale (β=3.48, p=0.006) and showed a trend towards higher (more masculine) composite scores (β=2.63, p=0.08). By contrast, in males (n=74), there was a trend towards an association between prenatal stress and higher PSAI feminine sub-scale scores (β=2.23, p=0.10), but no association with masculine or composite scores. These data confirm previous findings in humans and animal models suggesting that prenatal stress is a non-chemical endocrine disruptor that may have androgenic effects on female fetuses and anti-androgenic effects on male fetuses. PMID:24406375

Predicting Physical Activity and Healthy Nutrition Behaviors Using Social Cognitive Theory: Cross-Sectional Survey among Undergraduate Students in Chongqing, China.

PubMed

Xu, Xianglong; Pu, Yang; Sharma, Manoj; Rao, Yunshuang; Cai, Yilin; Zhao, Yong

2017-11-05

(1) Background: Generally suggested public health measures to reduce obesity were to limit television (TV) viewing, enhance daily physical activities, enable the consumption of fruit and vegetables, and reduce sugar-sweetened beverage intake. This study analyzed the extent to which selected social cognitive theory constructs can predict these behaviors among Chinese undergraduate students. (2) Methods: This cross-sectional study included 1976 undergraduate students from six universities in Chongqing, China. A self-administered five-point Likert common physical activity and nutrition behavior scale based on social cognitive theory was utilized. (3) Results: This study included 687 (34.77%) males and 1289 (65.23%) females. A total of 60.14% of the students engaged in exercise for less than 30 min per day. Approximately 16.5%of the participants spent at least 4 h watching TV and sitting in front of a computer daily. Approximately 79% of the participants consumed less than five cups of fruit and vegetables daily. Undergraduate students who had high self-efficacy scores had more leisure time physical activities. Those who have high expectation scores had considerable time watching TV and sitting in front of a computer. Undergraduate students who had high expectation and self-efficacy scores had substantially low consumption of sugar-sweetened beverages. Those who had high self-efficacy scores consumed considerable amounts of fruit and vegetables. Furthermore, the type of university, BMI group, gender, age, lack of siblings, and grade level were associated with the aforementioned four behaviors. (4) Conclusion: Physical inactivity and unhealthy nutrition behaviors are common among undergraduate students. This study used social cognitive theory to provide several implications for limiting the TV viewing, enhancing daily physical activities, consuming fruit and vegetables, and reducing sugar-sweetened beverage intake among undergraduate students.

Predicting Physical Activity and Healthy Nutrition Behaviors Using Social Cognitive Theory: Cross-Sectional Survey among Undergraduate Students in Chongqing, China

PubMed Central

Pu, Yang; Sharma, Manoj; Rao, Yunshuang; Cai, Yilin; Zhao, Yong

2017-01-01

(1) Background: Generally suggested public health measures to reduce obesity were to limit television (TV) viewing, enhance daily physical activities, enable the consumption of fruit and vegetables, and reduce sugar-sweetened beverage intake. This study analyzed the extent to which selected social cognitive theory constructs can predict these behaviors among Chinese undergraduate students. (2) Methods: This cross-sectional study included 1976 undergraduate students from six universities in Chongqing, China. A self-administered five-point Likert common physical activity and nutrition behavior scale based on social cognitive theory was utilized. (3) Results: This study included 687 (34.77%) males and 1289 (65.23%) females. A total of 60.14% of the students engaged in exercise for less than 30 min per day. Approximately 16.5% of the participants spent at least 4 h watching TV and sitting in front of a computer daily. Approximately 79% of the participants consumed less than five cups of fruit and vegetables daily. Undergraduate students who had high self-efficacy scores had more leisure time physical activities. Those who have high expectation scores had considerable time watching TV and sitting in front of a computer. Undergraduate students who had high expectation and self-efficacy scores had substantially low consumption of sugar-sweetened beverages. Those who had high self-efficacy scores consumed considerable amounts of fruit and vegetables. Furthermore, the type of university, BMI group, gender, age, lack of siblings, and grade level were associated with the aforementioned four behaviors. (4) Conclusion: Physical inactivity and unhealthy nutrition behaviors are common among undergraduate students. This study used social cognitive theory to provide several implications for limiting the TV viewing, enhancing daily physical activities, consuming fruit and vegetables, and reducing sugar-sweetened beverage intake among undergraduate students. PMID:29113089

German version, inter- and intrarater reliability and internal consistency of the "Agitated Behavior Scale" (ABS-G) in patients with moderate to severe traumatic brain injury.

PubMed

Hellweg, Stephanie; Schuster-Amft, Corina

2016-07-19

Agitation is frequently observed during early recovery after traumatic brain injury (TBI). Agitated behaviour often interferes with a goal-orientated rehabilitation and can be a substantial hindrance to therapy. Despite the relatively high occurance of agitation in TBI population there is no objective assessement in German (G) available. An existing scale with excellent psychometric properties is the "Agitated Behavior Scale (ABS)" developed by Corrigan in 1989. The aim of the study was to translate the Agitated Behavior Scale (ABS) into German (ABS-G) and investigate the inter- and intrarater reliability and internal consistency in patients with moderate to severe TBI. A formal nine-step translation and cross-cultural adaptation procedure (TCCA) was applied. Subsequently a prospective observational patient study was conducted. To examine the interrater reliability and internal consistency, two therapists rated 20 patients independently after a therapy session. This procedure was repeated twice on a weekly basis. The intrarater reliability was assessed through video recordings from three patients. Nine raters scored the demonstrated behaviour on the videotape with the ABS-G independently twice within one month. The inter- and intrarater reliability were evaluated with the Spearman rank correlation coefficient and the quadratic weighted kappa. The internal consistency was tested with Cronbach's alpha. Behaviour of 20 patients (18 males; mean age 41 ± 20.7; mean Functional Independence Measure (FIM) cognitive score on admission 7.1 ± 4.04; mean ABS-G score at first observation 17.3 ± 2.83) was assessed threefold. Interrater reliability yielded a correlation coefficient for ABS-G total score of all 60 paired observations of r s 0.845 and a weighted Kappa of 0.738. Intrarater reliability for ABS-G total score ranged between r s 0.719 and 0.953 and showed a weighted Kappa between 0.871 and 0.953. Cronbach's alpha indicated moderate internal consistency with 0.661. This study demonstrates that the ABS-G is a reliable instrument for evaluating agitation in patients with moderate to severe TBI. Hereby it would be possible to monitor agitation objectively and optimise the management of agitated patients according to international recommendations.

A description of disordered eating behaviors in Latino males.

PubMed

Reyes-Rodriguez, Mae Lynn; Sala, Margarita; Von Holle, Ann; Unikel, Claudia; Bulik, Cynthia M; Camara-Fuentes, Luis; Suarez-Torres, Alba

2011-01-01

To explore disordered eating and eating disorders (EDs) in Latino males. Participants are 722 male college students from a larger prevalence study conducted in the University of Puerto Rico system. Participants were selected from a list of sections of required courses for first-year students on each campus. Self-report instruments were used to explore ED symptoms (the Eating Attitudes Test [EAT-26] and the Bulimia Test-Revised [BULIT-26-R] and the Beck Depression Inventory depression (BDI). Overall, 2.26% scored above the cut-off point on the BULIT-R and 5.08% score above the cut-off point on the EAT-26. Of the males, 4.43% reported sufficient frequency and severity to approximate DSM-IV criteria for bulimia nervosa. Depression symptomatology was found in those who scored above the cut-off point on both instruments of EDs. College health practitioners should be aware of disordered eating in Latino males and include them in efforts to detect disordered eating behaviors in college students.

Gender role, eating disorder symptoms, and body image concern in ballet dancers.

PubMed

Ravaldi, Claudia; Vannacci, Alfredo; Bolognesi, Enrica; Mancini, Stefania; Faravelli, Carlo; Ricca, Valdo

2006-10-01

Our objective was to evaluate the relationships between gender role, eating behavior, and body image in nonprofessional female ballet dancers. One hundred ten female ballet dancers and 59 controls were administered the Bem Sex Role Inventory, the Eating Disorder Examination (EDE), the Body Uneasiness Test (BUT), and the Beck Depression Inventory. Ballet dancers scored higher than controls in most of the items evaluating body image and eating behaviors; a high number of ballet dancers with undifferentiated gender role were also observed. In the dancers group, male-typified subjects showed higher median scores of EDE and BUT scales, while in the control group, the highest median scores of EDE and BUT scales were found in undifferentiated subjects. Ballet schools' cultural pressure towards an ideal of leanness could interfere with the process of gender role acquisition. Ballet dancers appear to be overconcerned with performance; this could reinforce the internalization of several constructs that are generally considered as typically male.

Disordered Eating Behaviors in Emerging Adults With Type 1 Diabetes: A Common Problem for Both Men and Women.

PubMed

Doyle, Elizabeth A; Quinn, Sheila M; Ambrosino, Jodie M; Weyman, Kate; Tamborlane, William V; Jastreboff, Ania M

Emerging adults (EA) with disordered eating behaviors (DEBs) and Type 1 diabetes (T1D) are at increased risk for severe complications of T1D, and these behaviors have been reported in EA women with T1D. Few studies, though, have included men. This study assessed the prevalence of DEB in both EA men and women with T1D. DEB was measured with the diabetes-specific Diabetes Eating Problem Survey-Revised (DEPS-R); scores of 20 or greater indicate need for further evaluation for DEB. A total of 27 women and 33 men (age range = 21 ± 2.5 years) completed the DEPS-R; 27% of women and 18% of men had scores of 20 or greater (p = .23). Hemoglobin A1c level was significantly higher in subjects with elevated DEPS-R scores (10.4 ± 2.1% vs. 7.8 ± 1.3%; p < .001), and DEPS-R scores correlated with increased body mass index values (r = 0.27, p < .05). Clinicians should assess for DEB in both male and female emerging adults with T1D, especially overweight patients with poor glycemic control. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Relations of mood with body mass index changes in severely obese women enrolled in a supported physical activity treatment.

PubMed

Annesi, James J

2008-01-01

It has been suggested that physical activity may affect weight reduction outcomes through associated improvements in mood. Relations of physical activity, mood, and weight change are not well understood in persons classified as severely obese (BMI > or = 40 kg/m(2)), however. This research tested these relationships in women with severe obesity. 57 women with a mean BMI of 43.8 kg/m(2) were enrolled in a cognitive-behavioral exercise support treatment with group-based nutrition information. Measurement of depression, tension, overall mood, and BMI was taken at baseline and month 6, and exercise session attendance was recorded. The treatment was associated with significant improvements in depression, tension and total mood disturbance scores as well as in BMI over 6 months. Changes in mood scores that were more positive were correlated with a greater reduction in BMI. Mean attendance in the prescribed 3 session/week exercise regimen was 46.0%, and attendance was significantly correlated with changes in tension and total mood disturbance scores, and approached significance with changes in depression scores. Findings suggested significant relations of mood and weight change as well as of physical activity and mood in severely obese women associated with a treatment of moderate physical activity. With extensions of this research, weight loss theory and treatment may benefit. Copyright 2008 S. Karger AG, Basel.

Psychiatric Severity and HIV-Risk Sexual Behaviors among Persons with Substance Use Disorders

PubMed Central

Majer, John M.; Komer, Anne C.; Jason, and Leonard A.

2014-01-01

Objective The relationship between mental illness and human-immunodeficiency virus (HIV)-risk sexual behavior among persons with substance use disorders is not well established because of differences in assessing psychiatric factors (types, symptoms, severity), substance use (diagnosis, survey responses, past substance use) and HIV-risk sexual behaviors (individual measures, combination of sex/drug use risk behaviors) across studies. This study utilized a more global and dimensional aspect of psychiatric issues (problem severity), to examine the relationship with HIV-risk sexual behaviors and substance use among persons with substance use disorders. Methods Participants included 224 men and 46 women, with a mean age of 40.4 years (SD = 9.5). The most common substances were heroin/opiates, with 41.4% reporting use of these substances (n = 110, 110/266), while 27.8% reported using cocaine (n = 74, 74/266) and 12.8% reported using alcohol (n = 34, 34/266). Of all participants, 39 (14.4%) were identified as having high psychiatric severity (defined using the psychiatric severity score from the Addiction Severity Index), which was used as an indication of probable comorbid psychiatric and substance use disorders. Among these participants likely to have comorbid disorders, hierarchical linear regression was conducted to examine HIV-risk sexual behaviors (number of partners and unprotected sexual behaviors in the past 30 days) in relation to psychiatric severity, substance use, and gender. Results Gender (women) and psychiatric severity (higher) were significantly related to greater HIV-risk sexual behaviors. After entering gender and substance use into the regression model, psychiatric severity accounted for another 21.9% of the variance in number of partners and 14.1% of the variance in unprotected sexual behaviors. Overall, the models accounted for 55.5% and 15.6% of the variance, respectively. A significant interaction was found for number of partners (but not frequency of unprotected behavior), such that those higher in psychiatric severity and higher in substance use had a greater number of sexual partners. The model including this interaction term accounted for 63.4% of the variance in number of partners. Conclusions Findings suggest psychiatric severity is an underlying risk factor for HIV-risk sexual behavior among persons with substance use disorders who have various psychiatric comorbidities. PMID:25455334

Association between childhood dimensions of attention deficit hyperactivity disorder and adulthood clinical severity of bipolar disorders.

PubMed

Etain, Bruno; Lajnef, M; Loftus, J; Henry, C; Raust, A; Gard, S; Kahn, J P; Leboyer, M; Scott, J; Bellivier, F

2017-04-01

Clinical features of attention deficit hyperactivity disorder can be frequently observed in cases with bipolar disorders and associated with greater severity of bipolar disorders. Although designed as a screening tool for attention deficit hyperactivity disorder, the Wender Utah Rating Scale could, given its factorial structure, be useful in investigating the early history of impulsive, inattentive or mood-related symptoms among patients with bipolar disorders. We rated the Wender Utah Rating Scale in 276 adult bipolar disorder cases and 228 healthy controls and tested its factorial structure and any associations with bipolar disorder phenomenology. We confirmed a three-factor structure for the Wender Utah Rating Scale (' impulsivity/temper', ' inattentiveness' and ' mood/self-esteem'). Cases and controls differed significantly on Wender Utah Rating Scale total score and sub-scale scores ( p-values < 10 -5 ). About 23% of bipolar disorder cases versus 5% of controls were classified as ' WURS positive' (odds ratio = 5.21 [2.73-9.95]). In bipolar disorders, higher Wender Utah Rating Scale score was associated with earlier age at onset, severity of suicidal behaviors and polysubstance misuse; multivariate analyses, controlling for age and gender, confirmed the associations with age at onset ( p = 0.001) and alcohol and substance misuse ( p = 0.001). Adults with bipolar disorders who reported higher levels of childhood symptoms on the Wender Utah Rating Scale presented a more severe expression of bipolar disorders in terms of age at onset and comorbidity. The Wender Utah Rating Scale could be employed to screen for attention deficit hyperactivity disorder but also for ' at-risk behaviors' in adult bipolar disorder cases and possibly for prodromal signs of early onset in high-risk subjects.

Alexithymia level and response to computer-based training in cognitive behavioral therapy among cocaine-dependent methadone maintained individuals.

PubMed

Morie, Kristen P; Nich, Charla; Hunkele, Karen; Potenza, Marc N; Carroll, Kathleen M

2015-07-01

Alexithymia, a characteristic marked by poor ability to identify, define and communicate emotions, has been associated with poorer treatment outcome, including traditional clinician delivered CBT. Computerized cognitive behavioral therapy (CBT4CBT), an effective adjunct to treatment, may provide a means of conveying skills without requiring interaction with a clinician. Seventy-three methadone maintained, cocaine dependent individuals participating in an 8-week randomized clinical trial comparing standard methadone maintenance to methadone maintenance plus CBT4CBT completed the Toronto Alexithymia Scale (TAS-20) at pretreatment, post-treatment, and follow-ups conducted one, two, and 6 months after treatment. There were no statistically significant differences on baseline TAS-20 scores by multiple demographic and substance use variables including gender and substance use severity. Higher TAS-20 scores were associated with somewhat higher levels of distress as measured by the Beck Depression Inventory and multiple Brief Severity Index scales. TAS-20 scores remained relatively stable throughout the duration of treatment and follow-up. Indicators of treatment process, including treatment retention, adherence and therapeutic alliance, were not significantly correlated with TAS-20 scores. There was a significant interaction of alexithymia and treatment condition, such that individuals with higher baseline scores on the TAS-20 submitted significantly higher percentages of cocaine-negative urine toxicology specimens and reported a higher percentage of abstinence days, and longer periods of consecutive abstinence within treatment when assigned to CBT4CBT compared with treatment as usual. These findings suggest that individuals with increased alexithymia may benefit from computerized CBT; possibly via reduced demands on interpersonal skills and interactions associated with computerized therapies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Psychopathological status, behavior problems, and family adjustment of Kuwaiti children whose fathers were involved in the first gulf war

PubMed Central

Al-Turkait, Fawziyah A; Ohaeri, Jude U

2008-01-01

Objectives Following the end of the Gulf War that resulted in the liberation of Kuwait, there are no reports on the impact of veterans' traumatic exposure and posttraumatic stress disorder (PTSD) on their children. We compared the severity of anxiety, depression, deviant behavior and poor family adjustment among the children of a stratified random sample of four groups of Kuwaiti military men, viz: the retired; an active -in-the-army group (AIA) (involved in duties at the rear); an in-battle group (IB) (involved in combat); and a prisoners -of- war (POWs) group. Also, we assessed the association of father's PTSD/combat status and mother's characteristics with child psychosocial outcomes. Method Subjects were interviewed at home, 6 years after the war, using: the Child Behavior Index to assess anxiety, depression, and adaptive behavior; Rutter Scale A2 for deviant behavior; and Family Adjustment Device for adjustment at home. Both parents were assessed for PTSD. Results The 489 offspring (250 m, 239 f; mean age 13.8 yrs) belonged to 166 father-mother pairs. Children of POWs tended to have higher anxiety, depression, and abnormal behavior scores. Those whose fathers had PTSD had significantly higher depression scores. However, children of fathers with both PTSD and POW status (N = 43) did not have significantly different outcome scores than the other father PTSD/combat status groups. Mother's PTSD, anxiety, depression and social status were significantly associated with all the child outcome variables. Parental age, child's age and child's level of education were significant covariates. Although children with both parents having PTSD had significantly higher anxiety/depression scores, the mother's anxiety was the most frequent and important predictor of child outcome variables. The frequency of abnormal test scores was: 14% for anxiety/depression, and 17% for deviant behavior. Conclusion Our findings support the impression that child emotional experiences in vulnerable family situations transcend culture and are associated with the particular behavior of significant adults in the child's life. The primacy of the mother's influence has implications for interventions to improve the psychological functioning of children in such families. Mental health education for these families has the potential to help those in difficulty. PMID:18510770

Autistic characteristics in adults with epilepsy and perceived seizure activity.

PubMed

Wakeford, SallyAnn; Hinvest, Neal; Ring, Howard; Brosnan, Mark

2015-11-01

The prevalence of autism spectrum disorders in epilepsy is approximately 15%-47%, with previous research by Wakeford and colleagues reporting higher autistic traits in adults with epilepsy. The aim of this study was to investigate autistic characteristics and their relationship to having seizures by employing two behavioral assessments in two samples: adults with epilepsy and controls. The study employed the Social Responsiveness Scale - Shortened (SRS-S) (patients with epilepsy (n=76), control (n=19)) and the brief Repetitive Behavior Scale - Revised (RBS-R) (patients with epilepsy (n=47), control (n=21)). This study employed a unique method to quantify the extent to which autistic characteristics are related to perceived mild seizure activity. Adults with epilepsy were instructed to rate their usual behavior on each assessment and, at the same time, rate their behavior again when they perceived that they were having mild seizure activity. Significantly higher SRS-S scores were related to having a diagnosis of epilepsy and were perceived by adults with epilepsy to increase during mild seizure activity. These scores positively correlated with antiepileptic drug control. No difference was found for RBS-R scores in adults with epilepsy compared with controls. Together, these results suggest that adults with epilepsy have higher autistic characteristics measured by the social responsiveness scale, while sameness behaviors remain unimpaired. The autistic characteristics measured by the social responsiveness scale were reported by adults with epilepsy to be more severe during their mild seizure activity. Copyright © 2015 Elsevier Inc. All rights reserved.

Sulforaphane treatment of autism spectrum disorder (ASD)

PubMed Central

Singh, Kanwaljit; Connors, Susan L.; Macklin, Eric A.; Smith, Kirby D.; Fahey, Jed W.; Talalay, Paul; Zimmerman, Andrew W.

2014-01-01

Autism spectrum disorder (ASD), characterized by both impaired communication and social interaction, and by stereotypic behavior, affects about 1 in 68, predominantly males. The medico-economic burdens of ASD are enormous, and no recognized treatment targets the core features of ASD. In a placebo-controlled, double-blind, randomized trial, young men (aged 13–27) with moderate to severe ASD received the phytochemical sulforaphane (n = 29)—derived from broccoli sprout extracts—or indistinguishable placebo (n = 15). The effects on behavior of daily oral doses of sulforaphane (50–150 µmol) for 18 wk, followed by 4 wk without treatment, were quantified by three widely accepted behavioral measures completed by parents/caregivers and physicians: the Aberrant Behavior Checklist (ABC), Social Responsiveness Scale (SRS), and Clinical Global Impression Improvement Scale (CGI-I). Initial scores for ABC and SRS were closely matched for participants assigned to placebo and sulforaphane. After 18 wk, participants receiving placebo experienced minimal change (<3.3%), whereas those receiving sulforaphane showed substantial declines (improvement of behavior): 34% for ABC (P < 0.001, comparing treatments) and 17% for SRS scores (P = 0.017). On CGI-I, a significantly greater number of participants receiving sulforaphane had improvement in social interaction, abnormal behavior, and verbal communication (P = 0.015–0.007). Upon discontinuation of sulforaphane, total scores on all scales rose toward pretreatment levels. Dietary sulforaphane, of recognized low toxicity, was selected for its capacity to reverse abnormalities that have been associated with ASD, including oxidative stress and lower antioxidant capacity, depressed glutathione synthesis, reduced mitochondrial function and oxidative phosphorylation, increased lipid peroxidation, and neuroinflammmation. PMID:25313065

Sulforaphane treatment of autism spectrum disorder (ASD).

PubMed

Singh, Kanwaljit; Connors, Susan L; Macklin, Eric A; Smith, Kirby D; Fahey, Jed W; Talalay, Paul; Zimmerman, Andrew W

2014-10-28

Autism spectrum disorder (ASD), characterized by both impaired communication and social interaction, and by stereotypic behavior, affects about 1 in 68, predominantly males. The medico-economic burdens of ASD are enormous, and no recognized treatment targets the core features of ASD. In a placebo-controlled, double-blind, randomized trial, young men (aged 13-27) with moderate to severe ASD received the phytochemical sulforaphane (n = 29)--derived from broccoli sprout extracts--or indistinguishable placebo (n = 15). The effects on behavior of daily oral doses of sulforaphane (50-150 µmol) for 18 wk, followed by 4 wk without treatment, were quantified by three widely accepted behavioral measures completed by parents/caregivers and physicians: the Aberrant Behavior Checklist (ABC), Social Responsiveness Scale (SRS), and Clinical Global Impression Improvement Scale (CGI-I). Initial scores for ABC and SRS were closely matched for participants assigned to placebo and sulforaphane. After 18 wk, participants receiving placebo experienced minimal change (<3.3%), whereas those receiving sulforaphane showed substantial declines (improvement of behavior): 34% for ABC (P < 0.001, comparing treatments) and 17% for SRS scores (P = 0.017). On CGI-I, a significantly greater number of participants receiving sulforaphane had improvement in social interaction, abnormal behavior, and verbal communication (P = 0.015-0.007). Upon discontinuation of sulforaphane, total scores on all scales rose toward pretreatment levels. Dietary sulforaphane, of recognized low toxicity, was selected for its capacity to reverse abnormalities that have been associated with ASD, including oxidative stress and lower antioxidant capacity, depressed glutathione synthesis, reduced mitochondrial function and oxidative phosphorylation, increased lipid peroxidation, and neuroinflammmation.

Electroencephalographic findings related with mild cognitive impairment in idiopathic rapid eye movement sleep behavior disorder.

PubMed

Sasai, Taeko; Matsuura, Masato; Inoue, Yuichi

2013-12-01

Mild cognitive impairment (MCI) and electroencephalographic (EEG) slowing have been reported as common findings of idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) and α-synucleinopathies. The objective of this study is to clarify the relation between MCI and physiological markers in iRBD. Cross-sectional study. Yoyogi Sleep Disorder Center. Thirty-one patients with iRBD including 17 younger patients with iRBD (younger than 70 y) and 17 control patients for the younger patients with iRBD. N/A. Montreal Cognitive Assessment (MoCA) and n-polysomnogram (PSG) were conducted of all participants. In patients with iRBD, the factors associated with MCI were explored among parameters of REM sleep without atonia (RWA), score of Sniffin' Sticks Test (threshold-discrimination-identification [TDI] score), RBD morbidity, and RBD severity evaluated with the Japanese version of the RBD questionnaire (RBDQ-JP). The younger iRBD group showed significantly lower alpha power during wake and lower MoCA score than the age-matched control group. MCI was detected in 13 of 17 patients (76.5%) on MoCA in this group. Among patients wtih iRBD, the MoCA score negatively correlated with age, proportion of slow wave sleep, TDI score, and EEG spectral power. Multiple regression analysis provided the following equation: MoCA score = 50.871-0.116*age -5.307*log (δ power during REM sleep) + 0.086*TDI score (R² = 0.598, P < 0.01). The standardized partial regression coefficients were -0.558 for age, -0.491 for log (δ power during REM sleep), and 0.357 for TDI score (F = 9.900, P < 0.001). Electroencephalographic slowing, especially during rapid eye movement sleep and olfactory dysfunction, was revealed to be associated with cognitive decline in idiopathic rapid eye movement sleep behavior disorder.

Are Examiners' Judgments in OSCE-Style Assessments Influenced by Contrast Effects?

PubMed

Yeates, Peter; Moreau, Marc; Eva, Kevin

2015-07-01

Laboratory studies have shown that performance assessment judgments can be biased by "contrast effects." Assessors' scores become more positive, for example, when the assessed performance is preceded by relatively weak candidates. The authors queried whether this effect occurs in real, high-stakes performance assessments despite increased formality and behavioral descriptors. Data were obtained for the 2011 United Kingdom Foundational Programme clinical assessment and the 2008 University of Alberta Multiple Mini Interview. Candidate scores were compared with scores for immediately preceding candidates and progressively distant candidates. In addition, average scores for the preceding three candidates were calculated. Relationships between these variables were examined using linear regression. Negative relationships were observed between index scores and both immediately preceding and recent scores for all exam formats. Relationships were greater between index scores and the average of the three preceding scores. These effects persisted even when examiners had judged several performances, explaining up to 11% of observed variance on some occasions. These findings suggest that contrast effects do influence examiner judgments in high-stakes performance-based assessments. Although the observed effect was smaller than observed in experimentally controlled laboratory studies, this is to be expected given that real-world data lessen the strength of the intervention by virtue of less distinct differences between candidates. Although it is possible that the format of circuital exams reduces examiners' susceptibility to these influences, the finding of a persistent effect after examiners had judged several candidates suggests that the potential influence on candidate scores should not be ignored.

Use of the Behavior Rating Inventory of Executive Function and Child Behavior Checklist in Ugandan Children with HIV or a History of Severe Malaria.

PubMed

Familiar, Itziar; Ruisenor-Escudero, Horacio; Giordani, Bruno; Bangirana, Paul; Nakasujja, Noeline; Opoka, Robert; Boivin, Michael

2015-05-01

To assess the structural overlap between the Behavior Rating Inventory of Executive Function (BRIEF) and Achenbach Child Behavior Checklist (CBCL) among children in Uganda. Caregiver ratings for the BRIEF and CBCL were obtained for 2 independent samples of school-aged children: 106 children (5-12 years old, 50% males) with a history of severe malaria and on 144 HIV-infected children (5-12 years old, 58% males) in Uganda. Exploratory factor analysis was used to evaluate the factor structure of the 8 subscales for the BRIEF and the 8 scales of the CBCL to determine correlation. Overall, children in the severe malaria group had higher (increased symptom) BRIEF and CBCL scores than those in the HIV-infected group. Three factors that provided a reasonable fit to the data and could be characterized as 3 specific domains were identified: (1) Metacognition, which consisted of the scales in the BRIEF Metacognition domain, (2) Behavioral Adjustment, which comprised of the scales in the BRIEF Behavioral Regulation domain and the Externalizing Symptoms scales in the CBCL, and (3) Emotional Adjustment, which mainly consisted of the Internalizing Symptoms scales in the CBCL. The BRIEF Behavior Regulation and CBCL Externalizing Symptoms scales, however, did overlap in terms of assessing similar behavior symptoms. These findings were consistent across the severe malaria and HIV-infected samples of children. The BRIEF and CBCL instruments offer distinct, yet complementary, assessments of behavior in clinical pediatric populations in the Ugandan context, supporting the use of these measures for similar research settings.

Long-term and within-day variability of working memory performance and EEG in individuals.

PubMed

Gevins, Alan; McEvoy, Linda K; Smith, Michael E; Chan, Cynthia S; Sam-Vargas, Lita; Baum, Cliff; Ilan, Aaron B

2012-07-01

Assess individual-subject long-term and within-day variability of a combined behavioral and EEG test of working memory. EEGs were recorded from 16 adults performing n-back working memory tasks, with 10 tested in morning and afternoon sessions over several years. Participants were also tested after ingesting non-prescription medications or recreational substances. Performance and EEG measures were analyzed to derive an Overall score and three constituent sub-scores characterizing changes in performance, cortical activation, and alertness from each individual's baseline. Long-term and within-day variability were determined for each score; medication effects were assessed by reference to each individual's normal day-to-day variability. Over the several year period, the mean Overall score and sub-scores were approximately zero with standard deviations less than one. Overall scores were lower and their variability higher in afternoon relative to morning sessions. At the group level, alcohol, diphenhydramine and marijuana produced significant effects, but there were large individual differences. Objective working memory measures incorporating performance and EEG are stable over time and sensitive at the level of individual subjects to interventions that affect neurocognitive function. With further research these measures may be suitable for use in individualized medical care by providing a sensitive assessment of incipient illness and response to treatment. Published by Elsevier Ireland Ltd.

Cognitive-behavioral screening reveals prevalent impairment in a large multicenter ALS cohort

PubMed Central

Factor-Litvak, Pam; Goetz, Raymond; Lomen-Hoerth, Catherine; Nagy, Peter L.; Hupf, Jonathan; Singleton, Jessica; Woolley, Susan; Andrews, Howard; Heitzman, Daragh; Bedlack, Richard S.; Katz, Jonathan S.; Barohn, Richard J.; Sorenson, Eric J.; Oskarsson, Björn; Fernandes Filho, J. Americo M.; Kasarskis, Edward J.; Mozaffar, Tahseen; Rollins, Yvonne D.; Nations, Sharon P.; Swenson, Andrea J.; Koczon-Jaremko, Boguslawa A.; Mitsumoto, Hiroshi

2016-01-01

Objectives: To characterize the prevalence of cognitive and behavioral symptoms using a cognitive/behavioral screening battery in a large prospective multicenter study of amyotrophic lateral sclerosis (ALS). Methods: Two hundred seventy-four patients with ALS completed 2 validated cognitive screening tests and 2 validated behavioral interviews with accompanying caregivers. We examined the associations between cognitive and behavioral performance, demographic and clinical data, and C9orf72 mutation data. Results: Based on the ALS Cognitive Behavioral Screen cognitive score, 6.5% of the sample scored below the cutoff score for frontotemporal lobar dementia, 54.2% scored in a range consistent with ALS with mild cognitive impairment, and 39.2% scored in the normal range. The ALS Cognitive Behavioral Screen behavioral subscale identified 16.5% of the sample scoring below the dementia cutoff score, with an additional 14.1% scoring in the ALS behavioral impairment range, and 69.4% scoring in the normal range. Conclusions: This investigation revealed high levels of cognitive and behavioral impairment in patients with ALS within 18 months of symptom onset, comparable to prior investigations. This investigation illustrates the successful use and scientific value of adding a cognitive-behavioral screening tool in studies of motor neuron diseases, to provide neurologists with an efficient method to measure these common deficits and to understand how they relate to key clinical variables, when extensive neuropsychological examinations are unavailable. These tools, developed specifically for patients with motor impairment, may be particularly useful in patient populations with multiple sclerosis and Parkinson disease, who are known to have comorbid cognitive decline. PMID:26802094

Cognitive-behavioral screening reveals prevalent impairment in a large multicenter ALS cohort.

PubMed

Murphy, Jennifer; Factor-Litvak, Pam; Goetz, Raymond; Lomen-Hoerth, Catherine; Nagy, Peter L; Hupf, Jonathan; Singleton, Jessica; Woolley, Susan; Andrews, Howard; Heitzman, Daragh; Bedlack, Richard S; Katz, Jonathan S; Barohn, Richard J; Sorenson, Eric J; Oskarsson, Björn; Fernandes Filho, J Americo M; Kasarskis, Edward J; Mozaffar, Tahseen; Rollins, Yvonne D; Nations, Sharon P; Swenson, Andrea J; Koczon-Jaremko, Boguslawa A; Mitsumoto, Hiroshi

2016-03-01

To characterize the prevalence of cognitive and behavioral symptoms using a cognitive/behavioral screening battery in a large prospective multicenter study of amyotrophic lateral sclerosis (ALS). Two hundred seventy-four patients with ALS completed 2 validated cognitive screening tests and 2 validated behavioral interviews with accompanying caregivers. We examined the associations between cognitive and behavioral performance, demographic and clinical data, and C9orf72 mutation data. Based on the ALS Cognitive Behavioral Screen cognitive score, 6.5% of the sample scored below the cutoff score for frontotemporal lobar dementia, 54.2% scored in a range consistent with ALS with mild cognitive impairment, and 39.2% scored in the normal range. The ALS Cognitive Behavioral Screen behavioral subscale identified 16.5% of the sample scoring below the dementia cutoff score, with an additional 14.1% scoring in the ALS behavioral impairment range, and 69.4% scoring in the normal range. This investigation revealed high levels of cognitive and behavioral impairment in patients with ALS within 18 months of symptom onset, comparable to prior investigations. This investigation illustrates the successful use and scientific value of adding a cognitive-behavioral screening tool in studies of motor neuron diseases, to provide neurologists with an efficient method to measure these common deficits and to understand how they relate to key clinical variables, when extensive neuropsychological examinations are unavailable. These tools, developed specifically for patients with motor impairment, may be particularly useful in patient populations with multiple sclerosis and Parkinson disease, who are known to have comorbid cognitive decline. © 2016 American Academy of Neurology.

Modulatory effects of psychopathy on Wisconsin Card Sorting Test performance in male offenders with Antisocial Personality Disorder.

PubMed

Pera-Guardiola, Vanessa; Batalla, Iolanda; Bosque, Javier; Kosson, David; Pifarré, Josep; Hernández-Ribas, Rosa; Goldberg, Ximena; Contreras-Rodríguez, Oren; Menchón, José M; Soriano-Mas, Carles; Cardoner, Narcís

2016-01-30

Neuropsychological deficits in executive functions (EF) have been linked to antisocial behavior and considered to be cardinal to the onset and persistence of severe antisocial and aggressive behavior. However, when psychopathy is present, prior evidence suggests that the dorsolateral prefrontal cortex is unaffected leading to intact EF. Ninety-one male offenders with Antisocial Personality Disorder (ASPD) and 24 controls completed the Wisconsin Card Sorting Test (WCST). ASPD individuals were grouped in three categories according to Psychopathy Checklist-Revised (PCL-R) scores (low, medium and high). We hypothesized that ASPD offenders with high PCL-R scores will not differ from healthy controls in EF and will show better EF performance in comparison with subjects with low PCL-R scores. Results showed that ASPD offenders with low PCL-R scores committed more perseverative errors and responses than controls and offenders with high PCL-R scores, which did not differ from healthy controls. Moreover, scores on Factor 1 and the interpersonal facet of the PCL-R were predictors of better WCST performance. Our results suggest a modulatory role of psychopathy in the cognitive performance of ASPD offenders, and provide further evidence supporting that offenders with ASPD and psychopathy are characterized by a cognitive profile different from those with ASPD without psychopathy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Effectiveness of atomoxetine and methylphenidate for problematic online gaming in adolescents with attention deficit hyperactivity disorder.

PubMed

Park, Jeong Ha; Lee, Young Sik; Sohn, Ji Hyun; Han, Doug Hyun

2016-11-01

There is a high prevalence of problematic online gaming in adolescents with attention deficit hyperactivity disorder (ADHD). In the current study, we compared the effectiveness of atomoxetine (ATM) and methylphenidate (MPH) on problematic online gaming in adolescents with ADHD. We recruited 86 adolescents diagnosed with ADHD together with Internet gaming disorder. These participants were divided into two treatment groups: 44 participants were treated with MPH for 12 weeks, and 42 participants were treated with ATM for 12 weeks. During the 3-month study period, the MPH group showed greater improvement in Korean ADHD rating scale scores than the ATM group. The ATM group showed greater improvement in Child Depression Inventory scores than the MPH group. However, Young Internet Addiction Scale and Behavioral Inhibition & Activation Scales score changes did not differ significantly between the MPH and ATM groups. In both groups, changes in Young Internet Addiction Scale scores were positively correlated with the changes in Behavioral Inhibition & Activation Scales scores. Both MPH and ATM reduced the severity of Internet gaming disorder symptoms, and this reduction was correlated with impulsivity reduction, which also resulted from both ADHD medications. These findings suggest impulsivity plays a critical role in the development of problematic online gaming. Copyright © 2016 John Wiley & Sons, Ltd.

A controlled study of Tourette syndrome. IV. Obsessions, compulsions, and schizoid behaviors.

PubMed Central

Comings, D E; Comings, B G

1987-01-01

To determine the frequency of obsessive, compulsive, and schizoid behaviors in Tourette syndrome (TS), we prospectively questioned 246 patients with TS, 17 with attention-deficit disorder (ADD), 15 with ADD due to a TS gene, and 47 random controls. The comparative frequency of obsessive, compulsive, and repetitive behaviors--such as obsessive unpleasant thoughts, obsessive silly thoughts, echolalia, palilalia, touching things excessively, touching things a specific number of times, touching others excessively, sexual touching, biting or hurting oneself, head banging, rocking, mimicking others, counting things, and occasional or frequent public exhibitionism--were significantly more common in TS patients than in controls. The frequency of each of these was much higher for grade 3 (severe) TS. Most of these behaviors also occurred significantly more often in individuals with ADD or in individuals with ADD secondary to TS (ADD 2(0) TS). When these features were combined into an obsessive-compulsive score, 45.4% of TS patients had a score of 4-15, whereas 8.5% of controls had a score of 4 or 5. These results indicate that obsessive-compulsive behaviors are an integral part of the expression of the TS gene and can be inherited as an autosomal dominant trait. Schizoid symptoms, such as thinking that people were watching them or plotting against them, were significantly more common in TS patients than in controls. Auditory hallucinations of hearing voices were present in 14.6% of TS patients, compared with 2.1% of controls (P = .02). These symptoms were absent in ADD patients but present in ADD 2(0) TS patients. These voices were often blamed for telling them to do bad things and were frequently identified with the devil. None of the controls had a total schizoid behavior score greater than 3, whereas 10.9% of the TS patients had scores of 4-10 (P = .02). This frequency increased to 20.6% in the grade 3 TS patients. These quantitative results confirm our clinical impression that some TS patients have paranoid ideations, often feel that people are out to get them, and hear voices. PMID:3479015

A Cognitive-Behavioral Therapy Group Intervention for Hypersexual Disorder: A Feasibility Study.

PubMed

Hallberg, Jonas; Kaldo, Viktor; Arver, Stefan; Dhejne, Cecilia; Öberg, Katarina Görts

2017-07-01

The proposed criteria of the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition for hypersexual disorder (HD) included symptoms reported by patients seeking help for excessive and out-of-control non-paraphilic sexual behavior, including sexual behaviors in response to dysphoric mood states, impulsivity, and risk taking. Although no prior studies of cognitive-behavioral therapy (CBT) for the treatment of HD have been performed, CBT has been found effective for dysphoric mood states and impulsivity. To investigate the feasibility of a CBT manual developed for HD explored through symptom decrease, treatment attendance, and clients' treatment satisfaction. Ten men with a diagnosis of HD took part in the CBT group program. Measurements were taken before, during, and at the end of treatment and 3 and 6 months after treatment. The primary outcome was the Hypersexual Disorder: Current Assessment Scale (HD:CAS) score that measured the severity of problematic hypersexual symptoms and secondary outcomes were the Hypersexual Disorder Screening Inventory (HDSI) score, the proportion of attended sessions, and the Client Satisfaction Questionnaire (CSQ-8) score. Main results were significant decreases of HD symptoms from before to after treatment on HD:CAS and HDSI scores and a decrease in the number of problematic sexual behaviors during the course of therapy. A high attendance rate of 93% and a high treatment satisfaction score on CSQ-8 also were found. The CBT program seemed to ameliorate the symptoms of HD and therefore might be a feasible treatment option. This study provides data from a CBT program for the treatment of the specific proposed criteria of HD. Because of the small sample and lack of a control group, the results can be considered only preliminary. Although participants reported decreased HD symptoms after attending the CBT program, future studies should evaluate the treatment program with a larger sample and a randomized controlled procedure to ensure treatment effectiveness. Hallberg J, Kaldo V, Arver S, et al. A Cognitive-Behavioral Therapy Group Intervention for Hypersexual Disorder: A Feasibility Study. J Sex Med 2017;14:950-958. Copyright © 2017. Published by Elsevier Inc.

Aggression toward Familiar People, Strangers, and Conspecifics in Gonadectomized and Intact Dogs.

PubMed

Farhoody, Parvene; Mallawaarachchi, Indika; Tarwater, Patrick M; Serpell, James A; Duffy, Deborah L; Zink, Chris

2018-01-01

Gonadectomy is widely used to treat and prevent behavior problems including the aggressive behavior of dogs. The aim of this study was to determine whether aggressive behavior toward familiar people, strangers, or other dogs was significantly different in dogs gonadectomized at various ages vs. intact dogs using the Canine Behavioral Assessment Research Questionnaire (C-BARQ) with multivariate analysis. Of 15,370 initial surveys, those for dogs reported to have been gonadectomized at less than 6 weeks of age or to correct a behavior problem, and those with incomplete answers to questions regarding independent or dependent variables were excluded, leaving 13,795 for the analysis of aggressive behavior toward familiar people: 13,498 for aggressive behavior toward strangers and 13,237 for aggressive behavior toward dogs. Aggressive behavior was defined (a) using mean scores for all questions on the C-BARQ for aggressive behavior (range 0-4) and (b) comparing dogs with no aggressive behavior (all questions answered 0) to dogs with moderate or severe aggression (at least one score of 2, 3, or 4). Data for intact dogs were compared with those for dogs gonadectomized at 6 months or less, 7-12 months, 11-18 months, and >18 months. Neither gonadectomy nor age at gonadectomy showed an association with aggression toward familiar people or dogs. However, there was a low but significant increase in the odds of moderate or severe aggression toward strangers for all gonadectomized dogs compared with intact dogs, but this effect was driven entirely by data for dogs gonadectomized at 7-12 months of age, which were 26% more likely to demonstrate aggression toward strangers. This large, comprehensive study of the relationships between gonadectomy and aggressive behavior in dogs demonstrates that when the many factors affecting aggressive behavior are considered, there is no evidence that gonadectomy at any age alters aggressive behavior toward familiar people or dogs, and there is only a minimal increase in aggression toward strangers. Given the increasing evidence of significant negative health effects of gonadectomy, there is an urgent need to systematically examine other means of preventing unwanted procreation, such as vasectomy and hysterectomy.

Aggression toward Familiar People, Strangers, and Conspecifics in Gonadectomized and Intact Dogs

PubMed Central

Farhoody, Parvene; Mallawaarachchi, Indika; Tarwater, Patrick M.; Serpell, James A.; Duffy, Deborah L.; Zink, Chris

2018-01-01

Gonadectomy is widely used to treat and prevent behavior problems including the aggressive behavior of dogs. The aim of this study was to determine whether aggressive behavior toward familiar people, strangers, or other dogs was significantly different in dogs gonadectomized at various ages vs. intact dogs using the Canine Behavioral Assessment Research Questionnaire (C-BARQ) with multivariate analysis. Of 15,370 initial surveys, those for dogs reported to have been gonadectomized at less than 6 weeks of age or to correct a behavior problem, and those with incomplete answers to questions regarding independent or dependent variables were excluded, leaving 13,795 for the analysis of aggressive behavior toward familiar people: 13,498 for aggressive behavior toward strangers and 13,237 for aggressive behavior toward dogs. Aggressive behavior was defined (a) using mean scores for all questions on the C-BARQ for aggressive behavior (range 0–4) and (b) comparing dogs with no aggressive behavior (all questions answered 0) to dogs with moderate or severe aggression (at least one score of 2, 3, or 4). Data for intact dogs were compared with those for dogs gonadectomized at 6 months or less, 7–12 months, 11–18 months, and >18 months. Neither gonadectomy nor age at gonadectomy showed an association with aggression toward familiar people or dogs. However, there was a low but significant increase in the odds of moderate or severe aggression toward strangers for all gonadectomized dogs compared with intact dogs, but this effect was driven entirely by data for dogs gonadectomized at 7–12 months of age, which were 26% more likely to demonstrate aggression toward strangers. This large, comprehensive study of the relationships between gonadectomy and aggressive behavior in dogs demonstrates that when the many factors affecting aggressive behavior are considered, there is no evidence that gonadectomy at any age alters aggressive behavior toward familiar people or dogs, and there is only a minimal increase in aggression toward strangers. Given the increasing evidence of significant negative health effects of gonadectomy, there is an urgent need to systematically examine other means of preventing unwanted procreation, such as vasectomy and hysterectomy. PMID:29536014

Risk Factors for Self-Injury, Aggression, and Stereotyped Behavior Among Young Children At Risk for Intellectual and Developmental Disabilities

PubMed Central

Schroeder, Stephen R.; Marquis, Janet G.; Reese, R. Matthew; Richman, David M.; Mayo-Ortega, Liliana; Oyama-Ganiko, Rosa; LeBlanc, Judith; Brady, Nancy; Butler, Merlin G.; Johnson, Tiffany; Lawrence, Linda

2016-01-01

Before the 1990s, research on the early identification and prevention of severe behavior disorders (SBDs), such as aggression, self-injury, and stereotyped behavior, among young children with intellectual and developmental disabilities (IDD), was mostly done with children 3 years or older. More recent work suggests that signs of SBDs may occur as early as 6 months in some infants. The present study combined a cross-sectional and longitudinal approach to examine SBDs in 180 young children aged 4–48 months recruited through mass screening, then receiving an interdisciplinary evaluation and six-month follow-ups for one year. Twelve potential risk factors related to SBDs were examined. Eight of these risk factors, including age, gender, diagnosis, intellectual and communication levels, visual impairment, parent education, family income, were differentially related to scores for Aggression, SIB, and Stereotyped Behavior subscales on the Behavior Problems Inventory (BPI-01) at initial interdisciplinary evaluation. BPI-01 scores decreased over the year for 57% of the children and increased for 43%. The amount of decrease on each BPI-01 subscale varied with age, gender, and diagnosis. PMID:25007299

Memantine reduces stealing behavior and impulsivity in kleptomania: a pilot study.

PubMed

Grant, Jon E; Odlaug, Brian L; Schreiber, Liana R N; Chamberlain, Samuel R; Won Kim, Suck

2013-03-01

Kleptomania is characterized by repetitive stealing behavior and has been associated with deleterious unwanted outcomes including forensic contact and increased rates of suicidal behavior. Very few trials have been conducted to investigate pharmacological treatment options for this neglected condition. Memantine is an NMDA-receptor antagonist that has shown promising results in the treatment of other behavioral addictions and substance addictions. Twelve individuals with kleptomania received memantine (10 mg/day, titrated to 30 mg/day maximum depending on clinical response and tolerability) over the course of 8 weeks, in an open-label trial. The effects of treatment were quantified using well-validated measures and select neurocognitive tests (last observation carried forward analyses). Kleptomania disease severity scores decreased across all measures considered, and 11 (91.7%) of the participants met the responder criteria (35% improvement on the primary effectiveness measure plus CGI improved/very much improved; significant improvements were also observed in terms of mood, anxiety, and disability scores along with a significant improvement in stop-signal response inhibition. Memantine was generally well tolerated. This study shows the effectiveness of memantine in reducing urges to shoplift and shoplifting behavior along with improving impulsivity, mood, anxiety, and psychosocial functioning.

Suicidal behavior in obsessive-compulsive disorder.

PubMed

Kamath, Prakash; Reddy, Y C Janardhan; Kandavel, Thennarasu

2007-11-01

There are limited data on suicidal behavior in obsessive-compulsive disorder (OCD). This study examines suicidal behavior and its clinical correlates in OCD subjects. One hundred consecutive DSM-IV OCD subjects attending the specialty OCD clinic and the inpatient services of a major psychiatric hospital in India from November 1, 2003, to October 31, 2004, formed the sample of this study. Subjects were assessed systematically by using structured interviews and various rating scales. The Scale for Suicide Ideation-worst ever (lifetime) and -current measured suicidal ideation. The 24-item Hamilton Rating Scale for Depression (HAM-D) measured severity of depression, and the Beck Hopelessness Scale (BHS) measured hopelessness. We performed assessments at study entry. We employed binary logistic regression (Wald) forward stepwise analysis for prediction of suicidal ideation and suicide attempt, and we used structural equation modeling for identifying the potential factors contributing to suicidal ideation. The rates of suicidal ideation, worst ever and current, were 59% and 28%, respectively. History of suicide attempt was reported in 27% of the subjects. For past suicide attempt, worst ever suicidal ideation (p < .001) was the only significant predictor, with an overall prediction of 89%, and accounted for 60% of the variance. For worst ever suicidal ideation, major depression (p = .043), HAM-D score (p = .013), BHS score (p = .011), and history of attempt (p = .009) were significant predictors, with an overall prediction of 82% and variance of 56%. Somewhat similar predictors emerged as significant for current suicidal ideators, with an overall prediction of 85% and variance of 50%. In the structural equation model, too, presence of depression and high BHS score contributed to suicidal ideation. OCD is associated with a high risk for suicidal behavior. Depression and hopelessness are the major correlates of suicidal behavior. It is vital that patients with OCD undergo detailed assessment for suicide risk and associated depression. Aggressive treatment of depression may be warranted to modify the risk for suicide. Future studies should examine suicidal behavior in a prospective design in larger samples to examine if severity of OCD and treatment nonresponse contribute to suicide risk.

Reliability Generalization for Childhood Autism Rating Scale

ERIC Educational Resources Information Center

Breidbord, Jonathan; Croudace, Tim J.

2013-01-01

The Childhood Autism Rating Scale (CARS) is a popular behavior-observation instrument that was developed more than 34 years ago and has since been adopted in a wide variety of contexts for assessing the presence and severity of autism symptomatology in both children and adolescents. This investigation of the reliability of CARS scores involves…

Assertion and Overcontrolled Hostility among Mentally Disordered Murderers.

ERIC Educational Resources Information Center

Quinsey, Vernon L.; And Others

1983-01-01

Studied whether men (N=19) who had committed very severe assaults and who score high on the Overcontrolled Hostility (O-H) scale had assertion deficits that could be measured behaviorally. Results showed the high O-H group was significantly less assertive than control groups in role playing tasks and on questionnaire items. (WAS)

Childhood history of behavioral inhibition and comorbidity status in 256 adults with social phobia.

PubMed

Rotge, Jean-Yves; Grabot, Denis; Aouizerate, Bruno; Pélissolo, Antoine; Lépine, Jean-Pierre; Tignol, Jean

2011-03-01

Behavioral inhibition (BI), a heritable temperament, predisposes one to an increased risk of social phobia. Recent investigations have reported that BI may also be a precursor to anxiety as well as depressive and alcohol-related disorders, which are frequently comorbid with social phobia. In the present study, we explored the relationship between BI and psychiatric disorders in 256 adults with a primary diagnosis of social phobia. BI severity was retrospectively assessed with the Retrospective Self-Report of Inhibition (RSRI). The severity of social phobia and the presence of comorbid diagnoses were evaluated with the Liebowitz Social Anxiety Scale (LSAS) and the Mini-International Neuropsychiatric Interview, respectively. The RSRI score was significantly and positively correlated with both the LSAS score and the occurrence of a major depressive disorder. No significant association was found with other anxiety and substance-related disorders. The assessment of BI was retrospective and self-reported. A childhood history of BI was associated with an increased risk of depressive comorbidity in social phobia. Copyright © 2010 Elsevier B.V. All rights reserved.

Late neurologic and cognitive sequelae of inflicted traumatic brain injury in infancy.

PubMed

Barlow, Karen M; Thomson, Elaine; Johnson, David; Minns, Robert A

2005-08-01

There is limited information regarding the long-term outcome of inflicted traumatic brain injury (TBI), including shaken infant syndrome. The purpose of this study was to describe the long-term neurologic, behavioral, and cognitive sequelae seen in this population. A cross-sectional and prospective longitudinal study was conducted of 25 children with inflicted TBI in Scotland between 1980 and 1999. After consent was obtained, neurologic and cognitive examinations were performed on all participants and sequentially in the prospective cohort. Two global outcome measures were used: Glasgow Outcome Score (GOS) and Seshia's outcome score. Cognitive outcome was assessed using the Bayley Scales of Infant Development, British Ability Scales, and the Vineland Adaptive Behavior Scales. The mean length of follow-up was 59 months. A total of 68% of survivors were abnormal on follow-up, 36% had severe difficulties and were totally dependant, 16% had moderate difficulties, and 16% had mild difficulties on follow-up. A wide range of neurologic sequelae were seen, including motor deficits (60%), visual deficits (48%), epilepsy (20%), speech and language abnormalities (64%), and behavioral problems (52%). There was a wide range of cognitive abilities: the mean psychomotor index, 69.9 (SD: +/-25.73); and mean mental development index, 74.53 (SD: +/-28.55). Adaptive functioning showed a wide range of difficulties across all domains: communication domain (mean: 76.1; SD: +/-25.4), Daily living skills domain (mean: 76.9; SD: +/-24.3), and socialization domain (mean: 79.1; SD: +/-23.1). Outcome was found to correlate with the Pediatric Trauma Score and the Glasgow Coma Score but did not correlate with age at injury or mechanism of injury. Inflicted TBI has a very poor prognosis and correlates with severity of injury. Extended follow-up is necessary so as not to underestimate problems such as specific learning difficulties and attentional and memory problems that may become apparent only once the child is in school. Behavioral problems are present in 52% and begin to manifest clinically between the second and third years of life, although the consequences of frontal lobe injury may be underestimated unless follow-up is extended into adolescence and early adulthood.

Relationship between anxiety, anxiety sensitivity and conduct disorder symptoms in children and adolescents with attention-deficit/hyperactivity disorder (ADHD).

PubMed

Bilgiç, Ayhan; Türkoğlu, Serhat; Ozcan, Ozlem; Tufan, Ali Evren; Yılmaz, Savaş; Yüksel, Tuğba

2013-09-01

Attention-deficit hyperactivity disorder (ADHD) is often comorbid with anxiety disorders and previous studies observed that anxiety could have an impact on the clinical course of ADHD and comorbid disruptive behavioral disorders (conduct disorders and oppositional-defiant disorders). Anxiety sensitivity (AS) is a different concept from anxiety per se and it is believed to represent the constitutionally based sensitivity of individuals to anxiety and anxiety symptoms. We aimed to assess the associations between anxiety, AS and symptoms of disruptive behavioral disorders (DBD) in a clinical sample of children and adolescents with ADHD. The sample consisted of 274 treatment naive children with ADHD aged 8-17 years. The severity of ADHD symptoms and comorbid DBD were assessed via parent rated Turgay DSM-IV-Based Child and Adolescent Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S), Conners' Parent Rating Scale (CPRS), and Conners' Teacher Rating Scale (CTRS). AS and severity of anxiety symptoms of children were evaluated by self-report inventories. The association between anxiety, AS, and DBD was evaluated using structural equation modeling. Analyses revealed that AS social subscale scores negatively predicted symptoms of conduct disorder (CD) reported in T-DSM-IV-S. On the other hand, CD symptoms positively predicted severity of anxiety. No direct relationships were detected between anxiety, AS and oppositional-defiant behavior scores in any scales. These results may suggest a protective effect of AS social area on the development of conduct disorder in the presence of a diagnosis of ADHD, while the presence of symptoms of CD may be a vulnerability factor for the development of anxiety symptoms in children and adolescents with ADHD.

Ginkgo biloba L. attenuates spontaneous recurrent seizures and associated neurological conditions in lithium-pilocarpine rat model of temporal lobe epilepsy through inhibition of mammalian target of rapamycin pathway hyperactivation.

PubMed

Mazumder, Arindam Ghosh; Sharma, Pallavi; Patial, Vikram; Singh, Damanpreet

2017-05-23

Ginkgo biloba L. (Ginkgoaceae) has been widely used in traditional medicine for variety of neurological conditions particularly behavioral and memory impairments. The present study was envisaged to explore the effect of a standardized fraction of Ginkgo biloba leaves (GBbf) in rat model of lithium-pilocarpine induced spontaneous recurrent seizures, and associated behavioral impairments and cognitive deficit. Rats showing appearance of spontaneous recurrent seizures following lithium pilocarpine (LiPc)-induced status epilepticus (SE) were treated with different doses of GBbf or vehicle for subsequent 4 weeks. The severity of seizures and aggression in rats were scored following treatment with GBbf. Further, open field, forced swim, novel object recognition and Morris water maze tests were conducted. Histopathological, protein levels and gene expression studies were performed in the isolated brains. Treatment with GBbf reduced seizure severity score and aggression in epileptic animals. Improved spatial cognitive functions and recognition memory, along with reduction in anxiety-like behavior were also observed in the treated animals. Histopathological examination by Nissl staining showed reduction in neuronal damage in the hippocampal pyramidal layer. The dentate gyrus and Cornu Ammonis 3 regions of the hippocampus showed reduction in mossy fiber sprouting. GBbf treatment attenuated ribosomal S6 and pS6 proteins, and hippocampal mTOR, Rps6 and Rps6kb1 mRNA levels. The results of present study concluded that GBbf treatment suppressed lithium-pilocarpine induced spontaneous recurrent seizures severity and incidence with improved cognitive functions, reduced anxiety-like behavior and aggression. The effect was found to be due to inhibition of mTOR pathway hyperactivation linked with recurrent seizures. Copyright © 2017. Published by Elsevier B.V.

Elucidating Poor Decision-Making in a Rat Gambling Task

PubMed Central

Seriès, Peggy; Marchand, Alain R.; Dellu-Hagedorn, Françoise

2013-01-01

Although poor decision-making is a hallmark of psychiatric conditions such as attention deficit/hyperactivity disorder, pathological gambling or substance abuse, a fraction of healthy individuals exhibit similar poor decision-making performances in everyday life and specific laboratory tasks such as the Iowa Gambling Task. These particular individuals may provide information on risk factors or common endophenotypes of these mental disorders. In a rodent version of the Iowa gambling task – the Rat Gambling Task (RGT), we identified a population of poor decision makers, and assessed how these rats scored for several behavioral traits relevant to executive disorders: risk taking, reward seeking, behavioral inflexibility, and several aspects of impulsivity. First, we found that poor decision-making could not be well predicted by single behavioral and cognitive characteristics when considered separately. By contrast, a combination of independent traits in the same individual, namely risk taking, reward seeking, behavioral inflexibility, as well as motor impulsivity, was highly predictive of poor decision-making. Second, using a reinforcement-learning model of the RGT, we confirmed that only the combination of extreme scores on these traits could induce maladaptive decision-making. Third, the model suggested that a combination of these behavioral traits results in an inaccurate representation of rewards and penalties and inefficient learning of the environment. Poor decision-making appears as a consequence of the over-valuation of high-reward-high-risk options in the task. Such a specific psychological profile could greatly impair clinically healthy individuals in decision-making tasks and may predispose to mental disorders with similar symptoms. PMID:24339988

Elucidating poor decision-making in a rat gambling task.

PubMed

Rivalan, Marion; Valton, Vincent; Seriès, Peggy; Marchand, Alain R; Dellu-Hagedorn, Françoise

2013-01-01

Although poor decision-making is a hallmark of psychiatric conditions such as attention deficit/hyperactivity disorder, pathological gambling or substance abuse, a fraction of healthy individuals exhibit similar poor decision-making performances in everyday life and specific laboratory tasks such as the Iowa Gambling Task. These particular individuals may provide information on risk factors or common endophenotypes of these mental disorders. In a rodent version of the Iowa gambling task--the Rat Gambling Task (RGT), we identified a population of poor decision makers, and assessed how these rats scored for several behavioral traits relevant to executive disorders: risk taking, reward seeking, behavioral inflexibility, and several aspects of impulsivity. First, we found that poor decision-making could not be well predicted by single behavioral and cognitive characteristics when considered separately. By contrast, a combination of independent traits in the same individual, namely risk taking, reward seeking, behavioral inflexibility, as well as motor impulsivity, was highly predictive of poor decision-making. Second, using a reinforcement-learning model of the RGT, we confirmed that only the combination of extreme scores on these traits could induce maladaptive decision-making. Third, the model suggested that a combination of these behavioral traits results in an inaccurate representation of rewards and penalties and inefficient learning of the environment. Poor decision-making appears as a consequence of the over-valuation of high-reward-high-risk options in the task. Such a specific psychological profile could greatly impair clinically healthy individuals in decision-making tasks and may predispose to mental disorders with similar symptoms.

Relationship between objectively measured sedentary behavior and health outcomes in schizophrenia patients: The PsychiActive project.

PubMed

Bueno-Antequera, Javier; Oviedo-Caro, Miguel Ángel; Munguía-Izquierdo, Diego

2017-11-21

This study aimed to investigate possible relationships between sedentary behavior and body mass index (BMI), cardiorespiratory fitness (CRF), and health-related quality of life (HRQoL) in schizophrenia patients. Variables contributing to the variability in sedentary behavior were identified. Eighty-two schizophrenia outpatients (mean age±SD: 41.0±8.7years, 87% men, mean illness duration±SD: 17.1±8.9years) wore a multisensor armband for 7 consecutive full days to objectively measure sedentary behavior. BMI, walking capacity (6-minute walking test) as a proxy for CRF estimation and HRQoL (Short Form 36-Item Health Survey questionnaire version 2) were also assessed. Correlation (Pearson or Spearman coefficients) and multiple regression analysis were used. Sedentary behavior was significantly associated with BMI, CRF, and the physical component summary score of HRQoL (r values, -0.34-0.41; all P<0.001) and remained significant after adjustments for age, illness duration, symptom severity, adherence to Mediterranean diet, smoking, and antipsychotic medication (all P<0.05). BMI, CRF and vitality were identified as determinants of sedentary behavior. Consistent relationships between sedentary behavior and BMI, CRF, and the physical component summary score of HRQoL were found in schizophrenia patients. All the identified determinants of sedentary behavior are modifiable and may be important areas for future interventions in this population. Copyright © 2017 Elsevier B.V. All rights reserved.

Effects of the Health Belief Model (HBM)-Based Educational Program on the Nutritional Knowledge and Behaviors of CABG Patients

PubMed Central

Shojaei, Sarallah; Farhadloo, Roohollah; Aein, Afsaneh; Vahedian, Mostafa

2016-01-01

Background: Reducing blood pressure through diet decreases the possibility of heart attacks, and lowering blood cholesterol can reduce the risk of coronary artery disease. The aim of the present study was to examine the effects of education based on the Health Belief Model on the dietary behavior of patients following coronary artery bypass graft surgery (CABG) at the Heart Surgery Department of Shahid Beheshti Hospital of Qom. Methods: In this semi-experimental clinical trial, data were collected on 64 patients, at an average age of 59.9 ± 7.26 years in the intervention group and 58.5 ± 7.6 years in the control group. Seventy percent of the study subjects were male and 30% were female. Intervention and control groups were given a questionnaire, comprising 56 questions in 5 parts. The educational intervention was aimed at creating perceived susceptibility and perceived severity in the intervention group. After 1 month. Both groups were tested, and the resulting data were analyzed to investigate the effects of the educational intervention on the nutritional knowledge and behavior of the patients. Results: According to the results, educational intervention caused a significant increase in the mean scores of knowledge (p value = 0.001), perceived severity (p value = 0.007), and perceived benefits and barriers (p value = 0.003) in the intervention group but did not cause a significant increase in the mean score of nutritional behavior (p value = 0.390). Conclusion: Education based on the Health Belief Model seems to be effective in improving nutritional knowledge, but more consistent and comprehensive educational programs are necessary in order to change behavior and improve nutritional behavior. PMID:28496509

Effects of the Health Belief Model (HBM)-Based Educational Program on the Nutritional Knowledge and Behaviors of CABG Patients.

PubMed

Shojaei, Sarallah; Farhadloo, Roohollah; Aein, Afsaneh; Vahedian, Mostafa

2016-10-03

Background: Reducing blood pressure through diet decreases the possibility of heart attacks, and lowering blood cholesterol can reduce the risk of coronary artery disease. The aim of the present study was to examine the effects of education based on the Health Belief Model on the dietary behavior of patients following coronary artery bypass graft surgery (CABG) at the Heart Surgery Department of Shahid Beheshti Hospital of Qom. Methods: In this semi-experimental clinical trial, data were collected on 64 patients, at an average age of 59.9 ± 7.26 years in the intervention group and 58.5 ± 7.6 years in the control group. Seventy percent of the study subjects were male and 30% were female. Intervention and control groups were given a questionnaire, comprising 56 questions in 5 parts. The educational intervention was aimed at creating perceived susceptibility and perceived severity in the intervention group. After 1 month. Both groups were tested, and the resulting data were analyzed to investigate the effects of the educational intervention on the nutritional knowledge and behavior of the patients. Results: According to the results, educational intervention caused a significant increase in the mean scores of knowledge (p value = 0.001), perceived severity (p value = 0.007), and perceived benefits and barriers (p value = 0.003) in the intervention group but did not cause a significant increase in the mean score of nutritional behavior (p value = 0.390). Conclusion: Education based on the Health Belief Model seems to be effective in improving nutritional knowledge, but more consistent and comprehensive educational programs are necessary in order to change behavior and improve nutritional behavior.

Psychiatric symptom typology in a sample of youth receiving substance abuse treatment services: associations with self-reported child maltreatment and sexual risk behaviors.

PubMed

Oshri, Assaf; Tubman, Jonathan G; Jaccard, James

2011-11-01

Latent profile analysis (LPA) was used to classify 394 adolescents undergoing substance use treatment, based on past year psychiatric symptoms. Relations between profile membership and (a) self-reported childhood maltreatment experiences and (b) current sexual risk behavior were examined. LPA generated three psychiatric symptom profiles: Low-, High- Alcohol-, and High- Internalizing Symptoms profiles. Analyses identified significant associations between profile membership and childhood sexual abuse and emotional neglect ratings, as well as co-occurring sex with substance use and unprotected intercourse. Profiles with elevated psychiatric symptom scores (e.g., internalizing problems, alcohol abuse and dependence symptoms) and more severe maltreatment histories reported higher scores for behavioral risk factors for HIV/STI exposure. Heterogeneity in psychiatric symptom patterns among youth receiving substance use treatment services, and prior histories of childhood maltreatment, have significant implications for the design and delivery of HIV/STI prevention programs to this population.

Heightened Sensitivity to Reward and Punishment in Anorexia Nervosa

PubMed Central

Jappe, Leah M.; Frank, Guido K.W.; Shott, Megan E.; Rollin, Michael D.H.; Pryor, Tamara; Hagman, Jennifer O.; Yang, Tony T.; Davis, Elizabeth

2011-01-01

Objective To test whether women with Anorexia Nervosa (AN) have increased sensitivity to punishing or rewarding stimuli, behaviors that could drive high self-control and anxious, avoidant behaviors. Method Sixty-four women completed the study: 33 control women (CW, mean age 19.7 years) and 31 AN (mean age 19.6 years). Participants completed diagnostic exams, questionnaires for eating disorder severity and personality, as well as the Sensitivity to Punishment/Sensitivity to Reward Questionnaire (SPSRQ). Results AN scored higher than CW on SPSRQ sensitivity to punishment (p<0.00001) and sensitivity to reward (p=0.005). AN women without anxiety or depression continued to have increased SPSRQ scores compared to CW. Conclusion This is the first study comparing the SPSRQ in AN and CW. Results suggest that reward and punishment sensitivity are increased in AN and could be potential trait markers. It is possible that harm-avoidant, anxious behaviors in AN are related to this heightened sensitivity. PMID:21472750

Multi-Method Assessment of ADHD Characteristics in Preschool Children: Relations between Measures

PubMed Central

Sims, Darcey M.; Lonigan, Christopher J.

2011-01-01

Several forms of assessment tools, including behavioral rating scales and objective tests such as the Continuous Performance Test (CPT), can be used to measure inattentive and hyperactive/impulsive behaviors associated with Attention-Deficit/Hyperactivity Disorder (ADHD). However, research with school-age children has shown that the correlations between parent ratings, teacher ratings, and scores on objective measures of ADHD-characteristic behaviors are modest at best. In this study, we examined the relations between parent and teacher ratings of ADHD and CPT scores in a sample of 65 preschoolers ranging from 50 to 72 months of age. No significant associations between teacher and parent ratings of ADHD were found. Parent-ratings of both inattention and hyperactivity/impulsivity accounted for variance in CPT omission errors but not CPT commission errors. Teacher ratings showed evidence of convergent and discriminant validity when entered simultaneously in a hierarchical regression. These tools may be measuring different aspects of inattention and hyperactivity/impulsivity. PMID:22518069

SHORT COMMUNICATION: Hyperphagia among patients with Bardet-Biedl syndrome

PubMed Central

Sherafat-Kazemzadeh, Roya; Ivey, Lauren; Kahn, Stephanie R.; Sapp, Julie C.; Hicks, Melanie D.; Kim, Rachel C.; Krause, Amanda J.; Shomaker, Lauren B.; Biesecker, Leslie G.; Han, Joan C.; Yanovski, Jack A.

2014-01-01

Summary Background The importance of hyperphagia as a cause for energy imbalance in humans with Bardet-Biedl syndrome (BBS) has not been established. We therefore compared hyperphagic symptoms in patients with BBS versus controls. Methods We studied 13 patients with BBS and 23 nonsyndromic controls with similar age, sex, and BMI z-score. A 13-item hyperphagia questionnaire was completed by patients’ parents/guardians. Results Total hyperphagia questionnaire score was higher in BBS than controls (27.6±9.0 vs. 19.1±7.9, p=0.005). Behavior and drive sub-scales were higher for BBS than controls (12.5±4.1 vs. 7.8±3.2, p=0.001, and 11.2±4.1 vs. 8.3±3.8, p=0.04, respectively); severity was not significantly different between groups (3.8±1.5 vs. 3.0±1.3, p=0.072). After adjustment for demographic variables and BMI-Z score, total and behavior subscale scores remained significantly different between groups, suggesting food-seeking activity, rather than preoccupation with food may be the main hyperphagic feature among patients with BBS. Conclusion Appetite dysregulation may contribute to obesity in BBS. PMID:23776152

Factor Structure of Child Behavior Scale Scores in Peruvian Preschoolers

ERIC Educational Resources Information Center

Meyer, Erin L.; Schaefer, Barbara A.; Soto, Cesar Merino; Simmons, Crystal S.; Anguiano, Rebecca; Brett, Jeremy; Holman, Alea; Martin, Justin F.; Hata, Heidi K.; Roberts, Kimberly J.; Mello, Zena R.; Worrell, Frank C.

2011-01-01

Behavior rating scales aid in the identification of problem behaviors, as well as the development of interventions to reduce such behavior. Although scores on many behavior rating scales have been validated in the United States, there have been few such studies in other cultural contexts. In this study, the structural validity of scores on a…

Neurodevelopment of children under 3 years of age with Smith-Magenis syndrome.

PubMed

Wolters, Pamela L; Gropman, Andrea L; Martin, Staci C; Smith, Michaele R; Hildenbrand, Hanna L; Brewer, Carmen C; Smith, Ann C M

2009-10-01

Systematic data regarding early neurodevelopmental functioning in Smith-Magenis syndrome are limited. Eleven children with Smith-Magenis syndrome less than 3 years of age (mean, 19 months; range, 5-34 months) received prospective multidisciplinary assessments using standardized measures. The total sample scored in the moderately to severely delayed range in cognitive functioning, expressive language, and motor skills and exhibited generalized hypotonia, oral-motor abnormalities, and middle ear dysfunction. Socialization skills were average, and significantly higher than daily living, communication, and motor abilities, which were below average. Mean behavior ratings were in the nonautistic range. According to exploratory analyses, the toddler subgroup scored significantly lower than the infant subgroup in cognition, expressive language, and adaptive behavior, suggesting that the toddlers were more delayed than the infants relative to their respective peers. Infants aged approximately 1 year or younger exhibited cognitive, language, and motor skills that ranged from average to delayed, but with age-appropriate social skills and minimal maladaptive behaviors. At ages 2 to 3 years, the toddlers consistently exhibited cognitive, expressive language, adaptive behavior, and motor delays and mildly to moderately autistic behaviors. Combining age groups in studies may mask developmental and behavioral differences. Increased knowledge of these early neurodevelopmental characteristics should facilitate diagnosis and appropriate intervention.

Effects of treatment differences on psychosocial predictors of exercise and improved eating in obese, middle-age adults.

PubMed

Annesi, James

2013-09-01

Behavioral interventions for weight-loss have been largely unsuccessful. Exercise is the strongest predictor of maintained weight loss and much of its effects may be from associated changes in psychosocial factors. Middle-aged, formerly sedentary adults with severe obesity were randomly selected to 6-month treatments of cognitive-behavioral exercise support paired with either standard nutrition education (n = 99) or nutrition change supported by cognitive-behavioral means with an emphasis on self-regulation (n = 101). Overall improvements in self-efficacy and self-regulation for both exercise and managed eating, and mood, were found, with significantly greater improvements associated with the cognitive-behavioral nutrition condition in self-regulation for eating and mood. Change scores trended toward being stronger predictors of increased exercise and fruit and vegetable intake than scores at treatment end. Multiple regression analyses indicated that significant portions of the variance in both increased volume of exercise (R2 = 0.45) and fruit and vegetable intake (R2 = 0.21) were explained by changes in self-regulatory skill usage, self-efficacy, and mood. Cognitive-behavioral methods for improved eating paired with behavioral support of exercise may improve weight loss through effects on the psychosocial factors of self-regulation, self-efficacy, and overall mood more than when standard nutrition education is incorporated.

What does risperidone add to parent training and stimulant for severe aggression in child attention-deficit/hyperactivity disorder?

PubMed

Aman, Michael G; Bukstein, Oscar G; Gadow, Kenneth D; Arnold, L Eugene; Molina, Brooke S G; McNamara, Nora K; Rundberg-Rivera, E Victoria; Li, Xiaobai; Kipp, Heidi; Schneider, Jayne; Butter, Eric M; Baker, Jennifer; Sprafkin, Joyce; Rice, Robert R; Bangalore, Srihari S; Farmer, Cristan A; Austin, Adrienne B; Buchan-Page, Kristin A; Brown, Nicole V; Hurt, Elizabeth A; Grondhuis, Sabrina N; Findling, Robert L

2014-01-01

Although combination pharmacotherapy is common in child and adolescent psychiatry, there has been little research evaluating it. The value of adding risperidone to concurrent psychostimulant and parent training (PT) in behavior management for children with severe aggression was tested. One hundred sixty-eight children 6 to 12 years old (mean age 8.89 ± 2.01 years) with severe physical aggression were randomized to a 9-week trial of PT, stimulant (STIM), and placebo (Basic treatment; n = 84) or PT, STIM, and risperidone (Augmented treatment; n = 84). All had diagnoses of attention-deficit/hyperactivity disorder and oppositional-defiant disorder (n = 124) or conduct disorder (n = 44). Children received psychostimulant (usually Osmotic Release Oral System methylphenidate) for 3 weeks, titrated for optimal effect, while parents received PT. If there was room for improvement at the end of week 3, placebo or risperidone was added. Assessments included parent ratings on the Nisonger Child Behavior Rating Form (Disruptive-Total subscale was the primary outcome) and Antisocial Behavior Scale; blinded clinicians rated change on the Clinical Global Impressions scale. Compared with Basic treatment (PT + STIM [44.8 ± 14.6 mg/day] + placebo [1.88 mg/day ± 0.72]), Augmented treatment (PT + STIM [46.1 ± 16.8 mg/day] + risperidone [1.65 mg/day ± 0.75]) showed statistically significant improvement on the Nisonger Child Behavior Rating Form Disruptive-Total subscale (treatment-by-time interaction, p = .0016), the Nisonger Child Behavior Rating Form Social Competence subscale (p = .0049), and Antisocial Behavior Scale Reactive Aggression subscale (p = .01). Clinical Global Impressions scores were substantially improved for the 2 groups but did not discriminate between treatments (Clinical Global Impressions-Improvement score ≤2, 70% for Basic treatment versus 79% for Augmented treatment). Prolactin elevations and gastrointestinal upset occurred more with Augmented treatment; other adverse events differed modestly from Basic treatment; weight gain in the Augmented treatment group was minor. Risperidone provided moderate but variable improvement in aggressive and other seriously disruptive child behaviors when added to PT and optimized stimulant treatment. Clinical trial registration information-Treatment of Severe Childhood Aggression (The TOSCA Study), URL: http://clinicaltrials.gov, unique identifier: NCT00796302. Copyright © 2014 American Academy of Child and Adolescent Psychiatry. All rights reserved.

Stable self-serving personality traits in recreational and dependent cocaine users

PubMed Central

Quednow, Boris B.; Hulka, Lea M.; Preller, Katrin H.; Baumgartner, Markus R.; Eisenegger, Christoph; Vonmoos, Matthias

2017-01-01

Chronic cocaine use has been associated with impairments in social cognition, self-serving and antisocial behavior, and socially relevant personality disorders (PD). Despite the apparent relationship between Machiavellianism and stimulant use, no study has explicitly examined this personality concept in cocaine users so far. In the frame of the longitudinal Zurich Cocaine Cognition Study, the Machiavellianism Questionnaire (MACH-IV) was assessed in 68 recreational and 30 dependent cocaine users as well as in 68 psychostimulant-naïve controls at baseline. Additionally, three closely related personality dimensions from the Temperament and Character Inventory (TCI)–cooperativeness, (social) reward dependence, and self-directedness–and the screening questionnaire of the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) were acquired. At the one-year follow-up, 57 cocaine users and 48 controls were reassessed with the MACH-IV. Finally, MACH-IV scores were correlated with measures of social cognition and interaction (cognitive/emotional empathy, Theory-of-Mind, prosocial behavior) and with SCID-II PD scores assessed at baseline. Both recreational and dependent cocaine users showed significantly higher Machiavellianism than controls, while dependent cocaine users additionally displayed significantly lower levels of TCI cooperativeness and self-directedness. During the one-year interval, MACH-IV scores showed high test-retest reliability and also the significant gap between cocaine users and controls remained. Moreover, in cocaine users, higher Machiavellianism correlated significantly with lower levels of cooperativeness and self-directedness, with less prosocial behavior, and with higher cluster B PD scores. However, Machiavellianism was not correlated with measures of cocaine use severity (r<-.15). Both recreational and dependent cocaine users display pronounced and stable Machiavellian personality traits. The lack of correlations with severity of cocaine use and its temporal stability indicates that a Machiavellian personality trait might represent a predisposition for cocaine use that potentially serves as a predictor for stimulant addiction. PMID:28253291

Treatment of Internet Addiction with Anxiety Disorders: Treatment Protocol and Preliminary Before-After Results Involving Pharmacotherapy and Modified Cognitive Behavioral Therapy.

PubMed

Santos, Veruska Andrea; Freire, Rafael; Zugliani, Morená; Cirillo, Patricia; Santos, Hugo Henrique; Nardi, Antonio Egidio; King, Anna Lucia

2016-03-22

The growth of the Internet has led to significant change and has become an integral part of modern life. It has made life easier and provided innumerous benefits; however, excessive use has brought about the potential for addiction, leading to severe impairments in social, academic, financial, psychological, and work domains. Individuals addicted to the Internet usually have comorbid psychiatric disorders. Panic disorder (PD) and generalized anxiety disorder (GAD) are prevalent mental disorders, involving a great deal of damage in the patient's life. This open trial study describes a treatment protocol among 39 patients with anxiety disorders and Internet addiction (IA) involving pharmacotherapy and modified cognitive behavioral therapy (CBT). Of the 39 patients, 25 were diagnosed with PD and 14 with GAD, in addition to Internet addiction. At screening, patients responded to the MINI 5.0, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, Clinical Global Impressions Scale, and the Young Internet Addiction Scale. At that time, IA was observed taking into consideration the IAT scale (cutoff score above 50), while anxiety disorders were diagnosed by a psychiatrist. Patients were forwarded for pharmacotherapy and a modified CBT protocol. Psychotherapy was conducted individually, once a week, over a period of 10 weeks, and results suggest that the treatment was effective for anxiety and Internet addiction. Before treatment, anxiety levels suggested severe anxiety, with an average score of 34.26 (SD 6.13); however, after treatment the mean score was 15.03 (SD 3.88) (P<.001). A significant improvement in mean Internet addiction scores was observed, from 67.67 (SD 7.69) before treatment, showing problematic internet use, to 37.56 (SD 9.32) after treatment (P<.001), indicating medium Internet use. With respect to the relationship between IA and anxiety, the correlation between scores was .724. This study is the first research into IA treatment of a Brazilian population. The improvement was remarkable due to the complete engagement of patients in therapy, which contributed to the success of the treatment from a behavioral perspective, and gave patients the confidence to continue to manage Internet use in their lives.

Antisocial Behavior and Interpersonal Values in High School Students

PubMed Central

Molero Jurado, María del Mar; Pérez Fuentes, María del Carmen; Carrión Martínez, José J.; Luque de la Rosa, Antonio; Garzón Fernández, Anabella; Martos Martínez, África; Simón Márquez, Maria del Mar; Barragán Martín, Ana B.; Gázquez Linares, José J.

2017-01-01

This article analyzes the characteristics of antisocial behavior and interpersonal values of high school students (Compulsory Secondary Education) (CSE), the profile of students with high levels of antisocial behavior with regard to interpersonal values, and possible protection from antisocial behavior that interpersonal values could provide. The Interpersonal Values Questionnaire was used to assess interpersonal values, and the Antisocial-Delinquent Behaviors Questionnaire was employed to assess antisocial behaviors. The sample was made up of 885 CSE students aged 14–17. The results revealed a greater prevalence of antisocial behaviors among males and fourth-year CSE students. Moreover, antisocial behaviors were more frequent among participants with high scores in Stimulation, Recognition, Independence, and Leadership and low scores in Conformity and Benevolence. Lastly, logistic regression analyses showed that low scores in Conformity and Benevolence and high scores in Independence predicted high scores in antisocial behavior. The possibility of identifying certain interpersonal values which could positively or negatively affect the appearance of antisocial behavior during adolescence is discussed. PMID:28261124

Prevalence and risk factors for depression and anxiety in Chinese patients with Parkinson disease.

PubMed

Cui, Shi-Shuang; Du, Juan-Juan; Fu, Rao; Lin, Yi-Qi; Huang, Pei; He, Ya-Chao; Gao, Chao; Wang, Hua-Long; Chen, Sheng-Di

2017-11-22

Anxiety and depression are common in Parkinson disease and both are important determinants of quality of life in patients. Several risk factors are identified but few research have investigated general and Parkinson's disease (PD)-specific factors comprehensively. The aim of this work was to explore PD-specific and -non-specific risk factors for PD with depression or anxiety. A cross-sectional survey was performed in 403 patients with PD. Multivariate logistic analysis was used to investigate the prevalence and risk factors for the depression and anxiety in PD. The data of patients included demographic information, medicine history, disease duration, age at onset (AAO), family history, anti-parkinsonism drug, modified Hoehn and Yahr staging (H-Y) stage, scales of motor and non-motor symptoms and substantia nigra (SN) echogenic areas. 403 PD patients were recruited in the study. Depression and anxiety were present in 11.17% and 25.81% respectively. Marital status, tumor, higher Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) II score, dyskinesia, higher Hamilton Anxiety Rating Scale (HARS) score and lower the Parkinson's disease sleep scale (PDSS) score were associated with depression in PD. female gender, higher rapid eye movement behavior disorder Questionnaire-Hong Kong (RBD-HK) score, higher Hamilton Deprssion Rating Scale (HAMD) score, higher the scale for outcomes in PD for autonomic symptoms (SCOPA-AUT)score and larger SN echogenic areas were associated with anxiety. Neither depression nor anxiety was related to any anti-parkinsonism drugs. The prevalence of depression and anxiety in the current PD patients was 11.17% and 25.81% respectively. Disease of tumor, currently having no partner, severer motor function, dyskinesia, poorer sleep quality and anxiety were risk factors for PD with depression. Female, depression, rapid eye movement behavior disorder (RBD), autonomic dysfunction and larger SN area were risk factors for PD with anxiety.

Self-portraits and selected indices of psychopathology of a group of heroin-addicted patients.

PubMed

Nucho, A O

1979-01-01

This paper describes a self-portrait scoring system and compares the self-portraits of two groups of adults. The scoring system effectively differentiated between the two groups of subjects which were known to differ on several observable behavioral characteristics. It correlated well with the ratings obtained from counselors but not with a self-report inventory of anxiety. A self-portrait is a single manifestation of an individual's self-concept. It presents only a fraction of the hypothetical universe of one's behavioral manifestations. In addition, every single observation is affected by the place, time, and the presence of the observer. However, if these isolated observations can be studied systematically, they can contribute to a reliable and a valid index of the self-concept. This paper presents one means of achieving that end.

Prevalence of fatigue in Parkinson disease and its clinical correlates.

PubMed

Stocchi, Fabrizio; Abbruzzese, Giovanni; Ceravolo, Roberto; Cortelli, Pietro; D'Amelio, Marco; De Pandis, Maria F; Fabbrini, Giovanni; Pacchetti, Claudio; Pezzoli, Gianni; Tessitore, Alessandro; Canesi, Margherita; Iannacone, Claudio; Zappia, Mario

2014-07-15

To assess in a noninterventional setting the prevalence and severity of fatigue in patients with Parkinson disease (PD). This was a cross-sectional study conducted in Italian patients with PD. Objectives included the evaluation of the current prevalence and severity of fatigue in patients with PD measured using the 16-item Parkinson Fatigue Scale (PFS-16), distressing fatigue (defined as a PFS-16 mean score ≥3.3), and assessment of its clinical correlates. A total of 402 patients were enrolled and 394 patients completed the PFS-16 questionnaire with a PFS-16 mean (±SD) score of 2.87 ± 0.99. Of these, 136 patients (33.8%) reported distressing fatigue (PFS-16 mean score ≥3.3). Patients with distressing fatigue were older (p = 0.044) and had a longer duration of PD (p < 0.0001) than those without distressing fatigue. The presence of distressing fatigue was associated with higher total Unified Parkinson's Disease Rating Scale (UPDRS) scores, poorer quality of life (39-item Parkinson's Disease Questionnaire [PDQ-39]), worse social and psychological behaviors, a higher severity of depressive symptoms, and a higher prevalence of sleep disorders (all p < 0.001). Logistic regression analyses revealed that higher total UPDRS scores, female sex, depression, sleep disorders, as well as higher UPDRS activities of daily living scores and PDQ-39 mobility scores increase the likelihood of distressing fatigue in patients with PD. Approximately one-third of patients with PD have distressing fatigue, which is significantly associated with depression and sleep disorders. The fact that the presence of fatigue worsens patient quality of life supports the need to better diagnose and treat this debilitating symptom. © 2014 American Academy of Neurology.

Sensitivity of alternative measures of functioning and wellbeing for adults with sickle cell disease: comparison of PROMIS® to ASCQ-Me℠.

PubMed

Keller, San; Yang, Manshu; Treadwell, Marsha J; Hassell, Kathryn L

2017-06-02

Sickle Cell Disease (SCD) causes profound suffering and decrements in daily functioning. Demand is growing for valid and reliable measures to systematically document these effects, particularly in adults. The Adult Sickle Cell Quality of Life Measurement System, ASCQ-Me℠, was developed for this purpose. ASCQ-Me℠ is one of four measurement systems housed within the Person-Centered Assessment Resource (PCAR), funded by the National Institutes of Health, to support clinical research. To help users select the best of these measures for adults with SCD, we evaluated and compared two PCAR systems: one designed to be "universally applicable" (the Patient-Reported Outcome Measurement Information System, PROMIS®) and one designed specifically for SCD (ASCQ-Me℠). Respondents to PROMIS and ASCQ-Me questions were 490 adults with SCD from seven geographically-disbursed clinics within the US. Data were collected for six ASCQ-Me measures (Emotional Impact, Sleep Impact, Social Impact, Stiffness Impact, Pain Impact, SCD Pain Episode Frequency and Severity) and ten PROMIS measures (Pain Impact, Pain Behavior, Physical Functioning, Anxiety, Depression, Fatigue, Satisfaction with Discretionary Social Activities, Satisfaction with Social Roles, Sleep Disturbance, and Sleep-Related Impairment). Statistical analyses, including analysis of variance and multiple linear regression, were conducted to determine the sensitivity of measures to SCD severity. SCD severity was assessed via a checklist of associated treatments and conditions. For those with the most severe SCD, PROMIS scores showed worse health compared to the general population for nine of ten health domains: the magnitude of the difference ranged 0.5 to 1.1 standard deviation units. The PROMIS domains most severely affected were Physical Functioning and Pain (Impact and Behavior). Significant differences by tertile of the SCD-MHC were shown for most PROMIS short forms and all ASCQ-Me short and fixed forms. In most models, ASCQ-Me measures explained statistically significant unique variance in SCD-MHC scores complementary to that explained by corresponding PROMIS measures. Study results supported the validity of both PROMIS and ASCQ-Me measures for use in adults with SCD. Compared to comparable PROMIS scores, most ASCQ-Me scores were better predictors of SCD disease severity, as measured by a medical history checklist. The clinical implications of these results require further investigation.

Self injurious behavior in autism: clinical aspects and treatment with risperidone.

PubMed

Canitano, R

2006-03-01

Self injurious behavior (SIB) is frequent in autistic spectrum disorders. The aim of this study was to investigate the phenomenology of SIB in a group of children with autistic disorder, and to test whether treatment with risperidone might reduce it. A group of eleven children diagnosed with autistic disorder according to the DSM-IV criteria (mean age 8.7+/-2.2 ys) and with severe SIB were recruited for an open study of six months of treatment with risperidone. The Yale-Paris Self-Injurious Behavior Scale was used to delineate the clinical characteristics and as an outcome measure. Head-hitting and hand biting were the most frequent forms of self aggression observed. Nine children presented a mild improvement in SIB and 2 did not show any variation. A decrease in Yale-Paris Self Injurious Behavior Scale score (from M 15.1+/-1.4 to 13.3+/-1.4) was noted mainly due to the reduction of frequency. Side effects of risperidone were not severe.

Executive functions and psychiatric symptoms in drug-refractory juvenile myoclonic epilepsy.

PubMed

Walsh, Jordana; Thomas, Rhys H; Church, Carla; Rees, Mark I; Marson, Anthony G; Baker, Gus A

2014-06-01

The pattern of executive dysfunction reported in juvenile myoclonic epilepsy (JME) resembles that of patients with cluster B personality disorders. This study examined whether executive dysfunction and maladaptive behavior reported in patients with JME are related. Sixty patients with drug-refractory JME were administered tests of intellect, memory, and executive dysfunction. Anxiety, depression, personality traits, impact of epilepsy, and perceived cognitive effects of antiepileptic drugs were measured. Half of the cohort exhibited moderate to severe anxiety symptoms. The patients performed most poorly on naming ability and inhibition switching. Duration of epilepsy exacerbated poor performance on inhibition switching. Females presented with pathological scores for neurotic and introvert traits and males for introvert traits. Abnormal personality traits and psychiatric disorders were associated with worse intellectual and executive functioning. People with extreme Eysenck Personality Scale - Brief Version (EPQ-BV) scores demonstrated the greatest level of executive impairment. Furthermore, the same degree of dysfunction was not seen in any individual with unremarkable EPQ-BV scores. This study indicates that specific patterns of executive dysfunction are related to maladaptive behavior in JME. Distinct behavioral patterns may be used to identify functional and anatomical differences between people with JME and for stratification to enable gene discovery. Copyright © 2014. Published by Elsevier Inc.

Compulsive sexual behavior inventory: a preliminary study of reliability and validity.

PubMed

Coleman, E; Miner, M; Ohlerking, F; Raymond, N

2001-01-01

This preliminary study was designed to develop empirically a scale of compulsive sexual behavior (CSB) and to test its reliability and validity in a sample of individuals with nonparaphilic CSB (N = 15), in a sample of pedophiles (N = 35) in treatment for sexual offending, and in a sample of normal controls (N = 42). Following a factor analysis and a varimax rotation, those items with factor loadings on the rotated factors of greater than .60 were retained. Three factors were identified, which appeared to measure control, abuse, and violence. Cronbach's alphas indicated that the subscales have good reliability. The 28-item scale was then tested for validity by a linear discriminant function analysis. The scale successfully discriminated the nonparaphilic CSB sample and the pedophiles from controls. Further analysis indicated that this scale is a valid measure of CSB in that there were significant differences between the three groups on the control subscale. Pedophiles scored significantly lower than the other two groups on the abuse subscale, with the other two groups not scoring significantly differently from one another. This indicated that pedophiles were more abusive than the nonparaphilic CSB individuals or the controls. Pedophiles scored significantly lower than controls on the violence subscale. Nonparaphilic individuals with compulsive sexual behavior scored slightly lower on the violence subscale, although not significantly different. As a preliminary study, there are several limitations to this study, which should be addressed, in further studies with larger sample sizes.

Between-Individual Variability and Interpretation of Associations between Neurophysiological and Behavioral Measures in Aging Populations: Comment on Salthouse (2011)

ERIC Educational Resources Information Center

Rabbitt, Patrick

2011-01-01

Salthouse (2011) argued that (a) variance between individuals on cognitive test scores remains constant between 20 and 90 years of age and (b) widely recognized problems of deducing functional relationships from patterns of correlations between measurements become especially severe for neuropsychological indices, especially for gross indices of…

Disclosing Pleiotropic Effects during Genetic Risk Assessment for Alzheimer’s Disease: A Randomized, Controlled Trial

PubMed Central

Christensen, Kurt D.; Roberts, J. Scott; Whitehouse, Peter J.; Royal, Charmaine D. M.; Obisesan, Thomas O.; Cupples, L. Adrienne; Vernarelli, Jacqueline A.; Bhatt, Deepak L.; Linnenbringer, Erin; Butson, Melissa B.; Fasaye, Grace-Ann; Uhlmann, Wendy R.; Hiraki, Susan; Wang, Na; Cook-Deegan, Robert; Green, Robert C.

2016-01-01

Background Increasing use of genetic testing raises questions about disclosing secondary findings, including pleiotropic information. Objective To determine the safety and behavioral impact of disclosing modest associations between APOE genotype and coronary artery disease (CAD) risk during APOE-based genetic risk assessments for Alzheimer’s disease (AD). Design Randomized, multicenter equivalence clinical trial Setting Four teaching hospitals Participants 257 asymptomatic adults enrolled, 69% with one AD-affected first degree relative Intervention Disclosing AD and CAD genetic risk information (AD+CAD) versus disclosing only AD genetic risk (AD-only) Measurements Co-primary outcomes were Beck Anxiety Index (BAI) and Center for Epidemiologic Studies Depression Scale (CES-D) scores at 12 months. Secondary outcomes included test-related distress at 12 months, all measures at 6 weeks and 6 months, and health behavior changes at 12 months. Results 12 months after disclosure, mean BAI scores were 3.5 and 3.5 in AD-only and AD+CAD arms (Δ=0.0, 95%CI: −1.0 to 1.0), and mean CES-D scores were 6.4 and 7.1 in AD-only and AD+CAD arms (Δ=0.7, 95%CI: −1.0 to 2.4). Both confidence bounds fell within the equivalence margin of +/−5 points. Among ε4-positive participants, distress was lower in AD+CAD arms than AD-only arms (Δ=−4.8, 95%CI: −8.6 to −1.0) (p=0.031 for disclosure arm x APOE genotype). AD+CAD participants also reported more health behavior changes, regardless of APOE genotype. Limitations Outcomes were self-reported from volunteers without severe anxiety, severe depression, or cognitive problems. Analyses omitted 33 randomized participants. Conclusion Disclosing pleiotropic information did not increase anxiety or depression, and may have decreased distress among those at increased risk for two conditions. Providing risk modification information regarding CAD improved health behaviors. Findings highlight potential benefits of secondary genetic findings disclosure when options exist for decreasing risk. PMID:26810768

Trends in Classroom Observation Scores

PubMed Central

Lockwood, J. R.; McCaffrey, Daniel F.

2014-01-01

Observations and ratings of classroom teaching and interactions collected over time are susceptible to trends in both the quality of instruction and rater behavior. These trends have potential implications for inferences about teaching and for study design. We use scores on the Classroom Assessment Scoring System–Secondary (CLASS-S) protocol from 458 middle school teachers over a 2-year period to study changes over time in (a) the average quality of teaching for the population of teachers, (b) the average severity of the population of raters, and (c) the severity of individual raters. To obtain these estimates and assess them in the context of other factors that contribute to the variability in scores, we develop an augmented G study model that is broadly applicable for modeling sources of variability in classroom observation ratings data collected over time. In our data, we found that trends in teaching quality were small. Rater drift was very large during raters’ initial days of observation and persisted throughout nearly 2 years of scoring. Raters did not converge to a common level of severity; using our model we estimate that variability among raters actually increases over the course of the study. Variance decompositions based on the model find that trends are a modest source of variance relative to overall rater effects, rater errors on specific lessons, and residual error. The discussion provides possible explanations for trends and rater divergence as well as implications for designs collecting ratings over time. PMID:29795823

Trends in Classroom Observation Scores.

PubMed

Casabianca, Jodi M; Lockwood, J R; McCaffrey, Daniel F

2015-04-01

Observations and ratings of classroom teaching and interactions collected over time are susceptible to trends in both the quality of instruction and rater behavior. These trends have potential implications for inferences about teaching and for study design. We use scores on the Classroom Assessment Scoring System-Secondary (CLASS-S) protocol from 458 middle school teachers over a 2-year period to study changes over time in (a) the average quality of teaching for the population of teachers, (b) the average severity of the population of raters, and (c) the severity of individual raters. To obtain these estimates and assess them in the context of other factors that contribute to the variability in scores, we develop an augmented G study model that is broadly applicable for modeling sources of variability in classroom observation ratings data collected over time. In our data, we found that trends in teaching quality were small. Rater drift was very large during raters' initial days of observation and persisted throughout nearly 2 years of scoring. Raters did not converge to a common level of severity; using our model we estimate that variability among raters actually increases over the course of the study. Variance decompositions based on the model find that trends are a modest source of variance relative to overall rater effects, rater errors on specific lessons, and residual error. The discussion provides possible explanations for trends and rater divergence as well as implications for designs collecting ratings over time.

Evaluation of a multi-component approach to cognitive-behavioral therapy (CBT) using guided visualizations, cranial electrotherapy stimulation, and vibroacoustic sound.

PubMed

Rogers, Donna R B; Ei, Sue; Rogers, Kim R; Cross, Chad L

2007-05-01

This pilot study examines the use of guided visualizations that incorporate both cognitive and behavioral techniques with vibroacoustic therapy and cranial electrotherapy stimulation to form a multi-component therapeutic approach. This multi-component approach to cognitive-behavioral therapy (CBT) was used to treat patients presenting with a range of symptoms including anxiety, depression, and relationship difficulties. Clients completed a pre- and post-session symptom severity scale and CBT skills practice survey. The program consisted of 16 guided visualizations incorporating CBT techniques that were accompanied by vibroacoustic therapy and cranial electrotherapy stimulation. Significant reduction in symptom severity was observed in pre- and post-session scores for anxiety symptoms, relationship difficulties, and depressive symptoms. The majority of the clients (88%) reported use of CBT techniques learned in the guided visualizations at least once per week outside of the sessions.

Effects of television weather broadcasters on viewers during severe weather: To be or not to be on-screen

NASA Astrophysics Data System (ADS)

Lea, Amanda Marie

An association was tested between the presence of a television weather broadcaster on-screen and viewers' likelihood to seek shelter, measured via risk perception and preventative behavior. Social networking websites were used to recruit respondents. Four clips of archived severe weather videos, one pair (on-screen and off-screen broadcaster) using the reflectivity product and another pair (on-screen and off-screen broadcaster) using velocity product, were presented to participants. Viewers' trust and weather salience were also quantified for additional interactions. A relationship between viewers' risk perception (preflectivity = 0.821, pvelocity = 0.625) and preventative behavior (preflectivity = 0.217, p velocity = 0.236) and the presence of the broadcaster on-screen was not found. The reflectivity product was associated with higher risk perception and preventative behavior scores than the velocity product (prp = 0.000, ppb = 0.000).

Defensive behaviors and prosencephalic neurogenesis in pigeons (Columba livia) are affected by environmental enrichment in adulthood.

PubMed

Melleu, F F; Pinheiro, M V; Lino-de-Oliveira, C; Marino-Neto, J

2016-05-01

Neurogenesis in the adult brain appears to be phylogenetically conserved across the animal kingdom. In pigeons and other adult non-oscine birds, immature neurons are observed in several prosencephalic areas, suggesting that neurogenesis may participate in the control of different behaviors. The mechanisms controlling neurogenesis and its relevance to defensive behaviors in non-oscine birds remain elusive. Herein, the contribution of the environment to behavior and neurogenesis of pigeons was investigated. Adult pigeons (Columba livia, n = 6/group), housed in standard (SE) or enriched environment (EE) for 42 days, were exposed to an unfamiliar environment (UE) followed by presentation to a novel object (NO). Video recordings of UE+NO tests were analyzed and scored for latency, duration and frequency of angular head movements, peeping, grooming, immobility and locomotion. Twenty-four hours later, pigeons were submitted to the tonic immobility test (TI) and number of trials for TI and TI duration were scored, followed by euthanasia 2 h later. Brains were immunohistochemically processed to reveal doublecortin (DCX), a marker for newborn neurons. Compared to those housed in SE, the pigeons housed in EE responded to a NO with more immobility. In addition, the pigeons housed in EE presented longer TI, more DCX-immunoreactive (DCX-ir) cells in the hippocampus and fewer DCX-ir cells in the lateral striatum than those housed in SE. There was no correlation between the number of DCX-ir cells and the scores of immobility in behavioral tests. Together, these data suggest that enrichment favored behavioral inhibition and neurogenesis in the adult pigeons through different, parallel mechanisms.

Experimentally increasing sedentary behavior results in increased anxiety in an active young adult population.

PubMed

Edwards, Meghan K; Loprinzi, Paul D

2016-11-01

Knowledge regarding the effects of sedentary behavior on anxiety has resulted mainly from observational studies. The purpose of this study was to examine the effects of a free-living, sedentary behavior-inducing randomized controlled intervention on anxiety symptoms. Participants confirmed to be active (i.e., acquiring 150min/week of physical activity) via self-report and accelerometry were randomly assigned into a sedentary behavior intervention group (n=26) or a control group (n=13). For one week, the intervention group eliminated exercise and minimized steps to ≤5000 steps/day whereas the control group continued their normal physical activity levels. Both groups completed the Overall Anxiety Severity Impairment Scale (OASIS) pre- and post-intervention, with higher OASIS scores indicating worse overall anxiety. The intervention group resumed normal physical activity levels for one week post-intervention and then completed the survey once more. A significant group x time interaction effect was observed (F(1,37)=11.13; P=.002), with post-hoc contrast tests indicating increased OASIS scores in the intervention group in Visit 2 compared with Visit 1. That is, we observed an increase in anxiety levels when participants increased their sedentary behavior. OASIS scores significantly decreased from Visit 2 to Visit 3 (P=.001) in the intervention group. A one-week sedentary behavior-inducing intervention has deleterious effects on anxiety in an active, young adult population. To prevent elevated anxiety levels among active individuals, consistent regular physical activity may be necessary. Clinicians treating inactive patients who have anxiety may recommend a physical activity program in addition to any other prescribed treatment. Copyright © 2016 Elsevier B.V. All rights reserved.

What Did They Learn? Effects of a Brief Cognitive Behavioral Therapy Workshop on Community Therapists' Knowledge.

PubMed

Scott, Kelli; Klech, David; Lewis, Cara C; Simons, Anne D

2016-11-01

Knowledge gain has been identified as necessary but not sufficient for therapist behavior change. Declarative knowledge, or factual knowledge, is thought to serve as a prerequisite for procedural knowledge, the how to knowledge system, and reflective knowledge, the skill refinement system. The study aimed to examine how a 1-day workshop affected therapist cognitive behavioral therapy declarative knowledge. Participating community therapists completed a test before and after training that assessed cognitive behavioral therapy knowledge. Results suggest that the workshop significantly increased declarative knowledge. However, post-training total scores remained moderately low, with several questions answered incorrectly despite content coverage in the workshop. These findings may have important implications for structuring effective cognitive behavioral therapy training efforts and for the successful implementation of cognitive behavioral therapy in community settings.

Intervention Provided to Linguistically Diverse Middle School Students with Severe Reading Difficulties

PubMed Central

Denton, Carolyn A.; Wexler, Jade; Vaughn, Sharon; Bryan, Deanna

2012-01-01

This study investigated the effectiveness of a multicomponent reading intervention implemented with middle school students with severe reading difficulties, all of whom had received remedial and/or special education for several years with minimal response to intervention. Participants were 38 students in grades 6–8 who had severe deficits in word reading, reading fluency, and reading comprehension. Most were Spanish-speaking English language learners (ELLs) with identified disabilities. Nearly all demonstrated severely limited oral vocabularies in English and, for ELLs, in both English and Spanish. Students were randomly assigned to receive the research intervention (n = 20) or typical instruction provided in their school’s remedial reading or special education classes (n = 18). Students in the treatment group received daily explicit and systematic small-group intervention for 40 minutes over 13 weeks, consisting of a modified version of a phonics-based remedial program augmented with English as a Second Language practices and instruction in vocabulary, fluency, and comprehension strategies. Results indicated that treatment students did not demonstrate significantly higher outcomes in word recognition, comprehension, or fluency than students who received the school’s typical instruction and that neither group demonstrated significant growth over the course of the study. Significant correlations were found between scores on teachers’ ratings of students’ social skills and problem behaviors and posttest decoding and spelling scores, and between English oral vocabulary scores and scores in word identification and comprehension. The researchers hypothesize that middle school students with the most severe reading difficulties, particularly those who are ELLs and those with limited oral vocabularies, may require intervention of considerably greater intensity than that provided in this study. Further research directly addressing features of effective remediation for these students is needed. PMID:22736893

Results of a Multi-level Intervention to Prevent and Control Childhood Obesity among Latino Children: The Aventuras Para Niños Study

PubMed Central

Crespo, Noe C.; Elder, John P.; Ayala, Guadalupe X.; Campbell, Nadia R.; Arredondo, Elva M.; Slymen, Donald J.; Baquero, Barbara; Sallis, James F.; McKenzie, Thomas L.

2014-01-01

Background Community-based behavioral interventions are needed to reduce the burden of childhood obesity. Purpose This study evaluated the impact of a multi-level promotora-based (Community Health Advisor) intervention to promote healthy eating and physical activity (PA) and prevent excess weight gain among Latino children. Methods Thirteen elementary schools were randomized to one of four intervention conditions: individual and family level (Fam-only), school and community level (Comm-only), combined Fam+Comm intervention, or a measurement-only condition. Participants were 808 Latino parents and their children enrolled in kindergarten through 2nd grade. Measures included parent and child BMI and a self-administered parent survey that assessed several parent and child behaviors. Results There were no intervention effects on children's BMI z-score. The Fam-only and Fam+Comm interventions changed several obesity-related child behaviors and these were mediated by changes in parenting variables. Discussion A promotora-based behavioral intervention was efficacious at changing parental factors and child obesity-related health behaviors. PMID:22215470

Subtyping pathological gamblers based on impulsivity, depression and anxiety

PubMed Central

Ledgerwood, David M.; Petry, Nancy M.

2010-01-01

This study examined putative subtypes of pathological gamblers (PGs) based on the Pathways Model, and it also evaluated whether the subtypes would benefit differentially from treatment. Treatment-seeking PGs (N = 229) were categorized into Pathways subtypes based on scores from questionnaires assessing anxiety, depression and impulsivity. The Addiction Severity Index Gambling assessed severity of gambling problems at baseline, post-treatment and 12-month follow-up. Compared with Behaviorally Conditioned (BC) gamblers, Emotionally Vulnerable (EV) gamblers had higher psychiatric and gambling severity, and were more likely to have a parent with a psychiatric history. Antisocial Impulsive (AI) gamblers also had elevated gambling and psychiatric severity relative to BC gamblers. They were more likely to have antisocial personality disorder and had the highest legal and family/social severity scores. They were also most likely to have a history of substance abuse treatment, history of inpatient psychiatric treatment, and a parent with a substance use or gambling problem. AI and EV gamblers experienced greater gambling severity throughout treatment than BC gamblers, but all three subtypes demonstrated similar patterns of treatment response. Thus, the three Pathways subtypes differ based on some baseline characteristics, but subtyping did not predict treatment outcomes beyond a simple association with problem gambling severity. PMID:20822191

Comparison of 3 Different Teaching Methods for a Behavioral Therapy Program for Female Overactive Bladder: A Randomized Controlled Trial.

PubMed

Gezginci, Elif; Iyigun, Emine; Yilmaz, Sercan

The purpose of this study was to compare the effect of 3 instructional methods for behavioral therapy on lower urinary tract symptom (LUTS) severity and health-related quality of life (HRQOL) in women with overactive bladder. Single-center, parallel-group, randomized, clinical trial. The sample comprised 60 women diagnosed with overactive bladder. The study setting was a university-based female urology clinic in Ankara, Turkey; data were collected from November 2012 to May 2013. Eligible participants were ambulatory women 18 years or older with predominant overactive bladder and urge urinary incontinence (UI) symptoms, with or without stress UI symptoms. Subjects were randomized into 4 groups based on educational intervention; group 1 received structured verbal instruction plus a leaflet, group 2 received structured verbal instruction, group 3 received a leaflet alone, and group 4 received usual care that included unstructured verbal counseling about continence care. The primary outcome measures were Incontinence Impact Questionnaire-7 (IIQ-7) and Urinary Distress Inventory-6 (UDI-6) scores. We also measured changes in UI-specific HRQOL scores via the Urinary Incontinence Quality of Life Instrument (I-QOL). All outcomes were measured before and 6 to 8 weeks after the interventions. The Wilcoxon test was used to identify differences in LUTS severity and HRQOL before and after the educational intervention. The Kruskall-Wallis test was used to compare differences among the groups. The severity of LUTS and UI-specific quality of life assessed by the IIQ-7, UDI-6, and I-QOL scores significantly improved after training in all 4 groups (P < .05). The group that received structured verbal instruction plus an educational leaflet achieved significantly lower LUTS scores and significantly higher UI-specific HRQOL when compared to the other groups (P < .05). Findings suggest that structured verbal instruction plus educational leaflet is the most effective method of bladder training in women with overactive bladder and urge UI.

Parent-Reported Behavioral and Psychiatric Problems Mediate the Relationship between Sleep-Disordered Breathing and Cognitive Deficits in School-Aged Children.

PubMed

Smith, Dale L; Gozal, David; Hunter, Scott J; Kheirandish-Gozal, Leila

2017-01-01

Numerous studies over the past several decades have illustrated that children who suffer from sleep-disordered breathing (SDB) are at greater risk for cognitive, behavioral, and psychiatric problems. Although behavioral problems have been proposed as a potential mediator between SDB and cognitive functioning, these relationships have not been critically examined. This analysis is based on a community-based cohort of 1,115 children who underwent overnight polysomnography, and cognitive and behavioral phenotyping. Structural model of the relationships between SDB, behavior, and cognition, and two recently developed mediation approaches based on propensity score weighting and resampling were used to assess the mediational role of parent-reported behavior and psychiatric problems in the relationship between SDB and cognitive functioning. Multiple models utilizing two different SDB definitions further explored direct effects of SDB on cognition as well as indirect effects through behavioral pathology. All models were adjusted for age, sex, race, BMI z -score, and asthma status. Indirect effects of SDB through behavior problems were significant in all mediation models, while direct effects of SDB on cognition were not. The findings were consistent across different mediation procedures and remained essentially unaltered when different criteria for SDB, behavior, and cognition were used. Potential effects of SDB on cognitive functioning appear to occur through behavioral problems that are detectable in this pediatric population. Thus, early attentional or behavioral pathology may be implicated in the cognitive functioning deficits associated with SDB, and may present an early morbidity-related susceptibility biomarker.

Use of the BRIEF and CBCL in Ugandan Children with HIV or a History of Severe Malaria

PubMed Central

Itziar, Familiar; Horacio, Ruisenor-Escudero; Bruno, Giordani; Paul, Bangirana; Noeline, Nakasujja; Robert, Opoka; Michael, Boivin

2015-01-01

Objective To assess the structural overlap between the Behavior Rating Inventory of Executive Function (BRIEF) and Achenbach Child Behavior Check List (CBCL) among children in Uganda. Methods Caregiver ratings for the BRIEF and CBCL were obtained for two independent samples of school-aged children: 106 children (5-12 years old, 50% males) with a history of severe malaria, and on 144 HIV-infected children (5-12 years old, 58% males) in Uganda. Exploratory factor analysis was used to evaluate the factor structure of the 8 sub-scales for the BRIEF and the 8 scales of the CBCL to determine correlation. Results Overall, children in the severe malaria group had higher (increased symptom) BRIEF and CBCL scores than children in the HIV-infected group. We identified 3 factors that provided a reasonable fit to the data and could be characterized as 3 specific domains: 1) Metacognition, which consisted of the scales in the BRIEF Metacognition domain; 2) Behavioral Adjustment, which was comprised of the scales in the BRIEF Behavioral Regulation domain and the Externalizing Symptoms scales in the CBCL; and 3) Emotional Adjustment, which mainly consisted of the Internalizing Symptoms scales in the CBCL. The BRIEF Behavior Regulation and CBCL Externalizing Symptoms scales, however, did overlap in terms of assessing similar behavior symptoms. These findings were consistent across the severe malaria and HIV-infected samples of children. Conclusion The BRIEF and CBCL instruments offer distinct, yet complementary, assessments of behavior in clinical pediatric populations in the Ugandan context, supporting the use of these measures for similar research settings. PMID:25738440

Detailed assessments of childhood adversity enhance prediction of central obesity independent of gender, race, adult psychosocial risk and health behaviors.

PubMed

Davis, Cynthia R; Dearing, Eric; Usher, Nicole; Trifiletti, Sarah; Zaichenko, Lesya; Ollen, Elizabeth; Brinkoetter, Mary T; Crowell-Doom, Cindy; Joung, Kyoung; Park, Kyung Hee; Mantzoros, Christos S; Crowell, Judith A

2014-02-01

This study examined whether a novel indicator of overall childhood adversity, incorporating number of adversities, severity, and chronicity, predicted central obesity beyond contributions of "modifiable" risk factors including psychosocial characteristics and health behaviors in a diverse sample of midlife adults. The study also examined whether the overall adversity score (number of adversities × severity × chronicity) better predicted obesity compared to cumulative adversity (number of adversities), a more traditional assessment of childhood adversity. 210 Black/African Americans and White/European Americans, mean age=45.8; ±3.3 years, were studied cross-sectionally. Regression analysis examined overall childhood adversity as a direct, non-modifiable risk factor for central obesity (waist-hip ratio) and body mass index (BMI), with and without adjustment for established adult psychosocial risk factors (education, employment, social functioning) and heath behavior risk factors (smoking, drinking, diet, exercise). Overall childhood adversity was an independent significant predictor of central obesity, and the relations between psychosocial and health risk factors and central obesity were not significant when overall adversity was in the model. Overall adversity was not a statistically significant predictor of BMI. Overall childhood adversity, incorporating severity and chronicity and cumulative scores, predicts central obesity beyond more contemporaneous risk factors often considered modifiable. This is consistent with early dysregulation of metabolic functioning. Findings can inform practitioners interested in the impact of childhood adversity and personalizing treatment approaches of obesity within high-risk populations. Prevention/intervention research is necessary to discover and address the underlying causes and impact of childhood adversity on metabolic functioning. © 2013.

Behavior problems in school-aged physically abused and neglected children in Spain.

PubMed

de Paúl, J; Arruabarrena, M I

1995-04-01

The present study investigated behavior problems in school-aged physically abused, neglected, and comparison children in the Basque Country (Spain). Data from the Teacher's Report Form of the Child Behavior Checklist was obtained on 66 children consisting of three groups (17 physically abused children, 24 physically neglected children, and 25 low-risk comparison children). The three groups were matched on seven sociodemographic variables. Overall, the abused and neglected children were higher than the comparison group on Total Behavior Problems scores. However, only neglected children obtained higher scores than the comparison group on the total score of the Externalized Scale, and only abused children scored higher than the comparison group on the total score of the Internalized Scale. Follow-up analysis indicated that both abused and neglected children had higher scores on the Social Problems, Delinquent Behavior, and Attention Problems subscales. Moreover, neglected children had higher scores on the Aggressive Behavior subscale than the comparison children, and abused children had higher scores on the Withdrawn subscale than the comparison children. The abused and neglected children also showed a lower school adjustment than the comparison group. Possible explanations of these findings are discussed and their implications for research and treatment are considered.

Phenotypes of sleeplessness: stressing the need for psychodiagnostics in the assessment of insomnia.

PubMed

van de Laar, Merijn; Leufkens, Tim; Bakker, Bart; Pevernagie, Dirk; Overeem, Sebastiaan

2017-09-01

Insomnia is a too general term for various subtypes that might have different etiologies and therefore require different types of treatment. In this explorative study we used cluster analysis to distinguish different phenotypes in 218 patients with insomnia, taking into account several factors including sleep variables and characteristics related to personality and psychiatric comorbidity. Three clusters emerged from the analysis. The 'moderate insomnia with low psychopathology'-cluster was characterized by relatively normal personality traits, as well as normal levels of anxiety and depressive symptoms in the presence of moderate insomnia severity. The 'severe insomnia with moderate psychopathology'-cluster showed relatively high scores on the Insomnia Severity Index and scores on the sleep log that were indicative for severe insomnia. Anxiety and depressive symptoms were slightly above the cut-off and they were characterized by below average self-sufficiency and less goal-directed behavior. The 'early onset insomnia with high psychopathology'-cluster showed a much younger age and earlier insomnia onset than the other two groups. Anxiety and depressive symptoms were well above the cut-off score and the group consisted of a higher percentage of subjects with comorbid psychiatric disorders. This cluster showed a 'typical psychiatric' personality profile. Our findings stress the need for psychodiagnostic procedures next to a sleep-related diagnostic approach, especially in the younger insomnia patients. Specific treatment suggestions are given based on the three phenotypes.

Changes in Maladaptive Behaviors from Mid-Childhood to Young Adulthood in Autism Spectrum Disorder

PubMed Central

Anderson, Deborah K.; Maye, Melissa P.; Lord, Catherine

2011-01-01

The current study prospectively examined trajectories of change in symptoms of irritability, hyperactivity, and social withdrawal, as well as predictors of such behaviors from age 9 to 18 for youths with autism spectrum disorder (ASD) and a comparison group with nonspectrum developmental delays. Children with more severe core features of autism had consistently higher irritability and hyperactivity scores over time than those with broader ASD and nonspectrum delays. Across all diagnoses, behaviors related to hyperactivity showed the greatest improvement. Social withdrawal worsened with age for a substantial proportion of youths with ASD but not for the nonspectrum comparison group. Compared with nonspectrum youths, children with ASD showed greater heterogeneity in trajectories for maladaptive behaviors. PMID:21905806

The Use of Protective Behaviors in Relation to Gambling Among College Students

PubMed Central

Lostutter, Ty W.; Lewis, Melissa A.; Cronce, Jessica M.; Neighbors, Clayton; Larimer, Mary E.

2012-01-01

The purpose of the current study was to evaluate a measure of gambling protective behaviors and examine the relationship between indices of gambling behavior, including frequency, quantity and problem severity, and the use of gambling protective behaviors. Undergraduates from a large public university (N = 4,014) completed a web-based screening survey comprising measures of gambling and health behaviors, from which those who gambled within the past 6-months (n = 1,922, 48% of the entire sample) were invited to complete the baseline assessment, including the Gambling Protective Behavior Scale (GPBS). The GPBS was determined to have two subscales, primarily consisting of harm reduction strategies that reduce the money or time spent on gambling, or avoidance strategies that help to minimize engagement in gambling activities. Hierarchical multiple regressions found participants’ sex moderated the relationship between use of protective behavioral strategies and gambling outcomes. However, effects were in the opposite direction to those hypothesized. Specifically, because women gambled less, had lower gambling problem severity, and reported more frequent use of gambling avoidance protective behaviors, the relationship between use of gambling protective behaviors and gambling outcomes was stronger for men than women. Men who used more avoidance strategies gambled less frequently compared to men who used fewer avoidance strategies. Similarly, men who used more harm reduction strategies spent fewer dollars on gambling and had lower scores on gambling problem severity compared to men using fewer harm reduction strategies for women these relationships were less pronounced. Implications of incorporating specific gambling protective behavioral strategies into prevention and treatment programs are discussed. PMID:23224712

Novel clustering of items from the Autism Diagnostic Interview-Revised to define phenotypes within autism spectrum disorders

PubMed Central

Hu, Valerie W.; Steinberg, Mara E.

2009-01-01

Heterogeneity in phenotypic presentation of ASD has been cited as one explanation for the difficulty in pinpointing specific genes involved in autism. Recent studies have attempted to reduce the “noise” in genetic and other biological data by reducing the phenotypic heterogeneity of the sample population. The current study employs multiple clustering algorithms on 123 item scores from the Autism Diagnostic Interview-Revised (ADI-R) diagnostic instrument of nearly 2000 autistic individuals to identify subgroups of autistic probands with clinically relevant behavioral phenotypes in order to isolate more homogeneous groups of subjects for gene expression analyses. Our combined cluster analyses suggest optimal division of the autistic probands into 4 phenotypic clusters based on similarity of symptom severity across the 123 selected item scores. One cluster is characterized by severe language deficits, while another exhibits milder symptoms across the domains. A third group possesses a higher frequency of savant skills while the fourth group exhibited intermediate severity across all domains. Grouping autistic individuals by multivariate cluster analysis of ADI-R scores reveals meaningful phenotypes of subgroups within the autistic spectrum which we show, in a related (accompanying) study, to be associated with distinct gene expression profiles. PMID:19455643

A Pilot Study on the Combination of Applied Behavior Analysis and Bumetanide Treatment for Children with Autism.

PubMed

Du, Lin; Shan, Ling; Wang, Bing; Li, Honghua; Xu, Zhida; Staal, Wouter G; Jia, Feiyong

2015-09-01

The purpose of this study was to investigate the therapeutic effects of combined bumetanide and applied behavior analysis (ABA) treatment in children with autism. Sixty children diagnosed with autism according to the International Classification of Diseases, Tenth Revision (ICD-10) criteria (mean age of 4.5 years) were randomly divided into two groups: A single treatment group (n=28) and a combined treatment group (n=32). The combined treatment group received ABA training combined with oral bumetanide (0.5 mg twice a day). The single treatment group received ABA training only. Autism symptoms were evaluated with the Autism Behavior Checklist (ABC) and the Childhood Autism Rating Scale (CARS), whereas severity of disease (SI) and global improvement (GI) were measured with the Clinical Global Impressions (CGI). Assessment of ABC, CARS, and CGI was performed immediately before and 3 months after initiation of the treatment(s). Prior to intervention(s) no statistically significant differences in scores on the ABC, CARS, SI, or GI were found between the two groups. Total scores of the ABC, CARS, and SI were decreased in both groups after 3 months (p<0.05) compared with the scores prior to treatment. The total scores of the ABC and the CGI were significantly (p<0.05) lower in the combined treatment group than in the single treatment group. Although the total and item scores of the CARS in the combined treatment group were lower than in the single treatment group after a 3 month intervention, they did not reach statistical significance. No adverse effects of bumetanide were observed. Treatment with bumetanide combined with ABA training may result in a better outcome in children with autism than ABA training alone.

Opioid Attentional Bias and Cue-Elicited Craving Predict Future Risk of Prescription Opioid Misuse Among Chronic Pain Patients*

PubMed Central

Garland, Eric L.; Howard, Matthew O.

2014-01-01

Background Some chronic pain patients receiving long-term opioid analgesic pharmacotherapy are at risk for misusing opioids. Like other addictive behaviors, risk of opioid misuse may be signaled by an attentional bias (AB) towards drug-related cues. The purpose of this study was to examine opioid AB as a potential predictor of opioid misuse among chronic pain patients following behavioral treatment. Methods Chronic pain patients taking long-term opioid analgesics (N = 47) completed a dot probe task designed to assess opioid AB, as well as self-report measures of opioid misuse and pain severity, and then participated in behavioral treatment. Regression analyses examined opioid AB and cue-elicited craving as predictors of opioid misuse at 3-months posttreatment follow-up. Results Patients who scored high on a measure of opioid misuse risk following treatment exhibited significantly greater opioid AB scores than patients at low risk for opioid misuse. Opioid AB for 200 ms cues and cue-elicited craving significantly predicted opioid misuse risk 20 weeks later, even after controlling for pre-treatment opioid dependence diagnosis, opioid misuse, and pain severity (Model R2 = .50). Conclusion Biased initial attentional orienting to prescription opioid cues and cue-elicited craving may reliably signal future opioid misuse risk following treatment. These measures may therefore provide potential prognostic indicators of treatment outcome. PMID:25282309

Computational Dysfunctions in Anxiety: Failure to Differentiate Signal From Noise.

PubMed

Huang, He; Thompson, Wesley; Paulus, Martin P

2017-09-15

Differentiating whether an action leads to an outcome by chance or by an underlying statistical regularity that signals environmental change profoundly affects adaptive behavior. Previous studies have shown that anxious individuals may not appropriately differentiate between these situations. This investigation aims to precisely quantify the process deficit in anxious individuals and determine the degree to which these process dysfunctions are specific to anxiety. One hundred twenty-two subjects recruited as part of an ongoing large clinical population study completed a change point detection task. Reinforcement learning models were used to explicate observed behavioral differences in low anxiety (Overall Anxiety Severity and Impairment Scale score ≤ 8) and high anxiety (Overall Anxiety Severity and Impairment Scale score ≥ 9) groups. High anxiety individuals used a suboptimal decision strategy characterized by a higher lose-shift rate. Computational models and simulations revealed that this difference was related to a higher base learning rate. These findings are better explained in a context-dependent reinforcement learning model. Anxious subjects' exaggerated response to uncertainty leads to a suboptimal decision strategy that makes it difficult for these individuals to determine whether an action is associated with an outcome by chance or by some statistical regularity. These findings have important implications for developing new behavioral intervention strategies using learning models. Copyright © 2017 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Unprofessional behavior in medical school is associated with subsequent disciplinary action by a state medical board.

PubMed

Papadakis, Maxine A; Hodgson, Carol S; Teherani, Arianne; Kohatsu, Neal D

2004-03-01

To determine if medical students who demonstrate unprofessional behavior in medical school are more likely to have subsequent state board disciplinary action. A case-control study was conducted of all University of California, San Francisco, School of Medicine graduates disciplined by the Medical Board of California from 1990-2000 (68). Control graduates (196) were matched by medical school graduation year and specialty choice. Predictor variables were male gender, undergraduate grade point average, Medical College Admission Test scores, medical school grades, National Board of Medical Examiner Part 1 scores, and negative excerpts describing unprofessional behavior from course evaluation forms, dean's letter of recommendation for residencies, and administrative correspondence. Negative excerpts were scored for severity (Good/Trace versus Concern/Problem/Extreme). The outcome variable was state board disciplinary action. The alumni graduated between 1943 and 1989. Ninety-five percent of the disciplinary actions were for deficiencies in professionalism. The prevalence of Concern/Problem/Extreme excerpts in the cases was 38% and 19% in controls. Logistic regression analysis showed that disciplined physicians were more likely to have Concern/Problem/Extreme excerpts in their medical school file (odds ratio, 2.15; 95% confidence interval, 1.15-4.02; p =.02). The remaining variables were not associated with disciplinary action. Problematic behavior in medical school is associated with subsequent disciplinary action by a state medical board. Professionalism is an essential competency that must be demonstrated for a student to graduate from medical school.

Sexual scripts and sexual risk behaviors among Black heterosexual men: development of the Sexual Scripts Scale.

PubMed

Bowleg, Lisa; Burkholder, Gary J; Noar, Seth M; Teti, Michelle; Malebranche, David J; Tschann, Jeanne M

2015-04-01

Sexual scripts are widely shared gender and culture-specific guides for sexual behavior with important implications for HIV prevention. Although several qualitative studies document how sexual scripts may influence sexual risk behaviors, quantitative investigations of sexual scripts in the context of sexual risk are rare. This mixed methods study involved the qualitative development and quantitative testing of the Sexual Scripts Scale (SSS). Study 1 included qualitative semi-structured interviews with 30 Black heterosexual men about sexual experiences with main and casual sex partners to develop the SSS. Study 2 included a quantitative test of the SSS with 526 predominantly low-income Black heterosexual men. A factor analysis of the SSS resulted in a 34-item, seven-factor solution that explained 68% of the variance. The subscales and coefficient alphas were: Romantic Intimacy Scripts (α = .86), Condom Scripts (α = .82), Alcohol Scripts (α = .83), Sexual Initiation Scripts (α = .79), Media Sexual Socialization Scripts (α = .84), Marijuana Scripts (α = .85), and Sexual Experimentation Scripts (α = .84). Among men who reported a main partner (n = 401), higher Alcohol Scripts, Media Sexual Socialization Scripts, and Marijuana Scripts scores, and lower Condom Scripts scores were related to more sexual risk behavior. Among men who reported at least one casual partner (n = 238), higher Romantic Intimacy Scripts, Sexual Initiation Scripts, and Media Sexual Socialization Scripts, and lower Condom Scripts scores were related to higher sexual risk. The SSS may have considerable utility for future research on Black heterosexual men's HIV risk.

A Nationally Scaled Telebehavioral Health Program for Chronic Pain: Characteristics, Goals, and Psychological Outcomes.

PubMed

Mochari-Greenberger, Heidi; Peters, Aimee; Vue, Lee; Pande, Reena L

2017-08-01

Millions of U.S. adults suffer from chronic pain with a high prevalence of comorbid mental health issues. Telehealth-delivered behavioral therapy for chronic pain has been evaluated in the research setting. The purpose of this study was 1) to describe a nationally scaled, standardized, telebehavioral therapy program for patients with chronic pain and behavioral comorbidities, and 2) evaluate characteristics, goals, and psychosocial outcomes among program participants. This was mixed-methods retrospective cohort analysis among consecutive program graduates (mean age 53y; 24% male). The 8-week program was delivered by a licensed therapist and a behavior coach through telephone/secure video and tailored to each participant's behavioral health needs and goals. Participant chief complaints, behavioral goals, and mood triggers were abstracted by deidentified clinical record review using structured qualitative research methods. Depression, anxiety, and stress symptom data were collected at baseline and program graduation using the validated Depression Anxiety Stress Scales 21. Back pain (42%) and hip/leg/knee pain (28%) comprised the most common chief complaints. Pain management (44%) and weight loss (43%) were the most frequently cited goals. At baseline, approximately half of participants had elevated depression (59%), anxiety (54%), and/or stress (48%) scores. Triggers for depressed, anxious, or stressed mood included severe pain (47%), health concerns (46%), and interpersonal relationship challenges (45%). At graduation, significant improvement in median depression (-54%), anxiety (-50%), and stress (-33%) symptom scores was observed among those with non-normal baseline values (p < 0.001); degree of improvement did not vary by participant age or sex. Participants in a nationally scaled telebehavioral health program for chronic pain experienced significant improvement in depression, anxiety, and stress symptoms and shared several complaints, goals, and mood triggers.

Psychosocial Development in 5-Year-Old Children With Hearing Loss Using Hearing Aids or Cochlear Implants.

PubMed

Wong, Cara L; Ching, Teresa Y C; Cupples, Linda; Button, Laura; Leigh, Greg; Marnane, Vivienne; Whitfield, Jessica; Gunnourie, Miriam; Martin, Louise

2017-01-01

This article reports on the psychosocial development and factors influencing outcomes of 5-year-old children with cochlear implants (CIs) or hearing aids (HAs). It further examines differences between children with CIs and HAs with similar levels of hearing loss. Data were collected as part of the Longitudinal Outcomes of Children with Hearing Impairment study-a prospective, population-based study. Parents/caregivers of children completed the Strengths and Difficulties Questionnaire ( n = 333), the Social Skills subscale from the Child Development Inventory ( n = 317), and questionnaires on functional auditory behavior (Parents' Evaluation of Aural/oral performance of Children), and demographics. Children completed assessments of nonverbal cognitive ability (Wechsler Non-verbal Scale of Ability) and language (Preschool Language Scale - fourth edition). On average, parent-rated Strengths and Difficulties Questionnaire scores on emotional or behavioral difficulties were within 1 SD of the normative mean; however, Child Development Inventory scores on social skills were more than 1 SD below the norm. Children with severe-to-profound hearing losses using HAs had significantly more behavioral problems than children with CIs. Regression analyses showed that non-verbal cognitive ability, language, and functional auditory behavior were significantly associated with psychosocial outcomes for children with HAs, whereas outcomes for children with CIs were associated with functional auditory behavior and the presence of additional disabilities. Age at hearing intervention, severity of hearing loss, and communication mode were not associated with outcomes. The results suggest that even children who develop good language ability with the help of a HA or CI may have psychosocial problems if they exhibit difficulties with listening and communicating in everyday environments. The findings have implications for developing interventions for young children with hearing loss.

Psychosocial Development in 5-Year-Old Children With Hearing Loss Using Hearing Aids or Cochlear Implants

PubMed Central

Ching, Teresa Y. C.; Cupples, Linda; Button, Laura; Leigh, Greg; Marnane, Vivienne; Whitfield, Jessica; Gunnourie, Miriam; Martin, Louise

2017-01-01

This article reports on the psychosocial development and factors influencing outcomes of 5-year-old children with cochlear implants (CIs) or hearing aids (HAs). It further examines differences between children with CIs and HAs with similar levels of hearing loss. Data were collected as part of the Longitudinal Outcomes of Children with Hearing Impairment study—a prospective, population-based study. Parents/caregivers of children completed the Strengths and Difficulties Questionnaire (n = 333), the Social Skills subscale from the Child Development Inventory (n = 317), and questionnaires on functional auditory behavior (Parents’ Evaluation of Aural/oral performance of Children), and demographics. Children completed assessments of nonverbal cognitive ability (Wechsler Non-verbal Scale of Ability) and language (Preschool Language Scale - fourth edition). On average, parent-rated Strengths and Difficulties Questionnaire scores on emotional or behavioral difficulties were within 1 SD of the normative mean; however, Child Development Inventory scores on social skills were more than 1 SD below the norm. Children with severe-to-profound hearing losses using HAs had significantly more behavioral problems than children with CIs. Regression analyses showed that non-verbal cognitive ability, language, and functional auditory behavior were significantly associated with psychosocial outcomes for children with HAs, whereas outcomes for children with CIs were associated with functional auditory behavior and the presence of additional disabilities. Age at hearing intervention, severity of hearing loss, and communication mode were not associated with outcomes. The results suggest that even children who develop good language ability with the help of a HA or CI may have psychosocial problems if they exhibit difficulties with listening and communicating in everyday environments. The findings have implications for developing interventions for young children with hearing loss. PMID:28752809

Predictors of violent behavior among acute psychiatric patients: clinical study.

PubMed

Amore, Mario; Menchetti, Marco; Tonti, Cristina; Scarlatti, Fabiano; Lundgren, Eva; Esposito, William; Berardi, Domenico

2008-06-01

Violence risk prediction is a priority issue for clinicians working with mentally disordered offenders. The aim of the present study was to determine violence risk factors in acute psychiatric inpatients. The study was conducted in a locked, short-term psychiatric inpatient unit and involved 374 patients consecutively admitted in a 1-year period. Sociodemographic and clinical data were obtained through a review of the medical records and patient interviews. Psychiatric symptoms at admission were assessed using the Brief Psychiatric Rating Scale (BPRS). Psychiatric diagnosis was formulated using the Structured Clinical Interview for DSM-IV. Past aggressive behavior was evaluated by interviewing patients, caregivers or other collateral informants. Aggressive behaviors in the ward were assessed using the Overt Aggression Scale. Patients who perpetrated verbal and against-object aggression or physical aggression in the month before admission were compared to non-aggressive patients, moreover, aggressive behavior during hospitalization and persistence of physical violence after admission were evaluated. Violent behavior in the month before admission was associated with male sex, substance abuse and positive symptoms. The most significant risk factor for physical violence was a past history of physically aggressive behavior. The persistent physical assaultiveness before and during hospitalization was related to higher BPRS total scores and to more severe thought disturbances. Higher levels of hostility-suspiciousness BPRS scores predicted a change for the worse in violent behavior, from verbal to physical. A comprehensive evaluation of the history of past aggressive behavior and psychopathological variables has important implications for the prediction of violence in psychiatric settings.

Individual differences in drug abuse vulnerability: d-amphetamine and sensation-seeking status.

PubMed

Kelly, Thomas H; Robbins, Glenn; Martin, Catherine A; Fillmore, Mark T; Lane, Scott D; Harrington, Nancy G; Rush, Craig R

2006-11-01

While the personality dimensions of novelty seeking and sensation seeking are associated with drug abuse vulnerability, the mechanisms associated with this vulnerability remain obscure. This study examined the behavioral effects of d-amphetamine in healthy volunteers scoring in the upper and lower quartiles based on age- and gender-adjusted population norms on the impulsive Sensation-Seeking Scale (SSS) of the Zuckerman-Kuhlman personality questionnaire (ZKPQ). Participants completed 7-day outpatient studies examining the subjective, performance, and cardiovascular effects of d-amphetamine (0, 7.5, and 15 mg/70 kg, p.o.) under double-blind conditions according to a randomized block design. Performance tasks included behavioral measures of impulsivity, including attention, inhibition, and risk-taking behavior. No differences in baseline performance or d-amphetamine effects on measures of attention, inhibition, and risk-taking behavior were observed. High impulsive sensation seekers reported greater increases on several subjective report measures associated with drug abuse potential, including visual analog scales feel drug, like drug, and high. Healthy adults scoring in the top quartile on the population of the impulsive SSS of the ZKPQ may be vulnerable to the abuse potential of d-amphetamine.

N-Acetylcysteine in the Treatment of Excoriation Disorder: A Randomized Clinical Trial.

PubMed

Grant, Jon E; Chamberlain, Samuel R; Redden, Sarah A; Leppink, Eric W; Odlaug, Brian L; Kim, Suck Won

2016-05-01

Excoriation (skin-picking) disorder (SPD) is a disabling, underrecognized condition in which individuals repeatedly pick at their skin, leading to noticeable tissue damage. To date, there has been no clearly effective pharmacologic or psychological treatment for SPD. To determine whether N-acetylcysteine, an amino acid that appears to restore extracellular glutamate concentration in the nucleus accumbens, will be more effective than placebo in reducing compulsive picking behavior. A randomized, double-blind trial was conducted at ambulatory care centers at the University of Minnesota (September 12, 2011, to June 15, 2012) and the University of Chicago (December 17, 2012, to June 26, 2015) and included 66 adults with SPD. Data analysis was performed from July 16 to September 9, 2015. N-acetylcysteine (dosing range, 1200-3000 mg/d) or placebo was administered for 12 weeks. Participants were assessed using measures of skin-picking severity, including the modified Yale-Brown Obsessive Compulsive Scale (NE-YBOCS); total scores range from 0 to 40, with higher scores reflective of greater symptom severity. Another measure of skin-picking severity was the Clinical Global Impression-Severity Scale; total scores range from 1 (normal) to 7 (among the most extremely ill patients), and improvement ratings range from 7 (very much worse) to 1 (very much improved). Selected cognitive tasks included the Intra-dimensional/Extra-dimensional Shift Task to examine cognitive flexibility, with the key outcome measures being the number of errors, and Stop-Signal Reaction Time task, which evaluates motor inhibition. Outcomes were examined using a linear mixed-effects model. Of the 66 participants (31 randomized to placebo and 35 to N-acetylcysteine) included in the analysis, 59 (89%) were women; mean (SD) age was 34.8 (11.0) years. Compared with placebo, N-acetylcysteine treatment was associated with significant improvements in the NE-YBOCS. At baseline, NE-YBOCS scores were 18.9 and 17.9 for the treatment and placebo groups, respectively, and at 12 weeks, the scores were 11.5 and 14.1 for the treatment and placebo groups, respectively (P = .048). For the Clinical Global Impression-Severity scale, baseline scores were 3.5 and 4.0 and 12-week scores were 3.0 and 4.2, respectively (P = .003). These effects were significant both in terms of treatment by time interactions and post hoc tests at 1 or more individual time points. At the study's end point, of the 53 participants who completed the study, 15 of the 32 participants (47%) receiving N-acetylcysteine were much or very much improved compared with 4 of the 21 participants (19%) receiving placebo (P = .03). There were no significant differences between the active and placebo arms in terms of psychosocial functioning. N-acetylcysteine treatment resulted in significant reductions in skin-picking symptoms and was well tolerated. The glutamate system may prove a beneficial target in treating SPD and other compulsive behaviors. clinicaltrials.gov Identifier: NCT01063348.

Multimarker analysis suggests the involvement of BDNF signaling and microRNA biosynthesis in suicidal behavior.

PubMed

Pulay, Attila J; Réthelyi, János M

2016-09-01

Despite moderate heritability estimates the genetics of suicidal behavior remains unclear, genome-wide association and candidate gene studies focusing on single nucleotide associations reported inconsistent findings. Our study explored biologically informed, multimarker candidate gene associations with suicidal behavior in mood disorders. We analyzed the GAIN Whole Genome Association Study of Bipolar Disorder version 3 (n = 999, suicidal n = 358) and the GAIN Major Depression: Stage 1 Genomewide Association in Population-Based Samples (n = 1,753, suicidal n = 245) datasets. Suicidal behavior was defined as severe suicidal ideation or attempt. Candidate genes were selected based on literature search (Geneset1, n = 35), gene expression data of microRNA genes, (Geneset2, n = 68) and their target genes (Geneset3, n = 11,259). Quality control, dosage analyses were carried out with PLINK. Gene-based associations of Geneset1 were analyzed with KGG. Polygenic profile scores of suicidal behavior were computed in the major depression dataset both with PRSice and LDpred and validated in the bipolar disorder data. Several nominally significant gene-based associations were detected, but only DICER1 associated with suicidal behavior in both samples, while only the associations of NTRK2 in the depression sample reached family wise and experiment wise significance. Polygenic profile scores negatively predicted suicidal behavior in the bipolar sample for only Geneset2, with the strongest prediction by PRSice at Pt  < 0.03 (Nagelkerke R(2)  = 0.01, P < 0.007). Gene-based association results confirmed the potential involvement of the BDNF-NTRK2-CREB pathway in the pathogenesis of suicide and the cross-disorder association of DICER1. Polygenic risk prediction of the selected miRNA genes indicates that the miRNA system may play a mediating role, but with considerable pleiotropy. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Counselor-Assisted Problem Solving (CAPS) Improves Behavioral Outcomes in Older Adolescents with Complicated Mild to Severe TBI

PubMed Central

Wade, Shari L.; Stancin, Terry; Kirkwood, Michael; Brown, Tanya Maines; Rochester, Mayo Clinic; McMullen, Kendra M.; Taylor, H. Gerry

2013-01-01

Objective To test the efficacy of Counselor-Assisted Problem Solving (CAPS) versus an internet resources comparison (IRC) condition in reducing behavior problems in adolescents following traumatic brain injury (TBI). Design Randomized clinical trial with interviewers naïve to treatment condition. Setting Three large tertiary children's hospitals and two general hospitals with pediatric commitment. Participants 132 children ages 12-17 years hospitalized during the previous 6 months for moderate to severe TBI. Interventions Participants in CAPS (n = 65) completed 8-12 online modules providing training in problem solving, communication skills, and self-regulation and subsequent synchronous videoconferences with a therapist. Participants in the IRC group (n = 67) received links to internet resources about pediatric TBI. Main Outcome Measures Child Behavior Checklist (CBCL) administered before and after completion of treatment (i.e., approximately six months after treatment initiation). Results Post hoc analysis of covariance (ANCOVA), controlling for pre-treatment scores, was used to examine group differences in behavior problems in the entire sample and among older (n=59) and younger adolescents (n=53). Among older but not younger adolescents, CAPS resulted in greater improvements on multiple dimensions of externalizing behavior problems than did IRC. Conclusion Online problem-solving therapy may be effective in reducing behavior problems in older adolescent survivors of moderate-severe TBI. PMID:23640543

Comparison of personality traits in pedophiles, abstinent opiate addicts, and healthy controls: considering pedophilia as an addictive behavior.

PubMed

Cohen, Lisa J; Grebchenko, Yuli F; Steinfeld, Matthew; Frenda, Steven J; Galynker, Igor I

2008-11-01

To investigate the model of pedophilia as a disorder of addictive behavior, pedophiles and chemically addicted individuals were compared on personality traits potentially associated with impaired behavioral inhibition. Twenty-nine pedophiles, 25 opiate addicts (OA's), and 27 healthy controls were administered the Barratt Impulsivity Scale, Hare Psychopathy Checklist-Revised (PCL-R), and Structured Clinical Interview for DSM-V for Axis-II. OA's scored higher than either pedophiles or controls on the Barratt. Pedophiles and OA's scored higher than controls on all 3 Psychopathy Checklist-Revised scores but OA's scored marginally higher than pedophiles on factor 2 (behavioral) and total scores. On Structured Clinical Interview for DSM-V for Axis-II, pedophiles scored higher than controls on paranoid and schizoid scores whereas OA's did so on paranoid scores. Thus, both pedophiles and OA's may have elevated psychopathic traits and propensity toward cognitive distortions, as reflected in cluster A traits. Such similarities support the conceptualization of pedophilia as a behavioral addiction. Pedophiles may be less impulsive than OA's, however, and more prone toward cognitive distortions.

Correlation between Nutrition and Symptoms: Nutritional Survey of Children with Autism Spectrum Disorder in Chongqing, China

PubMed Central

Liu, Xiao; Liu, Juan; Xiong, Xueqin; Yang, Ting; Hou, Nali; Liang, Xiaohua; Chen, Jie; Cheng, Qian; Li, Tingyu

2016-01-01

Restricted diets and inadequate nutrient intake of children with autism spectrum disorder (ASD) have been reported. This study examined the nutritional statuses of children with ASD and the relationships between their behaviors and nutritional intake. A total of 154 children with ASD (age = 5.21 ± 1.83 years) and 73 typically-developing (TD) children (age = 4.83 ± 0.84 years) from Chongqing, China, were enrolled. The severity of ASD was evaluated using the Childhood Autism Rating Scale (CARS). The serum ferritin, folate, vitamin B12, 25(OH) vitamin D, and vitamin A concentrations in the children with ASD were determined. All participants underwent anthropometric examinations, dietary assessments, and questionnaire assessments about their feeding behaviors, and gastrointestinal symptoms. The ZHA, ZWA, and ZBMIA were found to be significantly lower in the children with ASD compared with those without ASD. In addition, the percentages of children exhibiting severe picky eating and severe resistance to new foods, as well as those with a reported general impression of severe eating problems and constipation, were higher among the children with ASD. These children consumed significantly fewer macronutrients compared with the children without ASD. In addition, the children with ASD had the highest rate of vitamin A deficiency, followed by iron deficiency. After adjusting for sex, the vitamin A concentration was found to be negatively correlated with the CARS score (rs = −0.222, p = 0.021). No correlation between the ferritin, folate, vitamin D, or vitamin B12 concentration and the CARS score was found. These results suggest that reduced macronutrient intakes, severe feeding behavior issues, constipation, and vitamin A deficiency are quite common among children with ASD. Further, a low serum vitamin A level may be a risk factor for symptoms of ASD. However, the underlying mechanism should be further studied. PMID:27187463

Social Anxiety in Online and Real-Life Interaction and Their Associated Factors

PubMed Central

Yen, Ju-Yu; Yen, Cheng-Fang; Chen, Cheng-Sheng; Wang, Peng-Wei; Chang, Yi-Hsin

2012-01-01

Abstract Social anxiety was compared between online and real-life interaction in a sample of 2,348 college students. Severity of social anxiety in both real-life and online interaction was tested for associations with depression, Internet addiction, Internet activity type (gaming versus chatting), and scores on Behavioral Inhibition System (BIS)/Behavioral Activation System (BAS) scales. The results showed that social anxiety was lower when interacting online than when interacting offline. Depression, Internet addiction, and high BIS and BAS scores were associated with high social anxiety. The social anxiety decreased more in online interaction among subjects with high social anxiety, depression, BIS, and BAS. This result suggests that the Internet has good potential as an alternative medium for delivering interventions for social anxiety. Further, the effect of BIS on social anxiety is decreased in online interaction. More attention should be paid for BIS when the treatment for social anxiety is delivered online. PMID:22175853

Social anxiety in online and real-life interaction and their associated factors.

PubMed

Yen, Ju-Yu; Yen, Cheng-Fang; Chen, Cheng-Sheng; Wang, Peng-Wei; Chang, Yi-Hsin; Ko, Chih-Hung

2012-01-01

Social anxiety was compared between online and real-life interaction in a sample of 2,348 college students. Severity of social anxiety in both real-life and online interaction was tested for associations with depression, Internet addiction, Internet activity type (gaming versus chatting), and scores on Behavioral Inhibition System (BIS)/Behavioral Activation System (BAS) scales. The results showed that social anxiety was lower when interacting online than when interacting offline. Depression, Internet addiction, and high BIS and BAS scores were associated with high social anxiety. The social anxiety decreased more in online interaction among subjects with high social anxiety, depression, BIS, and BAS. This result suggests that the Internet has good potential as an alternative medium for delivering interventions for social anxiety. Further, the effect of BIS on social anxiety is decreased in online interaction. More attention should be paid for BIS when the treatment for social anxiety is delivered online.

Nocturnal time monitoring behavior ("clock-watching") in patients presenting to a sleep medical center with insomnia and posttraumatic stress symptoms.

PubMed

Krakow, Barry; Krakow, Jacoby; Ulibarri, Victor A; Krakow, Jessica

2012-09-01

Time monitoring behavior (TMB) commonly occurs among insomnia patients, often leads to frustration about sleeplessness, and perpetuates insomnia symptoms. Few studies have explored relationships between time monitoring and insomnia, and none have studied the potential relationships between insomnia, TMB, and posttraumatic stress symptoms (PSSs). In this retrospective chart review of 1078 patients seeking care at a sleep medical center, the patients presented with one of three chief sleep complaints (poor sleep quality, 51%; sleep-disordered breathing, 26%; and insomnia, 24%), and 32% reported moderate to severe PSSs. Both insomnia and time monitoring severity were greater in the 350 patients with PSSs compared with the 728 patients with minimal or no such symptoms. Insomnia and time monitoring severity correlated significantly with total posttraumatic stress scores and most strongly with the arousal subscale. Research on interventions to treat TMB may inform relationships between insomnia and posttraumatic stress.

The relationship of prenatal maternal depression or anxiety to maternal caregiving behavior and infant behavior self-regulation during infant heel lance: an ethological time-based study of behavior.

PubMed

Warnock, Fay F; Craig, Kenneth D; Bakeman, Roger; Castral, Thaila; Mirlashari, Jila

2016-09-07

Sensitive and responsive maternal caregiving behavior strengthens infant self-regulatory capacities (HL), but this regulatory role may be diminished in some mothers with second-trimester prenatal exposure to depression and/ or anxiety (MDA). This study examined maternal and infant behavior during infant heel lance (HL) when mothers had or did not have MDA. Ethological methods and micro-analytic approaches capable of distinguishing and comparing time-based patterning in maternal and infant behavior were used to clarify biological mechanisms, such as MDA, that may underlie observed behavior. Aims were to examine group differences in caregiving behavior between mothers with and without MDA 5 min Pre-HL and 5 min Post-H, and relationships between MDA, maternal caregiving behavior and infant pain behavior self-regulation, concurrently. At second trimester, mothers were assessed for symptoms of mild-severe depression or anxiety. Mothers whose scores exceeded predetermined cut-off scores on one or more of the mental health measures were allocated to the MDA-exposure group, those below to the non-MDA-exposure group. Reliable observers, blinded to MDA status and study phases, coded video records of the caregiving behavior of each study mother for the full duration of the 5 min Pre-HL and 5 min Post-HL study phases. Group differences and associations between mean measures of maternal mental health scores, time-based measures of maternal behavior, and time-based measures of infant pain behavior regulation (previously coded) were concurrently analyzed using comparative and correlational statistics. MDA-exposed mothers spent significantly more time not embracing, engaging or responding to infant cues than maternal controls Pre-HL and Post-HL. MDA was associated with atypical maternal caregiving behavior, which in turn was related to atypical infant pain behavior self-regulation during and after the HL. Our findings have implication for practice. We recommend inclusion of mothers with MDA and their infants in interventions that strengthen the early mother-infant interaction and mother's regulatory caregiving role. MDA and maternal caregiving behavior must be considered in future infant pain studies to examine if they confound effectiveness of mother driven caregiving interventions for neonatal pain. We highlight the importance of examining maternal mental health throughout the perinatal and postnatal trajectory, and particularly the newborn period.

Effect of educational intervention based on the Health Belief Model on promoting self-care behaviors of type-2 diabetes patients.

PubMed

Shabibi, Parisa; Zavareh, Mohammad Sadegh Abedzadeh; Sayehmiri, Kourosh; Qorbani, Mostafa; Safari, Omid; Rastegarimehr, Babak; Mansourian, Morteza

2017-12-01

Diabetes is a chronic disease in which patients require lifelong self-care behaviors. The present study offset to determine the effect of educational intervention based on the Health Belief Model (HBM) on promoting self-care behaviors of type 2 diabetes patients in Ilam, Iran 2014. A quasi-experimental research was conducted based on HBM in which 70 type 2 diabetic patients from Ilam, western Iran in 2014 were selected by multi-stage random sampling. A self-designed questionnaire was used, and pre-test was administered, subsequently, the educational intervention sessions were provided in the form of presentation, questions and answers, group discussion, and practical demonstrations in four sessions over a period of one month. Two months after the intervention, the post-tests were administered. The data were analyzed via SPSS 20 applying independent samples t-test, paired samples t-test, and univariate and multivariate regressions at a significance level of less than 0.05. The mean scores of susceptibility, severity, perceived benefits and barriers, self-efficacy, and self-care behaviors were at average and lower levels before the intervention; nonetheless, after the educational intervention, the mean score of each HBM construct and the self-care behaviors significantly increased (p<0.001). Health education through HBM promotes the self-care behaviors of patients with type 2 diabetes.

Combined associations of sedentary behavior and cardiorespiratory fitness on cognitive function among older adults.

PubMed

Edwards, Meghan K; Loprinzi, Paul D

2017-02-15

Sedentary behavior, cardiorespiratory fitness, cognition and age are interrelated and associated with cardiovascular function. No study, however, has specifically evaluated the independent and combined associations of cardiorespiratory fitness and sedentary behavior on cognition, which was this study's purpose. Data from the 1999-2002 NHANES were used (N=2451; 60-85yrs). Sedentary behavior was assessed via self-report; cardiorespiratory fitness was assessed from a medical-related algorithm; and cognition function was assessed from the Digit Symbol Substitution Test (DSST). Being in the bottom quartile for sedentary behavior (β=2.13; 95% CI: 0.49-3.77; P=0.01) and the top quartile for cardiorespiratory fitness (β=7.48; 95% CI: 5.4-9.5; P<0.001) were independently associated with higher cognitive function. In the additive model, those with an index score of 1 (vs. 0) and 2 (vs. 0), respectively, had a 3.87 (β=3.87; 95% CI: 1.76-5.98; P=0.001) and 10.40 (β=10.4; 95% CI: 7.31-13.5; P<0.001) higher DSST score. High cardiorespiratory fitness and low sedentary behavior were jointly associated with the highest cognitive function. This has important cardiovascular implications as a progression of neurocognitive impairment is associated with increasingly severe manifestations of cardiovascular disease. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Prevalence and clinical characteristics of attention deficit hyperactivity disorder among primary school students in Bangkok.

PubMed

Benjasuwantep, Banchaun; Ruangdaraganon, Nichara; Visudhiphan, Pongsakdi

2002-11-01

Attention deficit hyperactivity disorder (ADHD) is an important disorder because it is the most prevalent chronic health condition affecting school aged children. Children with ADHD are at risk for academic and behavior problems. There are several studies in many countries worldwide. In Thailand, there have been a few published papers about ADHD. Most of them were studies in a clinically referred population. Four hundred and thirty-three first to sixth grade students from Wat Samiennaree School were included in this study. All children were administered Raven's progressive matrices test for estimation of intellectual functioning and were observed for their behavior in the classrooms by one researcher. Their demographic data was collected by questionnaires. The revised Conners rating scales were scored for each student. Students whose parents did not score the Conners parent rating scale were excluded. The parents of students, whose scores were positive for ADHD, were interviewed according to DSM IV criteria. 353 (81.5%) students from 433 were enrolled in this study. 23 students were diagnosed with ADHD making a prevalence of 6.5 per cent. There were 11 boys and 12 girls. The ratio of male to female was 1:1.09. The ADHD students had lower scores in mathematics than the group without this diagnosis with statistical significance (p = 0.006).

Functional differences among those high and low on a trait measure of psychopathy.

PubMed

Gordon, Heather L; Baird, Abigail A; End, Alison

2004-10-01

It has been established that individuals who score high on measures of psychopathy demonstrate difficulty when performing tasks requiring the interpretation of other's emotional states. The aim of this study was to elucidate the relation of emotion and cognition to individual differences on a standard psychopathy personality inventory (PPI) among a nonpsychiatric population. Twenty participants completed the PPI. Following survey completion, a mean split of their scores on the emotional-interpersonal factor was performed, and participants were placed into a high or low group. Functional magnetic resonance imaging data were collected while participants performed a recognition task that required attention be given to either the affect or identity of target stimuli. No significant behavioral differences were found. In response to the affect recognition task, significant differences between high- and low-scoring subjects were observed in several subregions of the frontal cortex, as well as the amygdala. No significant differences were found between the groups in response to the identity recognition condition. Results indicate that participants scoring high on the PPI, although not behaviorally distinct, demonstrate a significantly different pattern of neural activity (as measured by blood oxygen level-dependent contrast)in response to tasks that require affective processing. The results suggest a unique neural signature associated with personality differences in a nonpsychiatric population.

Kinship and Nonrelative Foster Care: The Effect of Placement Type on Child Well-Being

ERIC Educational Resources Information Center

Font, Sarah A.

2014-01-01

This study uses a national sample of 1,215 children, ages 6-17, who spent some time in formal kinship or nonrelative foster care to identify the effect of placement type on academic achievement, behavior, and health. Several identification strategies are used to reduce selection bias, including ordinary least squares, change score models,…

Cognitive Behavioral Therapy for insomnia with Veterans: evaluation of effectiveness and correlates of treatment outcomes.

PubMed

Trockel, Mickey; Karlin, Bradley E; Taylor, C Barr; Manber, Rachel

2014-02-01

This paper examines the effectiveness of Cognitive Behavioral Therapy for insomnia (CBT-I) in Veterans and the effects of two process measures on CBT-I outcomes: 1) therapist ratings of patient adherence and 2) patient ratings of therapeutic alliance. Data are from 316 therapists in the Department of Veterans Affairs CBT-I Training Program and 696 patients receiving CBT-I from therapists undergoing training. Mixed effects model results indicate Insomnia Severity Index scores decreased from 20.7 at baseline to 10.9 (d = 2.3) during a typical course of CBT-I. Patients with highest tercile compared to those with lowest tercile adherence achieved, on average, 4.1 points greater reduction in ISI scores (d = 0.95). The effect of therapeutic alliance on change in insomnia severity was not significant after adjusting for adherence to CBT-I. These results support the effectiveness and feasibility of large-scale training in and implementation of CBT-I and indicate that greater focus on patient adherence may lead to enhanced outcomes. The current findings suggest that CBT-I therapists and training programs place greater emphasis on attending to and increasing patient adherence. Published by Elsevier Ltd.

Association between eating behavior scores and obesity in Chilean children

PubMed Central

2011-01-01

Background Inadequate eating behavior and physical inactivity contribute to the current epidemic of childhood obesity. The aim of this study was to assess the association between eating behavior scores and childhood obesity in Chilean children. Design and methods We recruited 126 obese, 44 overweight and 124 normal-weight Chilean children (6-12 years-old; both genders) according to the International Obesity Task Force (IOTF) criteria. Eating behavior scores were calculated using the Child Eating Behavior Questionnaire (CEBQ). Factorial analysis in the culturally-adapted questionnaire for Chilean population was used to confirm the original eight-factor structure of CEBQ. The Cronbach's alpha statistic (>0.7 in most subscales) was used to assess internal consistency. Non-parametric methods were used to assess case-control associations. Results Eating behavior scores were strongly associated with childhood obesity in Chilean children. Childhood obesity was directly associated with high scores in the subscales "enjoyment of food" (P < 0.0001), "emotional overeating" (P < 0.001) and "food responsiveness" (P < 0.0001). Food-avoidant subscales "satiety responsiveness" and "slowness in eating" were inversely associated with childhood obesity (P < 0.001). There was a graded relation between the magnitude of these eating behavior scores across groups of normal-weight, overweight and obesity groups. Conclusion Our study shows a strong and graded association between specific eating behavior scores and childhood obesity in Chile. PMID:21985269

The caries experience and behavior of dental patients with autism spectrum disorder.

PubMed

Loo, Cheen Y; Graham, Richard M; Hughes, Christopher V

2008-11-01

Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder. The authors conducted a study to evaluate the demographics, caries experience and behavior of patients with ASD and compare these characteristics with those of patients without ASD (unaffected patients). The authors reviewed patients' charts and identified a group of 395 patients with ASD and a group of 386 unaffected patients. They obtained the following patient data for analysis: primary diagnosis, age, sex, residence (home versus institution or group home), presence of seizure disorder, additional diagnosis (mental retardation, cerebral palsy, self-injurious behavior or pica), medications, caries prevalence, caries severity and behavior. The ASD group had a male:female ratio of 4:1, and patients had a diagnosis of autism, pervasive developmental disorder-not otherwise specified or Asperger syndrome. Sex distribution was equal in the unaffected group, which was younger and had a higher decayed, missing and filled teeth (DMFT) score than did the ASD group. When the authors controlled for age and sex, they noted a statistically significant association between ASD and dental caries prevalence. A significantly higher percentage of patients with ASD than unaffected patients were uncooperative and required dental treatment to take place under general anesthesia. Caries prevalence and severity in patients with ASD were not associated with institutionalization, presence of seizure disorder or additional diagnosis. People with ASD were more likely to be caries-free and had lower DMFT scores than did their unaffected peers. Significantly more patients with ASD than unaffected patients were uncooperative and required general anesthesia to undergo dental treatment.

Elder-Clowning in Long-Term Dementia Care: Results of a Pilot Study.

PubMed

Kontos, Pia; Miller, Karen-Lee; Colobong, Romeo; Palma Lazgare, Luis I; Binns, Malcolm; Low, Lee-Fay; Surr, Claire; Naglie, Gary

2016-02-01

To assess the effects of elder-clowning on moderate to severe behavioral and psychological symptoms of dementia (BPSD) in nursing home residents with dementia, primarily of the Alzheimer's type. Before-and-after study. Nursing home. Nursing home residents with moderate to severe BPSD, as defined according to a Neuropsychiatric Inventory-Nursing Home version (NPI-NH) score of 10 or greater (N = 23), and their care aides. A pair of elder-clowns visited all residents twice weekly (~10 minutes per visit) for 12 weeks. They used improvisation, humor, empathy, and expressive modalities such as song, musical instruments, and dance to individualize resident engagement. Primary outcomes were BPSD measured using the the NPI-NH, quality of life measured using Dementia Care Mapping (DCM), and nursing burden of care measured using the Modified Nursing Care Assessment Scale (M-NCAS). Secondary outcomes were occupational disruptiveness measured using the NPI-NH, agitation measured using the Cohen Mansfield Agitation Inventory (CMAI), and psychiatric medication use. Over 12 weeks, NPI-NH scores declined significantly (t22 = -2.68, P = .01), and DCM quality-of-life scores improved significantly (F1,50 = 23.09, P < .001). CMAI agitation scores decreased nominally, but the difference was not statistically significant (t22 = -1.86, P = .07). Occupational disruptiveness score significantly improved (t22 = -2.58, P = .02), but there was no appreciable change in M-NCAS scores of staff burden of care. Results suggest that elder-clowning reduced moderate to severe BPSD of nursing home residents with dementia, primarily of the Alzheimer's type. Elder-clowning is a promising intervention that may improve Alzheimer's disease care for nursing home residents. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Measuring behavioral regulation in four societies

PubMed Central

Wanless, Shannon B.; McClelland, Megan M.; Acock, Alan C.; Ponitz, Claire C.; Son, Seung-Hee; Lan, Xuezhao; Morrison, Frederick J.; Chen, Jo-Lin; Chen, Taiwan Fu-Mei; Lee, Taiwan Kangyi; Sung, Miyoung; Li, Su

2010-01-01

The present study examined the psychometric properties of scores from a direct measure of behavioral regulation, the Head-Toes-Knees-Shoulders task (HTKS) with 3- to 6-year-old children in the U.S., Taiwan, South Korea, and China. Specifically, we investigated (1) the nature and variability of HTKS scores including relations to teacher-rated classroom behavioral regulation, and (2) relations between the HTKS and early mathematics, vocabulary, and literacy skills. Higher HTKS scores were significantly related to higher teacher ratings of classroom behavioral regulation in the U.S. and South Korea but not in Taiwan and China. Also, higher HTKS scores were significantly related to higher early mathematics, vocabulary, and literacy skills beyond the influence of demographic variables and teacher-rated classroom behavioral regulation. These initial findings suggest that HTKS scores may be interpreted as reflecting early behavioral regulation in these four societies, and that behavioral regulation is important for early academic success in the U.S. and in Asian countries. PMID:21381840

Neural correlates of self-injurious behavior in Prader-Willi syndrome.

PubMed

Klabunde, Megan; Saggar, Manish; Hustyi, Kristin M; Hammond, Jennifer L; Reiss, Allan L; Hall, Scott S

2015-10-01

Individuals with Prader-Willi syndrome (PWS), a genetic disorder caused by mutations to the q11-13 region on chromosome 15, commonly show severe skin-picking behaviors that can cause open wounds and sores on the body. To our knowledge, however, no studies have examined the potential neural mechanisms underlying these behaviors. Seventeen individuals with PWS, aged 6-25 years, who showed severe skin-picking behaviors, were recruited and scanned on a 3T scanner. We used functional magnetic resonance imaging (fMRI) while episodes of skin picking were recorded on an MRI-safe video camera. Three participants displayed skin picking continuously throughout the scan, three participants did not display skin picking, and the data for one participant evidenced significant B0 inhomogeneity that could not be corrected. The data for the remaining 10 participants (six male, four female) who displayed a sufficient number of picking and nonpicking episodes were subjected to fMRI analysis. Results showed that regions involved in interoceptive, motor, attention, and somatosensory processing were activated during episodes of skin-picking behavior compared with nonpicking episodes. Scores obtained on the Self-Injury Trauma scale were significantly negatively correlated with mean activation within the right insula and left precentral gyrus. These data indicate that itch and pain processes appear to underlie skin-picking behaviors in PWS, suggesting that interoceptive disturbance may contribute to the severity and maintenance of abnormal skin-picking behaviors in PWS. Implications for treatments are discussed. © 2015 Wiley Periodicals, Inc.

Transient cocaine-associated behavioral symptoms rated with a new instrument, the scale for assessment of positive symptoms for cocaine-induced psychosis (SAPS-CIP).

PubMed

Tang, Yi-lang; Kranzler, Henry R; Gelernter, Joel; Farrer, Lindsay A; Pearson, Deborah; Cubells, Joseph F

2009-01-01

Chronic use of cocaine is associated with a variety of behavioral symptoms. The current report describes the assessment of cocaine-related behavioral symptoms (CRB) using the Scale for Assessment of Positive Symptoms of Cocaine-Induced Psychosis (SAPS-CIP). The CRB section, one of the three domains in the SAPS-CIP, consists of sub-domains, including Aggressive/Agitated Behavior, Repetitive/Stereotyped Behavior, and Unusual Social or Sexual Behavior. Severity scores are assigned according to operational criteria, and range from 0 (not present) to 5 (severe). We interviewed 261 unrelated cocaine-abusing adults using the SAPS-CIP, and 243 of them met criteria for inclusion in the study. The proportion of subjects endorsing different classes of CRBs varied across categories, with 109 of 243 (44.9%) subjects reporting aggressive and agitated behaviors, 180 subjects (74.1%) repetitive/stereotyped behaviors, and 192 (79.0%) unusual social/sexual behaviors. A substantial minority of the subjects (10.3-25.1%) reported that they experienced marked-to-severe behavioral symptoms associated with cocaine use. The proportions of subjects endorsing CRB did not differ by ethnic/racial group or by sex. Correlations among the different domains of CRB were strong, but behaviors rated in the CRB section were less well correlated with psychotic symptoms, which were rated in the hallucination and delusion sections of the instrument. A variety of CRBs are common in cocaine-dependent subjects, and many of these are highly intercorrelated. CRBs also correlate with hallucinations and delusions induced by cocaine, but to a lesser degree. Our findings suggest that there may be some common vulnerability factors that contribute to both cocaine-induced psychosis and CRBs.

Web-Based Training Methods for Behavioral Health Providers: A Systematic Review.

PubMed

Jackson, Carrie B; Quetsch, Lauren B; Brabson, Laurel A; Herschell, Amy D

2018-07-01

There has been an increase in the use of web-based training methods to train behavioral health providers in evidence-based practices. This systematic review focuses solely on the efficacy of web-based training methods for training behavioral health providers. A literature search yielded 45 articles meeting inclusion criteria. Results indicated that the serial instruction training method was the most commonly studied web-based training method. While the current review has several notable limitations, findings indicate that participating in a web-based training may result in greater post-training knowledge and skill, in comparison to baseline scores. Implications and recommendations for future research on web-based training methods are discussed.

Association of Alcohol Misuse With Sexual Identity and Sexual Behavior in Women Veterans.

PubMed

Lehavot, Keren; Williams, Emily C; Millard, Steven P; Bradley, Katharine A; Simpson, Tracy L

2016-01-28

Sexual minority women report greater alcohol misuse than heterosexual women in the general population, with more pronounced differences found among younger age groups. It is unknown whether these differences exist among women veterans. We evaluated differences in alcohol misuse across two dimensions of sexual orientation (identity and behavior) among women veterans, and examined whether these differences were modified by age. Women veterans were recruited via the internet to participate in an online survey. Participants provided information on their self-reported sexual identity and behavior and responded to the validated 3-item Alcohol Use Disorders Identification Test-Consumption questionnaire (AUDIT-C). Regression models were used to compare the prevalence of alcohol misuse (AUDIT-C ≥ 3) and severity (AUDIT-C scores) across sexual identity and behavior and to test effect modification by age. Among the 702 participants (36% lesbian/bisexual), prevalence and severity of alcohol misuse varied by both sexual identity and behavior, but there were significant interactions with age. Prevalence and severity of alcohol misuse were higher among relatively younger self-identified lesbians compared to heterosexual women. Similarly, both prevalence and severity of alcohol misuse were generally higher among younger women who had any sex with women compared to those who had sex only with men. In this online study of women veterans, younger sexual minority women were more likely to screen positive for alcohol misuse, and they had more severe alcohol misuse, than their heterosexual counterparts. Prevention and treatment efforts focused specifically on sexual minority women veterans may be needed.

Quality of life after surgery for intractable partial epilepsy in children: a cohort study with controls.

PubMed

Mikati, Mohamad A; Ataya, Nour; Ferzli, Jessica; Kurdi, Rana; El-Banna, Diana; Rahi, Amal; Shamseddine, Alhan; Sinno, Durriyah; Comair, Youssef

2010-08-01

Investigate if quality of life (QOL) normalizes on long-term follow-up after surgery for partial epilepsy in children. This is a cohort study with controls in which a consecutive cohort of nineteen 2-14-year-old children who underwent focal resections for intractable partial seizures between 1996 and 2006, were matched with 19 non-surgery intractable partial epilepsy patients, and with 19 healthy subjects. The two epilepsy groups were matched for age, sex, socio-economic status (SES), cognitive level, seizure type, and seizure frequency. The healthy group was matched with the two epilepsy groups for age, sex, SES, and cognitive level. QOL was assessed using the QOLCE (Quality of Life in Childhood Epilepsy Questionnaire). In the surgery group (follow-up 3.84+/-2.26 years), 78.9% had Engel class-I versus 21.1% in non-surgery (p=0.01) (follow-up 3.44+/-2.95 years). Surgery patients were similar to healthy subjects in the social, emotional, cognitive, behavioral, and overall QOL (p>0.05) but had lower scores in the total QOL, physical, and health domains (p<0.05). Surgery patients scored better than non-surgery in the behavioral domain and the HASES (Hague Side Effects Scale) score (p<0.05). Non-surgery patients scored worse than healthy in total QOL, physical, behavioral, health, and overall QOL (p<0.05). IQ, HASS (Hague Seizure Severity Scale), and HASES scores were positively associated with total QOL score (p<0.05). Subgroup analysis on seizure-free surgery patients showed that they did not differ from healthy subjects in any of QOL domains (p>0.05, power>0.8). Our data indicate that epilepsy surgery for partial seizures in children is associated with better QOL as compared to children with intractable epilepsy who are not operated on, and suggest that in those who achieve seizure freedom normal QOL may at least potentially be possible.

Non suicidal self-injury, emotional eating and insomnia after child sexual abuse: Are those symptoms related to emotion regulation?

PubMed

Demirci, Esra

2018-01-01

The aim of this article was to assess the effects of child sexual abuse (CSA) on emotion regulation (ER) in adolescents and to evaluate the relationships between non suicidal self-injury (NSSI), emotional eating, insomnia and emotion disregulation (ED). Fifty two adolescents, aged 10-18 years, without who weren't diagnosed a psychiatric disease before abuse and completed 6-months of follow-up after abuse included the study. Control group consisted of 33 healthy voluntary participants without any known psychiatric disorders. Patients and volunteers who participated in the study were assessed with the Inventory of Statements About Self-injury (ISAS), Dutch Eating Behavior Questionnaire (DEBQ), Pittsburgh Sleep Quality Index (PSQI), Insomnia severity index (ISI), and the Difficulties in Emotion Regulation Scale (DERS). In our study, PSQI scores, DERS total scores and DEBQ emotional eating subscores were significantly higher in the CSA victims (In orderly; p = 0,034, p < 0.001, p = 0,023). 55.7% of the CSA victims reported self-injurious behavior, while 15.5% of healthy voluntary participants reporting self-injurious behavior. The CSA victims reporting NSSI had higher DERS scores than CSA victims without NSSI. (p = 0.024). The CSA victims with post-traumatic stress disorder (PTSD) and CSA victims without PTSD had a positive correlation between DEBQ emotional eating subscores and DERS total scores (In orderly: r = 0.762, p = 0.031; r = 0.872, p < 0.001). There was a positive correlation between the PSQI scores and DERS scores in the CSA victims with PTSD (r = 0.827, p = 0.023). Further studies are needed to assess the relationship between self-injury, emotional eating, insomnia and ED, and to determine how sexual abuse effect the ER in a clinical sample of CSA. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

COMT met allele differentially predicts risk versus severity of aberrant eating in a large community sample.

PubMed

Donofry, Shannon D; Roecklein, Kathryn A; Wildes, Jennifer E; Miller, Megan A; Flory, Janine D; Manuck, Stephen B

2014-12-15

Prefrontal dopamine (DA) transmission participates in the reinforcement of reward-driven behaviors like eating. Because catechol-O-methyltransferase (COMT) degrades DA and is expressed in the prefrontal cortex, variation in the COMT gene may modulate eating behavior. Previous studies have shown that the met allele of the COMT val158met single nucleotide polymorphism (SNP) is associated with Bulimia Nervosa (BN). The specific aim of this study was to test whether the met allele increased risk for, and severity of, eating disorder symptomatology in community volunteers. Caucasian adults (N=1003; 51.2% female) from the University of Pittsburgh Adult Health and Behavior Project (AHAB) were genotyped and completed the Eating Disorders Inventory (EDI). Logistic and Poisson regression analyses assessed genotype-dependent presence and severity of eating disorder symptomatology. The met allele was significantly associated with the presence of symptoms on the Bulimia subscale and the severity of Body Dissatisfaction scores. All EDI subscales significantly predicted BMI. To our knowledge, these are the first data indicating that the COMT met allele increases risk for some symptoms of disordered eating, while increasing severity of others, in a community sample. These novel findings may have important implications for understanding the etiology of heterogeneous disordered eating phenotypes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Obsessive-compulsive symptoms among alcoholics in outpatient treatment: Prevalence, severity and correlates.

PubMed

Campos, Luana Moraes; Yoshimi, Nicoli Tamie; Simão, Maria Odete; Torresan, Ricardo Cezar; Torres, Albina Rodrigues

2015-09-30

The literature on symptoms of obsessive-compulsive disorder (OCD) in alcoholic patients is scarce and such symptoms can go unnoticed, worsening the prognosis of alcoholism. The objectives were to estimate the prevalence and severity of obsessive-compulsive symptoms in alcoholics undergoing outpatient treatment and to assess sociodemographic and clinical correlates, including suicidal behaviors. The instruments used in this cross-sectional study were the Obsessive-Compulsive Inventory - Revised (OCI-R), the Short Alcohol Dependence Data and the Beck Depression Inventory. After descriptive analyses, bivariate analyses between the categorical ("probable OCD": OCI-R≥27) and dimensional (OCI-R total and subscales scores) outcomes and all explanatory variables were conducted. Eleven (20.4%) of the 54 alcoholic patients (37 men and 17 women) presented "probable OCD", which was associated with lower income, more severe dependence, depression, lifetime suicidal thoughts and plans and suicide attempts. OCI-R severity (mean 16.0) was associated with the same predictors and with psychiatric hospitalization. Suicidal behaviors were mainly associated with the Obsession, Hoarding and Washing subscales. It is essential to investigate and treat OCD symptoms in alcoholics, as they are associated with greater severity of dependence, depression and suicidal behaviors. Longitudinal studies are required to assess the impact of OCD treatment on the clinical course of alcoholism. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Children's and parent's psychological profiles in selective mutism and generalized anxiety disorder: a clinical study.

PubMed

Capozzi, Flavia; Manti, Filippo; Di Trani, Michela; Romani, Maria; Vigliante, Miriam; Sogos, Carla

2018-06-01

Selective mutism (SM) is classified in DSM-5 as an anxiety disorder. The aim of the study was to investigate the psychological features of children with SM and their parental psychological profiles, compared to generalized anxiety disorder (GAD) children and their parents. The parents of 26 preschool children with SM and 32 with children with GAD filled out the child behavior check list for 1½-5 years (CBCL1½-5) and the symptom checklist-90-revised (SCL-90-R). Information about the children and their parents' histories was collected through clinical interviews. Children with SM scored higher than children with GAD on the CBCL1½-5 withdrawn scale and lower on the attention problems, aggressive behavior, and externalizing problems scales. Mothers of children with SM scored higher on the SCL-90-R obsessive-compulsive subscale and Global Severity Index than mothers of children with GAD, while fathers of children with SM scored higher on the SCL-90-R Phobic Anxiety subscale and on the Global Severity Index than fathers of children with GAD. Parents of children with SM displayed a greater presence of stressful life events than parents of children with GAD. Data appeared to confirm that SM and GAD share a common anxious core, though some differences in the children's psychological profiles and the parents' history and personality emerged. Future research should focus on the role of external factors, such as parent-child relationship, in the development of SM.

Predictors of dropout from internet-based self-help cognitive behavioral therapy for insomnia.

PubMed

Yeung, Wing-Fai; Chung, Ka-Fai; Ho, Fiona Yan-Yee; Ho, Lai-Ming

2015-10-01

Dropout from self-help cognitive-behavioral therapy for insomnia (CBT-I) potentially diminishes therapeutic effect and poses clinical concern. We analyzed the characteristics of subjects who did not complete a 6-week internet-based CBT-I program. Receiver operator characteristics (ROC) analysis was used to identify potential variables and cutoff for predicting dropout among 207 participants with self-report insomnia 3 or more nights per week for at least 3 months randomly assigned to self-help CBT-I with telephone support (n = 103) and self-help CBT-I (n = 104). Seventy-two participants (34.4%) did not complete all 6 sessions, while 42 of the 72 (56.9%) dropped out prior to the fourth session. Significant predictors of non-completion are total sleep time (TST) ≥ 6.82 h, Hospital Anxiety and Depression Scale depression score ≥ 9 and Insomnia Severity Index score < 13 at baseline in this ranking order. Only TST ≥ 5.92 h predicts early dropout. Longer TST and less severe insomnia predict dropout in this study of self-help CBT-I, in contrast to shorter TST as a predictor in 2 studies of face-to-face CBT-I, while greater severity of depression predicts dropout in both this study and a study of face-to-face CBT-I. Strategies for minimizing dropout from internet-based CBT-I are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Can Cognitive Behavioral Therapy for Insomnia also treat fatigue, pain, and mood symptoms in individuals with traumatic brain injury? - A multiple case report.

PubMed

Lu, William; Krellman, Jason W; Dijkers, Marcel P

2016-01-01

Individuals with traumatic brain injury (TBI) often develop sleep disorders post-injury. The most common one is insomnia, which can exacerbate other post-injury symptoms, including fatigue, impaired cognition, depression, anxiety, and pain. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a manualized treatment that effectively treats insomnia with secondary effects on cognition, mood, and pain in various populations. This paper reviews the use of CBT-I for three participants with TBI of different severities. Pre- and post-treatment assessments of insomnia, fatigue, depression, anxiety, and pain were conducted. Mood was further assessed at follow-up. Minimal clinically important difference (MCID) scores derived from the research literature were used to establish clinically meaningful symptom improvement on self-report questionnaires. The reduction in insomnia severity scores for all three participants were not large enough to be considered a clinically significant improvement following CBT-I, although trends toward improvement were observed. However, all participants showed clinically significant reductions in anxiety at post-treatment; the effects persisted for 2 participants at follow-up. Reductions in depression symptoms were observed for 2 participants at post-treatment, and treatment effects persisted for 1 participant at follow-up. One participant endorsed clinically significant improvements in fatigue and pain severity. We conclude that CBT-I may provide secondary benefits for symptoms commonly experienced by individuals with TBI, especially mood disturbances.

Relation of Mental Health to Alcohol and Substance Use Among Texas College Students.

PubMed

Shafer, Alan B; Koenig, Jessica A; Becker, Emilie A

2017-04-01

We examined the effect of mental health problems and difficulties on alcohol, tobacco, and other drug (ATOD) use among college students by using the 2013 Texas College Survey of Substance Use (n=11,216), which includes the K6 screening scale for severe mental illness (SMI). Students' K6 scores were used to classify them into 3 groups: those likely to have SMI (9% with scores ≥ 13), those with some mental health problems (36%), and those without mental health issues (55% with scores ≤ 4). Questions regarding ATOD use were analyzed using these 3 groups. Alcohol use was not significantly associated with K6 scores, although problematic alcohol behaviors as measured by the CAGE test were. Higher cigarette use was significantly associated with higher K6 scores. Finally, both higher marijuana and higher drug use (across 9 other individual drugs) were significantly associated with higher K6 scores. Although higher K6 scores were associated with higher rates of drug use, most students with high K6 scores did not use drugs. However, given the higher level of risk, drug and alcohol interventions should be made available for those students who receive mental health counseling.

Effects of Cognitive Behavioral Therapy for Insomnia on Suicidal Ideation in Veterans

PubMed Central

Trockel, Mickey; Karlin, Bradley E.; Taylor, C. Barr; Brown, Gregory K.; Manber, Rachel

2015-01-01

Objective: To examine the effects of cognitive behavioral therapy for insomnia (CBT-I) on suicidal ideation among Veterans with insomnia. Design: Longitudinal data collected in the course of an uncontrolled evaluation of a large-scale CBT-I training program. Setting: Outpatient and residential treatment facilities. Participants: Four hundred five Veterans presenting for treatment of insomnia. Interventions: Cognitive behavioral therapy for insomnia. Measurement and Results: At baseline, 32% of patients, compared with 21% at final assessment, endorsed some level of suicidal ideation [χ2(df = 1) = 125; P < 0.001]. After adjusting for demographic variables and baseline insomnia severity, each 7-point decrease in Insomnia Severity Index score achieved during CBT-I treatment was associated with a 65% (odds ratio = 0.35; 95% confidence intervals = 0.24 to 0.52) reduction in odds of suicidal ideation. The effect of change in insomnia severity on change in depression severity was also significant. After controlling for change in depression severity and other variables in the model, the effect of change in insomnia severity on change in suicidal ideation remained significant. Conclusion: This evaluation of the largest dissemination of cognitive behavioral therapy for insomnia (CBT-I) in the United States found a clinically meaningful reduction in suicidal ideation among Veterans receiving CBT-I. The mechanisms by which effective treatment of insomnia with CBT-I reduces suicide risk are unknown and warrant investigation. The current results may have significant public health implications for preventing suicide among Veterans. Citation: Trockel M, Karlin BE, Taylor CB, Brown GK, Manber R. Effects of cognitive behavioral therapy for insomnia on suicidal ideation in veterans. SLEEP 2015;38(2):259–265. PMID:25515115

Car surfing: an underreported mechanism of serious injury in children and adolescents.

PubMed

Geiger, J D; Newsted, J; Drongowski, R A; Lelli, J L

2001-01-01

Car surfing, in which participants stand on top of a moving vehicle as though it were a surfboard, has been reported as a cause of traumatic injury in only 5 cases in the literature. Over the last 8 years, however, the authors have treated 26 children, primarily adolescents, for injuries resulting from car surfing. This report describes the injuries and outcomes of this potentially underreported mechanism of injury. Medical records of 26 patients treated for car surfing injuries between 1991 and 1999 were reviewed. Demographics, hospital course, and type and severity of injuries were analyzed. Eighteen boys (69%) and 8 girls (31%) with an average age of 15.7+/-3.4 years (range, 6 to 22) have presented with injuries related to car surfing. All patients had fallen from the hood, roof, or trunk of a moving motor vehicle, the majority falling from the hood (n = 13; 50%). Injury severity was evaluated using the Injury Severity Scores (ISS; 12.4+/-6.5), Revised Trauma Score (RTS; 7.5+/- 1.1) and Glasgow Coma Score (GCS; 13.5+/-3.2). Injury severity was equivalent between boys and girls (P>.05). Central nervous system injuries predominated, with closed head injuries occurring in 22 (85%) and loss of consciousness in 10 (39%). Skull fractures occurred in 11 (42%) and intracranial bleeding in 9 (35%). Long-term cognitive rehabilitation was necessary in 22 (85%) patients. Three patients (12%) had spinal column fractures, with 2 (8%) suffering permanent paralysis. Two extremity (8%) and 3 (11.7%) pelvic fractures occurred. Most patients (73%) suffered significant skin and soft tissue injuries. Two patients (8%) presented with solid visceral injuries, and 1 child died. Car surfing is an extremely high-risk behavior in children and adolescents that leads to significant morbidity, long-term disability, and is potentially fatal. The incidence of car surfing may be greater than has been reported previously; therefore, prevention programs aimed at discouraging this high-risk behavior in children and adolescents should be considered.

A comparison of cognitive-behavioral therapy, antidepressants, their combination and standard treatment for Chinese patients with moderate-severe major depressive disorders.

PubMed

Zu, Si; Xiang, Yu-Tao; Liu, Jing; Zhang, Ling; Wang, Gang; Ma, Xin; Kilbourne, Amy M; Ungvari, Gabor S; Chiu, Helen F K; Lai, Kelly Y C; Wong, Samuel Y S; Yu, Doris S F; Li, Zhan-Jiang

2014-01-01

No study has examined the effect of cognitive-behavioral therapy (CBT) on moderate-severe major depressive disorders (MDD) in China. The objective of this study was to evaluate the effect of CBT, antidepressants alone (MED), combined CBT and antidepressants (COMB) and standard treatment (ST; i.e., receiving psycho-educational intervention and/or medication treatment determined by treating psychiatrists) on depressive symptoms and social functioning in Chinese patients with moderate-severe MDD. A total of 180 patients diagnosed with MDD according to ICD-10 were randomly allocated to one of the four treatment regimens for a period of 6 months. Depressive symptoms were measured using the Hamilton Rating Scale for Depression (HAMD) and the Quick Inventory of Depressive Symptomatology-Self-Report (C-QIDS-SR). Remission threshold was defined as a C-QIDS-SR total score of <5. Social functioning was evaluated with the Work and Social Adjustment Scale (WSAS). All outcome measures were evaluated at entry, and at 3- and 6-months follow-up. At the 6-months assessment, the remission rates in the whole sample (n=96), the MED, the CBT, the COMB and the ST groups were 54.2%, 48%, 75%, 53.5% and 50%, respectively. Following the treatment periods, there was no significant difference in any of the study outcomes between the four groups. However, the CBT showed the greatest effect in the HAMD total score with the effect size=0.94, whereas the ST has only a moderate effect size in the WSAS total score (effect size=0.47). The findings support the feasibility and effectiveness of CBT as a psychosocial intervention for Chinese patients with moderate-severe MDD. We also found that single treatment using MED or CBT performed equally well as the combined CBT-antidepressant treatment in controlling the remission. The study provided important knowledge to inform the mental health care planning in China. © 2013 Elsevier B.V. All rights reserved.

Breast cancer knowledge, attitudes and screening behaviors among Indian-Australian women.

PubMed

Kwok, C; Tranberg, R; Lee, F C

2015-12-01

The aims of the study were to report breast cancer screening practices among Indian-Australian women and to examine the relationship between demographic characteristics, cultural beliefs and women's breast cancer screening (BCS) behaviors. A descriptive and cross-sectional method was used. Two hundred and forty two Indian-Australian women were recruited from several Indian organizations. English versions of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ) were administered. The main research variables are BCS practices, demographic characteristics and total scores on each of the BCSBQ subscales. The majority of participants (72.7%-81.4%) had heard of breast awareness, clinical breast examination (CBE) and mammograms. Only 28.9% performed a BSE monthly and although 60% had practiced CBE, only 27.3% of women within the targeted age group had annual CBE. Only 23.6% of women within the targeted age group reported they had a mammogram biennial. Marital status and length of stay in Australia were positively associated with women's screening behaviors. In terms of BCSBQ score, women who had the three screening practices regularly as recommended obtained significantly higher scores on the "attitude towards general health check-ups" and "barriers to mammographic screening" subscales. There was a significant difference in the mean score of the "knowledge and perceptions about breast cancer" between women who did and who did not engage in breast awareness. Our study reveals that attitudes toward health check-ups and perceived barriers to mammographic screening were influential in determining compliance with breast cancer screening practices among Indian-Australian women. Copyright © 2015 Elsevier Ltd. All rights reserved.

Autism beyond diagnostic categories: characterization of autistic phenotypes in schizophrenia.

PubMed

Kästner, Anne; Begemann, Martin; Michel, Tanja Maria; Everts, Sarah; Stepniak, Beata; Bach, Christiane; Poustka, Luise; Becker, Joachim; Banaschewski, Tobias; Dose, Matthias; Ehrenreich, Hannelore

2015-05-13

Behavioral phenotypical continua from health to disease suggest common underlying mechanisms with quantitative rather than qualitative differences. Until recently, autism spectrum disorders and schizophrenia were considered distinct nosologic entities. However, emerging evidence contributes to the blurring of symptomatic and genetic boundaries between these conditions. The present study aimed at quantifying behavioral phenotypes shared by autism spectrum disorders and schizophrenia to prepare the ground for biological pathway analyses. Specific items of the Positive and Negative Syndrome Scale were employed and summed up to form a dimensional autism severity score (PAUSS). The score was created in a schizophrenia sample (N = 1156) and validated in adult high-functioning autism spectrum disorder (ASD) patients (N = 165). To this end, the Autism Diagnostic Observation Schedule (ADOS), the Autism (AQ) and Empathy Quotient (EQ) self-rating questionnaires were applied back to back with the newly developed PAUSS. PAUSS differentiated between ASD, schizophrenia and a disease-control sample and substantially correlated with the Autism Diagnostic Observation Schedule. Patients with ADOS scores ≥12 obtained highest, those with scores <7 lowest PAUSS values. AQ and EQ were not found to vary dependent on ADOS diagnosis. ROC curves for ADOS and PAUSS resulted in AuC values of 0.9 and 0.8, whereas AQ and EQ performed at chance level in the prediction of ASD. This work underscores the convergence of schizophrenia negative symptoms and autistic phenotypes. PAUSS evolved as a measure capturing the continuous nature of autistic behaviors. The definition of extreme-groups based on the dimensional PAUSS may permit future investigations of genetic constellations modulating autistic phenotypes.

Linear clinical progression, independent of age of onset, in Niemann-Pick disease, type C.

PubMed

Yanjanin, Nicole M; Vélez, Jorge I; Gropman, Andrea; King, Kelly; Bianconi, Simona E; Conley, Sandra K; Brewer, Carmen C; Solomon, Beth; Pavan, William J; Arcos-Burgos, Mauricio; Patterson, Marc C; Porter, Forbes D

2010-01-05

Niemann-Pick disease, type C is a neurodegenerative, lysosomal storage disorder with a broad clinical spectrum and a variable age of onset. The absence of a universally accepted clinical outcome measure is an impediment to the design of a therapeutic trial for NPC. Thus, we developed a clinical severity scale to characterize and quantify disease progression. Clinical signs and symptoms in nine major (ambulation, cognition, eye movement, fine motor, hearing, memory, seizures, speech, and swallowing) and eight minor (auditory brainstem response, behavior, gelastic cataplexy, hyperreflexia, incontinence, narcolepsy, psychiatric, and respiratory problems) domains were scored. Data were collected from 18 current NPC patients and were extracted from records of 19 patients. Both patient cohorts showed a linear increase in severity scores over time. Cross-sectional evaluation of current patients showed a linear increase in the severity score. Longitudinal chart review of historical data demonstrated that although age of onset varied significantly, the rate of progression appeared linear, independent of age of onset, and similar in all patients. Combining the data from both cohorts, disease progression could be modeled by the following equation: ŝ(t0+x) = ŝ(t0) + 1.87x; where ŝ(t0) is the initial score and ŝ(t0+x) is the predicted future score after x years. Our observation that disease progression is similar across patients and independent of age of onset is consistent with a biphasic pathological model for NPC. This scale may prove useful in the characterization of potential biomarkers, and as an outcome measure to monitor disease progression in NPC patients. (c) 2009 Wiley-Liss, Inc.

Personality correlates of the Five-Factor Model for a sample of business owners/managers: associations with scores on Self-Monitoring, Type A Behavior, Locus of Control, and Subjective Well-being.

PubMed

Morrison, K A

1997-02-01

Bivariate relationships were examined between scores on the Five-Factor Model of personality and four personality dimensions including Self-monitoring, Locus of Control, Type A Behavior, and Subjective Well-being. Data were collected from 307 franchise business owner/managers from four different industries. Scores for Self-monitoring were positively related to those on Extraversion; Self-monitoring was the only personality measure significantly correlated with scores on Openness to Experience. Scores for Type A Behavior, measured by the Jenkins Activity Survey, were negatively correlated with Agreeableness and positively correlated with those for Extraversion. Somewhat surprisingly, the score for Type A Behavior had a relatively low correlation with the score for Conscientiousness. Scores for Subjective Well-being and Locus of Control were most strongly correlated with the positive pole of Neuroticism (Emotional Stability), Conscientiousness, and Extraversion. Possible explanations for the observed relationships are discussed.

The Behavior Pain Assessment Tool for critically ill adults: a validation study in 28 countries.

PubMed

Gélinas, Céline; Puntillo, Kathleen A; Levin, Pavel; Azoulay, Elie

2017-05-01

Many critically ill adults are unable to communicate their pain through self-report. The study purpose was to validate the use of the 8-item Behavior Pain Assessment Tool (BPAT) in patients hospitalized in 192 intensive care units from 28 countries. A total of 4812 procedures in 3851 patients were included in data analysis. Patients were assessed with the BPAT before and during procedures by 2 different raters (mostly nurses and physicians). Those who were able to self-report were asked to rate their pain intensity and pain distress on 0 to 10 numeric rating scales. Interrater reliability of behavioral observations was supported by moderate (0.43-0.60) to excellent (>0.60) kappa coefficients. Mixed effects multilevel logistic regression models showed that most behaviors were more likely to be present during the procedure than before and in less sedated patients, demonstrating discriminant validation of the tool use. Regarding criterion validation, moderate positive correlations were found during procedures between the mean BPAT scores and the mean pain intensity (r = 0.54) and pain distress (r = 0.49) scores (P < 0.001). Regression models showed that all behaviors were significant predictors of pain intensity and pain distress, accounting for 35% and 29% of their total variance, respectively. A BPAT cut-point score >3.5 could classify patients with or without severe levels (≥8) of pain intensity and distress with sensitivity and specificity findings ranging from 61.8% to 75.1%. The BPAT was found to be reliable and valid. Its feasibility for use in practice and the effect of its clinical implementation on patient pain and intensive care unit outcomes need further research.

Are Angelman and Prader-Willi syndromes more similar than we thought? Food-related behavior problems in Angelman, Cornelia de Lange, fragile X, Prader-Willi and 1p36 deletion syndromes.

PubMed

Welham, Alice; Lau, Johnny; Moss, Joanna; Cullen, Jenny; Higgs, Suzanne; Warren, Gemma; Wilde, Lucy; Marr, Abby; Cook, Faye; Oliver, Chris

2015-03-01

Food-related behavior problems are well documented in Prader-Willi syndrome (PWS), with impaired satiety, preoccupation with food and negative food-related behaviors (such as taking and storing food) frequently reported as part of the behavioral phenotype of older children and adults. Food-related behavior problems in other genetic neurodevelopmental syndromes remain less well studied, including those seen in Angelman Syndrome (AS), the 'sister imprinted disorder' of PWS. Food-related behavior problems were assessed in 152 participants each with one of five genetic neurodevelopmental syndromes – PWS, AS, 1p36 deletion, Cornelia de Lange, and fragile X. Predictably, levels of food-related behavior problems reported in participants with PWS significantly exceeded those of at least one other groups in most areas (impaired satiety; preoccupation with food; taking and storing food; composite negative behavior). However, in some areas people with AS were reported to display food-related problems at least as severe as those with PWS, with the AS group reported to display significantly more food-related behavior problems than at least one comparison group on measures of taking and storing food, composite negative behaviors, impaired satiety and preoccupation with food. Over 50% of participants in the AS group scored above the median point of the distribution of PWS scores on a measure of taking and storing food. These findings indicate further investigation of eating problems in AS are warranted and have implications for current theoretical interpretations of the behavioral differences between AS and PWS. © 2015 Wiley Periodicals, Inc.

[Association between behavioral problems and gastrointestinal disorders among children with autism spectrum disorder].

PubMed

Zhu, J; Guo, M; Yang, T; Lai, X; Lei, Y Y; He, M L; Chen, J; Li, T Y

2017-12-02

Objective: To investigate the relationship between gastrointestinal disorders (GID) and core symptoms or behavioral problems among the children with autism spectrum disorder (ASD) . Method: Totally 328 children with ASD and 202 normal controls were enrolled in this cross-sectional study from August 2013 to October 2016. The information about the gastrointestinal disorders, behavioral and emotional problems was collected by using questionnaires. Childhood Autism Rating Scale (CARS), Autism Behavior Checklist (ABC) were used to assess the core symptoms of the children with ASD. Neurodevelopmental status was evaluated with Gesell Developmental Scale (GDS). These variables were analyzed by using student's t -test and chi-square test. Result: The prevalence of GID was significantly higher in the children with ASD than in the normally developing children (49.4% (162/328) vs .25.7% (52/202), χ(2)=29.039, P= 0.000), especially the symptoms of constipation (33.2% (109/328) vs . 13.9% (28/202)), diarrhea (9.5%(31/328) vs . 1.5% (3/202)), nausea and vomiting (9.5% (31/328) vs . 3.5% (7/202)), and foul defecation (16.5% (54/328) vs . 5.0% (10/202)) (all P< 0.05). Among the ASD children, the prevalence of GID was similar between male and female (46.7% (133/285) vs . 46.5%(20/43), χ(2)=0.006, P= 0.938), as well as among all age groups (χ(2)=1.907, P= 0.862). There was no significant difference in scores of GDS in the ASD children with or without GID (all P> 0.05). Compared with ASD children without GID ( n =166), the ASD children with GID ( n =162) got higher scores in the "Body and Object Use" of ABC scale ( (16.4±9.3) vs . (12.3±6.7) scores, t= 2.258, P= 0.028), and had more emotional problems (63.6% (103/162) vs . 49.4% (82/166), χ(2)=6.707, P= 0.010). Moreover, the score of behavior problems questionnaire was higher in the ASD children with GID ( (35.3±16.8) vs . (16.1±13.6) scores, t= 5.748, P= 0.000). Conclusion: Children with ASD have higher risk of GID than the normal developing children. While the stereotyped behaviors, problem behaviors and emotional problems are severer in the ASD children with GID. Hence, it is important to provide comprehensive treatment and management for these groups of children.

Elevated manganese exposure and school-aged children's behavior: a gender-stratified analysis.

PubMed

Menezes-Filho, José A; de Carvalho-Vivas, Chrissie F; Viana, Gustavo F S; Ferreira, Junia R D; Nunes, Lorena S; Mergler, Donna; Abreu, Neander

2014-12-01

High levels of waterborne manganese have been associated with problematic behavior in school-aged children, however to date this has not been reported for children exposed to airborne manganese. The objective of the present study was to examine behavioral traits among children with exposure to airborne manganese from a ferro-manganese alloy plant, located in the metropolitan region of Salvador, Brazil. The study included 34 boys and 36 girls, aged 7-12 years, living in two communities within a 3-km radius from the plant. For each child, hair manganese levels (MnH) and blood lead (PbB) levels were analyzed by graphite furnace atomic absorption spectrometry. The Children's Behavior Check List (CBCL) (Portuguese version validated in Brazil) was administered to parents or caregivers, providing scale scores of internalizing (withdrawn, somatic complaints, and anxious/depressed scales), externalizing (disruptive and aggressive) behaviors and a separate scale for attention problems. Median and range for MnH and PbB were 11.48 μg/g (range: 0.52-55.74); 1.1 μg/dL (range: 0.5-6.1), respectively. Spearman correlation analyses showed that several behavioral indices were significantly correlated with MnH levels for girls, but not for boys: total externalizing behavior (rho=0.484 vs rho=0.041) and attention problem scores (rho=0.542 vs rho=0.003) coefficients were significantly at p<0.001 level, respectively for girls and boys. No significant correlation was observed with any of the internalizing sub-scales. A linear regression model was fitted with the total externalizing behavior, inattention and total CBCL scores as dependent variables, with log transformed MnH stratified by sex, adjusting for age and maternal IQ. Total externalizing behaviors and attention problem scores were significantly associated with girls' MnH levels but not with boys'. Adjusting for maternal IQ, the β-coefficients for LogMnH associations with total externalizing and attention problems are 8.85 (95%CI 2.44-15.24) and 4.03 (95%CI 1.50-6.56) for girls. For boys, after adjusting for age, the β-coefficients are 0.08 (95%CI 11.51-11.66) and -0.05 (95%CI 4.34-4.25), respectively. The findings of this study suggest a positive association between elevated Mn exposure and externalizing behavioral problems and inattention, with girls presenting more pronounced effects. Future studies on Mn exposure in children should attempt to further elucidate sex and/or gender differences in Mn exposed populations. Copyright © 2013 Elsevier Inc. All rights reserved.

Relationships between behavioral symptoms of non-medicated Chinese children with attention deficit hyperactivity disorder and parenting stress: Comparison of different subtypes and comorbidities.

PubMed

Li, Yan; Jiang, Wen-Qing; Du, Ya-Song; Coghill, David

2016-06-01

To identify the characteristics of behavior problems among children with attention deficit hyperactivity disorder (ADHD) and their relation with parenting stress. The Conners Parent Symptom Questionnaire (PSQ) and Parenting Stress Index (PSI) were used to assess the symptoms and parenting stress of 132 non-medicated children with ADHD as compared with 88 healthy controls. Every PSQ factor of ADHD children was higher than in the control group; children with the combined subtype of ADHD had the highest scores in conduct and learning problems, impulsivity/hyperactivity, and overall hyperactivity index; the PSI total stress, child domain, and parent domain scores were all higher in the ADHD group than in the control group; children with the combined subtype of ADHD had the highest score in the competence subscale of the parent domain, whereas the PSI total stress score of parents of children with ADHD and comorbid oppositional defiant disorder (ODD) was higher than that of parents of children with only ADHD. The PSI total stress score was positively correlated with all PSQ factor scores. The PSQ factors of conduct problems and learning problems were found to be significant predictors in a regression analysis. The children with ADHD exhibited abnormal parenting stress compared with healthy controls, which was much more pronounced when the children had comorbid ODD. Furthermore, parenting stress was related with the severity of ADHD symptoms, suggesting that children with the combined subtype of ADHD require particular attention in the future. © 2015 Wiley Publishing Asia Pty Ltd.

Choosing the best index for the average score intraclass correlation coefficient.

PubMed

Shieh, Gwowen

2016-09-01

The intraclass correlation coefficient (ICC)(2) index from a one-way random effects model is widely used to describe the reliability of mean ratings in behavioral, educational, and psychological research. Despite its apparent utility, the essential property of ICC(2) as a point estimator of the average score intraclass correlation coefficient is seldom mentioned. This article considers several potential measures and compares their performance with ICC(2). Analytical derivations and numerical examinations are presented to assess the bias and mean square error of the alternative estimators. The results suggest that more advantageous indices can be recommended over ICC(2) for their theoretical implication and computational ease.

Treatment of Internet Addiction with Anxiety Disorders: Treatment Protocol and Preliminary Before-After Results Involving Pharmacotherapy and Modified Cognitive Behavioral Therapy

PubMed Central

Santos, Hugo Henrique

2016-01-01

Background The growth of the Internet has led to significant change and has become an integral part of modern life. It has made life easier and provided innumerous benefits; however, excessive use has brought about the potential for addiction, leading to severe impairments in social, academic, financial, psychological, and work domains. Individuals addicted to the Internet usually have comorbid psychiatric disorders. Panic disorder (PD) and generalized anxiety disorder (GAD) are prevalent mental disorders, involving a great deal of damage in the patient’s life. Objective This open trial study describes a treatment protocol among 39 patients with anxiety disorders and Internet addiction (IA) involving pharmacotherapy and modified cognitive behavioral therapy (CBT). Methods Of the 39 patients, 25 were diagnosed with PD and 14 with GAD, in addition to Internet addiction. At screening, patients responded to the MINI 5.0, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, Clinical Global Impressions Scale, and the Young Internet Addiction Scale. At that time, IA was observed taking into consideration the IAT scale (cutoff score above 50), while anxiety disorders were diagnosed by a psychiatrist. Patients were forwarded for pharmacotherapy and a modified CBT protocol. Psychotherapy was conducted individually, once a week, over a period of 10 weeks, and results suggest that the treatment was effective for anxiety and Internet addiction. Results Before treatment, anxiety levels suggested severe anxiety, with an average score of 34.26 (SD 6.13); however, after treatment the mean score was 15.03 (SD 3.88) (P<.001). A significant improvement in mean Internet addiction scores was observed, from 67.67 (SD 7.69) before treatment, showing problematic internet use, to 37.56 (SD 9.32) after treatment (P<.001), indicating medium Internet use. With respect to the relationship between IA and anxiety, the correlation between scores was .724. Conclusions This study is the first research into IA treatment of a Brazilian population. The improvement was remarkable due to the complete engagement of patients in therapy, which contributed to the success of the treatment from a behavioral perspective, and gave patients the confidence to continue to manage Internet use in their lives. PMID:27005889

Effects of asenapine on agitation and hostility in adults with acute manic or mixed episodes associated with bipolar I disorder.

PubMed

Citrome, Leslie; Landbloom, Ronald; Chang, Cheng-Tao; Earley, Willie

2017-01-01

Bipolar disorder is associated with an increased risk of aggression. However, effective management of hostility and/or agitation symptoms may prevent patients from becoming violent. This analysis investigated the efficacy of the antipsychotic asenapine on hostility and agitation in patients with bipolar I disorder. Data were pooled from three randomized, double-blind, placebo-controlled, Phase III trials of asenapine in adults with manic or mixed episodes of bipolar I disorder (NCT00159744, NCT00159796, and NCT00764478). Post hoc analyses assessed the changes from baseline to day 21 on the Young Mania Rating Scale (YMRS) and the Positive and Negative Syndrome Scale (PANSS) hostility-related item scores in asenapine- or placebo-treated patients with at least minimal or mild symptom severity and on the PANSS-excited component (PANSS-EC) total score in agitated patients. Changes were adjusted for improvements in overall mania symptoms to investigate direct effects on hostility. Significantly greater changes in favor of asenapine versus placebo were observed in YMRS hostility-related item scores (irritability: least squares mean difference [95% confidence interval] =-0.5 [-0.87, -0.22], P =0.001; disruptive-aggressive behavior: -0.7 [-0.99, -0.37], P <0.0001), PANSS hostility item score (-0.2 [-0.44, -0.04]; P =0.0181), and PANSS-EC total score (-1.4 [-2.4, -0.4]; P =0.0055). Changes in the YMRS disruptive-aggressive behavior score and the sum of the hostility-related items remained significant after adjusting for improvements in other YMRS item scores. Asenapine significantly reduced hostility and agitation in patients with bipolar I disorder; improvement was at least partially independent of overall improvement on mania symptoms.

Impact of Auditory Integrative Training on Transforming Growth Factor-β1 and Its Effect on Behavioral and Social Emotions in Children with Autism Spectrum Disorder.

PubMed

Al-Ayadhi, Laila; Alhowikan, Abdulrahman Mohammed; Halepoto, Dost Muhammad

2018-01-01

To explore the impact of auditory integrative training (AIT) on the inflammatory biomarker transforming growth factor (TGF)-β1 and to assess its effect on social behavior in children with autism spectrum disorder (ASD). In this cross-sectional study, 15 patients (14 males and 1 female) with ASD aged 3-12 years were recruited. All were screened for autism using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Plasma levels of TGF-β1 were measured in all patients using a sandwich enzyme-linked immunoassay (ELISA) immediately and 1 and 3 months after the AIT sessions. Pre- and post-AIT behavioral scores were also calculated for each child using the Childhood Autism Rating Scale (CARS), the Social Responsiveness Scale (SRS), and the Short Sensory Profile (SSP). Data were analyzed using the Statistical Package for the Social Sciences (SPSS 21.0 for Windows). Plasma levels of TGF-β1 significantly increased to 85% immediately after AIT (20.13 ± 12 ng/mL, p < 0.05), to 95% 1 month after AIT (21.2 ± 11 ng/mL, p < 0.01), and to 105% 3 months after AIT (22.25 ± 16 ng/mL, p < 0.01) compared to before AIT (10.85 ± 8 ng/mL). Results also revealed that behavioral rating scales (CARS, SRS, and SSP) improved in terms of disease severity after AIT. Increased plasma levels of TGF-β1 support the therapeutic effect of AIT on TGF-β1 followed by improvement in social awareness, social cognition, and social communication in children with ASD. Furthermore, TGF-β1 was associated with severity in all scores tested (CARS, SRS, and SSP); if confirmed in studies with larger sample sizes, TGF-β1 may be considered as a marker of ASD severity and to assess the efficacy of therapeutic interventions. © 2018 The Author(s) Published by S. Karger AG, Basel.

Detailed Assessments of Childhood AdversityEnhance Prediction of Central Obesity Independent of Gender, Race, Adult Psychosocial Risk and Health Behaviors

PubMed Central

Davis, Cynthia R.; Dearing, Eric; Usher, Nicole; Trifiletti, Sarah; Zaichenko, Lesya; Ollen, Elizabeth; Brinkoetter, Mary T.; Crowell-Doom, Cindy; Joung, Kyoung; Park, Kyung Hee; Mantzoros, Christos S.; Crowell, Judith A.

2017-01-01

Objective This study examined whether a novel indicator of overall childhood adversity, incorporating number of adversities, severity, and chronicity, predicted central obesity beyond contributions of “modifiable” risk factors including psychosocial characteristics and health behaviors in a diverse sample of midlife adults. The study also examined whether the overall adversity score (number of adversities X severity X chronicity) better predicted obesity compared to cumulative adversity (number of adversities), a more traditional assessment of childhood adversity. Materials/Methods 210 Black/African Americans and White/European Americans, mean age = 45.8; ±3.3 years, were studied cross-sectionally. Regression analysis examined overall childhood adversity as a direct, non-modifiable risk factor for central obesity (waist-hip ratio) and body mass index (BMI), with and without adjustment for established adult psychosocial risk factors (education, employment, social functioning) and heath behavior risk factors (smoking, drinking, diet, exercise). Results Overall childhood adversity was an independent significant predictor of central obesity, and the relations between psychosocial and health risk factors and central obesity were not significant when overall adversity was in the model. Overall adversity was not a statistically significant predictor of BMI. Conclusions Overall childhood adversity, incorporating severity and chronicity and cumulative scores, predicts central obesity beyond more contemporaneous risk factors often considered modifiable. This is consistent with early dysregulation of metabolic functioning. Findings can inform practitioners interested in the impact of childhood adversity and personalizing treatment approaches of obesity within high-risk populations. Prevention/intervention research is necessary to discover and address the underlying causes and impact of childhood adversity on metabolic functioning. PMID:24211017

Intranasal carbetocin reduces hyperphagia in individuals with Prader-Willi syndrome.

PubMed

Dykens, Elisabeth M; Miller, Jennifer; Angulo, Moris; Roof, Elizabeth; Reidy, Michael; Hatoum, Hind T; Willey, Richard; Bolton, Guy; Korner, Paul

2018-06-21

Prader-Willi syndrome (PWS) is a genetic neurodevelopmental disorder of life-threatening hyperphagia, obesity, intellectual deficits, compulsivity, and other behavioral problems. The efficacy and safety of i.n. carbetocin, an oxytocin analog, was evaluated in a prospective, randomized, double-blinded trial in adolescents with PWS. Eligible patients aged 10-18 years with genetically confirmed PWS were randomized (1:1) to i.n. carbetocin or placebo 3 times daily for 14 days. The primary efficacy endpoint was change in parent/caregiver-rated Hyperphagia in PWS Questionnaire-Responsiveness (HPWSQ-R) total score. Secondary efficacy endpoints included HPWSQ-R behavior, drive, and severity domains; clinician-rated HPWSQ; Children's Yale-Brown Obsessive-Compulsive Severity Scale; food domain of the Reiss Profile; and Clinical Global Impression-Improvement scale. Endpoints were assessed using analysis of covariance. Relationship between primary and secondary endpoints was assessed using Pearson correlation coefficients. Safety was assessed throughout the study. Demographics and clinical characteristics were similar between treatment groups (carbetocin, n = 17; placebo, n = 20). Patients receiving carbetocin had statistically significant reductions in HPWSQ-R total score at study end (-15.6) versus patients receiving placebo (-8.9; P = 0.029); several secondary efficacy endpoints also demonstrated significant differences (P < 0.05). Treatment effects for the primary and secondary endpoints were highly correlated (P ≤ 0.0001). Incidence of adverse events (AEs) was similar between treatment groups. I.n. carbetocin was well tolerated and improved hyperphagia and behavioral symptoms of PWS. ClinicalTrials.gov: NCT01968187FUNDING. The study was funded by Ferring Pharmaceuticals. Recruitment was aided by ongoing work in PWS performed through Eunice Kennedy Shriver National Institute of Child Health and Human Development grant U54 HD083211.

Children with 7q11.23 duplication syndrome: psychological characteristics.

PubMed

Mervis, Carolyn B; Klein-Tasman, Bonita P; Huffman, Myra J; Velleman, Shelley L; Pitts, C Holley; Henderson, Danielle R; Woodruff-Borden, Janet; Morris, Colleen A; Osborne, Lucy R

2015-07-01

To begin to delineate the psychological characteristics associated with classic 7q11.23 duplication syndrome (duplication of the classic Williams syndrome region; hereafter classic Dup7), we tested 63 children with classic Dup7 aged 4-17 years. Sixteen toddlers aged 18-45 months with classic Dup7 and 12 adults identified by cascade testing also were assessed. For the child group, median General Conceptual Ability (similar to IQ) on the Differential Ability Scales-II was 85.0 (low average), with a range from severe disability to high average ability. Median reading and mathematics achievement standard scores were at the low average to average level, with a range from severe impairment to high average or superior ability. Adaptive behavior was considerably more limited; median Scales of Independent Behavior-Revised Broad Independence standard score was 62.0 (mild impairment), with a range from severe adaptive impairment to average adaptive ability. Anxiety disorders were common, with 50.0% of children diagnosed with Social Phobia, 29.0% with Selective Mutism, 12.9% with Separation Anxiety Disorder, and 53.2% with Specific Phobia. In addition, 35.5% were diagnosed with Attention Deficit/Hyperactivity Disorder and 24.2% with Oppositional Defiant Disorder or Disruptive Behavior Disorder-Not Otherwise Specified. 33.3% of the children screened positive for a possible Autism Spectrum Disorder and 82.3% were diagnosed with Speech Sound Disorder. We compare these findings to previously reported results for children with Williams syndrome and argue that genotype/phenotype studies involving the Williams syndrome region offer important opportunities to understand the contribution of genes in this region to common disorders affecting the general population. © 2015 Wiley Periodicals, Inc.

Using Consensus Building Procedures with Expert Raters to Establish Comparison Scores of Behavior for Direct Behavior Rating

ERIC Educational Resources Information Center

Jaffery, Rose; Johnson, Austin H.; Bowler, Mark C.; Riley-Tillman, T. Chris; Chafouleas, Sandra M.; Harrison, Sayward E.

2015-01-01

To date, rater accuracy when using Direct Behavior Rating (DBR) has been evaluated by comparing DBR-derived data to scores yielded through systematic direct observation. The purpose of this study was to evaluate an alternative method for establishing comparison scores using expert-completed DBR alongside best practices in consensus building…

Yokukansan (TJ-54) for treatment of pervasive developmental disorder not otherwise specified and Asperger's disorder: a 12-week prospective, open-label study.

PubMed

Miyaoka, Tsuyoshi; Wake, Rei; Furuya, Motohide; Liaury, Kristian; Ieda, Masa; Kawakami, Kazunori; Tsuchie, Keiko; Inagaki, Takuji; Horiguchi, Jun

2012-11-29

Numerous medications have been tested on patients with pervasive developmental disorder not otherwise specified (PDD-NOS) and Asperger's disorder. Although many of these medications have been demonstrated to be useful, no clear primary treatment for PDD-NOS and Asperger's disorder has emerged. Despite the efficacy of some of the medicines, the acceptability and side effects have proven to be barriers to their use. Recent studies indicate that the traditional Japanese herbal medicine yokukansan (TJ-54) may be safe and useful in treating behavioral and psychological symptoms in dementia and some neuropsychiatric disorders. We aimed at evaluating both the efficacy and safety of TJ-54 in patients with well-defined PDD-NOS and Asperger's disorder. This was a 12-week prospective, open-label investigation of TJ-54 in 40 children, adolescents, and adults diagnosed with PDD-NOS or Asperger's disorder. Primary outcome measures included the Clinical Global Impressions-Severity of Illness Scale (CGI-S) and the Aberrant Behavior Checklist-Iritability subscale score (ABC-I). Forty subjects, ages 8-40 years (mean 22.7 ± 7.3 years) received a mean final TJ-54 dosage of 6.4 ± 1.3 g/day (range 2.5-7.5 g/day). Full-scale intelligence quotient (IQ) scores ranged from 70 to 110 (mean 88.9 ± 13.2). Thirty-six (90%) of 40 subjects showed fewer interfering symptoms of irritability, including aggression, self-injury, and tantrums, with a final CGI-S of 1 or 2 (normal, not at all ill or borderline mentally ill) and a 80% or greater improvement on the ABC-I. The mean CGI-S score at baseline was 6.8 ± 0.8 whereas scores at end point was 1.9 ± 0.1 (< 0.0001). ABC-I scores ranged from 11 to 29 (mean 17.4 ± 3.66) at baseline, whereas scores at week 12 ranged from 0 to 5 (mean 0.93 ± 0.97) (p <0.0001). TJ-54 was well tolerated. No subject exited the study due to a drug-related adverse event. These preliminary data suggest that TJ-54 may be effective and well tolerated for treatment of severe irritability, lethargy/withdrawal, stereotypic behavior, hyperactivity/noncompliance, and inappropriate speech in patients with PDD-NOS or Asperger's disorder. However, given the characteristics of this trial, the present findings should be taken cautiously, and larger-scale placebo-controlled studies are needed to elucidate the efficacy and tolerability of TJ-54 in this understudied population.

The Impact of Symptom Dimensions on Outcome for Exposure and Ritual Prevention Therapy in Obsessive-Compulsive Disorder

PubMed Central

Williams, Monnica T.; Farris, Samantha G.; Turkheimer, Eric N.; Franklin, Martin E.; Simpson, H. Blair; Liebowitz, Michael; Foa, Edna B.

2014-01-01

Objective Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. The behavioral treatment with the most empirical support is exposure and ritual prevention (EX/RP). This study examined the impact of symptom dimensions on EX/RP outcomes in OCD patients. Method The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to determine primary symptoms for each participant. An exploratory factor analysis (EFA) of 238 patients identified five dimensions: contamination/cleaning, doubts about harm/checking, hoarding, symmetry/ordering, and unacceptable/taboo thoughts (including religious/moral and somatic obsessions among others). A linear regression was conducted on those who had received EX/RP (n = 87) to examine whether scores on the five symptom dimensions predicted post-treatment Y-BOCS scores, accounting for pre-treatment Y-BOCS scores. Results The average reduction in Y-BOCS score was 43.0%, however the regression indicated that unacceptable/taboo thoughts (β = .27, p = .02) and hoarding dimensions (β = .23, p = .04) were associated with significantly poorer EX/RP treatment outcomes. Specifically, patients endorsing religious/moral obsessions, somatic concerns, and hoarding obsessions showed significantly smaller reductions in Y-BOCS severity scores. Conclusions EX/RP was effective for all symptom dimensions, however it was less effective for unacceptable/taboo thoughts and hoarding than for other dimensions. Clinical implications and directions for research are discussed. PMID:24983796

The impact of symptom dimensions on outcome for exposure and ritual prevention therapy in obsessive-compulsive disorder.

PubMed

Williams, Monnica T; Farris, Samantha G; Turkheimer, Eric N; Franklin, Martin E; Simpson, H Blair; Liebowitz, Michael; Foa, Edna B

2014-08-01

Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. The behavioral treatment with the most empirical support is exposure and ritual prevention (EX/RP). This study examined the impact of symptom dimensions on EX/RP outcomes in OCD patients. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to determine primary symptoms for each participant. An exploratory factor analysis (EFA) of 238 patients identified five dimensions: contamination/cleaning, doubts about harm/checking, hoarding, symmetry/ordering, and unacceptable/taboo thoughts (including religious/moral and somatic obsessions among others). A linear regression was conducted on those who had received EX/RP (n=87) to examine whether scores on the five symptom dimensions predicted post-treatment Y-BOCS scores, accounting for pre-treatment Y-BOCS scores. The average reduction in Y-BOCS score was 43.0%, however the regression indicated that unacceptable/taboo thoughts (β=.27, p=.02) and hoarding dimensions (β=.23, p=.04) were associated with significantly poorer EX/RP treatment outcomes. Specifically, patients endorsing religious/moral obsessions, somatic concerns, and hoarding obsessions showed significantly smaller reductions in Y-BOCS severity scores. EX/RP was effective for all symptom dimensions, however it was less effective for unacceptable/taboo thoughts and hoarding than for other dimensions. Clinical implications and directions for research are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Intelligence and psychosocial functioning during long-term growth hormone therapy in children born small for gestational age.

PubMed

van Pareren, Yvonne K; Duivenvoorden, Hugo J; Slijper, Froukje S M; Koot, Hans M; Hokken-Koelega, Anita C S

2004-11-01

Short stature is not the only problem faced by small for gestational age (SGA) children. Being born SGA has also been associated with lowered intelligence, poor academic performance, low social competence, and behavioral problems. Although GH treatment in short children born SGA can result in a normalization of height during childhood, the effect of GH treatment on intelligence and psychosocial functioning remains to be investigated. We show the longitudinal results of a randomized, double-blind, GH-dose response study initiated in 1991 to follow growth, intelligence quotient (IQ), and psychosocial functioning in SGA children during long-term GH treatment. Patients were assigned to one of two treatment groups (1 or 2 mg GH/m(2) body surface.d, or approximately 0.035 or 0.07 mg/kg.d). Intelligence and psychosocial functioning were evaluated at start of GH treatment (n = 74), after 2 yr of GH treatment (n = 76), and in 2001 (n = 53). IQ was assessed by a short-form Wechsler Intelligence Scale for Children-Revised or Wechsler Adult Intelligence Scale (Block-design and Vocabulary subtests). Behavioral problems were measured by the Achenbach Child Behavior Checklist or Young Adult Behavior Checklist, and self-perception was measured by the Harter Self-Perception Profile. Mean (sem) birth length sd score was -3.6 (0.2), mean age and height at start was 7.4 (0.2) yr and -3.0 (0.1) sd score, respectively, mean duration of GH treatment was 8.0 (0.2) yr, and mean age in 2001 was 16.5 (0.3) yr. After 2 yr of GH treatment, 96% of both GH groups showed a height gain sd score of 1 sd from the start of treatment or more, resulting in a normal height (i.e. height >/= -2.0 sd for age and sex) in 70% of the children. In 2001, 48 (91%) of the 53 children participating in this study had reached a normal height. Block-design s-score and the estimated total IQ significantly increased (P < 0.001 and P < 0.001, respectively) from scores significantly lower than Dutch peers at start (P < 0.001 and P < 0.001, respectively) to comparable scores in 2001. The increase over time for the Vocabulary s-score was not significant. Internalizing Behavior sd scores remained comparable to Dutch peers, whereas Externalizing Behavior sd scores and Total Problem Behavior sd scores improved significantly during GH therapy (P < 0.01 and P < 0.05, respectively) to scores comparable to Dutch peers. Self-perception sd scores improved from start of GH treatment until 2001 (P < 0.001) to scores significantly higher than Dutch peers (P < 0.05). No significant differences between the two GH dosage groups were found. Improvement in Externalizing and Total Problem Behavior sd scores over time was significantly related to change in height sd score (P < 0.05 and P < 0.01, respectively), whereas scores over time for Vocabulary, Block-design, Internalizing, or total Harter Self-Perception score were not related to change in height sd scores. In conclusion, parallel to a GH-induced catch-up growth in adolescents born SGA, IQ, behavior, and self-perception showed a significant improvement over time from scores below average to scores comparable to Dutch peers. In addition, children whose height over time became closer to that of their peers showed less problem behavior.

Subtyping pathological gamblers based on impulsivity, depression, and anxiety.

PubMed

Ledgerwood, David M; Petry, Nancy M

2010-12-01

This study examined putative subtypes of pathological gamblers (PGs) based on the Pathways model, and it also evaluated whether the subtypes would benefit differentially from treatment. Treatment-seeking PGs (N = 229) were categorized into Pathways subtypes based on scores from questionnaires assessing anxiety, depression, and impulsivity. The Addiction Severity Index-Gambling assessed severity of gambling problems at baseline, posttreatment, and 12-month follow-up. Compared with behaviorally conditioned (BC) gamblers, emotionally vulnerable (EV) gamblers had higher psychiatric and gambling severity, and were more likely to have a parent with a psychiatric history. Antisocial impulsive (AI) gamblers also had elevated gambling and psychiatric severity relative to BC gamblers. They were more likely to have antisocial personality disorder and had the highest legal and family/social severity scores. They were also most likely to have a history of substance abuse treatment, history of inpatient psychiatric treatment, and a parent with a substance use or gambling problem. AI and EV gamblers experienced greater gambling severity throughout treatment than BC gamblers, but all three subtypes demonstrated similar patterns of treatment response. Thus, the three Pathways subtypes differ on some baseline characteristics, but subtyping did not predict treatment outcomes beyond a simple association with problem gambling severity. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

The youth form of the Motivators of and Barriers to Health-Smart Behaviors Inventory.

PubMed

Tucker, Carolyn M; Rice, Kenneth G; Desmond, Frederic F; Hou, Wei; Kaye, Lillian B; Smith, Tasia M

2012-06-01

To develop a youth form of the Motivators of and Barriers to Health-Smart Behaviors Inventory (MB-HSBI-Youth) for use in identifying self-reported motivators of and barriers to the following health-promoting behaviors (called health-smart behaviors): eating a healthy breakfast, eating healthy foods and snacks, drinking healthy drinks, and engaging in physical activity. The MB-HSBI-Youth was developed through several research phases as part of a larger, multisite, and multicomponent study on modifying and preventing obesity in families. A critical aspect of the larger study was to identify the motivators of and barriers to the above-identified health-smart behaviors among African American, Asian American, Hispanic/Latino American, and non-Hispanic White American adults and youth. After preliminary research involving content validity, item analyses, and pilot testing, a pilot version of the MB-HSBI-Youth was administered to a national sample of 567 culturally diverse youth ranging from 9 to 17 years old. Factor analyses and internal consistency results revealed the existence of multiple subscales measuring motivators of and barriers to each of the above-specified health-smart behaviors. Scores on the MB-HSBI-Youth correlated in expected directions with health self-efficacy scores and with ratings of the importance of health-related behavioral goals. The MB-HSBI-Youth may be a useful and novel tool for developing assessment-based, culturally sensitive health promotion programs customized to be responsive to the motivators of and barriers to health-smart behaviors identified in target communities, particularly those communities whose members are mostly racial/ethnic minorities. (c) 2012 APA, all rights reserved

Previously unrecognized behavioral phenotype in Gaucher disease type 3

PubMed Central

Potegal, Michael; Shapiro, Elsa G.; Nestrasil, Igor

2017-01-01

Objective: To provide a comprehensive description of abnormal behaviors in patients with Gaucher disease type 3 (GD3) and relate these behaviors to demographic, neurodevelopmental, and neurologic characteristics. Methods: Thirty-four Egyptian patients with GD3 (mean age of 7.9 years) were enrolled in the study. They were selected based on parent report and/or physician observation of one or more abnormal behaviors documented in 2 settings and by 2 different individuals and/or by video recording. Behaviors were grouped into 4 categories: Crying/Withdrawal, Impatience/Overactivity, Anger/Aggression, and Repetitive Acts. Baseline and follow-up 6–12 monthly neurologic evaluations included IQ assessment and an EEG. All patients were receiving enzyme replacement therapy (30–60 IU/kg every 2 weeks) and were followed for periods of 3–10 years. Results: Supranuclear palsy of horizontal gaze, and of both horizontal and vertical gaze, bulbar symptoms, seizures, convergent strabismus, abnormal gait, and neck retroflexion were present in 97.1%, 50%, 55.9%, 29.4%, 29.4%, 20.6%, and 4.4% of patients, respectively. The most abnormal behavioral features were excessive anger (88.2%) and aggression (64.7%), and both were significantly higher in males. Anger/Aggression scores were highly correlated with IQ but not with either EEG/Seizure status or neurologic signs. Conclusions: We describe behavioral problems with a unique pattern of excessive anger and aggression in patients with GD3. Defining these components using quantitative behavioral scoring methods holds promise to provide a marker of neurologic disease progression and severity. PMID:28634598

Increased impulsivity associated with severity of suicide attempt history in patients with bipolar disorder.

PubMed

Swann, Alan C; Dougherty, Donald M; Pazzaglia, Peggy J; Pham, Mary; Steinberg, Joel L; Moeller, F Gerard

2005-09-01

Impulsivity is a prominent and measurable characteristic of bipolar disorder that can contribute to risk for suicidal behavior. The purpose of this study was to investigate the relationship between impulsivity and severity of past suicidal behavior, a potential predictor of eventual suicide, in patients with bipolar disorder. In bipolar disorder subjects with either a definite history of attempted suicide or no such history, impulsivity was assessed with both a questionnaire (Barratt Impulsiveness Scale) and behavioral laboratory performance measures (immediate memory/delayed memory tasks). Diagnosis was determined with the Structured Clinical Interview for DSM-IV. Interviews of patients and review of records were used to determine the number of past suicide attempts and the medical severity of the most severe attempt. Subjects with a history of suicide attempts had more impulsive errors on the immediate memory task and had shorter response latencies, especially for impulsive responses. Impulsivity was highest in subjects with the most medically severe suicide attempts. Effects were not accounted for by presence of depression or mania at the time of testing. Barratt Impulsiveness Scale scores were numerically, but not significantly, higher in subjects with suicide attempts. A history of alcohol abuse was associated with greater probability of a suicide attempt. Multivariate analysis showed that ethanol abuse history and clinical state at the time of testing did not have a significant effect after impulsivity was taken into account. These results suggest that a history of severe suicidal behavior in patients with bipolar disorder is associated with impulsivity, manifested as a tendency toward rapid, unplanned responses.

Sexual Scripts and Sexual Risk Behaviors among Black Heterosexual Men: Development of the Sexual Scripts Scale

PubMed Central

Bowleg, Lisa; Burkholder, Gary J.; Noar, Seth M.; Teti, Michelle; Malebranche, David J.; Tschann, Jeanne M.

2014-01-01

Sexual scripts are widely shared gender and culture-specific guides for sexual behavior with important implications for HIV prevention. Although several qualitative studies document how sexual scripts may influence sexual risk behaviors, quantitative investigations of sexual scripts in the context of sexual risk are rare. This mixed methods study involved the qualitative development and quantitative testing of the Sexual Scripts Scale (SSS). Study 1 included qualitative semi-structured interviews with 30 Black heterosexual men about sexual experiences with main and casual sex partners to develop the SSS. Study 2 included a quantitative test of the SSS with 526 predominantly low-income Black heterosexual men. A factor analysis of the SSS resulted in a 34-item, seven-factor solution that explained 68% of the variance. The subscales and coefficient alphas were: Romantic Intimacy Scripts (α = .86), Condom Scripts (α = .82), Alcohol Scripts (α = .83), Sexual Initiation Scripts (α = .79), Media Sexual Socialization Scripts (α = .84), Marijuana Scripts (α = .85), and Sexual Experimentation Scripts (α = .84). Among men who reported a main partner (n = 401), higher Alcohol Scripts, Media Sexual Socialization Scripts, and Marijuana Scripts scores, and lower Condom Scripts scores were related to more sexual risk behavior. Among men who reported at least one casual partner (n = 238), higher Romantic Intimacy Scripts, Sexual Initiation Scripts, and Media Sexual Socialization Scripts, and lower Condom Scripts scores were related to higher sexual risk. The SSS may have considerable utility for future research on Black heterosexual men’s HIV risk. PMID:24311105

Sex differences in behavioral outcome following neonatal hypoxia ischemia: insights from a clinical meta-analysis and a rodent model of induced hypoxic ischemic brain injury.

PubMed

Smith, Amanda L; Alexander, Michelle; Rosenkrantz, Ted S; Sadek, Mona Lisa; Fitch, R Holly

2014-04-01

Hypoxia ischemia (HI; reduced oxygen and/or blood flow to the brain) is one of the most common injuries among preterm infants and term infants with birth complications. Both populations show cognitive/behavioral deficits, including impairments in sensory, learning/memory, and attention domains. Clinical data suggests a sex difference in HI outcomes, with males exhibiting more severe cognitive/behavioral deficits relative to matched females. Our laboratory has also reported more severe behavioral deficits among male rats with induced HI relative to females with comparable injury (Hill et al., 2011a,b). The current study initially examined published clinical studies from the past 20years where long-term IQ outcome scores for matched groups of male and female premature infants were reported separately (IQ being the most common outcome measure). A meta-analysis revealed a female "advantage," as indicated by significantly better scores on performance and full scale IQ (but not verbal IQ) for premature females. We then utilized a rodent model of neonatal HI injury to assess sham and postnatal day 7 (P7) HI male and female rats on a battery of behavioral tasks. Results showed expected deficits in HI male rats, but also showed task-dependent sex differences, with HI males having significantly larger deficits than HI females on some tasks but equivalent deficits on other tasks. In contrast to behavioral results, post mortem neuropathology associated with HI was comparable across sex. These findings suggest: 1) neonatal female "protection" in some behavioral domains, as indexed by superior outcome following early injury relative to males; and 2) female protection may entail sex-specific plasticity or compensation, rather than a reduction in gross neuropathology. Further exploration of the mechanisms underlying this sex effect could aid in neuroprotection efforts for at-risk neonates in general, and males in particular. Moreover, our current report of comparable anatomical damage coupled with differences in cognitive outcomes (by sex) provides a framework for future studies to examine neural mechanisms underlying sex differences in cognition and behavior in general. Copyright © 2014. Published by Elsevier Inc.

Cognitive Deficits Underlying Error Behavior on a Naturalistic Task after Severe Traumatic Brain Injury

PubMed Central

Hendry, Kathryn; Ownsworth, Tamara; Beadle, Elizabeth; Chevignard, Mathilde P.; Fleming, Jennifer; Griffin, Janelle; Shum, David H. K.

2016-01-01

People with severe traumatic brain injury (TBI) often make errors on everyday tasks that compromise their safety and independence. Such errors potentially arise from the breakdown or failure of multiple cognitive processes. This study aimed to investigate cognitive deficits underlying error behavior on a home-based version of the Cooking Task (HBCT) following TBI. Participants included 45 adults (9 females, 36 males) with severe TBI aged 18–64 years (M = 37.91, SD = 13.43). Participants were administered the HBCT in their home kitchens, with audiovisual recordings taken to enable scoring of total errors and error subtypes (Omissions, Additions, Estimations, Substitutions, Commentary/Questions, Dangerous Behavior, Goal Achievement). Participants also completed a battery of neuropsychological tests, including the Trail Making Test, Hopkins Verbal Learning Test-Revised, Digit Span, Zoo Map test, Modified Stroop Test, and Hayling Sentence Completion Test. After controlling for cooking experience, greater Omissions and Estimation errors, lack of goal achievement, and longer completion time were significantly associated with poorer attention, memory, and executive functioning. These findings indicate that errors on naturalistic tasks arise from deficits in multiple cognitive domains. Assessment of error behavior in a real life setting provides insight into individuals' functional abilities which can guide rehabilitation planning and lifestyle support. PMID:27790099

The Impact of Neglect on Initial Adaptation to School

PubMed Central

Manly, Jody Todd; Lynch, Michael; Oshri, Assaf; Herzog, Margaret; Wortel, Sanne N.

2013-01-01

This study examined the impact of child neglect during the first four years of life on adaptation to school during kindergarten and first grade in the context of neighborhood poverty. Processes related to the development of school competencies were examined, including the mediational role of cognitive functioning and ego-resiliency in shaping children’s school outcomes. 170 low-income urban children were followed prospectively for two years (ages four to six). Results indicated that neglected children had significantly lower scores on kindergarten classroom behavior and first grade academic performance than nonneglected children. Children’s cognitive performance at age four, controlling for maternal IQ, mediated the relation between severity of neglect and children’s behavior in kindergarten as well as their academic performance in first grade. Moreover, severity of neglect was related to children’s ego-resiliency at age four. However, additional ecological adversity in the form of neighborhood poverty moderated the link between ego-resiliency and classroom behavior such that at lower levels of poverty, ego-resiliency mediated the relation between severity of neglect and school adaptation. Conversely, when neighborhood poverty was extreme, the effects of ego-resiliency were attenuated and ego-resiliency ceased to predict behavioral performance in kindergarten. The implications of these findings for prevention and intervention are discussed. PMID:23843472

Dietary patterns and socioeconomic position.

PubMed

Mullie, P; Clarys, P; Hulens, M; Vansant, G

2010-03-01

To test a socioeconomic hypothesis on three dietary patterns and to describe the relation between three commonly used methods to determine dietary patterns, namely Healthy Eating Index, Mediterranean Diet Score and principal component analysis. Cross-sectional design in 1852 military men. Using mailed questionnaires, the food consumption frequency was recorded. The correlation coefficients between the three dietary patterns varied between 0.43 and 0.62. The highest correlation was found between Healthy Eating Index and Healthy Dietary Pattern (principal components analysis). Cohen's kappa coefficient of agreement varied between 0.10 and 0.20. After age-adjustment, education and income remained associated with the most healthy dietary pattern. Even when both socioeconomic indicators were used together in one model, higher income and education were associated with higher scores for Healthy Eating Index, Mediterranean Diet Score and Healthy Dietary Pattern. The least healthy quintiles of dietary pattern as measured by the three methods were associated with a clustering of unhealthy behaviors, that is, smoking, low physical activity, highest intake of total fat and saturated fatty acids, and low intakes of fruits and vegetables. The three dietary patterns used indicated that the most healthy patterns were associated with a higher socioeconomic position, while lower patterns were associated with several unhealthy behaviors.

Psychosocial Risk Factors Associated with Internet Addiction in Korea

PubMed Central

Lee, Ju Young; Shin, Kyoung Min; Cho, Sun-Mi

2014-01-01

Objective The aim of this study was to examine the prevalence of Internet addiction in middle school students and to identify associated psychosocial risk factors and depression. Methods This study was part of a larger epidemiological study on childhood psychiatric disorders conducted in Osan, a city of Republic of Korea. We used IAS for internet addiction, K-YSR for subjects' emotional and behavioral problems and K-CDI for depressive symptoms. We used the data of n=1217 completed cases. We put on independent variables, which are sex, age, smoking and alcohol experiences, economic status, age of first Internet use, K-YSR and K-CDI score. Results The subjects consisted of addicted users (2.38%), over users (36.89%) and normal Internet users (60.72%). Attention problems, sex, delinquent problems, K-CDI scores, thought problems, age and aggressive behavior were predictable variables of internet addiction. Age of initial Internet use negatively predicted Internet addiction. Conclusion This result showed similar to other researches about sociodemographic, emotional or behavioral factors related to internet addiction. Generally, subjects with more severe internet addiction had more emotional or behavioral problems. It means that they already have had various difficulties when we found internet addiction of adolescents. Therefore it is necessary to evaluate whether the subjects have any emotional or behavioral troubles and to intervene to prevent internet addiction. PMID:25395968

Sex differences and gender-invariance of mother-reported childhood problem behavior.

PubMed

van der Sluis, Sophie; Polderman, Tinca J C; Neale, Michael C; Verhulst, Frank C; Posthuma, Danielle; Dieleman, Gwen C

2017-09-01

Prevalence and severity of childhood behavioral problems differ between boys and girls, and in psychiatry, testing for gender differences is common practice. Population-based studies show that many psychopathology scales are (partially) Measurement Invariance (MI) with respect to gender, i.e. are unbiased. It is, however, unclear whether these studies generalize towards clinical samples. In a psychiatric outpatient sample, we tested whether the Child Behavior Checklist 6-18 (CBCL) is unbiased with respect to gender. We compared mean scores across gender of all syndrome scales of the CBCL in 3271 patients (63.3% boys) aged 6-18. Second, we tested for MI on both the syndrome scale and the item-level using a stepwise modeling procedure. Six of the eight CBCL syndrome scales included one or more gender-biased items (12.6% of all items), resulting in slight over- or under-estimation of the absolute gender difference in mean scores. Two scales, Somatic Complaints and Rule-breaking Behavior, contained no biased items. The CBCL is a valid instrument to measure gender differences in problem behavior in children and adolescents from a clinical sample; while various gender-biased items were identified, the resulting bias was generally clinically irrelevant, and sufficient items per subscale remained after exclusion of biased items. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Theory of mind in schizophrenia: correlation with clinical symptomatology, emotional recognition and ward behavior.

PubMed

Lee, Woo Kyeong; Kim, Yong Kyu

2013-09-01

Several studies have suggested the presence of a theory of mind (ToM) deficit in schizophrenic disorders. This study examined the relationship of emotion recognition, theory of mind, and ward behavior in patients with schizophrenia. Fifty-five patients with chronic schizophrenia completed measures of emotion recognition, ToM, intelligence, Positive and Negative Syndrome Scale (PANSS) and Nurse's Observation Scale for Inpatient Evaluation (NOSIE). Theory of mind sum score correlated significantly with IQ, emotion recognition, and ward behavior. Ward behavior was linked to the duration of the illness, and even more so to theory of mind deficits. Theory of mind contributed a significant proportion of the amount of variance to explain social behavior on the ward. Considering our study results, impaired theory of mind contributes significantly to the understanding of social competence in patients with schizophrenia. Copyright © 2012 Wiley Publishing Asia Pty Ltd.

Utility of behavioral versus cognitive measures in differentiating between subtypes of frontotemporal lobar degeneration and Alzheimer's disease.

PubMed

Heidler-Gary, Jennifer; Gottesman, Rebecca; Newhart, Melissa; Chang, Shannon; Ken, Lynda; Hillis, Argye E

2007-01-01

We hypothesized that a modified version of the Frontal Behavioral Inventory (FBI-mod), along with a few cognitive tests, would be clinically useful in distinguishing between clinically defined Alzheimer's disease (AD) and subtypes of frontotemporal lobar degeneration (FTLD): frontotemporal dementia (dysexecutive type), progressive nonfluent aphasia, and semantic dementia. We studied 80 patients who were diagnosed with AD (n = 30) or FTLD (n = 50), on the basis of a comprehensive neuropsychological battery, imaging, neurological examination, and history. We found significant between-group differences on the FBI-mod, two subtests of the Rey Auditory Verbal Learning Test (verbal learning and delayed recall), and the Trail Making Test Part B (one measure of 'executive functioning'). AD was characterized by relatively severe impairment in verbal learning, delayed recall, and executive functioning, with relatively normal scores on the FBI-mod. Frontotemporal dementia was characterized by relatively severe impairment on the FBI-mod and executive functioning in the absence of severe impairment in verbal learning and recall. Progressive nonfluent aphasia was characterized by severe impairment in executive functioning with relatively normal scores on verbal learning and recall and FBI-mod. Finally, semantic dementia was characterized by relatively severe deficits in delayed recall, but relatively normal performance on new learning, executive functioning, and on FBI-mod. Discriminant function analysis confirmed that the FBI-mod, in conjunction with the Rey Auditory Verbal Learning Test, and the Trail Making Test Part B categorized the majority of patients as subtypes of FTLD or AD in the same way as a full neuropsychological battery, neurological examination, complete history, and imaging. These tests may be useful for efficient clinical diagnosis, although progressive nonfluent aphasia and semantic dementia are likely to be best distinguished by language tests not included in standard neuropsychological test batteries.

Relationships between non-pathological dream-enactment and mirror behaviors.

PubMed

Nielsen, Tore; Kuiken, Don

2013-09-01

Dream-enacting behaviors (DEBs) are behavioral expressions of forceful dream images often occurring during sleep-to-wakefulness transitions. We propose that DEBs reflect brain activity underlying social cognition, in particular, motor-affective resonance generated by the mirror neuron system. We developed a Mirror Behavior Questionnaire (MBQ) to assess some dimensions of mirror behaviors and investigated relationships between MBQ scores and DEBs in a large of university undergraduate cohort. MBQ scores were normally distributed and described by a four-factor structure (Empathy/Emotional Contagion, Behavioral Imitation, Sleepiness/Anger Contagion, Motor Skill Imitation). DEB scores correlated positively with MBQ total and factor scores even with social desirability, somnambulism and somniloquy controlled. Emotion-specific DEB items correlated with corresponding emotion-specific MBQ items, especially crying and smiling. Results provide preliminary evidence for cross-state relationships between propensities for dream-enacting and mirror behaviors--especially behaviors involving motor-affective resonance--and our suggestion that motor-affective resonance mediates dream-enactment imagery during sleep and emotional empathy during waking. Copyright © 2013 Elsevier Inc. All rights reserved.

Functional Outcome Trajectories After Out-of-Hospital Pediatric Cardiac Arrest.

PubMed

Silverstein, Faye S; Slomine, Beth S; Christensen, James; Holubkov, Richard; Page, Kent; Dean, J Michael; Moler, Frank W

2016-12-01

To analyze functional performance measures collected prospectively during the conduct of a clinical trial that enrolled children (up to age 18 yr old), resuscitated after out-of-hospital cardiac arrest, who were at high risk of poor outcomes. Children with Glasgow Motor Scale score less than 5, within 6 hours of resuscitation, were enrolled in a clinical trial that compared two targeted temperature management interventions (THAPCA-OH, NCT00878644). The primary outcome, 12-month survival with Vineland Adaptive Behavior Scale, second edition, score greater or equal to 70, did not differ between groups. Thirty-eight North American PICUs. Two hundred ninety-five children were enrolled; 270 of 295 had baseline Vineland Adaptive Behavior Scale, second edition, scores greater or equal to 70; 87 of 270 survived 1 year. Targeted temperatures were 33.0°C and 36.8°C for hypothermia and normothermia groups. Baseline measures included Vineland Adaptive Behavior Scale, second edition, Pediatric Cerebral Performance Category, and Pediatric Overall Performance Category. Pediatric Cerebral Performance Category and Pediatric Overall Performance Category were rescored at hospital discharges; all three were scored at 3 and 12 months. In survivors with baseline Vineland Adaptive Behavior Scale, second edition scores greater or equal to 70, we evaluated relationships of hospital discharge Pediatric Cerebral Performance Category with 3- and 12-month scores and between 3- and 12-month Vineland Adaptive Behavior Scale, second edition, scores. Hospital discharge Pediatric Cerebral Performance Category scores strongly predicted 3- and 12-month Pediatric Cerebral Performance Category (r = 0.82 and 0.79; p < 0.0001) and Vineland Adaptive Behavior Scale, second edition, scores (r = -0.81 and -0.77; p < 0.0001). Three-month Vineland Adaptive Behavior Scale, second edition, scores strongly predicted 12-month performance (r = 0.95; p < 0.0001). Hypothermia treatment did not alter these relationships. In comatose children, with Glasgow Motor Scale score less than 5 in the initial hours after out-of-hospital cardiac arrest resuscitation, function scores at hospital discharge and at 3 months predicted 12-month performance well in the majority of survivors.

[Association of pubertal timing and the different dimensionality of adolescents' aggressive behavior].

PubMed

Han, Hui; Wang, Gengfu; Su, Puyu

2016-01-01

To explore the relationship between pubertal timing and aggressive behaviors. Stratified random sampling was used to choose 5760 students from one junior high school and one high school. The pubertal development scale (PDS) questionnaire and perceived pubertal timing were used to evaluate the pubertal timing, and the Buss-Perry questionnaire was used to explore the students' aggressive behaviors. The score of aggressive behavior was significantly different in junior high school students with different perceived pubertal timing, the score of early pubertal timing was highest and the score of delay pubertal timing was lowest, and the score of physical aggression and verbal aggression of schoolboy in early pubertal timing and normal pubertal timing in high school was higher than the delay pubertal timing (P < 0.05). The score of physical aggression, anger and hostility of schoolgirl in early pubertal timing was highest, there was significant difference between them. The relationship between the perceived pubertal timing and the aggressive behavior was the physical aggression, anger and hostility score was highest in schoolgirls both in junior high school and high school, and the score of verbal aggression was higher in normal pubertal timing and early pubertal timing in schoolboys (P < 0.05), there was significant difference between them. There are closely relationship between the early pubertal timing and aggressive behaviors by used the PDS questionnaire, and the perceived pubertal timing is in a relatively large impact on girls' aggressive behaviors.

Systemic lupus erythematosus in three ethnic groups. VI: Factors associated with fatigue within 5 years of criteria diagnosis. LUMINA Study Group. LUpus in MInority populations: NAture vs Nurture.

PubMed

Zonana-Nacach, A; Roseman, J M; McGwin, G; Friedman, A W; Baethge, B A; Reveille, J D; Alarcón, G S

2000-01-01

To determine the frequency, degree and associated features of fatigue among Hispanic (H), African American (AA) and Caucasian (C) patients with recent onset (< or = 5 yr) systemic lupus erythematosus (SLE) at their baseline evaluation. H (n = 69), AA (n = 83) and C (n = 71) patients from the LUMINA (LUpus in MInority populations: NAture vs Nurture) cohort were studied. Fatigue [Fatigue Severity Scale (FSS)] was defined as present if FSS score > or = 3.0. Variables from functional, clinical, sociodemographic, health behaviors, behavioral and psychological and immunogenetics domains were ascertained at study entry. Associations were examined using regression models. Eighty-six percent (85.7%) of patients reported having fatigue (82.6% H; 85.5% AA; 88.7% C); median FSS score, 5.3. Factors from the psychological and clinical domains were primarily associated with FSS; immunogenetic (HLA Class II phenotypes) features were not. Increased fatigue was strongly associated with decreasing function, both physical and mental. Variables associated with significantly greater degree of fatigue at baseline in the multivariable stepwise model in order of decreasing additional partial R2 explained included: abnormal illness-related behaviors, older age, higher self-reported pain, greater degree of helplessness, greater disease activity, Caucasian race, and lacking health insurance (model R2 = 37%). Fatigue is one of the most prevalent clinical manifestations of SLE across all ethnic groups. The perception of fatigue severity in SLE may be multifactorial in origin, including psychosocial factors and disease activity. If these prove causal, knowledge of their contribution may suggest therapeutic and/or behavioral interventions, which could ameliorate this pervasive and often incapacitating symptom of SLE.

Bisphenol A, phthalates and lead and learning and behavioral problems in Canadian children 6-11 years of age: CHMS 2007-2009.

PubMed

Arbuckle, Tye E; Davis, Karelyn; Boylan, Khrista; Fisher, Mandy; Fu, Jingshan

2016-05-01

Childhood developmental disorders and related problems such as learning disabilities and attention deficit hyperactivity disorder (ADHD) account for a growing burden on the family, education and health care systems. Exposure to environmental chemicals such as bisphenol A (BPA) and phthalates may play a role in the development of child behavioral problems. Using cross-sectional data from Cycle 1 of the Canadian Health Measures Survey (CHMS), we examined the potential association between urinary concentrations of BPA and various phthalate metabolites and child learning and behavioral problems, considering important covariates such as gender, blood lead and environmental tobacco smoke (ETS). The Strengths and Difficulties Questionnaire (SDQ) outcomes of interest were emotional symptoms, hyperactivity/inattention, and a total difficulties score with borderline and abnormal scores grouped together and compared with children with normal scores. Other outcomes studied included any reported learning disability, a subset of learning disabilities reported as ADD/ADHD (attention deficit disorder) and use of psychotropic medications in the past month. Among children ages 6-11 years, the prevalences of any learning disability, ADD, and ADHD were 8.7%, 1.5% and 2.8%, respectively. Estimated prevalences for SDQ hyperactivity/inattention, emotional symptoms and total difficulties scores were 16.9%, 15.0%, and 13.0%, respectively. Child's urinary BPA was associated with taking psychotropic medications (OR 1.59; 95% CI 1.05-2.40). Urinary MBzP concentration was significantly associated with emotional symptoms in girls (OR 1.38 95% CI 1.09-1.75) but not in boys (OR 1.05 95% CI 0.82-1.36).) Blood lead was significantly associated with several of the outcomes examined, with a significant interaction observed between prenatal smoking and blood lead for the total difficulties score (OR=10.57; 95% CI 2.81-39.69 vs. OR=1.98; 95% CI 1.41-2.79 if mother did not smoke during pregnancy). Although limited by the cross-sectional nature of the study which precludes examining causation, the results suggest that although some indicators of child behavior were significantly associated with their urinary BPA and phthalate concentrations, the major chemical associated with adverse behavioral indicators was lead. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

Predictors of non-pharmacological intervention effect on cognitive function and behavioral and psychological symptoms of older people with dementia.

PubMed

Hsu, Ting-Jung; Tsai, Hui-Te; Hwang, An-Chun; Chen, Liang-Yu; Chen, Liang-Kung

2017-04-01

Our previous work showed that non-pharmacological interventions could effectively reduce the severity of behavioral and psychological symptoms of dementia (BPSD), while the factors influencing the effect of intervention were less explored. Therefore, the main purpose of the present study was to investigate the predictors of the non-pharmacological intervention effect for old veterans with dementia and BPSD. A total of 141 old veterans with dementia living in two veterans' homes in northern Taiwan were recruited. The participants received an organized non-pharmacological intervention program of physical activity/exercise, music therapy, reality orientation, art therapy, reminiscence therapy and horticultural therapy once every week for 6 months. All participants were evaluated by the Barthel Index, Lawton-Brody Instrumental Activities of Daily Living Scale, Mini-Mental State Examination, neuropsychiatric inventory (NPI), and the Cornell Scale for Depression in Dementia before and after the intervention. Logistic regression was used to investigate factors associated with improvement/maintenance of cognition (measured by the Mini-Mental State Examination), and improvement of BPSD (measured by NPI) and its subdomains during the intervention period. Multivariate logistic regression analysis showed that the improvement/maintenance of cognitive function was independently associated with a lower Mini-Mental State Examination score at baseline (odds ratio [OR] 0.88, 95% CI 0.80-0.97, P = 0.008), whereas participants with antipsychotic use were less likely to gain the effect (OR 0.42, 95% CI 0.17-1.04, P = 0.061). In addition, the improvement of BPSD was associated with a higher baseline total NPI score (OR 1.33, 95% CI 1.15-1.55, P < 0.001), and the result was consistent in different NPI subdomains (psychotic domain: OR 1.96, 95% CI 0.83-4.58, P = 0.123; affective domain: OR 1.63, 95% CI 1.25-2.13, P < 0.001; behavior domain: OR 2.25, 95% CI 1.53-3.30, P < 0.001) and caregiver burden (OR 1.63, 95% CI 1.24-2.14, P < 0.001). In addition, a higher Cornell Scale for Depression in Dementia score was correlated with an improvement in the NPI behavior domain (OR 1.48, 95% CI 1.01-2.18, P = 0.047), whereas participants with hearing impairment had a lower chance of improvement in the NPI behavior domain (OR 0.11, 95% CI 0.01-1.23, P = 0.073) and care burden (OR 0.17, 95% CI 0.03-0.99, P = 0.050). Our findings show that non-pharmacological intervention programs have a significant effect on reducing overall NPI score, NPI caregiver burden score and NPI subdomains - psychotic, affective and behavior syndrome - in old veterans with dementia. In addition, participants with lower cognitive performance, more severe BPSD and depressive symptoms at baseline were more likely to gain benefit from the intervention, whereas antipsychotic use and hearing impairment were negative predictors of improvement of cognition and BPSD, respectively. Geriatr Gerontol Int 2017: 17 (Suppl. 1): 28-35. © 2017 Japan Geriatrics Society.

Patterns and associates of hyperphagia in patients with dementia.

PubMed

Smith, G; Vigen, V; Evans, J; Fleming, K; Bohac, D

1998-04-01

This study examined patterns and associates of excessive eating (hyperphagia) in a community-based registry of patients with dementia. From patients enrolled in the Mayo Clinic Alzheimer's Disease Patient Registry (n = 439), 39 were identified with excessive eating reported on the Behavior Symptom Checklist at some time during their illness. They were matched for age, gender, duration of disease, and Global Deterioration Scale (GDS) score to "normal eaters." Annualized weight change was determined based on weight from the 6 months before the evaluation to weight 6 months after the evaluation. Annualized weight change scores were not significantly different between excessive eaters and normal eaters nor between wanderers and nonwanderers. In cross-sectional analysis, univariate modeling suggested age at onset, GDS, and Mini-Mental State Examination score to be significant predictors of excessive eating. Using multivariate logistic model with backward elimination, only age of onset and GDS were retained as associates of excess eating. Rater type also emerged as a significant predictor for excessive eating with family raters reporting this behavior in 16% of patients compared to 5% for other raters. In chi-square analyses excessive eating was associated with greater frequency of wandering, unpredictable behavior, inappropriate dressing, inappropriate bodily concerns, and threatening self-harm. Associates of excess eating were subsequently examined separately in wandering and nonwandering excessive eaters. Logistic modeling suggested that among nonwanderers, patients who were younger but more severely demented were likely to have reported excessive eating. These results suggest hyperphagia to be present in approximately 10% of a community-based cohort of patients with dementia and associated with increasing functional decline. Excessive eating does not appear to arise from memory dysfunction, but for wanderers may result from needing increased caloric intake because of increased activity levels. Thus, for wandering excessive eaters, it may be appropriate to endure the eating to ensure appropriate caloric intake. Nonwandering excessive eaters were younger, had greater dementia severity, and had more unpredictable behavior. They may have dementia with prominent frontal lobe involvement and may respond to any food stimulus respective of hunger. Restricting food exposure may be an effective management intervention for them.

Neuropsychological Characteristics of Italian Children with Fetal Alcohol Spectrum Disorders

PubMed Central

Aragón, Alfredo S.; Coriale, Giovanna; Fiorentino, Daniela; Kalberg, Wendy O.; Buckley, David; Gossage, J. Phillip; Ceccanti, Mauro; Mitchell, Elisha R.; May, Philip A.

2008-01-01

Background Children with fetal alcohol spectrum disorders (FASD) display many problems ranging from deficits in intelligence to behavioral difficulties. Thus, many studies have aimed to better define the neuropsychological characteristics of children with FASD. The current article describes the neuropsychological characteristics of Italian children with severe diagnosis within FASD and compares them with controls. It was expected that intellectual functioning, language comprehension, academic skills, and inattention/hyperactivity would discriminate children with FASD from randomly-selected peers without FASD. Methods This paper presents data from a second cohort of children examined in 2005 as part of an in-school epidemiological study of FASD in Italy. Eighty children, 23 diagnosed with a FASD, and 57 randomly-selected control children from the same 1st grade classes, participated. After screening for FASD via growth and dysmorphology, the children were administered a test of general intelligence (WISC-R) as well as tests of nonverbal reasoning (Raven Colored Progressive Matrices), language comprehension (Rustioni), academic achievement (IPDA), and problem behavior (Disruptive Behavior Disorder Rating Scale). Results Children diagnosed with a FASD achieved lower scores than control children on Verbal, Performance, and Full Scale IQ. Profile analysis of the WISC-R indicates overall differences between the groups. However, some intact functioning within the FASD group was found, as the Similarities and Vocabulary subtests were similar to the controls. After an alpha adjustment to .004, the Block Design, Object Assembly, and Mazes subtests were significantly different from controls. On tests of nonverbal reasoning, language comprehension, and academic achievement, the children with a FASD scored significantly lower. Moreover, teachers rated children with a severe diagnosis within FASD as showing more inattentive symptoms than controls, while hyperactive/impulsive characteristics among children with a FASD were comparable with the control children. Significant correlations between head circumference, child dysmorphology, WISC-R, and Raven CPM scores are also reported. Conclusions This study indicates that a sample of Italian children with a FASD, when compared to control children, display poorer functioning on measures of general intelligence, nonverbal reasoning, academic achievement, and teacher-rated problem behaviors. The findings also contribute to the formulation of a neuropsychological profile of children diagnosed with a FASD. PMID:18715277

Abnormal network connectivity in frontotemporal dementia: evidence for prefrontal isolation.

PubMed

Farb, Norman A S; Grady, Cheryl L; Strother, Stephen; Tang-Wai, David F; Masellis, Mario; Black, Sandra; Freedman, Morris; Pollock, Bruce G; Campbell, Karen L; Hasher, Lynn; Chow, Tiffany W

2013-01-01

Degraded social function, disinhibition, and stereotypy are defining characteristics of frontotemporal dementia (FTD), manifesting in both the behavioral variant of frontotemporal dementia (bvFTD) and semantic dementia (SD) subtypes. Recent neuroimaging research also associates FTD with alterations in the brain's intrinsic connectivity networks. The present study explored the relationship between neural network connectivity and specific behavioral symptoms in FTD. Resting-state functional magnetic resonance imaging was employed to investigate neural network changes in bvFTD and SD. We used independent components analysis (ICA) to examine changes in frontolimbic network connectivity, as well as several metrics of local network strength, such as the fractional amplitude of low-frequency fluctuations, regional homogeneity, and seed-based functional connectivity. For each analysis, we compared each FTD subgroup to healthy controls, characterizing general and subtype-unique network changes. The relationship between abnormal connectivity in FTD and behavior disturbances was explored. Across multiple analytic approaches, both bvFTD and SD were associated with disrupted frontolimbic connectivity and elevated local connectivity within the prefrontal cortex. Even after controlling for structural atrophy, prefrontal hyperconnectivity was robustly associated with apathy scores. Frontolimbic disconnection was associated with lower disinhibition scores, suggesting that abnormal frontolimbic connectivity contributes to positive symptoms in dementia. Unique to bvFTD, stereotypy was associated with elevated default network connectivity in the right angular gyrus. The behavioral variant was also associated with marginally higher apathy scores and a more diffuse pattern of prefrontal hyperconnectivity than SD. The present findings support a theory of FTD as a disorder of frontolimbic disconnection leading to unconstrained prefrontal connectivity. Prefrontal hyperconnectivity may represent a compensatory response to the absence of affective feedback during the planning and execution of behavior. Increased reliance upon prefrontal processes in isolation from subcortical structures appears to be maladaptive and may drive behavioral withdrawal that is commonly observed in later phases of neurodegeneration. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Identification of difficulties at the beginning of breastfeeding by means of protocol application].

PubMed

Carvalhaes, Maria Antonieta de Barros Leite; Corrêa, Cláudia Regina Hostin

2003-01-01

To assess a group of mothers/newborns with the necessity of special support at the beginning of breastfeeding by means of protocol application recommended by UNICEF and to verify assisting practices associated with difficulties of breastfeeding.\\par In this descriptive study, the sample comprised 50 mother/newborn pairs randomly selected in a maternity where low risk deliveries are cared by SUS (Brazilian Unified Health System). The breastfeeding observation protocol was used to record the behavior of each pair, including the frequency of negative behavior regarding breastfeeding. Next, each aspect was scored as good, regular or poor. The association between negative scores and particular assisting practices was also investigated. A critical level of p < 0.05 was used.\\par The frequency of pairs presenting evidence of severe problems (poor score) at the beginning of breastfeeding ranged from 2% to 22% according to the aspects assessed. The most frequently observed difficulties were mother and infant's bad positioning during breastfeeding and inappropriate mother/newborn interaction. These problems were significantly more frequent after surgical deliveries (p < 0.05). Milk formula and/or glucose solution was also associated with the worst scores in some breastfeeding aspects. \\par The protocol application to observe and evaluate breastfeeding identified a high prevalence of mothers/newborn pairs with difficulties to begin breastfeeding, especially when the delivery was surgically performed and when the newborn was offered supplementary liquids.

Racial Disparities in Cardiovascular Health Behaviors: The Coronary Artery Risk Development in Young Adults Study.

PubMed

Whitaker, Kara M; Jacobs, David R; Kershaw, Kiarri N; Demmer, Ryan T; Booth, John N; Carson, April P; Lewis, Cora E; Goff, David C; Lloyd-Jones, Donald M; Gordon-Larsen, Penny; Kiefe, Catarina I

2018-07-01

There are known racial differences in cardiovascular health behaviors, including smoking, physical activity, and diet quality. A better understanding of these differences may help identify intervention targets for reducing cardiovascular disease disparities. This study examined whether socioeconomic, psychosocial, and neighborhood environmental factors, in isolation or together, mediate racial differences in health behaviors. Participants were 3,081 men and women from the Coronary Artery Risk Development in Young Adults study who were enrolled in 1985-1986 (Year 0) and completed a follow-up examination in 2015-2016 (Year 30). A health behavior score was created at Years 0, 7, 20, and 30 using smoking, physical activity, and diet assessed that year. The race difference in health behavior score was estimated using linear regression in serial cross-sectional analyses. Mediation analyses computed the proportion of the race and health behavior score association attributable to socioeconomic, psychosocial, and neighborhood factors. Data analysis conducted in 2016-2017 found that blacks had significantly lower health behavior scores than whites across 30 years of follow-up. Individual socioeconomic factors mediated 48.9%-70.1% of the association between race and health behavior score, psychosocial factors 20.3%-30.0%, and neighborhood factors 22.1%-41.4% (p<0.01 for all). Racial differences in health behavior scores appear to be mediated predominately by correspondingly large differences in socioeconomic factors. This study highlights the profound impact of socioeconomic factors, which are mostly not under an individual's control, on health behaviors. Policy action targeting socioeconomic factors may help reduce disparities in health behaviors. Copyright © 2018 American Journal of Preventive Medicine. All rights reserved.

Can the Five Factor Model of Personality Account for the Variability of Autism Symptom Expression? Multivariate Approaches to Behavioral Phenotyping in Adult Autism Spectrum Disorder.

PubMed

Schwartzman, Benjamin C; Wood, Jeffrey J; Kapp, Steven K

2016-01-01

The present study aimed to: determine the extent to which the five factor model of personality (FFM) accounts for variability in autism spectrum disorder (ASD) symptomatology in adults, examine differences in average FFM personality traits of adults with and without ASD and identify distinct behavioral phenotypes within ASD. Adults (N = 828; nASD = 364) completed an online survey with an autism trait questionnaire and an FFM personality questionnaire. FFM facets accounted for 70 % of variance in autism trait scores. Neuroticism positively correlated with autism symptom severity, while extraversion, openness to experience, agreeableness, and conscientiousness negatively correlated with autism symptom severity. Four FFM subtypes emerged within adults with ASD, with three subtypes characterized by high neuroticism and none characterized by lower-than-average neuroticism.

Behavioral and Electrophysiological Alterations for Reinforcement Learning in Manic and Euthymic Patients with Bipolar Disorder.

PubMed

Ryu, Vin; Ha, Ra Yeon; Lee, Su Jin; Ha, Kyooseob; Cho, Hyun-Sang

2017-03-01

Bipolar disorder is characterized by behavioral changes such as risk-taking and increasing goal-directed activities, which may result from altered reward processing. Patients with bipolar disorder show impaired reward learning in situations that require the integration of reinforced feedback over time. In this study, we examined the behavioral and electrophysiological characteristics of reward learning in manic and euthymic patients with bipolar disorder using a probabilistic reward task. Twenty-four manic and 20 euthymic patients with bipolar I disorder and 24 healthy control subjects performed the probabilistic reward task. We assessed response bias (RB) as a preference for the stimulus paired with the more frequent reward and feedback-related negativity (FRN) to correct identification of the rich stimulus. Both manic and euthymic patients showed significantly lower RB scores in the early learning stage (block 1) in comparison with the late learning stage (block 2 or block 3) of the task, as well as significantly lower RB scores in the early stage compared to healthy subjects. Relatively more negative FRN amplitude is elicited by no presentation of an expected reward, compared to that elicited by presentation of expected feedback. The FRN became significantly more negative from the early (block 1) to the later stages (blocks 2 and 3) in both manic and euthymic patients, but not in healthy subjects. Changes in RB scores and FRN amplitudes between blocks 2 and 3 and block 1 correlated positively in healthy controls, but correlated negatively in manic and euthymic patients. The severity of manic symptoms correlated positively with reward learning scores and negatively with the FRN. These findings suggest that patients with bipolar disorder during euthymic or manic states have behavioral and electrophysiological alterations in reward learning compared to healthy subjects. This dysfunctional reward processing may be related to the abnormal decision-making or altered goal-directed activities frequently seen in patients with bipolar disorder. © 2017 John Wiley & Sons Ltd.

Nonsuicidal self-injury and disordered eating: Differences in acquired capability and suicide attempt severity.

PubMed

Brausch, Amy M; Perkins, Natalie M

2018-05-21

Nonsuicidal self-injury (NSSI) and eating disorders are both strongly related to suicide behaviors, and both can be conceptualized as painful and provocative events that associate with acquired capability for suicide. Individuals who self-injure report greater acquired capability than those who do not engage in these behaviors, but results are mixed in eating disorder samples. Given that NSSI and disordered eating (DE) commonly co-occur, it is important to examine how acquired capability for suicide and suicide attempt severity may differ between individuals who engage in either, both, or neither of these behaviors. It was expected that individuals with both NSSI and DE would report the greatest acquired capability, assessed by fearlessness about death and fear about suicide, and suicide attempt severity, compared to NSSI only, DE only, and controls. In a sample of 1179 undergraduates, results indicated no differences on fearlessness about death, but the NSSI + DE group reported the lowest scores on fear of suicide and greatest suicide attempt severity compared to the other groups. Differences between fearlessness about death and fear about suicide are discussed, as well as the possible additive effect of engaging in both direct (NSSI) and indirect (DE) self-harm on fear about suicide and suicide risk. Copyright © 2018 Elsevier B.V. All rights reserved.

Effect on Behavior Problems of Teen Online Problem-Solving for Adolescent Traumatic Brain Injury

PubMed Central

Walz, Nicolay C.; Carey, JoAnne; McMullen, Kendra M.; Cass, Jennifer; Mark, Erin; Yeates, Keith Owen

2011-01-01

PURPOSE: To report the results of a randomized clinical trial of teen online problem-solving (TOPS) meant to improve behavioral outcomes of adolescents with traumatic brain injury (TBI). METHODS: A randomized clinical trial was conducted to compare the efficacy of TOPS with access to Internet resources in teenagers with TBI in improving parent and self-reported behavior problems and parent-teen conflicts. Participants included 41 adolescents aged 11 to 18 years (range: 11.47–17.90 years) who had sustained a moderate-to-severe TBI between 3 and 19 months earlier. Teens in the TOPS group received 10 to 14 online sessions that provided training in problem-solving, communication skills, and self-regulation. Outcomes were assessed before treatment and at a follow-up assessment an average of 8 months later. Groups were compared on follow-up scores after we controlled for pretreatment levels. Injury severity and socioeconomic status were examined as potential moderators of treatment efficacy. RESULTS: Forty-one participants provided consent and completed baseline assessments, and follow-up assessments were completed for 35 participants (16 TOPS, 19 Internet resource comparison). The TOPS group reported significantly less parent-teen conflict at follow-up than did the Internet-resource-comparison group. Improvements in teen behavior after TOPS were moderated by injury severity; there were greater improvements in the teens' internalizing symptoms after TOPS among adolescents with severe TBI. Family socioeconomic status also moderated the efficacy of TOPS in improving behavior problems reported by both parents and teens, although the nature of the moderation effects varied. CONCLUSION: Our findings suggest that TOPS contributes to improvements in parent-teen conflict generally and parent and self-reported teen behavior problems for certain subsets of participants. PMID:21890828

Effect on behavior problems of teen online problem-solving for adolescent traumatic brain injury.

PubMed

Wade, Shari L; Walz, Nicolay C; Carey, Joanne; McMullen, Kendra M; Cass, Jennifer; Mark, Erin; Yeates, Keith Owen

2011-10-01

To report the results of a randomized clinical trial of teen online problem-solving (TOPS) meant to improve behavioral outcomes of adolescents with traumatic brain injury (TBI). A randomized clinical trial was conducted to compare the efficacy of TOPS with access to Internet resources in teenagers with TBI in improving parent and self-reported behavior problems and parent-teen conflicts. Participants included 41 adolescents aged 11 to 18 years (range: 11.47-17.90 years) who had sustained a moderate-to-severe TBI between 3 and 19 months earlier. Teens in the TOPS group received 10 to 14 online sessions that provided training in problem-solving, communication skills, and self-regulation. Outcomes were assessed before treatment and at a follow-up assessment an average of 8 months later. Groups were compared on follow-up scores after we controlled for pretreatment levels. Injury severity and socioeconomic status were examined as potential moderators of treatment efficacy. Forty-one participants provided consent and completed baseline assessments, and follow-up assessments were completed for 35 participants (16 TOPS, 19 Internet resource comparison). The TOPS group reported significantly less parent-teen conflict at follow-up than did the Internet-resource-comparison group. Improvements in teen behavior after TOPS were moderated by injury severity; there were greater improvements in the teens' internalizing symptoms after TOPS among adolescents with severe TBI. Family socioeconomic status also moderated the efficacy of TOPS in improving behavior problems reported by both parents and teens, although the nature of the moderation effects varied. Our findings suggest that TOPS contributes to improvements in parent-teen conflict generally and parent and self-reported teen behavior problems for certain subsets of participants.

Measuring cervical cancer risk: development and validation of the CARE Risky Sexual Behavior Index.

PubMed

Reiter, Paul L; Katz, Mira L; Ferketich, Amy K; Ruffin, Mack T; Paskett, Electra D

2009-12-01

To develop and validate a risky sexual behavior index specific to cervical cancer research. Sexual behavior data on 428 women from the Community Awareness Resources and Education (CARE) study were utilized. A weighting scheme for eight risky sexual behaviors was generated and validated in creating the CARE Risky Sexual Behavior Index. Cutpoints were then identified to classify women as having a low, medium, or high level of risky sexual behavior. Index scores ranged from 0 to 35, with women considered to have a low level of risky sexual behavior if their score was less than six (31.3% of sample), a medium level if their score was 6–10 (30.6%), or a high level if their score was 11 or greater (38.1%). A strong association was observed between the created categories and having a previous abnormal Pap smear test (p < 0.001). The CARE Risky Sexual Behavior Index provides a tool for measuring risky sexual behavior level for cervical cancer research. Future studies are needed to validate this index in varied populations and test its use in the clinical setting.

Costs and effectiveness of the fast track intervention for antisocial behavior.

PubMed

Foster, E Michael

2010-09-01

Antisocial behavior is enormously costly to the youth involved, their families, victims, taxpayers and other members of society. These costs are generated by school failure, delinquency and involvement in the juvenile justice system, drug use, health services and other services. For prevention programs to be cost effective, they must reduce these costly behaviors and outcomes. The Fast Track intervention is a 10-year, multi-component prevention program targeting antisocial behavior. The intervention identified children at school entry and provided intervention services over a 10-year period. This study examined the intervention's impact on outcomes affecting societal costs using data through late adolescence. The intervention is being evaluated through a multi-cohort, multi-site, multi-year randomized control trial of program participants and comparable children and youth in similar schools, and that study provides the data for these analyses. Schools within four sites (Durham, NC; Nashville, TN; Seattle, WA; and rural central Pennsylvania) were selected as high-risk based on crime and poverty statistics of the neighborhoods they served. Within each site, schools were divided into multiple sets matched for demographics (size, percentage free/reduced lunch, ethnic composition); one set within each pair was randomly assigned to the intervention and one to the control condition. Within participating schools, high-risk children were identified using a multiple-gating procedure. For each of three annual cohorts, all kindergarteners (9,594 total) in 54 schools were screened for classroom conduct problems by teachers. Those children scoring in the top 40% within cohort and site were then solicited for the next stage of screening for home behavior problems by the parents, and 91% agreed (n = 3,274). The teacher and parent screening scores were then standardized within site and combined into a sum score. These summed scores represented a total severity-of-risk screen score. Children were selected for inclusion into the study based on this screen score, moving from the highest score downward until desired sample sizes were reached within sites, cohorts, and conditions. The intervention lacked both the breadth and depth of effects on costly outcomes to demonstrate cost-effectiveness or even effectiveness. The outcomes examined here reflect effects observed during measurement windows that are not complete for every outcome. Data are lacking on some potential outcomes, such as the use of mental health services before year 7. The most intensive psychosocial intervention ever fielded did not produce meaningful and consistent effects on costly outcomes. The lack of effects through high school suggests that the intervention will not become cost-effective as participants progress through adulthood. Future research should consider alternative approaches to prevention youth violence.

The Implications of Family Size and Birth Order for Test Scores and Behavioral Development

ERIC Educational Resources Information Center

Silles, Mary A.

2010-01-01

This article, using longitudinal data from the National Child Development Study, presents new evidence on the effects of family size and birth order on test scores and behavioral development at age 7, 11 and 16. Sibling size is shown to have an adverse causal effect on test scores and behavioral development. For any given family size, first-borns…

Baseline Factors Predicting Placebo Response to Treatment in Children and Adolescents With Autism Spectrum Disorders

PubMed Central

King, Bryan H.; Dukes, Kimberly; Donnelly, Craig L.; Sikich, Linmarie; McCracken, James T.; Scahill, Lawrence; Hollander, Eric; Bregman, Joel D.; Anagnostou, Evdokia; Robinson, Fay; Sullivan, Lisa; Hirtz, Deborah

2016-01-01

IMPORTANCE The finding of factors that differentially predict the likelihood of response to placebo over that of an active drug could have a significant impact on study design in this population. OBJECTIVE To identify possible nonspecific, baseline predictors of response to intervention in a large randomized clinical trial of children and adolescents with autism spectrum disorders. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial of citalopram hydrobromide for children and adolescents with autism spectrum disorders and prominent repetitive behavior. Baseline data at study entry were examined with respect to final outcome to determine if response predictors could be identified. A total of 149 children and adolescents 5 to 17 years of age (mean [SD] age, 9.4 [3.1] years) from 6 academic centers were randomly assigned to citalopram (n = 73) or placebo (n = 76). Participants had autistic disorder, Asperger syndrome, or pervasive developmental disorder, not otherwise specified; had illness severity ratings that were moderate or more than moderate on the Clinical Global Impression–Severity scale; and scored moderate or more than moderate on compulsive behaviors measured with the modified Children’s Yale-Brown Obsessive-Compulsive Scale. INTERVENTIONS Twelve weeks of treatment with citalopram (10 mg/5 mL) or placebo. The mean (SD) maximum dose of citalopram was 16.5 (6.5) mg by mouth daily (maximum dose, 20 mg/d). MAIN OUTCOMES AND MEASURES A positive response was defined as having a score of at least much improved on the Clinical Global Impression–Improvement scale at week 12. Baseline measures included demographic (sex, age, weight, and pubertal status), clinical, and family measures. Clinical variables included baseline illness severity ratings (the Aberrant Behavior Checklist, the Child and Adolescent Symptom Inventory, the Vineland Adaptive Behavior Scales, the Repetitive Behavior Scale–Revised, and the Children’s Yale-Brown Obsessive-Compulsive Scale). Family measures included the Caregiver Strain Questionnaire. RESULTS Several baseline predictors of response were identified, and a principal component analysis yielded 3 composite measures (disruptive behavior, autism/mood, and caregiver strain) that significantly predicted response at week 12. Specifically, participants in the placebo group were significantly less likely than participants in the citalopram group to respond at week 12 if they entered the study more symptomatic on each of the 3 composite measures, and they were at least 2 times less likely to be responders. CONCLUSIONS AND RELEVANCE This analysis suggests strategies that may be useful in anticipating and potentially mitigating the nonspecific response in randomized clinical trials of children and adolescents with autism spectrum disorders. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00086645 PMID:24061784

Direct behavior rating as a school-based behavior universal screener: replication across sites.

PubMed

Kilgus, Stephen P; Riley-Tillman, T Chris; Chafouleas, Sandra M; Christ, Theodore J; Welsh, Megan E

2014-02-01

The purpose of this study was to evaluate the utility of Direct Behavior Rating Single Item Scale (DBR-SIS) targets of disruptive, engaged, and respectful behavior within school-based universal screening. Participants included 31 first-, 25 fourth-, and 23 seventh-grade teachers and their 1108 students, sampled from 13 schools across three geographic locations (northeast, southeast, and midwest). Each teacher rated approximately 15 of their students across three measures, including DBR-SIS, the Behavioral and Emotional Screening System (Kamphaus & Reynolds, 2007), and the Student Risk Screening Scale (Drummond, 1994). Moderate to high bivariate correlations and area under the curve statistics supported concurrent validity and diagnostic accuracy of DBR-SIS. Receiver operating characteristic curve analyses indicated that although respectful behavior cut scores recommended for screening remained constant across grade levels, cut scores varied for disruptive behavior and academic engaged behavior. Specific cut scores for first grade included 2 or less for disruptive behavior, 7 or greater for academically engaged behavior, and 9 or greater for respectful behavior. In fourth and seventh grades, cut scores changed to 1 or less for disruptive behavior and 8 or greater for academically engaged behavior, and remained the same for respectful behavior. Findings indicated that disruptive behavior was particularly appropriate for use in screening at first grade, whereas academically engaged behavior was most appropriate at both fourth and seventh grades. Each set of cut scores was associated with acceptable sensitivity (.79-.87), specificity (.71-.82), and negative predictive power (.94-.96), but low positive predictive power (.43-.44). DBR-SIS multiple gating procedures, through which students were only considered at risk overall if they exceeded cut scores on 2 or more DBR-SIS targets, were also determined acceptable in first and seventh grades, as the use of both disruptive behavior and academically engaged behavior in defining risk yielded acceptable conditional probability indices. Overall, the current findings are consistent with previous research, yielding further support for the DBR-SIS as a universal screener. Limitations, implications for practice, and directions for future research are discussed. Copyright © 2013 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model.

PubMed

Dawson, Geraldine; Rogers, Sally; Munson, Jeffrey; Smith, Milani; Winter, Jamie; Greenson, Jessica; Donaldson, Amy; Varley, Jennifer

2010-01-01

To conduct a randomized, controlled trial to evaluate the efficacy of the Early Start Denver Model (ESDM), a comprehensive developmental behavioral intervention, for improving outcomes of toddlers diagnosed with autism spectrum disorder (ASD). Forty-eight children diagnosed with ASD between 18 and 30 months of age were randomly assigned to 1 of 2 groups: (1) ESDM intervention, which is based on developmental and applied behavioral analytic principles and delivered by trained therapists and parents for 2 years; or (2) referral to community providers for intervention commonly available in the community. Compared with children who received community-intervention, children who received ESDM showed significant improvements in IQ, adaptive behavior, and autism diagnosis. Two years after entering intervention, the ESDM group on average improved 17.6 standard score points (1 SD: 15 points) compared with 7.0 points in the comparison group relative to baseline scores. The ESDM group maintained its rate of growth in adaptive behavior compared with a normative sample of typically developing children. In contrast, over the 2-year span, the comparison group showed greater delays in adaptive behavior. Children who received ESDM also were more likely to experience a change in diagnosis from autism to pervasive developmental disorder, not otherwise specified, than the comparison group. This is the first randomized, controlled trial to demonstrate the efficacy of a comprehensive developmental behavioral intervention for toddlers with ASD for improving cognitive and adaptive behavior and reducing severity of ASD diagnosis. Results of this study underscore the importance of early detection of and intervention in autism.

Affective network and default mode network in depressive adolescents with disruptive behaviors

PubMed Central

Kim, Sun Mi; Park, Sung Yong; Kim, Young In; Son, Young Don; Chung, Un-Sun; Min, Kyung Joon; Han, Doug Hyun

2016-01-01

Aim Disruptive behaviors are thought to affect the progress of major depressive disorder (MDD) in adolescents. In resting-state functional connectivity (RSFC) studies of MDD, the affective network (limbic network) and the default mode network (DMN) have garnered a great deal of interest. We aimed to investigate RSFC in a sample of treatment-naïve adolescents with MDD and disruptive behaviors. Methods Twenty-two adolescents with MDD and disruptive behaviors (disrup-MDD) and 20 age- and sex-matched healthy control (HC) participants underwent resting-state functional magnetic resonance imaging (fMRI). We used a seed-based correlation approach concerning two brain circuits including the affective network and the DMN, with two seed regions including the bilateral amygdala for the limbic network and the bilateral posterior cingulate cortex (PCC) for the DMN. We also observed a correlation between RSFC and severity of depressive symptoms and disruptive behaviors. Results The disrup-MDD participants showed lower RSFC from the amygdala to the orbitofrontal cortex and parahippocampal gyrus compared to HC participants. Depression scores in disrup-MDD participants were negatively correlated with RSFC from the amygdala to the right orbitofrontal cortex. The disrup-MDD participants had higher PCC RSFC compared to HC participants in a cluster that included the left precentral gyrus, left insula, and left parietal lobe. Disruptive behavior scores in disrup-MDD patients were positively correlated with RSFC from the PCC to the left insular cortex. Conclusion Depressive mood might be correlated with the affective network, and disruptive behavior might be correlated with the DMN in adolescent depression. PMID:26770059

Dark personality traits and impulsivity among adolescents: Differential links to problem behaviors and family relations.

PubMed

Dubas, Judith Semon; Baams, Laura; Doornwaard, Suzan M; van Aken, Marcel A G

2017-10-01

Research on how dark personality traits develop and relate to risky behaviors and family relations during adolescence is scarce. This study used a person-oriented approach to examine (a) whether distinct groups of adolescents could be identified based on their developmental profiles of callous-unemotional (CU), grandiose manipulative (GM), and dysfunctional impulsivity (DI) traits and (b) whether these groups differ in their problem behaviors and parent-adolescent relationship quality. Latent class growth analyses on 4-wave data of 1,131 Dutch adolescents revealed 3 personality profiles: (1) a dark impulsive group (13.9%), with high scores on all 3 traits (CU, GM, and DI) that were stable over time; (2) an impulsive group (26.1%), with high and increasing levels of impulsivity and relatively low scores on CU and GM; and (3) and a low risk group (60.0%), with relatively low levels on all 3 personality characteristics, with impulsivity decreasing over time. Compared with adolescents in the low risk group, adolescents in the dark impulsive and impulsive groups reported higher initial levels of substance use, sexual risk behaviors, permissive sexual attitudes, parent-adolescent conflict, and lower parent-adolescent satisfaction, as well as greater increases in sexual risk behavior over time. Compared with adolescents in the impulsive group, those in the dark impulsive group showed the highest levels of risk behaviors. Hence, dark personality traits coupled with impulsivity may be indicative of an earlier and more severe trajectory of problem behaviors that may differ from the trajectory of youth who are only impulsive. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The REM Sleep Behavior Disorder Screening Questionnaire: Validation Study of the Korean Version (RBDQ-KR).

PubMed

You, Sooyeoun; Moon, Hye-Jin; Do, So Young; Wing, Yun-Kwok; Sunwoo, Jun-Sang; Jung, Ki-Young; Cho, Yong Won

2017-12-15

REM sleep behavior disorder (RBD) is a parasomnia that is commonly associated with neurodegenerative disorders. We aimed to validate the Hong Kong version of the self-reported RBD questionnaire (RBDQ-HK) with the Korean version (RBDQ-KR) and to investigate its clinical usefulness. One-hundred five patients with RBD and 105 age- and sex-matched controls were enrolled. Thirty were randomly selected for a retest with the questionnaire after 2 to 4 weeks without any treatment. Receiver operating characteristic curve and exploratory factor analysis were used to evaluate the scale, which had a score ranging from 0 to 100. There was no difference in mean age and sex in patients with RBD and control subjects. Patients with RBD had a significantly higher total RBDQ-KR score than the control group ( P < .001). The RBDQ-KR demonstrated high sensitivity (93.3%), specificity (89.5%), positive predictive value (89.9%), and negative predictive value (93.1%). Cronbach α coefficient for internal consistency of the total score of the RBDQ-KR was 0.9, which shows high reliability. Exploratory factor analysis showed two components, dream-related and behavioral factors, consistent with the main clinical features of RBD. Based on the results, the best cutoff for the total score ranging from 0 to 100 was at 18/19 and for factor 2 ranging from 0 to 75 was at 11. This study showed RBDQ-KR is a valid and reliable questionnaire for RBD symptoms and severity in Korea. It serves as an effective tool to identify patients with RBD and to facilitate future clinical and research studies. © 2017 American Academy of Sleep Medicine

A five-factor model of personality and addiction, psychiatric, and AIDS risk severity in pregnant and postpartum cocaine misusers.

PubMed

Ball, S A; Schottenfeld, R S

1997-01-01

The relationship between addiction severity, psychiatric symptoms, AIDS risk behaviors, and an alternative five-factor measure of personality, the Zuckerman-Kuhlman Personality Questionnaire, was assessed in 92 cocaine-misusing pregnant and postpartum women in an inner city outpatient treatment program. Three of the personality traits (Neuroticism-Anxiety, Impulsive Sensation Seeking, Aggression-Hostility) were significantly related to different subscales of the Addiction Severity Index, Beck Depression Inventory, various psychiatric symptoms, and high HIV risk sexual activity. Of these traits, Neuroticism-Anxiety seemed to be the most powerful predictor of symptom severity for this sample of women. Scores on the personality dimensions were not related to recency, frequency, amount, or duration of drug use or to treatment outcomes.

Intrusions and provoked and spontaneous confabulations on memory tests in Korsakoff's syndrome.

PubMed

Rensen, Yvonne C M; Oosterman, Joukje M; Walvoort, Serge J W; Eling, Paul A T M; Kessels, Roy P C

2017-03-01

Intrusions on verbal memory tests have been used as an index for clinical confabulation. Severe memory impairments in combination with executive dysfunction have been suggested to be the underlying mechanism of confabulation, but to date, this relation is unclear. The aim of this study was (a) to examine the relation between (different types of) intrusions and confabulations in a large sample of confabulating patients with Korsakoff's syndrome (KS) and (b) to investigate whether different measures of executive functioning and memory performance are related to provoked and spontaneous confabulation. The Dutch version of the California Verbal Learning Test (CVLT) and various executive function and memory tests were administered to a group of 51 confabulating patients with KS. Professional caregivers rated the severity of provoked and spontaneous confabulation behavior of the patients using the Nijmegen-Venray Confabulation List-20 (NVCL-20). The total number of intrusions on the CVLT was not related to either provoked or spontaneous confabulation scores. None of the CVLT intrusion scores correlated significantly with any of the confabulation scores, but we did find small-to-medium, positive correlations between unrelated intrusions and both provoked confabulations and spontaneous confabulation. Provoked confabulation behavior was associated with executive dysfunction and poorer memory performances. Spontaneous confabulation was not related to performance on measures of executive function and memory. The total number of intrusions on verbal memory tests and clinical confabulations appear to be different phenomena. Only unrelated intrusions produced on the CVLT might possibly be related to confabulations. The production of provoked, but not spontaneous, confabulation is associated with executive dysfunction and memory deficits.

Relationship of nutrition and physical activity behaviors and fitness measures to academic performance for sixth graders in a midwest city school district.

PubMed

Edwards, Jane U; Mauch, Lois; Winkelman, Mark R

2011-02-01

To support curriculum and policy, a midwest city school district assessed the association of selected categories of nutrition and physical activity (NUTR/PA) behaviors, fitness measures, and body mass index (BMI) with academic performance (AP) for 800 sixth graders. Students completed an adapted Youth Risk Behavior Surveillance Survey (NUTR/PA behaviors), fitness assessments (mile run, curl-ups, push-ups, height, and weight) with results matched to standardized scores (Measures of Academic Progress [MAP]), meal price status, and gender. Differences in mean MAP scores (math and reading) were compared by selected categories of each variable utilizing 1-way analysis of variance. Associations were determined by stepwise multiple regression utilizing mean MAP scores (for math and for reading) as the dependent variable and NUTR/PA behaviors, fitness, and BMI categories as independent variables. Significance was set at α = 0.05. Higher MAP math scores were associated with NUTR (more milk and breakfast; less 100% fruit juice and sweetened beverages [SB]) and PA (increased vigorous PA and sports teams; reduced television), and fitness (higher mile run performance). Higher MAP reading scores were associated with NUTR (fewer SB) and PA (increased vigorous PA, reduced television). Regression analysis indicated about 11.1% of the variation in the mean MAP math scores and 6.7% of the mean MAP reading scores could be accounted for by selected NUTR/PA behaviors, fitness, meal price status, and gender. Many positive NUTR/PA behaviors and fitness measures were associated with higher MAP scores supporting the school district focus on healthy lifestyles. Additional factors, including meal price status and gender, contribute to AP. © 2011, Fargo Public School.

Early-Onset Bipolar Disorder: Characteristics and Outcomes in the Clinic.

PubMed

Connor, Daniel F; Ford, Julian D; Pearson, Geraldine S; Scranton, Victoria L; Dusad, Asha

2017-12-01

To assess patient characteristics and clinician-rated outcomes for children diagnosed with early-onset bipolar disorder in comparison to a depressive disorders cohort from a single clinic site. To assess predictors of bipolar treatment response. Medical records from 714 consecutive pediatric patients evaluated and treated at an academic tertiary child and adolescent psychiatry clinic between 2006 and 2012 were reviewed. Charts of bipolar children (n = 49) and children with depressive disorders (n = 58) meeting study inclusion/exclusion criteria were compared on variables assessing clinical characteristics, treatments, and outcomes. Outcomes were assessed by using pre- and post-Clinical Global Impressions (CGI)-Severity and Children's Global Assessment Scale (CGAS) scores, and a CGI-Improvement score ≤2 at final visit determined responder status. Bipolar outcome predictors were assessed by using multiple linear regression. Clinic prevalence rates were 6.9% for early-onset bipolar disorder and 1.5% for very early-onset bipolar disorder. High rates of comorbid diagnoses, symptom severity, parental stress, and child high-risk behaviors were found in both groups. The bipolar cohort had higher rates of aggression and higher lifetime systems of care utilization. The final CGI and CGAS outcomes for unipolar depression patients differed statistically significantly from those for the bipolar cohort, reflecting better clinical status and more improvement at outcome for the depression patients. Both parent-reported Child Behavior Checklist total T-score at clinic admission and the number of lifetime systems-of-care for the child were significantly and inversely associated with improvement for the bipolar cohort. Early-onset bipolar disorder is a complex and heterogeneous psychiatric disorder. Evidence-based treatment should emphasize psychopharmacology with adjunctive family and individual psychotherapy. Strategies to improve engagement in treatment may be especially important. Given high rates of high-risk behaviors in these youth, regular mental health follow-up to assess safety is important. Additional evidence-based treatments for pediatric bipolar disorder are needed.

Computational principles underlying recognition of acoustic signals in grasshoppers and crickets.

PubMed

Ronacher, Bernhard; Hennig, R Matthias; Clemens, Jan

2015-01-01

Grasshoppers and crickets independently evolved hearing organs and acoustic communication. They differ considerably in the organization of their auditory pathways, and the complexity of their songs, which are essential for mate attraction. Recent approaches aimed at describing the behavioral preference functions of females in both taxa by a simple modeling framework. The basic structure of the model consists of three processing steps: (1) feature extraction with a bank of 'LN models'-each containing a linear filter followed by a nonlinearity, (2) temporal integration, and (3) linear combination. The specific properties of the filters and nonlinearities were determined using a genetic learning algorithm trained on a large set of different song features and the corresponding behavioral response scores. The model showed an excellent prediction of the behavioral responses to the tested songs. Most remarkably, in both taxa the genetic algorithm found Gabor-like functions as the optimal filter shapes. By slight modifications of Gabor filters several types of preference functions could be modeled, which are observed in different cricket species. Furthermore, this model was able to explain several so far enigmatic results in grasshoppers. The computational approach offered a remarkably simple framework that can account for phenotypically rather different preference functions across several taxa.

Psychopathology in Young People With Intellectual Disability

PubMed Central

Einfeld, Stewart L.; Piccinin, Andrea M.; Mackinnon, Andrew; Hofer, Scott M.; Taffe, John; Gray, Kylie M.; Bontempo, Daniel E.; Hoffman, Lesa R.; Parmenter, Trevor; Tonge, Bruce J.

2008-01-01

Context Comorbid severe mental health problems complicating intellectual disability are a common and costly public health problem. Although these problems are known to begin in early childhood, little is known of how they evolve over time or whether they continue into adulthood. Objective To study the course of psychopathology in a representative population of children and adolescents with intellectual disability. Design, Setting, and Participants The participants of the Australian Child to Adult Development Study, an epidemiological cohort of 578 children and adolescents recruited in 1991 from health, education, and family agencies that provided services to children with intellectual disability aged 5 to 19.5 years in 6 rural and urban census regions in Australia, were followed up for 14 years with 4 time waves of data collection. Data were obtained from 507 participants, with 84% of wave 1 (1991-1992) participants being followed up at wave 4 (2002-2003). Main Outcome Measures The Developmental Behaviour Checklist (DBC), a validated measure of psychopathology in young people with intellectual disability, completed by parents or other caregivers. Changes over time in the Total Behaviour Problem Score and 5 subscale scores of the DBC scores were modeled using growth curve analysis. Results High initial levels of behavioral and emotional disturbance decreased only slowly over time, remaining high into young adulthood, declining by 1.05 per year on the DBC Total Behaviour Problem Score. Overall severity of psychopathology was similar across mild to severe ranges of intellectual disability (with mean Total Behaviour Problem Scores of approximately 44). Psychopathology decreased more in boys than girls over time (boys starting with scores 2.61 points higher at baseline and ending with scores 2.57 points lower at wave 4), and more so in participants with mild intellectual disability compared with those with severe or profound intellectual disability who diverged from having scores 0.53 points lower at study commencement increasing to a difference of 6.98 points below severely affected children by wave 4. This trend was observed in each of the subscales, except the social-relating disturbance subscale, which increased over time. Prevalence of participants meeting criteria for major psychopathology or definite psychiatric disorder decreased from 41% at wave 1 to 31% at wave 4. Few of the participants (10%) with psychopathology received mental health interventions during the study period. Conclusion These results provide evidence that the problem of psychopathology comorbid with intellectual disability is both substantial and persistent and suggest the need for effective mental health interventions. PMID:17062861

Impact of Self-concept on Preschoolers’ Dental Anxiety and Behavior

PubMed Central

Erfanparast, Leila; Vafaei, Ali; Sohrabi, Azin; Ranjkesh, Bahram; Bahadori, Zahra; Pourkazemi, Maryam; Dadashi, Shabnam; Shirazi, Sajjad

2015-01-01

Background and aims. Different factors affect children’s behavior during dental treatment, including psychological and behavioral characteristics. The aim of this study was to evaluate the correlation of self-concept on child’s anxiety and behavior during dental treatment in 4 to 6-year-old children. Materials and methods. A total of 235 preschoolers aged 4 to 6 years were included in this descriptive analytic study. Total self-concept score for each child was assessed according to Primary Self-concept Scale before dental treatment. Child’s anxiety and child’s behavior were assessed, during the restoration of mandibular primary molar, using clinical anxiety rating scale and Frankl Scale, respectively. Spearman’s correlation coefficient was used to evaluate the correlation between the total self-concept score with the results of clinical anxiety rating scale and Frankl Scale. Results. There was a moderate inverse correlation between the self-concept and clinical anxiety rating scale scores (r = -0.545, P < 0.001), and a moderate correlation between the self-concept and child’s behavior scores (r = 0.491, P < 0.001). A strong inverse relation was also found between the anxiety and behavior scores (r = -0.91, P < 0.001). Conclusion. Children with higher self-concept had lower anxiety level and better behavioral feedback during dental treatment. PMID:26697152

Combined methylphenidate and atomoxetine pharmacotherapy in attention deficit hyperactivity disorder.

PubMed

Ozbaran, Burcu; Kose, Sezen; Yuzuguldu, Onur; Atar, Burcu; Aydin, Cahide

2015-01-01

Pharmacological treatment of attention deficit hyperactivity disorder (ADHD) includes stimulant and non-stimulant medications. Our purpose in this study is to investigate efficacy, safety and tolerability of combined methylphenidate and atomoxetine pharmacotherapy. We included 12 patients of the 824 patients with ADHD using methylphenidate and atomoxetine combined therapy between the years 2010 and 2014. Kiddie-SADS, Turgay DSM-IV Based Child and Adolescent Behavior Disorders Screening and Rating Scale, Child Behavior Checklist, Clinic Global Impression Scale Severity and Impression (CGIS-S-I) scales were used. Patients were between the ages of 7 and 17 years. Before combined pharmacotherapy the CGIS-S score mean was 5.08. Mean CGIS-S score after the combined pharmacotherapy was 3.08 (P = 0.03; -2,980). The most common side effects were irritability (n = 5, 41.6%), appetite reduction (n = 3, 25%), palpitations (n = 2, 16.7%), headache (n = 1, 8.3%). Nine of these 12 patients showed significant improvement in their symptoms, combined therapy enhanced the effectiveness of monotherapy.

Multigroup confirmatory factor analysis and structural invariance with age of the Behavior Rating Inventory of Executive Function (BRIEF)--French version.

PubMed

Fournet, Nathalie; Roulin, Jean-Luc; Monnier, Catherine; Atzeni, Thierry; Cosnefroy, Olivier; Le Gall, Didier; Roy, Arnaud

2015-01-01

The parent and teacher forms of the French version of the Behavioral Rating Inventory of Executive Function (BRIEF) were used to evaluate executive function in everyday life in a large sample of healthy children (N = 951) aged between 5 and 18. Several psychometric methods were applied, with a view to providing clinicians with tools for score interpretation. The parent and teacher forms of the BRIEF were acceptably reliable. Demographic variables (such as age and gender) were found to influence the BRIEF scores. Confirmatory factor analysis was then used to test five competing models of the BRIEF's latent structure. Two of these models (a three-factor model and a two-factor model, both based on a nine-scale structure) had a good fit. However, structural invariance with age was only obtained with the two-factor model. The French version of the BRIEF provides a useful measure of everyday executive function and can be recommended for use in clinical research and practice.

Quality of life in anorexia nervosa, bulimia nervosa and eating disorder not-otherwise-specified

PubMed Central

2013-01-01

Background This study aimed to assess differences in Quality of Life (QoL) across eating disorder (ED) diagnoses, and to examine the relationship of QoL to specific clinical features. Results 199 patients with a diagnosed ED completed the Clinical Impairment Assessment (CIA) [Cognitive Behavior Therapy and Eating Disorders, 315–318, 2008] and the Eating Disorders Examination (EDE) [Int J Eat Disord 6:1–8]. Differences between diagnostic groups were examined, as were differences between restrictive and binge-purge subtypes. CIA scores and EDE scores were positively correlated and higher in groups with binge-purge behaviours. CIA scores were not correlated with BMI, illness duration or frequency of bingeing/purging behaviours, except in the binge-purge AN group, where CIA scores negatively correlated with BMI. Conclusions Patients with EDs have poor QoL and impairment increases with illness severity. Patients with binge/purge diagnoses are particularly impaired. It remains unclear which clinical features best predict the degree of impairment experienced by patients with EDs. PMID:24999421

From Feline Idiopathic Ulcerative Dermatitis to Feline Behavioral Ulcerative Dermatitis: Grooming Repetitive Behaviors Indicators of Poor Welfare in Cats

PubMed Central

Titeux, Emmanuelle; Gilbert, Caroline; Briand, Amaury; Cochet-Faivre, Noëlle

2018-01-01

Feline idiopathic head-and-neck dermatitis—also named feline idiopathic ulcerative dermatitis (IUD)—is considered as a rare skin disease of unknown origin. It is usually associated with a crusted, non-healing, self-induced ulcer occurring most commonly on the dorsal or lateral neck or between the scapula where self-grooming by scratching occurs. Usually, IUD is diagnosed after exclusion of other causes of pruritus. In feline medicine, self-induced alopecia is recognized as a behavioral disorder (abnormal repetitive behavior) due to excessive licking, which is an amplification of a normal maintenance behavior. Such repetitive behaviors, like self-induced alopecia or self-induced wounds, are named stereotypies and considered as indicators of poor welfare. The objectives of our study were to determine, first, if the repetitive behavior associated with self-induced wounds was related to a poor welfare, and, second, if improving the welfare in the cat’s environment would lead to healing, thanks to environmental enrichment. We recruited 13 cats diagnosed with IUD by a dermatologist. These cats were referred to a behaviorist for welfare evaluation. A welfare score was attributed using a new 21-point welfare scale. The median score of the 13 IUD cats was 16, while the median score of 35 healthy cats was 7 (significant difference, p < 0.001). Major modifications of the cat’s environment and the human–cat relationship were then recommended for IUD cats. Within 15 days after environment modifications, ulcerative lesions were healed and welfare scores improved significantly (median score of 6, significantly different from the score before environmental modifications), being similar to healthy cats (no significant differences). Only one cat was treated with a psychotropic drug, owners being reluctant to improve environmental modifications. These results suggest that feline IUD is a behavioral disorder indicative of poor welfare and that it requires management by behavior specialists, proposing environmental modifications. We hence propose to rename this affection to “behavioral ulcerative dermatitis,” given that welfare scores were significantly different from healthy cats, and that environmental modifications modified welfare scores and lead to successful healing in all cases. PMID:29713639

The Effect of Maternal Stress during Pregnancy on IQ and ADHD Symptomatology.

PubMed

Grizenko, Natalie; Fortier, Marie-Ève; Gaudreau-Simard, Mathilde; Jolicoeur, Claude; Joober, Ridha

2015-01-01

Maternal stress during pregnancy (MSDP) has been linked to a decrease in Intelligence Quotient (IQ) in the general population. The purpose of this study is to first examine the association between MSDP and IQ in children with Attention-Deficit/Hyperactivity Disorder (ADHD) and second, to confirm, in a large sample, the link between MSDP and ADHD behavioral symptomatology. Four hundred ten children diagnosed with ADHD, ages six to 12, were consecutively recruited from the ADHD clinic and day hospital at the Douglas Institute from 1999 to 2013. IQ was assessed using the WISC III and IV. Symptom severity was evaluated using the Child Behavior Checklist (CBCL) and Connor's Global Index for Parents (CGI-P) and Teachers (CGI-T). No significant effect of MSDP on full scale IQ was observed, but MSDP had a significant effect on CBCL and CGI scores. Elevated MSDP was significantly associated with increased CBCL internalizing scores (β=4.2, p<.01), CBCL externalizing scores (β=1.9, p=.04), CGI-P restless-impulsive scores (β=2.6, p=.01), CGI-P emotional lability scores (β=3.1, p=.02), and CGI-T restless-impulsive (β=2.2, p=.05) and emotional lability (β=3.4, p=.04) scores. MSDP increased the variance explained of ADHD symptomatology even after controlling for various factors (i.e. familial income, parental education, smoking and drinking during pregnancy, gender and age). The study demonstrates that in children with ADHD, MSDP does not have an impact on IQ but rather on ADHD symptomatology, highlighting the importance of potentially offering psychological and social support to mothers who experience stress during pregnancy.

Modernization of the Driver Behaviour Questionnaire.

PubMed

Cordazzo, Sheila T D; Scialfa, Charles T; Ross, Rachel Jones

2016-02-01

The current study builds on previous versions of the Driver Behaviour Questionnaire (DBQ) by incorporating a larger sample of driving behaviors targeting inattention, distraction, aggressive driving, and health related to aging. The goals of this study were to determine if the resulting factor structure was consistent with a more contemporary view of unsafe driving behaviors, and to determine whether scores on the factors could predict self-reported collisions and police citations. The instrument was given to a sample of 3295 drivers ranging in age from 19 to 80+ years old. It was divided in two sections, the first to provide demographic information and driving history data and the second containing 105 driver behavior questions. An exploratory factor analysis resulted in a 65-item scale organized in four factors. The factors were labeled tentatively as Inattention Errors, Age-Related Problems, Distraction and Hurry, and Aggressive Violations. Regression analyses showed that the factors were predictors of self-reported, at-fault collisions and police citations. The factor scores found in this research are consistent with a useful theoretical framework for understanding unsafe driver actions, and demonstrate some potential to identify several individual difference variables that predict self-reported collisions and citations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Personality and trait aggression profiles of male and female prison inmates.

PubMed

Falk, Örjan; Sfendla, Anis; Brändström, Sven; Anckarsäter, Henrik; Nilsson, Thomas; Kerekes, Nóra

2017-04-01

Gender specific personality profiles in association with the level of aggressive antisocial behavior in offenders have not been previously investigated. In the present study we analyzed data collected from 65 male and 50 female offenders using structured protocols regarding criminal history (by criminal register data), trait aggression (by the Life History of Aggression (LHA) questionnaire), and personality profiles (by the Temperament and Character Inventory (TCI)). Prison inmates differed significantly on several personality dimensions, most pronouncedly were they characterized with low character maturity (low scores in the Self-Directedness and Cooperativeness dimensions of TCI) when compared to gender and age matched controls of the general population. The majority of offenders scored distinctively high on trait aggression. There were moderate to strong associations between the personality dimensions and each of the subscales of LHA (Aggression, Self-directed Aggression and Antisocial behavior). These associations were stronger in the female offender sample. Trait aggression could be best explained by a model, which included male gender, younger age, high novelty seeking temperament and low character maturity. Our results suggest that therapies aiming at strengthening self-governance and increasing cooperativeness (focusing on character maturity) may alleviate aggressive antisocial behavior in offenders. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Parenting practices as mediating variables between parents' psychopathology and oppositional defiant disorder in preschoolers.

PubMed

Trepat, Esther; Granero, Roser; Ezpeleta, Lourdes

2014-01-01

Oppositional defiant disorder (ODD) is very frequent in preschoolers. The severity and the long-term negative outcomes make the understanding of this disorder a priority. The goal in this study was to assess the mediating role of parenting practices in the relationship between parents' psychopathology and ODD in preschoolers. A community sample of 622 children was assessed longitudinally at age 3 and age 5. Parents reported on children's psychopathology through a diagnostic interview, and on their own psychological state and parenting style through questionnaires. At ages 3 and 5, corporal punishment mediated the relationships between mothers' anxiety-depression and ODD (in girls), between mothers' aggressive behavior and ODD (in boys), and between parents' rule-breaking and ODD both in boys and girls. For both sexes, there was a direct association between mothers' aggressive behavior score and ODD. The association between fathers' psychopathology and ODD was not mediated by the fathers' parenting practices. Fathers' anxiety-depression and aggressive behavior scores were directly associated with ODD. Parents' psychopathology must be explored and, in families where such psychopathology is a relevant variable, parenting practices must be addressed with a view to the prevention and treatment of children's ODD in the preschool years.

Freezing of gait is associated with cognitive impairment in patients with Parkinson disease.

PubMed

Yao, Zhiwen; Shao, Yuan; Han, Xiang

2017-08-24

To explore whether the cognitive impairment is correlated with freezing of gait (FOG) in patients with Parkinson disease (PD). A total of 186 patients with Parkinson disease (104 patients with FOG and 82 patients with no clinical history of freezing behavior) and 125 healthy individuals were selected for this study. Neuropsychological assessments, including the scales for outcomes in Parkinson disease cognition, unified Parkinson's disease rating scale, and Hamilton depression/anxiety rating scale etc., were applied to evaluate the patients'cognitive functioning. We found that the scores of Unified Parkinson's Disease Rating Scale (UPDRS) were significantly higher among PD patients with FOG, compared with non-FOG group. We also showed that Mini-Mental State Examination score (MMSE) was lower among subjects with FOG than in patients without FOG. Patients with FOG displayed lower Scales for OUTCOMES: in Parkinson's Disease Cognition (SCOPA-COG) score than non-FOG patients. In addition, significant higher Hamilton Anxiety Rating Scale (HAMD) scores were found in patients with FOG than patients without FOG. Moreover, disease duration, stage of the disease, the severity of motor symptom, increased depressive and anxiety complaints measured by FOG questionnaire were significantly associated with severity of FOG. Meanwhile, we also found that the score of Freezing of Gait Questionnaire (FOGQ) score was negatively correlated with MMSE. Our results demonstrated that FOG is related to impaired cognitive functions in PD patients with FOG. The understanding of impaired cognitive functions in PD patients with FOG can provide evidences for possible therapeutic interventions. Copyright © 2017 Elsevier B.V. All rights reserved.

The Impact of Childhood Abuse on Inpatient Substance Users: Specific Links with Risky Sex, Aggression, and Emotion Dysregulation

PubMed Central

Banducci, Anne N.; Hoffman, Elana M.; Lejuez, C.W.; Koenen, Karestan

2014-01-01

Adults with substance use disorders (SUDs) report a high prevalence of childhood abuse. Research in the general population suggests specific types of abuse lead to particular negative outcomes; it is not known whether this pattern holds for adults with SUDs. We hypothesized that specific types of abuse would be associated with particular behavioral and emotional outcomes among substance users. That is, childhood sexual abuse would be associated with risky sex behaviors, childhood physical abuse with aggression, and childhood emotional abuse with emotion dysregulation. 280 inpatients (M age = 43.3; 69.7% male; 88.4% African American) in substance use treatment completed the Childhood Trauma Questionnaire (CTQ), HIV Risk-Taking Behavior Scale, Addiction Severity Index, Difficulties with Emotion Regulation Scale (DERS), Distress Tolerance Scale (DTS), and Affect Intensity and Dimensions of Affiliation Motivation (AIM). Consistent with our hypotheses, the CTQ Sexual Abuse subscale uniquely predicted exchanging sex for cocaine and heroin, number of arrests for prostitution, engaging in unprotected sex with a casual partner during the prior year, and experiencing low sexual arousal when sober. The Physical Abuse subscale uniquely predicted number of arrests for assault and weapons offenses. The Emotional Abuse subscale uniquely predicted the DERS total score, AIM score, and DTS score. Among substance users, different types of abuse are uniquely associated with specific negative effects. Assessment of specific abuse types among substances users may be informative in treatment planning and relapse prevention. PMID:24521524

The impact of childhood abuse on inpatient substance users: specific links with risky sex, aggression, and emotion dysregulation.

PubMed

Banducci, Anne N; Hoffman, Elana M; Lejuez, C W; Koenen, Karestan C

2014-05-01

Adults with substance use disorders (SUDs) report a high prevalence of childhood abuse. Research in the general population suggests specific types of abuse lead to particular negative outcomes; it is not known whether this pattern holds for adults with SUDs. We hypothesized that specific types of abuse would be associated with particular behavioral and emotional outcomes among substance users. That is, childhood sexual abuse would be associated with risky sex behaviors, childhood physical abuse with aggression, and childhood emotional abuse with emotion dysregulation. 280 inpatients (M age=43.3; 69.7% male; 88.4% African American) in substance use treatment completed the Childhood Trauma Questionnaire (CTQ), HIV Risk-Taking Behavior Scale, Addiction Severity Index, Difficulties with Emotion Regulation Scale (DERS), Distress Tolerance Scale (DTS), and Affect Intensity and Dimensions of Affiliation Motivation (AIM). Consistent with our hypotheses, the CTQ sexual abuse subscale uniquely predicted exchanging sex for cocaine and heroin, number of arrests for prostitution, engaging in unprotected sex with a casual partner during the prior year, and experiencing low sexual arousal when sober. The physical abuse subscale uniquely predicted number of arrests for assault and weapons offenses. The emotional abuse subscale uniquely predicted the DERS total score, AIM score, and DTS score. Among substance users, different types of abuse are uniquely associated with specific negative effects. Assessment of specific abuse types among substance users may be informative in treatment planning and relapse prevention. Copyright © 2014 Elsevier Ltd. All rights reserved.

Interpreting patient decisional conflict scores: behavior and emotions in decisions about treatment.

PubMed

Knops, Anouk M; Goossens, Astrid; Ubbink, Dirk T; Legemate, Dink A; Stalpers, Lukas J; Bossuyt, Patrick M

2013-01-01

Patient decision aids facilitate treatment decisions. They are often evaluated in terms of their effect on decisional conflict, as measured by the Decisional Conflict Scale (DCS). It is unclear to what extent lower DCS scores are accompanied by observable patient behavior or emotions. To help interpret DCS scores. In a Dutch university hospital, statements on behaviors or emotions during decision making were collected from asymptomatic aneurysm patients and healthy employees. Subsequently, they rated the intensity of decisional conflict that each statement expresses on a 1 to 10 scale. Selected statements were prospectively tested in aneurysm patients and cancer patients facing treatment dilemmas. Associations between patients' DCS scores and reported behavior and emotions were analyzed using logistic regression analysis. Participants provided 363 statements on behaviors and emotions during decision making, of which 28 were mentioned more than 4 times. Nine forms of behavior and emotions were selected as they were graded with the least variable median ratings of intensity of decisional conflict. Among 100 patients facing a treatment dilemma, each point increase in DCS lowered their odds for "immediately making the decision" (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.93-0.98), whereas the odds of "fretting regularly" (OR, 1.05; 95% CI, 1.02-1.08) and "feeling nervous when thinking of the decision" (OR, 1.04; 95% CI, 1.01-1.06) where higher. A decrease in decisional conflict scores leads to less decision postponing behavior, fretting, and nervousness. Research should focus on which DCS scores are needed to make deliberate decisions and which scores hinder patients in decision making.

Adolescent behavior and achievement, social capital, and the timing of geographic mobility.

PubMed

Gillespie, Brian Joseph

2013-09-01

This paper examines the relationship between geographic mobility and adolescent academic achievement and behavior problems. Specifically, it addresses how the effects of moving differ by age and how social capital moderates the impact of moving on children (aged 6 to 15). Children's behavior problems and academic achievement test scores were compared across four survey waves of the National Longitudinal Survey of Youth (2000, 2002, 2004, and 2006) and matched to data from their mothers' reports from the National Longitudinal Survey of Youth 1979. The findings indicate that the negative behavioral effects of geographic mobility on adolescents are most pronounced for individuals relocating to a new city, county, or state as opposed to those moving locally (i.e., within the same city). Furthermore, as suggested by a life-course perspective, the negative effects of moving on behavior problems decrease as children get older. The results also show that several social capital factors moderate the effects of moving on behavior but not achievement. Copyright © 2013 Elsevier Ltd. All rights reserved.

Mobile Technology Use by People Experiencing Multiple Sclerosis Fatigue: Survey Methodology.

PubMed

Van Kessel, Kirsten; Babbage, Duncan R; Reay, Nicholas; Miner-Williams, Warren M; Kersten, Paula

2017-02-28

Fatigue is one of the most commonly reported symptoms of multiple sclerosis (MS). It has a profound impact on all spheres of life, for people with MS and their relatives. It is one of the key precipitants of early retirement. Individual, group, and Internet cognitive behavioral therapy-based approaches to supporting people with MS to manage their fatigue have been shown to be effective. The aim of this project was to (1) survey the types of mobile devices and level of Internet access people with MS use or would consider using for a health intervention and (2) characterize the levels of fatigue severity and their impact experienced by the people in our sample to provide an estimate of fatigue severity of people with MS in New Zealand. The ultimate goal of this work was to support the future development of a mobile intervention for the management of fatigue for people with MS. Survey methodology using an online questionnaire was used to assess people with MS. A total of 51 people with MS participated. The average age was 48.5 years, and the large majority of the sample (77%) was female. Participants reported significant levels of fatigue as measured with the summary score of the Neurological Fatigue Index (mean 31.4 [SD 5.3]). Most (84%) respondents scored on average more than 3 on the fatigue severity questions, reflecting significant fatigue. Mobile phone usage was high with 86% of respondents reporting having a mobile phone; apps were used by 75% of respondents. Most participants (92%) accessed the Internet from home. New Zealand respondents with MS experienced high levels of both fatigue severity and fatigue impact. The majority of participants have a mobile device and access to the Internet. These findings, along with limited access to face-to-face cognitive behavioral therapy-based interventions, create an opportunity to develop a mobile technology platform for delivering a cognitive behavioral therapy-based intervention to decrease the severity and impact of fatigue in people with MS. ©Kirsten Van Kessel, Duncan R Babbage, Nicholas Reay, Warren M Miner-Williams, Paula Kersten. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 28.02.2017.

Mobile Technology Use by People Experiencing Multiple Sclerosis Fatigue: Survey Methodology

PubMed Central

Reay, Nicholas

2017-01-01

Background Fatigue is one of the most commonly reported symptoms of multiple sclerosis (MS). It has a profound impact on all spheres of life, for people with MS and their relatives. It is one of the key precipitants of early retirement. Individual, group, and Internet cognitive behavioral therapy–based approaches to supporting people with MS to manage their fatigue have been shown to be effective. Objective The aim of this project was to (1) survey the types of mobile devices and level of Internet access people with MS use or would consider using for a health intervention and (2) characterize the levels of fatigue severity and their impact experienced by the people in our sample to provide an estimate of fatigue severity of people with MS in New Zealand. The ultimate goal of this work was to support the future development of a mobile intervention for the management of fatigue for people with MS. Methods Survey methodology using an online questionnaire was used to assess people with MS. A total of 51 people with MS participated. The average age was 48.5 years, and the large majority of the sample (77%) was female. Results Participants reported significant levels of fatigue as measured with the summary score of the Neurological Fatigue Index (mean 31.4 [SD 5.3]). Most (84%) respondents scored on average more than 3 on the fatigue severity questions, reflecting significant fatigue. Mobile phone usage was high with 86% of respondents reporting having a mobile phone; apps were used by 75% of respondents. Most participants (92%) accessed the Internet from home. Conclusions New Zealand respondents with MS experienced high levels of both fatigue severity and fatigue impact. The majority of participants have a mobile device and access to the Internet. These findings, along with limited access to face-to-face cognitive behavioral therapy–based interventions, create an opportunity to develop a mobile technology platform for delivering a cognitive behavioral therapy–based intervention to decrease the severity and impact of fatigue in people with MS. PMID:28246073

Automated Cognitive Health Assessment From Smart Home-Based Behavior Data.

PubMed

Dawadi, Prafulla Nath; Cook, Diane Joyce; Schmitter-Edgecombe, Maureen

2016-07-01

Smart home technologies offer potential benefits for assisting clinicians by automating health monitoring and well-being assessment. In this paper, we examine the actual benefits of smart home-based analysis by monitoring daily behavior in the home and predicting clinical scores of the residents. To accomplish this goal, we propose a clinical assessment using activity behavior (CAAB) approach to model a smart home resident's daily behavior and predict the corresponding clinical scores. CAAB uses statistical features that describe characteristics of a resident's daily activity performance to train machine learning algorithms that predict the clinical scores. We evaluate the performance of CAAB utilizing smart home sensor data collected from 18 smart homes over two years. We obtain a statistically significant correlation ( r=0.72) between CAAB-predicted and clinician-provided cognitive scores and a statistically significant correlation ( r=0.45) between CAAB-predicted and clinician-provided mobility scores. These prediction results suggest that it is feasible to predict clinical scores using smart home sensor data and learning-based data analysis.

Social Performance Cues Induce Behavioral Flexibility in Humans

PubMed Central

Toelch, Ulf; Bruce, Matthew J.; Meeus, Marius T. H.; Reader, Simon M.

2011-01-01

Behavioral flexibility allows individuals to react to environmental changes, but changing established behavior carries costs, with unknown benefits. Individuals may thus modify their behavioral flexibility according to the prevailing circumstances. Social information provided by the performance level of others provides one possible cue to assess the potential benefits of changing behavior, since out-performance in similar circumstances indicates that novel behaviors (innovations) are potentially useful. We demonstrate that social performance cues, in the form of previous players’ scores in a problem-solving computer game, influence behavioral flexibility. Participants viewed only performance indicators, not the innovative behavior of others. While performance cues (high, low, or no scores) had little effect on innovation discovery rates, participants that viewed high scores increased their utilization of innovations, allowing them to exploit the virtual environment more effectively than players viewing low or no scores. Perceived conspecific performance can thus shape human decisions to adopt novel traits, even when the traits employed cannot be copied. This simple mechanism, social performance feedback, could be a driver of both the facultative adoption of innovations and cumulative cultural evolution, processes critical to human success. PMID:21811477

The Relation of Severity and Comorbidity to Treatment Outcome with Cognitive Behavioral Therapy for Childhood Anxiety Disorders

PubMed Central

van Widenfelt, Brigit M.; van der Leeden, Adelinde J. M.; Goedhart, Arnold W.; Utens, Elisabeth M. W. J.; Treffers, Philip D. A.

2010-01-01

The present study investigated the impact of comorbidity over and above the impact of symptom severity on treatment outcome of Cognitive Behavioral Therapy for children with anxiety disorders. Children (aged 8–12, n = 124) diagnosed with an anxiety disorder were treated with a short-term CBT protocol. Severity was assessed with a composite measure of parent-reported behavior problems. Two approaches to comorbidity were examined; “total comorbidity” which differentiated anxiety disordered children with (n = 69) or without (n = 55) a co-occurring disorder and “non-anxiety comorbidity’ which differentiated anxious children with (n = 22) or without a non-anxiety comorbid disorder (n = 102). Treatment outcome was assessed in terms of Recovery, represented by post-treatment diagnostic status, and Reliable Change, a score reflecting changes in pre- to post-treatment symptom levels. Severity contributed to the prediction of (no) Recovery and (more) Reliable Change in parent-reported internalizing and externalizing symptoms and self-reported depressive symptoms. Total and non-anxiety comorbidity added to the prediction of diagnostic recovery. Non-anxiety comorbidity added to the prediction of Reliable Change in parent reported measures by acting as a suppressor variable. Non-anxiety comorbidity operated as a strong predictor that explained all of the variance associated with severity for self-reported depressive symptoms. The results support the need for further research on mechanisms by which treatment gains in children with higher symptom severity and non-anxiety comorbidity can be achieved. PMID:20180011

Psychometric Properties of the Psychosocial Assessment Tool-Chronic Pain Version in Families of Children With Headache.

PubMed

Woods, Kristine; Ostrowski-Delahanty, Sarah

2017-07-01

Children with headache disorders are at increased psychosocial risk, and no validated screening measures exist to succinctly assess for risk. This study examined the psychometric properties of the Psychosocial Assessment Tool-Chronic Pain, a previously adapted screening measure of risk, in a retrospective sample of families of children diagnosed with headaches. Participants included 127 children and caregivers presenting for behavioral health evaluation of headache. Children and their primary caregivers completed several psychosocial assessment measures. Internal consistency for the Psychosocial Assessment Tool-Chronic Pain total score was high (α = 0.80), and all subscale scores had moderate to high internal consistency (α = 0.597-0.88), with the exception of the caregiver beliefs subscale (α = 0.443). The total score and the majority of subscale scores on the Psychosocial Assessment Tool-Chronic Pain were correlated with caregiver- and child-reported scores on study measures. The results demonstrate that the Psychosocial Assessment Tool-Chronic Pain has adequate psychometric properties, and because of the brief administration time, ease of scoring, and accessibility of the measure, it is a promising measure of screening for psychosocial risk in this population.

Sexting: Prevalence, Predictors, and Associated Sexual Risk Behaviors among Postsecondary School Young People in Ibadan, Nigeria.

PubMed

Olatunde, Oluwatoyin; Balogun, Folusho

2017-01-01

Sending and receiving sexually suggestive or explicit images or texts (sexting) have been shown to be associated with health risk behaviors but literature about this phenomenon is scarce in Nigeria. This study looked at the prevalence, predictors, and associated sexual risk behaviors of sexting among postsecondary school young persons in Ibadan, Nigeria. This was a cross-sectional study using a self-administered questionnaire. Data were obtained for sociodemographic characteristics and sexual orientation, sexting behavior, personality assessment (using the International Personality Item Pool Big-Five factor markers), indicators for problematic phone use (using Mobile Phone Problem Use Scale), and sexual behavior. Chi square test and logistic regression were used for data analysis with p  = 0.05. Five hundred seventy-five participants were recruited, age range 14-24 years, and 46.0% were males. Twenty percent had sent sexts, while 33.2% had received sexts. Fifty-four percent had high scores in extraversion, 46.5% had moderate-severe problematic phone use. Sixteen percent had ever had sex, and 40.0% of these had multiple sexual partners. Males were more likely than females to have sent sexts (OR = 2.67, 95% CI: 1.68-4.24). Having a high extraversion score (OR = 2.44, 95% CI: 1.35-4.41) and moderate-severe problematic phone use (OR = 5.56, 95% CI: 2.73-11.32) was predictive of sexting. Sending and receiving of sext were significantly associated with ever having sexual intercourse (OR = 4.01, 95% CI: 2.25-7.17 and OR = 2.96, 95% CI: 1.72-5.12, respectively). Sexting was prevalent among postsecondary school young persons in Ibadan and was associated with male sex and problematic phone use. Intervention targeted at the identified susceptible group of young people may reduce its associated problems in this study group.

Types of gambling and levels of harm: A UK study to assess severity of presentation in a treatment-seeking population

PubMed Central

Ronzitti, Silvia; Soldini, Emiliano; Lutri, Vittorio; Smith, Neil; Clerici, Massimo; Bowden-Jones, Henrietta

2016-01-01

Background and aim Previous international research emphasized that some forms of gambling are more “addictive” than others. More recently, research has shown that we should shift our attention from the type of gambling activity to the level of involvement in a number of different gambling activities. The aim of our study was to verify whether a higher Problem Gambling Severity Index (PGSI) score was associated with particular gambling activities and evaluate the impact of involvement on gambling behavior. Methods A total of 736 treatment-seeking individuals with gambling disorder were assessed at the National Problem Gambling Clinic in London. First, the independent two-sample t-test and the Mann–Whitney test were used to verify if the PGSI score changed significantly according to the gambling activity at a bivariate level. Second, we conducted a cluster analysis and finally, we fitted a linear regression model in order to verify if some variables are useful to predict gambling addiction severity. Results The PGSI score was significantly higher for lower stakes gaming machine gamblers (1% significance level) and for fixed-odds betting terminal (FOBT) gamblers (5% significance level) at a bivariate level. Moreover, such finding was confirmed by cluster and linear regression analyses. Conclusions The results of this study indicated that gambling addiction severity was related to gambling involvement and, for a given level of gambling involvement, gambling addiction severity may vary according to gambling type, with a particularly significant increase for FOBT and gaming machine gambling. PMID:27677350

Types of gambling and levels of harm: A UK study to assess severity of presentation in a treatment-seeking population.

PubMed

Ronzitti, Silvia; Soldini, Emiliano; Lutri, Vittorio; Smith, Neil; Clerici, Massimo; Bowden-Jones, Henrietta

2016-09-01

Background and aim Previous international research emphasized that some forms of gambling are more "addictive" than others. More recently, research has shown that we should shift our attention from the type of gambling activity to the level of involvement in a number of different gambling activities. The aim of our study was to verify whether a higher Problem Gambling Severity Index (PGSI) score was associated with particular gambling activities and evaluate the impact of involvement on gambling behavior. Methods A total of 736 treatment-seeking individuals with gambling disorder were assessed at the National Problem Gambling Clinic in London. First, the independent two-sample t-test and the Mann-Whitney test were used to verify if the PGSI score changed significantly according to the gambling activity at a bivariate level. Second, we conducted a cluster analysis and finally, we fitted a linear regression model in order to verify if some variables are useful to predict gambling addiction severity. Results The PGSI score was significantly higher for lower stakes gaming machine gamblers (1% significance level) and for fixed-odds betting terminal (FOBT) gamblers (5% significance level) at a bivariate level. Moreover, such finding was confirmed by cluster and linear regression analyses. Conclusions The results of this study indicated that gambling addiction severity was related to gambling involvement and, for a given level of gambling involvement, gambling addiction severity may vary according to gambling type, with a particularly significant increase for FOBT and gaming machine gambling.

Self-Regulation and Executive Functioning as Related to Survival in Motor Neuron Disease: Preliminary Findings.

PubMed

Garcia-Willingham, Natasha E; Roach, Abbey R; Kasarskis, Edward J; Segerstrom, Suzanne C

2018-05-16

Disease progression varies widely among patients with motor neuron disease (MND). Patients with MND and coexisting dementia have shorter survival. However, implications of mild cognitive and behavioral difficulties are unclear. The present study examined the relative contribution of executive functioning and self-regulation difficulties on survival over a 6-year period among patients with MND, who scored largely within normal limits on cognitive and behavioral indices. Patients with MND (N=37, age=59.97±11.57, 46% female) completed the Wisconsin Card Sorting Task (WCST) as an executive functioning perseveration index. The Behavior Rating Inventory of Executive Functions (BRIEF-A) was used as a behavioral measure of self-regulation in two subdomains self-regulatory behavior (Behavioral Regulation) and self-regulatory problem-solving (Metacognition). Cox proportional hazard regression analyses were used. In total, 23 patients died during follow-up. In Cox proportional hazard regressions adjusted for a priori covariates, each 10-point T-score increment in patient-reported BRIEF-A self-regulatory behavior and problem-solving difficulties increased mortality risk by 94% and103%, respectively (adjusted HR=1.94, 95% CI [1.07, 3.52]; adjusted HR=2.03, 95% CI [1.19, 3.48]). In sensitivity analyses, patient-reported self-regulatory problem-solving remained significant independent of disease severity and a priori covariates (adjusted HR=1.68, 95% CI [1.01, 2.78], though the predictive value of self-regulatory behavior was attenuated in adjusted models (HR=1.67, 95% CI [0.85, 3.27). Caregiver-reported BRIEF-A ratings of patients and WCST perseverative errors did not significantly predict survival. Preliminary evidence suggests patient-reported self-regulatory problem-solving difficulties indicate poorer prognosis in MND. Further research is needed to uncover mechanisms that negatively affect patient survival.

Invited review: Animal-based indicators for on-farm welfare assessment for dairy goats.

PubMed

Battini, M; Vieira, A; Barbieri, S; Ajuda, I; Stilwell, G; Mattiello, S

2014-11-01

This paper reviews animal-based welfare indicators to develop a valid, reliable, and feasible on-farm welfare assessment protocol for dairy goats. The indicators were considered in the light of the 4 accepted principles (good feeding, good housing, good health, appropriate behavior) subdivided into 12 criteria developed by the European Welfare Quality program. We will only examine the practical indicators to be used on-farm, excluding those requiring the use of specific instruments or laboratory analysis and those that are recorded at the slaughterhouse. Body condition score, hair coat condition, and queuing at the feed barrier or at the drinker seem the most promising indicators for the assessment of the "good feeding" principle. As to "good housing," some indicators were considered promising for assessing "comfort around resting" (e.g., resting in contact with a wall) or "thermal comfort" (e.g., panting score for the detection of heat stress and shivering score for the detection of cold stress). Several indicators related to "good health," such as lameness, claw overgrowth, presence of external abscesses, and hair coat condition, were identified. As to the "appropriate behavior" principle, different criteria have been identified: agonistic behavior is largely used as the "expression of social behavior" criterion, but it is often not feasible for on-farm assessment. Latency to first contact and the avoidance distance test can be used as criteria for assessing the quality of the human-animal relationship. Qualitative behavior assessment seems to be a promising indicator for addressing the "positive emotional state" criterion. Promising indicators were identified for most of the considered criteria; however, no valid indicator has been identified for "expression of other behaviors." Interobserver reliability has rarely been assessed and warrants further attention; in contrast, short-term intraobserver reliability is frequently assessed and some studies consider mid- and long-term reliability. The feasibility of most of the reviewed indicators in commercial farms still needs to be carefully evaluated, as several studies were performed under experimental conditions. Our review highlights some aspects of goat welfare that have been widely studied, but some indicators need to be investigated further and drafted before being included in a valid, reliable, and feasible welfare assessment protocol. The indicators selected and examined may be an invaluable starting point for the development of an on-farm welfare assessment protocol for dairy goats. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Reduced ventral cingulum integrity and increased behavioral problems in children with isolated optic nerve hypoplasia and mild to moderate or no visual impairment.

PubMed

Webb, Emma A; O'Reilly, Michelle A; Clayden, Jonathan D; Seunarine, Kiran K; Dale, Naomi; Salt, Alison; Clark, Chris A; Dattani, Mehul T

2013-01-01

To assess the prevalence of behavioral problems in children with isolated optic nerve hypoplasia, mild to moderate or no visual impairment, and no developmental delay. To identify white matter abnormalities that may provide neural correlates for any behavioral abnormalities identified. Eleven children with isolated optic nerve hypoplasia (mean age 5.9 years) underwent behavioral assessment and brain diffusion tensor imaging, Twenty four controls with isolated short stature (mean age 6.4 years) underwent MRI, 11 of whom also completed behavioral assessments. Fractional anisotropy images were processed using tract-based spatial statistics. Partial correlation between ventral cingulum, corpus callosum and optic radiation fractional anisotropy, and child behavioral checklist scores (controlled for age at scan and sex) was performed. Children with optic nerve hypoplasia had significantly higher scores on the child behavioral checklist (p<0.05) than controls (4 had scores in the clinically significant range). Ventral cingulum, corpus callosum and optic radiation fractional anisotropy were significantly reduced in children with optic nerve hypoplasia. Right ventral cingulum fractional anisotropy correlated with total and externalising child behavioral checklist scores (r = -0.52, p<0.02, r = -0.46, p<0.049 respectively). There were no significant correlations between left ventral cingulum, corpus callosum or optic radiation fractional anisotropy and behavioral scores. Our findings suggest that children with optic nerve hypoplasia and mild to moderate or no visual impairment require behavioral assessment to determine the presence of clinically significant behavioral problems. Reduced structural integrity of the ventral cingulum correlated with behavioral scores, suggesting that these white matter abnormalities may be clinically significant. The presence of reduced fractional anisotropy in the optic radiations of children with mild to moderate or no visual impairment raises questions as to the pathogenesis of these changes which will need to be addressed by future studies.

Using dolls for therapeutic purposes: A study on nursing home residents with severe dementia.

PubMed

Cantarella, A; Borella, E; Faggian, S; Navuzzi, A; De Beni, R

2018-04-19

Among the psychosocial interventions intended to reduce the behavioral and psychological symptoms of dementia (BPSD), doll therapy (DT) is increasingly used in clinical practice. Few studies on DT have been based on empirical data obtained with an adequate procedure; however, none have assessed its efficacy using an active control group, and the scales used to assess changes in BPSD are usually unreliable. The aim of the present study was to measure the impact of DT on people with severe dementia with a reliable, commonly used scale for assessing their BPSD, and the related distress in formal caregivers. Effects of DT on the former's everyday abilities (ie, eating behavior) were also examined. Twenty-nine nursing home residents aged from 76 to 96 years old, with severe dementia (Alzheimer's or vascular dementia), took part in the experiment. They were randomly assigned to an experimental group that used dolls or an active control group that used hand warmers with sensory characteristics equivalent to the dolls. Benefits of DT on BPSD and related formal caregiver distress were examined with the Neuropsychiatric Inventory. The effects of DT on eating behavior were examined with the Eating Behavior Scale. Only the DT group showed a reduction in BPSD scores and related caregiver distress. DT did not benefit eating behavior, however. This study suggests that DT is a promising approach for reducing BPSD in people with dementia, supporting evidence emerging from previous anecdotal studies. Copyright © 2018 John Wiley & Sons, Ltd.

Who Takes Precautionary Action in the Face of the New H1N1 Influenza? Prediction of Who Collects a Free Hand Sanitizer Using a Health Behavior Model

PubMed Central

Reuter, Tabea; Renner, Britta

2011-01-01

Background In order to fight the spread of the novel H1N1 influenza, health authorities worldwide called for a change in hygiene behavior. Within a longitudinal study, we examined who collected a free bottle of hand sanitizer towards the end of the first swine flu pandemic wave in December 2009. Methods 629 participants took part in a longitudinal study assessing perceived likelihood and severity of an H1N1 infection, and H1N1 influenza related negative affect (i.e., feelings of threat, concern, and worry) at T1 (October 2009, week 43–44) and T2 (December 2009, week 51–52). Importantly, all participants received a voucher for a bottle of hand sanitizer at T2 which could be redeemed in a university office newly established for this occasion at T3 (ranging between 1–4 days after T2). Results Both a sequential longitudinal model (M2) as well as a change score model (M3) showed that greater perceived likelihood and severity at T1 (M2) or changes in perceived likelihood and severity between T1 and T2 (M3) did not directly drive protective behavior (T3), but showed a significant indirect impact on behavior through H1N1 influenza related negative affect. Specifically, increases in perceived likelihood (β = .12), severity (β = .24) and their interaction (β = .13) were associated with a more pronounced change in negative affect (M3). The more threatened, concerned and worried people felt (T2), the more likely they were to redeem the voucher at T3 (OR = 1.20). Conclusions Affective components need to be considered in health behavior models. Perceived likelihood and severity of an influenza infection represent necessary but not sufficient self-referential knowledge for paving the way for preventive behaviors. PMID:21789224

Who takes precautionary action in the face of the new H1N1 influenza? Prediction of who collects a free hand sanitizer using a health behavior model.

PubMed

Reuter, Tabea; Renner, Britta

2011-01-01

In order to fight the spread of the novel H1N1 influenza, health authorities worldwide called for a change in hygiene behavior. Within a longitudinal study, we examined who collected a free bottle of hand sanitizer towards the end of the first swine flu pandemic wave in December 2009. 629 participants took part in a longitudinal study assessing perceived likelihood and severity of an H1N1 infection, and H1N1 influenza related negative affect (i.e., feelings of threat, concern, and worry) at T1 (October 2009, week 43-44) and T2 (December 2009, week 51-52). Importantly, all participants received a voucher for a bottle of hand sanitizer at T2 which could be redeemed in a university office newly established for this occasion at T3 (ranging between 1-4 days after T2). Both a sequential longitudinal model (M2) as well as a change score model (M3) showed that greater perceived likelihood and severity at T1 (M2) or changes in perceived likelihood and severity between T1 and T2 (M3) did not directly drive protective behavior (T3), but showed a significant indirect impact on behavior through H1N1 influenza related negative affect. Specifically, increases in perceived likelihood (β = .12), severity (β = .24) and their interaction (β = .13) were associated with a more pronounced change in negative affect (M3). The more threatened, concerned and worried people felt (T2), the more likely they were to redeem the voucher at T3 (OR = 1.20). Affective components need to be considered in health behavior models. Perceived likelihood and severity of an influenza infection represent necessary but not sufficient self-referential knowledge for paving the way for preventive behaviors.

Psychological Assessment of Adolescents and Adults with Autism.

ERIC Educational Resources Information Center

Perez, Juan; del Sol Fortea Sevilla, Maria

1993-01-01

This study compared scores of 17 children with autism and mental retardation on the Psychoeducational Profile with scores on the Adolescent and Adult Psychoeducational Profile 5 years later. Eye-hand coordination predicted scores in vocational skills, independent functioning, and vocational behavior; imitation predicted interpersonal behavior;…

Surgeons' Leadership Styles and Team Behavior in the Operating Room

PubMed Central

Hu, Yue-Yung; Parker, Sarah Henrickson; Lipsitz, Stuart R; Arriaga, Alexander F; Peyre, Sarah E; Corso, Katherine A; Roth, Emilie M; Yule, Steven J; Greenberg, Caprice C

2016-01-01

Background The importance of leadership is recognized in surgery, but the specific impact of leadership style on team behavior is not well understood. In other industries, leadership is a well-characterized construct. One dominant theory proposes that transactional (task-focused) leaders achieve minimum standards, whereas transformational (team-oriented) leaders inspire performance beyond expectations. Study Design We video-recorded 5 surgeons performing complex operations. Each surgeon was scored on the Multifactor Leadership Questionnaire, a validated method for scoring transformational and transactional leadership style, by an organizational psychologist and a surgeon-researcher. Independent coders assessed surgeons' leadership behaviors according to the Surgical Leadership Inventory and team behaviors (information-sharing, cooperative, and voice behaviors). All coders were blinded. Leadership style (MLQ) was correlated with surgeon behavior (SLI) and team behavior using Poisson regression, controlling for time and the total number of behaviors, respectively. Results All surgeons scored similarly on transactional leadership (2.38-2.69), but varied more widely on transformational leadership (1.98-3.60). Each 1-point increase in transformational score corresponded to 3× more information-sharing behaviors (p<0.0001) and 5.4× more voice behaviors (p=0.0005) amongst the team. With each 1-point increase in transformational score, leaders displayed 10× more supportive behaviors (p<0.0001) and 12.5× less frequently displayed poor behaviors (p<0.0001). Excerpts of representative dialogue are included for illustration. Conclusions We provide a framework for evaluating surgeons' leadership and its impact on team performance in the OR. As in other fields, our data suggest that transformational leadership is associated with improved team behavior. Surgeon leadership development therefore has the potential to improve the efficiency and safety of operative care. PMID:26481409

Surgeons' Leadership Styles and Team Behavior in the Operating Room.

PubMed

Hu, Yue-Yung; Parker, Sarah Henrickson; Lipsitz, Stuart R; Arriaga, Alexander F; Peyre, Sarah E; Corso, Katherine A; Roth, Emilie M; Yule, Steven J; Greenberg, Caprice C

2016-01-01

The importance of leadership is recognized in surgery, but the specific impact of leadership style on team behavior is not well understood. In other industries, leadership is a well-characterized construct. One dominant theory proposes that transactional (task-focused) leaders achieve minimum standards and transformational (team-oriented) leaders inspire performance beyond expectations. We videorecorded 5 surgeons performing complex operations. Each surgeon was scored on the Multifactor Leadership Questionnaire, a validated method for scoring transformational and transactional leadership style, by an organizational psychologist and a surgeon researcher. Independent coders assessed surgeons' leadership behaviors according to the Surgical Leadership Inventory and team behaviors (information sharing, cooperative, and voice behaviors). All coders were blinded. Leadership style (Multifactor Leadership Questionnaire) was correlated with surgeon behavior (Surgical Leadership Inventory) and team behavior using Poisson regression, controlling for time and the total number of behaviors, respectively. All surgeons scored similarly on transactional leadership (range 2.38 to 2.69), but varied more widely on transformational leadership (range 1.98 to 3.60). Each 1-point increase in transformational score corresponded to 3 times more information-sharing behaviors (p < 0.0001) and 5.4 times more voice behaviors (p = 0.0005) among the team. With each 1-point increase in transformational score, leaders displayed 10 times more supportive behaviors (p < 0.0001) and displayed poor behaviors 12.5 times less frequently (p < 0.0001). Excerpts of representative dialogue are included for illustration. We provide a framework for evaluating surgeons' leadership and its impact on team performance in the operating room. As in other fields, our data suggest that transformational leadership is associated with improved team behavior. Surgeon leadership development, therefore, has the potential to improve the efficiency and safety of operative care. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Multi-dimensional correlates of Internet addiction symptoms in adolescents with attention-deficit/hyperactivity disorder.

PubMed

Chou, Wen-Jiun; Liu, Tai-Ling; Yang, Pinchen; Yen, Cheng-Fang; Hu, Huei-Fan

2015-01-30

This study examined the associations of the severity of Internet addiction symptoms with reinforcement sensitivity, family factors, Internet activities, and attention-deficit/hyperactivity disorder (ADHD) symptoms among adolescents in Taiwan diagnosed with ADHD. A total of 287 adolescents diagnosed with ADHD and aged between 11 and 18 years participated in this study. Their levels of Internet addiction symptoms, ADHD symptoms, reinforcement sensitivity, family factors, and various Internet activities in which the participants engaged were assessed. The correlates of the severities of Internet addiction symptoms were determined using multiple regression analyses. The results indicated that low satisfaction with family relationships was the strongest factor predicting severe Internet addiction symptoms, followed by using instant messaging, watching movies, high Behavioral Approach System (BAS) fun seeking, and high Behavioral Inhibition System scores. Meanwhile, low paternal occupational SES, low BAS drive, and online gaming were also significantly associated with severe Internet addiction symptoms. Multiple factors are significantly associated with the severity of Internet addiction symptoms among adolescents with ADHD. Clinicians, educational professionals, and parents of adolescents with ADHD should monitor the Internet use of adolescents who exhibit the factors identified in this study. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Transcranial direct current stimulation reduces food-craving and measures of hyperphagia behavior in participants with Prader-Willi syndrome.

PubMed

Bravo, Gabriela L; Poje, Albert B; Perissinotti, Iago; Marcondes, Bianca F; Villamar, Mauricio F; Manzardo, Ann M; Luque, Laura; LePage, Jean F; Stafford, Diane; Fregni, Felipe; Butler, Merlin G

2016-03-01

Prader-Willi syndrome (PWS) is a neurodevelopmental genetic disorder characterized by intellectual disabilities and insatiable appetite with compulsive eating leading to severe obesity with detrimental health consequences. Transcranial direct current stimulation (tDCS) has been shown to modulate decision-making and cue-induced food craving in healthy adults. We conducted a pilot double blind, sham-controlled, multicenter study of tDCS modulation of food drive and craving in 10 adult PWS participants, 11 adult obese (OB) and 11 adult healthy-weight control (HWC) subjects. PWS and OB subjects received five consecutive daily sessions of active or sham tDCS over the right dorsolateral prefrontal cortex (DLPFC), while HWC received a single sham and active tDCS in a crossover design. Standardized psychometric instruments assessed food craving, drive and hyperphagia by self-report and caregiver assessment over 30 days. Robust baseline differences were observed in severity scores for the Three-Factor Eating Questionnaire (TFEQ) and Dykens Hyperphagia Questionnaire (DHQ) for PWS compared to HWC while obese participants were more similar to HWC. Active tDCS stimulation in PWS was associated with a significant change from baseline in TFEQ Disinhibition (Factor II) (Ƶ = 1.9, P < 0.05, 30 days) and Total Scores (Ƶ = 2.3, P < 0.02, 30 days), and participant ratings of the DHQ Severity (Ƶ = 1.8, P < 0.06, 5 days) and Total Scores (Ƶ = 1.9, P < 0.05, 15 days). These findings support sustained neuromodulatory effects and efficacy of tDCS to reduce food drive and behaviors impacting hyperphagia in PWS. Transcranial direct current stimulation may represent a straight-forward, low risk and low cost method to improve care, management and quality of life in PWS. © 2015 Wiley Periodicals, Inc.

Brain functional integration: an epidemiologic study on stress-producing dissociative phenomena.

PubMed

Sperandeo, Raffaele; Monda, Vincenzo; Messina, Giovanni; Carotenuto, Marco; Maldonato, Nelson Mauro; Moretto, Enrico; Leone, Elena; De Luca, Vincenzo; Monda, Marcellino; Messina, Antonietta

2018-01-01

Dissociative phenomena are common among psychiatric patients; the presence of these symptoms can worsen the prognosis, increasing the severity of their clinical conditions and exposing them to increased risk of suicidal behavior. Personality disorders as long duration stressful experiences may support the development of dissociative phenomena. In 933 psychiatric outpatients consecutively recruited, presence of dissociative phenomena was identified with the Dissociative Experience Scale (DES). Dissociative phenomena were significantly more severe in the group of people with mental disorders and/or personality disorders. All psychopathologic traits detected with the symptom checklist-90-revised had a significant correlation with the total score on the DES. Using total DES score as the dependent variable, a linear regression model was constructed. Mental and personality disorders which were associated with greater severity of dissociative phenomena on analysis of variance were included as predictors; scores from the nine scales of symptom checklist-90-revised, significantly correlated to total DES score, were used as covariates. The model consisted of seven explanatory variables (four factors and three covariates) explaining 82% of variance. The four significant factors were the presence of borderline and narcissistic personality disorder, substance abuse disorders and psychotic disorders. Significant covariates were psychopathologic traits of anger, psychoticism and obsessiveness. This study, confirming Janet's theory, explains that, mental disorders and psychopathologic experiences of patients can configure the chronic stress condition that produces functional damage to the adaptive executive system. The symptoms of dissociative depersonalization/derealization and dissociative amnesia can be explained, in large part, through their current and previous psychopathologic experiences.

Brain functional integration: an epidemiologic study on stress-producing dissociative phenomena

PubMed Central

Messina, Giovanni; Carotenuto, Marco; Maldonato, Nelson Mauro; Moretto, Enrico; Leone, Elena; De Luca, Vincenzo; Monda, Marcellino; Messina, Antonietta

2018-01-01

Dissociative phenomena are common among psychiatric patients; the presence of these symptoms can worsen the prognosis, increasing the severity of their clinical conditions and exposing them to increased risk of suicidal behavior. Personality disorders as long duration stressful experiences may support the development of dissociative phenomena. In 933 psychiatric outpatients consecutively recruited, presence of dissociative phenomena was identified with the Dissociative Experience Scale (DES). Dissociative phenomena were significantly more severe in the group of people with mental disorders and/or personality disorders. All psychopathologic traits detected with the symptom checklist-90-revised had a significant correlation with the total score on the DES. Using total DES score as the dependent variable, a linear regression model was constructed. Mental and personality disorders which were associated with greater severity of dissociative phenomena on analysis of variance were included as predictors; scores from the nine scales of symptom checklist-90-revised, significantly correlated to total DES score, were used as covariates. The model consisted of seven explanatory variables (four factors and three covariates) explaining 82% of variance. The four significant factors were the presence of borderline and narcissistic personality disorder, substance abuse disorders and psychotic disorders. Significant covariates were psychopathologic traits of anger, psychoticism and obsessiveness. This study, confirming Janet’s theory, explains that, mental disorders and psychopathologic experiences of patients can configure the chronic stress condition that produces functional damage to the adaptive executive system. The symptoms of dissociative depersonalization/derealization and dissociative amnesia can be explained, in large part, through their current and previous psychopathologic experiences. PMID:29296086

Parent-Reported Repetitive Behavior in Toddlers on the Autism Spectrum.

PubMed

Schertz, Hannah H; Odom, Samuel L; Baggett, Kathleen M; Sideris, John H

2016-10-01

Toddlers with autism spectrum disorder (ASD) were assessed on the Repetitive Behavior Scale-Revised (RBS-R), which we found to have acceptable internal consistency. Stereotypical subscale scores showed a negligible association with cognitive level, but correlated more strongly with adaptive and social indicators. Relative to earlier reported RBS-R scores for older age groups, toddlers' scores trended toward higher stereotyped behavior and lower ritualistic/sameness behavior. Our findings on associations with developmental indicators align with those of researchers who used more resource-intensive repetitive behavior measures. The convergence of these findings with those derived from other measurement methods suggests that the RBS-R, a cost effective parent-report measure, is a viable means of assessing repetitive behavior in toddlers with autism.

Bayley-III scales at 12 months of corrected age in preterm infants: Patterns of developmental performance and correlations to environmental and biological influences.

PubMed

Velikos, Konstantinos; Soubasi, Vasiliki; Michalettou, Irene; Sarafidis, Kosmas; Nakas, Christos; Papadopoulou, Vasiliki; Zafeiriou, Dimitrios; Drossou, Vasiliki

2015-01-01

Premature infants are at high risk for neurodevelopmental impairment (NDI) even in the absence of known brain complications of prematurity. Evaluation of the effectiveness of therapeutic interventions in association to neurodevelopmental outcome is required to improve or prevent the neurodevelopmental consequences of prematurity. The Bayley-III is currently the most commonly applied measurement tool for assessing early development both in clinical practice and research settings. To evaluate the relationship between known risk factors and early performance on the Bayley Scales of Infant Development-Third Edition at 12 months adjusted age in premature infants. Prospective study in a cohort of premature infants with gestational age ≤32 weeks, who underwent comprehensive developmental assessment using the five domains of Bayley Scales, cognitive, language, motor, social emotional and adaptive behavior at 12 months corrected age. Developmental scores were evaluated in relation to environmental influences, therapeutic interventions or practices and complications of prematurity. Composite and Subscale scores for the cognitive, language and motor scales were below the 50th percentile, with no significant differences among them. Scores for the social-emotional and adaptive behavior, which are derived from the parent-report questionnaires, were near the average and significantly higher than the scores derived by the examiners. Multiple regression analyses showed that blood transfusions, apart from severely abnormal head ultrasound, gender, being small for gestational age and duration of invasive mechanical ventilation and oxygen administration were consistently related to neurodevelopmental outcome. Bayley-III assessments are important for getting early information about development following premature birth. Parents may overestimate children's performance. Neurodevelopmental outcome is related to several environmental, biological or medical conditions associated with prematurity. Adoption of therapeutic strategies targeting known neonatal risk factors could positively affect neurodevelopmental outcome. Copyright © 2015 Elsevier Ltd. All rights reserved.

Comparing Phlebotomy by Tail Tip Amputation, Facial Vein Puncture, and Tail Vein Incision in C57BL/6 Mice by Using Physiologic and Behavioral Metrics of Pain and Distress

PubMed Central

Moore, Elizabeth S; Cleland, Thomas A; Williams, Wendy O; Peterson, Christine M; Singh, Bhupinder; Southard, Teresa L; Pasch, Bret; Labitt, Rachael N; Daugherity, Erin K

2017-01-01

Tail tip amputation with minimal restraint is not widely used for mouse phlebotomy. In part, this infrequency may reflect policies influenced by tail tip amputation procedures for genotyping, which involve greater handling and tissue removal. To assess tail tip amputation with minimal restraint as a phlebotomy technique, we compared it with 2 more common methods: scruffing with facial vein puncture and lateral tail vein incision with minimal restraint. Blood glucose levels, audible and ultrasonic vocalizations, postphlebotomy activity and grooming behavior, open field and elevated plus maze behaviors, nest-building scores, and histologic changes at the phlebotomy site were evaluated. Mice in the facial vein phlebotomy group produced more audible vocalizations, exhibited lower postphlebotomy activity in the open field, and had more severe histologic changes than did mice in the tail incision and tail tip amputation groups. Facial vein phlebotomy did not affect grooming behavior relative to sham groups, whereas tail vein incision—but not tail tip amputation—increased tail grooming compared with that in control mice. Blood glucose levels, nest-building scores, and elevated plus maze behavior did not differ between groups, and no mice in any group produced ultrasonic vocalizations. Tail tip amputation mice did not perform differently than sham mice in any metric analyzed, indicating that this technique is a potentially superior method of blood collection in mice in terms of animal wellbeing. PMID:28535866

Comparing Phlebotomy by Tail Tip Amputation, Facial Vein Puncture, and Tail Vein Incision in C57BL/6 Mice by Using Physiologic and Behavioral Metrics of Pain and Distress.

PubMed

Moore, Elizabeth S; Cleland, Thomas A; Williams, Wendy O; Peterson, Christine M; Singh, Bhupinder; Southard, Teresa L; Pasch, Bret; Labitt, Rachael N; Daugherity, Erin K

2017-05-01

Tail tip amputation with minimal restraint is not widely used for mouse phlebotomy. In part, this infrequency may reflect policies influenced by tail tip amputation procedures for genotyping, which involve greater handling and tissue removal. To assess tail tip amputation with minimal restraint as a phlebotomy technique, we compared it with 2 more common methods: scruffing with facial vein puncture and lateral tail vein incision with minimal restraint. Blood glucose levels, audible and ultrasonic vocalizations, postphlebotomy activity and grooming behavior, open field and elevated plus maze behaviors, nest-building scores, and histologic changes at the phlebotomy site were evaluated. Mice in the facial vein phlebotomy group produced more audible vocalizations, exhibited lower postphlebotomy activity in the open field, and had more severe histologic changes than did mice in the tail incision and tail tip amputation groups. Facial vein phlebotomy did not affect grooming behavior relative to sham groups, whereas tail vein incision-but not tail tip amputation-increased tail grooming compared with that in control mice. Blood glucose levels, nest-building scores, and elevated plus maze behavior did not differ between groups, and no mice in any group produced ultrasonic vocalizations. Tail tip amputation mice did not perform differently than sham mice in any metric analyzed, indicating that this technique is a potentially superior method of blood collection in mice in terms of animal wellbeing.

Polysomnographic Findings and Clinical Correlates in Huntington Disease: A Cross-Sectional Cohort Study

PubMed Central

Piano, Carla; Losurdo, Anna; Della Marca, Giacomo; Solito, Marcella; Calandra-Buonaura, Giovanna; Provini, Federica; Bentivoglio, Anna Rita; Cortelli, Pietro

2015-01-01

Study Objectives: To evaluate the sleep pattern and the motor activity during sleep in a cohort of patients affected by Huntington disease (HD). Design: Cross-sectional cohort study. Setting: Sleep laboratory. Patients: Thirty HD patients, 16 women and 14 men (mean age 57.3 ± 12.2 y); 30 matched healthy controls (mean age 56.5 ± 11.8 y). Interventions: Subjective sleep evaluation: Epworth Sleepiness Scale (ESS); Berlin's Questionnaire, interview for restless legs syndrome (RLS), questionnaire for REM sleep behavior disorder (RBD). Clinical evaluation: disease duration, clinical severity (unified Huntington disease motor rating scale [UHDMRS]), genetic tests. Laboratory-based full-night attended video-polysomnography (V-PSG). Measurements and Results: The duration of the disease was 9.4 ± 4.4 y, UHMDRS score was 55.5 ± 23.4, CAG repeats were 44.3 ± 4.1. Body mass index was 21.9 ± 4.0 kg/m2. No patients or caregivers reported poor sleep quality. Two patients reported symptoms of RLS. Eight patients had an ESS score ≥ 9. Eight patients had high risk of obstructive sleep apnea. At the RBD questionnaire, two patients had a pathological score. HD patients, compared to controls, showed shorter sleep, reduced sleep efficiency index, and increased arousals and awakenings. Four patients presented with sleep disordered breathing (SDB). Periodic limb movements (PLMs) during wake and sleep were observed in all patients. No episode of RBD was observed in the V-PSG recordings, and no patients showed rapid eye movement (REM) sleep without atonia. The disease duration correlated with ESS score (P < 0.02). UHMDRS correlated positively with the ESS score (P < 0.005), and negatively with the percentage of REM sleep. Conclusions: Patients with Huntington disease showed a severe sleep disruption and a high prevalence of periodic limb movements, but no evidence of sleep disordered breathing or REM sleep behavior disorder. Citation: Piano C, Losurdo A, Della Marca G, Solito M, Calandra-Buonaura G, Provini F, Bentivoglio AR, Cortelli P. Polysomnographic findings and clinical correlates in Huntington disease: a cross-sectional cohort study. SLEEP 2015;38(9):1489–1495. PMID:25845698

Suicidal events in the Treatment for Adolescents With Depression Study (TADS).

PubMed

Vitiello, Benedetto; Silva, Susan G; Rohde, Paul; Kratochvil, Christopher J; Kennard, Betsy D; Reinecke, Mark A; Mayes, Taryn L; Posner, Kelly; May, Diane E; March, John S

2009-04-21

The Treatment for Adolescents with Depression Study (TADS) database was analyzed to determine whether suicidal events (attempts and ideation) occurred early in treatment, could be predicted by severity of depression or other clinical characteristics, and were preceded by clinical deterioration or symptoms of increased irritability, akathisia, sleep disruption, or mania. TADS was a 36-week randomized, controlled clinical trial of pharmacologic and psychotherapeutic treatments involving 439 youths with major depressive disorder (DSM-IV criteria). Suicidal events were defined according to the Columbia Classification Algorithm of Suicidal Assessment. Patients were randomly assigned into the study between spring 2000 and summer 2003. Forty-four patients (10.0%) had at least 1 suicidal event (no suicide occurred). Events occurred 0.4 to 31.1 weeks (mean +/- SD = 11.9 +/- 8.2) after starting TADS treatment, with no difference in event timing for patients receiving medication versus those not receiving medication. Severity of self-rated pretreatment suicidal ideation (Suicidal Ideation Questionnaire adapted for adolescents score > or = 31) and depressive symptoms (Reynolds Adolescent Depression Scale score > or = 91) predicted occurrence of suicidal events during treatment (P < .05). Patients with suicidal events were on average still moderately ill prior to the event (mean +/- SD Clinical Global Impressions-Severity of Illness scale score = 4.0 +/- 1.3) and only minimally improved (mean +/- SD Clinical Global Impressions-Improvement scale score = 3.2 +/- 1.1). Events were not preceded by increased irritability, akathisia, sleep disturbance, or manic signs. Specific interpersonal stressors were identified in 73% of cases (N = 44). Of the events, 55% (N = 24) resulted in overnight hospitalization. Most suicidal events occurred in the context of persistent depression and insufficient improvement without evidence of medication-induced behavioral activation as a precursor. Severity of self-rated suicidal ideation and depressive symptoms predicted emergence of suicidality during treatment. Risk for suicidal events did not decrease after the first month of treatment, suggesting the need for careful clinical monitoring for several months after starting treatment. Copyright 2009 Physicians Postgraduate Press, Inc.

Predicting Active Users' Personality Based on Micro-Blogging Behaviors

PubMed Central

Hao, Bibo; Guan, Zengda; Zhu, Tingshao

2014-01-01

Because of its richness and availability, micro-blogging has become an ideal platform for conducting psychological research. In this paper, we proposed to predict active users' personality traits through micro-blogging behaviors. 547 Chinese active users of micro-blogging participated in this study. Their personality traits were measured by the Big Five Inventory, and digital records of micro-blogging behaviors were collected via web crawlers. After extracting 845 micro-blogging behavioral features, we first trained classification models utilizing Support Vector Machine (SVM), differentiating participants with high and low scores on each dimension of the Big Five Inventory. The classification accuracy ranged from 84% to 92%. We also built regression models utilizing PaceRegression methods, predicting participants' scores on each dimension of the Big Five Inventory. The Pearson correlation coefficients between predicted scores and actual scores ranged from 0.48 to 0.54. Results indicated that active users' personality traits could be predicted by micro-blogging behaviors. PMID:24465462

Relationship between behavioral indices of pain during labor pain with pain intensity and duration of delivery

PubMed Central

Asl, Bibi Marziyeh Hashemi; Golmakani, Nahid; Najafi, Alireza

2018-01-01

Background Certain behaviors can be adopted by women to cope with labor pain according to their individual characteristics, which are currently called behavioral indicators during labor pain, and include facial expressions, verbal expressions, tone of voice, body movements, degree of relaxation, and respiratory system functioning during delivery. Moreover, severity of pain and duration of labor can vary due to several factors including individual characteristics. Objective The purpose of the present study was to determine the relationship between behavioral indicators during labor pain, severity of pain, and delivery duration. Methods In this cross-sectional study, 120 low risk pregnant women who referred to Omolbanin (AS) Hospital in the city of Mashhad (Iran) for delivery in 2014, were selected via convenience sampling method, which was then followed by completion of demographic information forms. From cervical dilatation of 3–5 centimeters until delivery, the Labor Pain Coping Behavior Observation Form (comprised of 6 sub-groups of facial expressions, verbal expressions, tone of voice, body movements, degree of relaxation, and respiratory function and severity and duration of pain) was completed during uterine contractions and every half an hour. Using the Inventory of Labor Information; vital signs, frequency of contractions, and duration of the first and second stages of labor were measured. Furthermore, the content validity of the questionnaire was determined and its reliability was confirmed by Cronbach’s alpha method. Then, the data were analyzed using the SPSS version 16, through Pearson Product-Moment Correlation and Spearman’s Rank-Order Correlation, Kruskal-Wallis test, and ANOVA. Results According to the results, 16.2% of the individuals had undesirable behavioral indicators during labor pain, 50% of them were endowed with acceptable behaviors, and 33.8% of these women had desirable behaviors. The findings also revealed that the duration of the active phase of the first stage of labor (p<0.001 and r=−0.453), the duration of the second stage of labor (p<0.012 and r=−0.146), and the severity of pain (p<0.001 and r=−0.450) were significantly and inversely correlated with behavioral indicators during labor pain; i.e. an increase in the mean score of behavioral indicators during labor pain could lead to a decline in the duration of stages of labor and severity of pain. Conclusion It was concluded that behaviors demonstrated by women in labor had effects on their pains in the course of delivery, and there was also a relationship between the duration of stages of labor and its severity of pain. Therefore, it was recommended to turn attention to behaviors by women in labor in order to achieve a desirable clinical management. PMID:29588826

Predicting in-hospital mortality of traffic victims: A comparison between AIS-and ICD-9-CM-related injury severity scales when only ICD-9-CM is reported.

PubMed

Van Belleghem, Griet; Devos, Stefanie; De Wit, Liesbet; Hubloue, Ives; Lauwaert, Door; Pien, Karen; Putman, Koen

2016-01-01

Injury severity scores are important in the context of developing European and national goals on traffic safety, health-care benchmarking and improving patient communication. Various severity scores are available and are mostly based on Abbreviated Injury Scale (AIS) or International Classification of Diseases (ICD). The aim of this paper is to compare the predictive value for in-hospital mortality between the various severity scores if only International Classification of Diseases, 9th revision, Clinical Modification ICD-9-CM is reported. To estimate severity scores based on the AIS lexicon, ICD-9-CM codes were converted with ICD Programmes for Injury Categorization (ICDPIC) and four AIS-based severity scores were derived: Maximum AIS (MaxAIS), Injury Severity Score (ISS), New Injury Severity Score (NISS) and Exponential Injury Severity Score (EISS). Based on ICD-9-CM, six severity scores were calculated. Determined by the number of injuries taken into account and the means by which survival risk ratios (SRRs) were calculated, four different approaches were used to calculate the ICD-9-based Injury Severity Scores (ICISS). The Trauma Mortality Prediction Model (TMPM) was calculated with the ICD-9-CM-based model averaged regression coefficients (MARC) for both the single worst injury and multiple injuries. Severity scores were compared via model discrimination and calibration. Model comparisons were performed separately for the severity scores based on the single worst injury and multiple injuries. For ICD-9-based scales, estimation of area under the receiver operating characteristic curve (AUROC) ranges between 0.94 and 0.96, while AIS-based scales range between 0.72 and 0.76, respectively. The intercept in the calibration plots is not significantly different from 0 for MaxAIS, ICISS and TMPM. When only ICD-9-CM codes are reported, ICD-9-CM-based severity scores perform better than severity scores based on the conversion to AIS. Copyright © 2015 Elsevier Ltd. All rights reserved.

Yokukansan (TJ-54) for treatment of pervasive developmental disorder not otherwise specified and Asperger’s disorder: a 12-week prospective, open-label study

PubMed Central

2012-01-01

Background Numerous medications have been tested on patients with pervasive developmental disorder not otherwise specified (PDD-NOS) and Asperger’s disorder. Although many of these medications have been demonstrated to be useful, no clear primary treatment for PDD-NOS and Asperger’s disorder has emerged. Despite the efficacy of some of the medicines, the acceptability and side effects have proven to be barriers to their use. Recent studies indicate that the traditional Japanese herbal medicine yokukansan (TJ-54) may be safe and useful in treating behavioral and psychological symptoms in dementia and some neuropsychiatric disorders. We aimed at evaluating both the efficacy and safety of TJ-54 in patients with well-defined PDD-NOS and Asperger’s disorder. Methods This was a 12-week prospective, open-label investigation of TJ-54 in 40 children, adolescents, and adults diagnosed with PDD-NOS or Asperger’s disorder. Primary outcome measures included the Clinical Global Impressions-Severity of Illness Scale (CGI-S) and the Aberrant Behavior Checklist-Iritability subscale score (ABC-I). Results Forty subjects, ages 8–40 years (mean 22.7 ± 7.3 years) received a mean final TJ-54 dosage of 6.4 ± 1.3 g/day (range 2.5-7.5 g/day). Full-scale intelligence quotient (IQ) scores ranged from 70 to 110 (mean 88.9 ± 13.2). Thirty-six (90%) of 40 subjects showed fewer interfering symptoms of irritability, including aggression, self-injury, and tantrums, with a final CGI-S of 1 or 2 (normal, not at all ill or borderline mentally ill) and a 80% or greater improvement on the ABC-I. The mean CGI-S score at baseline was 6.8 ± 0.8 whereas scores at end point was 1.9 ± 0.1 (< 0.0001). ABC-I scores ranged from 11 to 29 (mean 17.4 ± 3.66) at baseline, whereas scores at week 12 ranged from 0 to 5 (mean 0.93 ± 0.97) (p <0.0001). TJ-54 was well tolerated. No subject exited the study due to a drug-related adverse event. Conclusions These preliminary data suggest that TJ-54 may be effective and well tolerated for treatment of severe irritability, lethargy/withdrawal, stereotypic behavior, hyperactivity/noncompliance, and inappropriate speech in patients with PDD-NOS or Asperger’s disorder. However, given the characteristics of this trial, the present findings should be taken cautiously, and larger-scale placebo-controlled studies are needed to elucidate the efficacy and tolerability of TJ-54 in this understudied population. PMID:23194148

[Quantitative research on operation behavior of acupuncture manipulation].

PubMed

Li, Jing; Grierson, Lawrence; Wu, Mary X; Breuer, Ronny; Carnahan, Heather

2014-03-01

To explore a method of quantitative evaluation on operation behavior of acupuncture manipulation and further analyze behavior features of professional acupuncture manipulation. According to acupuncture basic manipulations, Scales for Operation Behavior of Acupuncture Basic Manipulation was made and Delphi method was adopted to test its validity. Two independent estimators utilized this scale to assess operation behavior of acupuncture manipulate among 12 acupuncturists and 12 acupuncture-novices and calculate interrater reliability, also the differences of total score of operation behavior in the two groups as well as single-step score, including sterilization, needle insertion, needle manipulation and needle withdrawal, were compared. The validity of this scale was satisfied. The inter-rater reliability was 0. 768. The total score of operation behavior in acupuncturist group was significantly higher than that in the acupuncture-novice group (13.80 +/- 1.05 vs 11.03 +/- 2.14, P < 0.01). The scores of needle insertion and needle manipulation in the acupuncturist group were significantly higher than those in the acupuncture-novice group (4.28 +/- 0.91 vs 2.54 +/- 1.51, P < 0.01; 2.56 +/- 0.65 vs 1.88 +/- 0.88, P < 0.05); however, the scores of sterilization and needle withdrawal in the acupuncturist group were not different from those in the acupuncture-novice group. This scale is suitable for quantitative evaluation on operation behavior of acupuncture manipulation. The behavior features of professional acupuncture manipulation are mainly presented with needle insertion and needle manipulation which has superior difficulty, high coordination and accuracy.

Lods, wrods, and mods: the interpretation of lod scores calculated under different models.

PubMed

Hodge, S E; Elston, R C

1994-01-01

In this paper we examine the relationships among classical lod scores, "wrod" scores (lod scores calculated under the wrong genetic model), and "mod" scores (lod scores maximized over genetic model parameters). We compare the behavior of these scores when the state of nature is linkage to their behavior when the state of nature is no linkage. We describe sufficient conditions for mod scores to be valid and discuss their use to determine the correct genetic model. We show that lod scores represent a likelihood-ratio test for independence. We explain the "ascertainment-assumption-free" aspect of using mod scores to determine mode of inheritance and we set this aspect into a well-established statistical framework. Finally, we summarize practical guidelines for the use of mod scores.

The impact of clinical, psychological, behavioral, social, and environmental factors on self-perceived symptom severity in a male cohort with intermittent claudication.

PubMed

Sharath, Sherene E; Kougias, Panos; Pisimisis, George; Barshes, Neal R

2016-05-01

To understand the relationship between self-perceived severity of intermittent claudication and various associated nonclinical factors, we examined how correlates in domains of physical activity (ie, clinical, psychological, behavioral, social, and environmental factors) relate to exertional limb symptoms. A survey was administered to individuals with intermittent claudication during their initial outpatient assessment. The subjects' self-reported exertional limb symptom severity and classic-versus-atypical claudication classification was based on the Walking Impairment Questionnaire (WIQ) and San Diego Claudication Questionnaire (SDCQ), respectively. We evaluated psychosocial and environmental factors, osteoarthritis symptoms, health, behaviors, and beliefs. Logistic and linear regressions identified factors with a strong independent association with total WIQ scores and the SDCQs. A cohort of 102 subjects (99.0% male) was enrolled in the study. The median age was 65 years with a median ankle-brachial index of 0.69. Forty-three subjects (43%) had "typical" claudication per SDCQs. Individuals with atypical claudication were more likely to report higher Aberdeen Clinical Back Pain Questionnaire scores (odds ratio, 1.04; P = .04) and no depressive symptoms (odds ratio, 8.30; P = .03). Exertional limb symptom severity among the entire cohort was significantly associated with increasing osteoarthritis symptoms (P <.001), age (P = .02), a reserved personality (P = .008), and the belief that an exercise regimen would not improve symptoms (P = .005), self-perceived levels of boredom (P = .002), and the belief that exercise (P = .002) was the best way to improve symptoms were associated with decreased symptom severity. When restricted to those with atypical pain, significant factors associated with increasing exertional symptom severity included age greater than 60 years (P = .005), osteoarthritis (P = .02), alcohol use (P = .01), belief that exercise would not improve walking (P = .03), and difficulty walking around the neighborhood (P = .02). When restricted to those with classic claudication, significant factors associated with increasing exertional limb symptom severity included frequent pain or aching in the calves while walking or sitting (P = .03 [walking]; P = .01 [sitting]) and occasional morning joint stiffness (P = .007). Exertional limb symptom severity was also associated with high limitations at home (P = .003) and a belief that exercise would not improve walking (P = .005) among those with classic claudication. Symptom severity and type of pain are associated with a number of nonclinical factors. A multidomain approach, as indicated by the models above, would benefit the continuum of care for intermittent claudication, where management is integrated and coordinated among multiple lines of care. Published by Elsevier Inc.

How Do Observational Scales Correlate the Ratings of Children's Behavior during Pediatric Procedural Sedation?

PubMed Central

Moura, Larissa da Silva

2016-01-01

Background. There is little information regarding the ability of observational scales to properly assess children's behavior during procedural sedation. Aim. To evaluate the characteristics of the Houpt scales, the Ohio State University Behavioral Rating Scale (OSUBRS) and the Venham Behavior Rating Scale when applied to preschool children undergoing conscious dental sedation. Design. This study included 27 children, 4–6 years old with early childhood caries that participated in a clinical trial (NCT02284204) that investigated two sedative regimes using oral midazolam/ketamine. Dental appointments were video-recorded; five calibrated observers assessed 1,209 minutes of video recording to score the children's behavior, following the instructions of the investigated scales. Data were analyzed by descriptive analysis and Spearman correlation tests (P < 0.05). Results. The Houpt overall behavior and the Venham scale were highly correlated (rho = −0.87; P < 0.001). OSUBRS scores were better correlated with Houpt overall behavior and Venham ratings, when compared to Houpt scores in the categories for movement and crying. Conclusions. The Houpt overall behavior and the Venham scores are global scales that properly measure children's behavior during dental sedation. Continuous assessment with OSUBRS through videos has a chance to give more precise data, while the Houpt categories can easily demonstrate children's behavior during procedures. PMID:28116299

Predictors of Broad Dimensions of Psychopathology among Patients with Panic Disorder after Cognitive-Behavioral Therapy

PubMed Central

Kondo, Masaki; Ino, Keiko; Imai, Risa; Ii, Toshitaka; Furukawa, Toshi A.; Akechi, Tatsuo

2018-01-01

Background Many patients with panic disorder meet criteria for at least one other diagnosis, most commonly other anxiety or mood disorders. Cognitive-behavioral therapy is the best empirically supported psychotherapy for panic disorder. There is now evidence indicating that cognitive-behavioral therapy for panic disorder yields positive benefits upon comorbid disorders. Objectives The present study aimed to examine the predictors of broad dimensions of psychopathology in panic disorder after cognitive-behavioral therapy. Methods Two hundred patients affected by panic disorder were treated with manualized group cognitive-behavioral therapy. We examined if the baseline personality dimensions of NEO Five Factor Index predicted the subscales of Symptom Checklist-90 Revised at endpoint using multiple regression analysis based on the intention-to-treat principle. Results Conscientiousness score of NEO Five Factor Index at baseline was a predictor of four Symptom Checklist-90 Revised subscales including obsessive-compulsive (β = −0.15, P < 0.01), depression (β = −0.13, P < 0.05), phobic anxiety (β = −0.15, P < 0.05), and Global Severity Index (β = −0.13, P < 0.05). Conclusion Conscientiousness at baseline may predict several dimensions of psychopathology in patients with panic disorder after cognitive-behavioral therapy. For the purpose of improving a wide range of psychiatric symptoms with patients affected by panic disorder, it may be useful to pay more attention to this personal trait at baseline. PMID:29721499

Predictors of Broad Dimensions of Psychopathology among Patients with Panic Disorder after Cognitive-Behavioral Therapy.

PubMed

Ogawa, Sei; Kondo, Masaki; Ino, Keiko; Imai, Risa; Ii, Toshitaka; Furukawa, Toshi A; Akechi, Tatsuo

2018-01-01

Many patients with panic disorder meet criteria for at least one other diagnosis, most commonly other anxiety or mood disorders. Cognitive-behavioral therapy is the best empirically supported psychotherapy for panic disorder. There is now evidence indicating that cognitive-behavioral therapy for panic disorder yields positive benefits upon comorbid disorders. The present study aimed to examine the predictors of broad dimensions of psychopathology in panic disorder after cognitive-behavioral therapy. Two hundred patients affected by panic disorder were treated with manualized group cognitive-behavioral therapy. We examined if the baseline personality dimensions of NEO Five Factor Index predicted the subscales of Symptom Checklist-90 Revised at endpoint using multiple regression analysis based on the intention-to-treat principle. Conscientiousness score of NEO Five Factor Index at baseline was a predictor of four Symptom Checklist-90 Revised subscales including obsessive-compulsive ( β = -0.15, P < 0.01), depression ( β = -0.13, P < 0.05), phobic anxiety ( β = -0.15, P < 0.05), and Global Severity Index ( β = -0.13, P < 0.05). Conscientiousness at baseline may predict several dimensions of psychopathology in patients with panic disorder after cognitive-behavioral therapy. For the purpose of improving a wide range of psychiatric symptoms with patients affected by panic disorder, it may be useful to pay more attention to this personal trait at baseline.

Grouping and trajectories of the neuropsychiatric symptoms in patients with Alzheimer's disease, part I: symptom clusters.

PubMed

Garre-Olmo, Josep; López-Pousa, Secundino; Vilalta-Franch, Joan; de Gracia Blanco, Manuel; Vilarrasa, Antoni Bulbena

2010-01-01

Behavioral and psychological symptoms of dementia (BPSD) are frequently observed in Alzheimer's disease (AD) and affect more than 80% of patients over the course of AD. The goal of this study was to establish a model for grouping the symptoms of BPSD into clinical syndromes. Over a 24-month period, an observational study was conducted using a population of ambulatory patients with AD of mild to moderate severity. The Neuropsychiatric Inventory (NPI) was administered to the patients' caregivers every 6 months. BPSD were grouped using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) of the NPI scores of each assessment. The sample population consisted of 491 patients (70.9% women) with an average age of 75.2 years (SD=6.6). The five EFA suggested that there was a stable three-factor structure. According to the results of the EFA, three models of symptom grouping were adjusted using CFA methodology. The CFA model that satisfactorily grouped the NPI scores into three factors included a psychotic syndrome (hallucinations, delusions), an affective syndrome (depression, anxiety, irritability, agitation) and a behavior syndrome (euphoria, disinhibition, apathy, aberrant motor behavior). Based on our findings, we propose a model for grouping the BDSD in which there are core nuclear syndromes (psychotic and affective) as well as an unspecified behavior syndrome comprising satellite symptoms that may be related to the presence of the nuclear syndromes.

Minnesota multiphasic personality inventory-2-restructured form (MMPI-2-RF) predictors of violating probation after felonious crimes.

PubMed

Tarescavage, Anthony M; Luna-Jones, Lynn; Ben-Porath, Yossef S

2014-12-01

We compared Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) scores of 25 individuals convicted of felonies who violated probation within 1 year of sentencing with those of 45 similarly sentenced defendants who completed probation successfully. The sample (51 males, 19 females) ranged in age from 18 to 81 years (M = 35.2, SD = 13.8) and had 8 to 16 years of education (M = 11.7, SD = 2.1). The majority were Caucasian (85.7%), but African Americans were also represented (14.3%). Individuals in the sample were primarily convicted of mid-level felonies (F-1: 2.9%; F-2: 14.3%; F-3: 22.9%; F-4: 31.4%; F-5: 12.9%). As hypothesized, moderate to large statistically significant differences between probation completers and violators were found on several MMPI-2-RF scales, including Behavioral/Externalizing Dysfunction, Antisocial Behavior, Juvenile Conduct Problems, Substance Abuse, Aggression, Activation, and Disconstraint. Relative risk ratio analyses indicated that probationers who produced elevated scores on these scales were up to 3 times more likely to violate probation than were those with non-elevated scores. Implications of these results and limitations of our findings are discussed. (c) 2014 APA, all rights reserved.

Internet-Delivered Cognitive Behavioral Therapy to Treat Insomnia: A Systematic Review and Meta-Analysis.

PubMed

Seyffert, Michael; Lagisetty, Pooja; Landgraf, Jessica; Chopra, Vineet; Pfeiffer, Paul N; Conte, Marisa L; Rogers, Mary A M

2016-01-01

Insomnia is of major public health importance. While cognitive behavioral therapy is beneficial, in-person treatment is often unavailable. We assessed the effectiveness of internet-delivered cognitive behavioral therapy for insomnia. The primary objectives were to determine whether online cognitive behavioral therapy for insomnia could improve sleep efficiency and reduce the severity of insomnia in adults. Secondary outcomes included sleep quality, total sleep time, time in bed, sleep onset latency, wake time after sleep onset, and number of nocturnal awakenings. We searched PubMed/MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Cochrane Library, Embase, and the Web of Science for randomized trials. Studies were eligible if they were randomized controlled trials in adults that reported application of cognitive behavioral therapy for insomnia via internet delivery. Mean differences in improvement in sleep measures were calculated using the Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis. We found 15 trials, all utilizing a pretest-posttest randomized control group design. Sleep efficiency was 72% at baseline and improved by 7.2% (95% CI: 5.1%, 9.3%; p<0.001) with internet-delivered cognitive behavioral therapy versus control. Internet-delivered cognitive behavioral therapy resulted in a decrease in the insomnia severity index by 4.3 points (95% CI: -7.1, -1.5; p = 0.017) compared to control. Total sleep time averaged 5.7 hours at baseline and increased by 20 minutes with internet-delivered therapy versus control (95% CI: 9, 31; p = 0.004). The severity of depression decreased by 2.3 points (95% CI: -2.9, -1.7; p = 0.013) in individuals who received internet-delivered cognitive behavioral therapy compared to control. Improvements in sleep efficiency, the insomnia severity index and depression scores with internet-delivered cognitive behavioral therapy were maintained from 4 to 48 weeks after post-treatment assessment. There were no statistically significant differences between sleep efficiency, total sleep time, and insomnia severity index for internet-delivered versus in-person therapy with a trained therapist. In conclusion, internet-delivered cognitive behavioral therapy is effective in improving sleep in adults with insomnia. Efforts should be made to educate the public and expand access to this therapy. Registration Number, Prospero: CRD42015017622.

Internet-Delivered Cognitive Behavioral Therapy to Treat Insomnia: A Systematic Review and Meta-Analysis

PubMed Central

Seyffert, Michael; Lagisetty, Pooja; Landgraf, Jessica; Chopra, Vineet; Pfeiffer, Paul N.; Conte, Marisa L.; Rogers, Mary A. M.

2016-01-01

Background Insomnia is of major public health importance. While cognitive behavioral therapy is beneficial, in-person treatment is often unavailable. We assessed the effectiveness of internet-delivered cognitive behavioral therapy for insomnia. Objectives The primary objectives were to determine whether online cognitive behavioral therapy for insomnia could improve sleep efficiency and reduce the severity of insomnia in adults. Secondary outcomes included sleep quality, total sleep time, time in bed, sleep onset latency, wake time after sleep onset, and number of nocturnal awakenings. Data Sources We searched PubMed/MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Cochrane Library, Embase, and the Web of Science for randomized trials. Methods Studies were eligible if they were randomized controlled trials in adults that reported application of cognitive behavioral therapy for insomnia via internet delivery. Mean differences in improvement in sleep measures were calculated using the Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis. Results We found 15 trials, all utilizing a pretest-posttest randomized control group design. Sleep efficiency was 72% at baseline and improved by 7.2% (95% CI: 5.1%, 9.3%; p<0.001) with internet-delivered cognitive behavioral therapy versus control. Internet-delivered cognitive behavioral therapy resulted in a decrease in the insomnia severity index by 4.3 points (95% CI: -7.1, -1.5; p = 0.017) compared to control. Total sleep time averaged 5.7 hours at baseline and increased by 20 minutes with internet-delivered therapy versus control (95% CI: 9, 31; p = 0.004). The severity of depression decreased by 2.3 points (95% CI: -2.9, -1.7; p = 0.013) in individuals who received internet-delivered cognitive behavioral therapy compared to control. Improvements in sleep efficiency, the insomnia severity index and depression scores with internet-delivered cognitive behavioral therapy were maintained from 4 to 48 weeks after post-treatment assessment. There were no statistically significant differences between sleep efficiency, total sleep time, and insomnia severity index for internet-delivered versus in-person therapy with a trained therapist. Conclusion In conclusion, internet-delivered cognitive behavioral therapy is effective in improving sleep in adults with insomnia. Efforts should be made to educate the public and expand access to this therapy. Registration Number, Prospero: CRD42015017622 PMID:26867139

Cognitive behavioral therapy to reduce overt aggression behavior in Chinese young male violent offenders.

PubMed

Chen, Chen; Li, Chun; Wang, Hong; Ou, Jian-Jun; Zhou, Jian-Song; Wang, Xiao-Ping

2014-01-01

This 9-week study was designed to determine whether a commercial cognitive-behavioral training program could effectively reduce overt aggression behavior in Chinese young male violent offenders. Sixty-six participants were randomly assigned to receive routine intervention alone (control group) or routine intervention plus Williams LifeSkills Training (WLST group) in a 1:1 ratio. The primary outcome was change scores on the Modified Overt Aggression Scale (MOAS) from baseline to one week following end of training. Secondary outcomes were change scores on the Barratt Impulsiveness Scale-11 (BIS-11) and Cook-Medley Hostility Scale (CMHS). There were significant between-group differences in change of MOAS total score (P < .001) and all sub-scores (Ps < .01) except aggression against property. Between-group differences were also observed in change of BIS-11 and CMHS total score (Ps < 0.05). All results favored the WLST group. These findings suggest WLST has the potential to be an effective intervention to reduce overt aggressive behavior in young male violent offenders. © 2013 Wiley Periodicals, Inc.

Prenatal Exposure to Perfluoroalkyl Substances and Behavioral Development in Children.

PubMed

Quaak, Ilona; de Cock, Marijke; de Boer, Michiel; Lamoree, Marja; Leonards, Pim; van de Bor, Margot

2016-05-19

In recent years, prevalence rates of behavioral disorders in children have increased. One factor possibly implied in the etiology of behavioral disorders is exposure to perfluoroalkyl substances (PFASs). The use of PFASs is highly integrated into everyday life, and exposure is ubiquitous. Exposure to PFASs during early life may be particularly harmful, as it represents a critical time window for brain development. However, research in the area is limited, especially among preschool children. The objective of the current study was to explore the relationship between prenatal exposure to several PFASs and behavioral development at the age of 18 months. Data from the Dutch cohort LINC (Linking Maternal Nutrition to Child Health) were used. Perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) were measured in cord plasma. The total exposure of PFASs was also calculated (ΣPFASs). Behavioral development was assessed with the Child Behavior Checklist 1.5-5 (CBCL 1.5-5). The CBCL scales "Attention Deficit Hyperactivity Disorder" (ADHD) and "Externalizing problems" were used for further analysis. Separate regression models were composed for each combination, in which exposure levels were classified in tertiles. Both whole population and sex-stratified analyses were performed. A family history of ADHD, the educational level, smoking or using alcohol or illicit drugs during pregnancy were considered as confounders. In total, data from 76 mother-child pairs was included. No significant associations were found between prenatal PFAS exposure and ADHD scores in the whole population and in the sex-stratified analyses. With regard to externalizing behavior, a significant negative association was found between the highest levels of ΣPFAS exposure and externalizing problem behavior in the whole population, but only in the crude model. After stratifying for sex, boys in the second and third tertile of exposure to PFOA presented significantly lower scores on the Externalizing Problem Scale than boys with the lowest exposure levels in the adjusted model. Girls exposed to higher levels of ΣPFAS exposure (T2) showed significantly lower scores on the Externalizing Problem Scale, in both crude and adjusted models. No significant associations with PFOS were found. RESULTS from the current study show that prenatal exposure to PFOA was negatively related to externalizing behavior in boys. RESULTS were different for boys and girls, emphasizing that mechanisms at work might be sex-dependent. However, results should be interpreted with caution as the sample size was small.

A comparison of IQ and memory cluster solutions in moderate and severe pediatric traumatic brain injury.

PubMed

Thaler, Nicholas S; Terranova, Jennifer; Turner, Alisa; Mayfield, Joan; Allen, Daniel N

2015-01-01

Recent studies have examined heterogeneous neuropsychological outcomes in childhood traumatic brain injury (TBI) using cluster analysis. These studies have identified homogeneous subgroups based on tests of IQ, memory, and other cognitive abilities that show some degree of association with specific cognitive, emotional, and behavioral outcomes, and have demonstrated that the clusters derived for children with TBI are different from those observed in normal populations. However, the extent to which these subgroups are stable across abilities has not been examined, and this has significant implications for the generalizability and clinical utility of TBI clusters. The current study addressed this by comparing IQ and memory profiles of 137 children who sustained moderate-to-severe TBI. Cluster analysis of IQ and memory scores indicated that a four-cluster solution was optimal for the IQ scores and a five-cluster solution was optimal for the memory scores. Three clusters on each battery differed primarily by level of performance, while the others had pattern variations. Cross-plotting the clusters across respective IQ and memory test scores indicated that clusters defined by level were generally stable, while clusters defined by pattern differed. Notably, children with slower processing speed exhibited low-average to below-average performance on memory indexes. These results provide some support for the stability of previously identified memory and IQ clusters and provide information about the relationship between IQ and memory in children with TBI.

Antisomnogenic cytokines, quality of life, and chronic rhinosinusitis: a pilot study.

PubMed

Alt, Jeremiah A; Sautter, Nathan B; Mace, Jess C; Detwiller, Kara Y; Smith, Timothy L

2014-04-01

Sleep disturbance, reduced quality of life (QOL), and other components of "sickness behavior" in patients with chronic rhinosinusitis (CRS) are poorly understood. These complex changes in central behavior are due to the effects of immune mediators acting in the brain. We hypothesized that immune mediators that have been associated with CRS are also associated with sickness behavior, somnifacient complaints, and CRS disease-specific QOL. Pilot study. Twenty patients with CRS were prospectively enrolled and completed the Pittsburgh Sleep Quality Index (PSQI), disease-specific QOL, and olfactory instruments. Ethmoid mucosa was obtained and reverse transcription-polymerase chain reaction was performed for the cytokines interleukin (IL)-4, -13, and transforming growth factor-β (TGF-β). Average change in crossover threshold was calculated, and differences in gene expression were correlated with sleep quality, CRS-specific QOL, and disease severity. Patients with CRS reported overall poor sleep quality and poor CRS-specific QOL with significant correlations between them. Increased expression of TGF-β (r = -0.443; P = .050) and IL-4 (r = -0.548; P = .012) correlated with sleep dysfunction, whereas IL-13 expression was linearly associated with worse sleep quality (PSQI scores r = -0.417; P = .075). IL-4 and TGF-β expression was not associated with CRS disease severity or QOL, whereas significantly higher levels of IL-13 expression correlated with worse CRS disease severity and QOL. Patients with CRS exhibited behavioral changes commonly referred to as sickness behavior, which include poor sleep quality and reduced QOL. The upregulation of IL-4 and TGF-β may contribute to inflammatory brain-mediated effects on sleep quality, whereas IL-13 may be a pleiotropic signaling molecule influencing sleep, QOL, and CRS disease severity. 2b. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Behavioral and Emotional Regulation and Adolescent Substance Use Problems: A Test of Moderation Effects in a Dual-Process Model

PubMed Central

Wills, Thomas A.; Pokhrel, Pallav; Morehouse, Ellen; Fenster, Bonnie

2011-01-01

In a structural model, we tested how relations of predictors to level of adolescent substance use (tobacco, alcohol, marijuana), and to substance-related impaired-control and behavior problems, are moderated by good self-control and poor regulation in behavioral and emotional domains. The participants were a sample of 1,116 public high-school students. In a multiple-group analysis for good self-control, the paths from negative life events to substance use level and from level to behavior problems were lower among persons scoring higher on good behavioral self-control. In a multiple-group analysis for poor regulation, the paths from negative life events to level and from peer substance use to level were greater among persons scoring higher on poor behavioral (but not emotional) regulation; an inverse path from academic competence to level was greater among persons scoring higher on both aspects of poor regulation. Paths from level to impaired-control and behavior problems were greater among persons scoring higher on both poor behavioral and poor emotional regulation. Theoretical implications for the basis of moderation effects are discussed. PMID:21443302

Examining cross-cultural differences in autism spectrum disorder: A multinational comparison from Greece, Italy, Japan, Poland, and the United States.

PubMed

Matson, J L; Matheis, M; Burns, C O; Esposito, G; Venuti, P; Pisula, E; Misiak, A; Kalyva, E; Tsakiris, V; Kamio, Y; Ishitobi, M; Goldin, R L

2017-05-01

Autism spectrum disorder (ASD) is characterized by social and communication impairments as well as restricted, repetitive behavior patterns. Despite the fact that ASD is reported worldwide, very little research exists examining ASD characteristics on a multinational scale. Cross-cultural comparisons are especially important for ASD, since cultural differences may impact the perception of symptoms. Identifying behaviors that are similarly reported as problematic across cultures as well as identifying behaviors in which there is cultural variation could aid in the development and refinement of more universally effective measures. The present study sought to examine similarities and differences in caregiver endorsement of symptom severity through scores on the Baby Infant Screen for Children with aUtIsm Traits (BISCUIT). The BISCUIT was utilized to examine ASD core symptomology in 250 toddlers diagnosed with ASD from Greece, Italy, Japan, Poland, and the United States. Significant differences in overall ASD symptom severity and endorsement were found between multinational groups. Implications of the results are discussed. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Long-term cognitive and behavioral consequences of neonatal encephalopathy following perinatal asphyxia: a review

PubMed Central

Swaab, Hanna; de Vries, Linda S.; Jongmans, Marian J.

2007-01-01

Neonatal encephalopathy (NE) following perinatal asphyxia (PA) is considered an important cause of later neurodevelopmental impairment in infants born at term. This review discusses long-term consequences for general cognitive functioning, educational achievement, neuropsychological functioning and behavior. In all areas reviewed, the outcome of children with mild NE is consistently positive and the outcome of children with severe NE consistently negative. However, children with moderate NE form a more heterogeneous group with respect to outcome. On average, intelligence scores are below those of children with mild NE and age-matched peers, but within the normal range. With respect to educational achievement, difficulties have been found in the domains reading, spelling and arithmetic/mathematics. So far, studies of neuropsychological functioning have yielded ambiguous results in children with moderate NE. A few studies suggest elevated rates of hyperactivity in children with moderate NE and autism in children with moderate and severe NE. Conclusion: Behavioral monitoring is required for all children with NE. In addition, systematic, detailed neuropsychological examination is needed especially for children with moderate NE. PMID:17426984

Association of the FTO fat mass and obesity-associated gene rs9939609 polymorphism with rewarding value of food and eating behavior in Chilean children.

PubMed

Obregón Rivas, Ana Maria; Santos, Jose L; Valladares, Macarena A; Cameron, Jameson; Goldfield, Gary

2018-03-27

The aim of this study was to assess the association between the single-nucleotide polymorphism rs9939609 in the FTO gene and homeostatic/non-homeostatic eating behavior patterns in Chilean children. A cross-sectional study was conducted in 258 children (44% female; 8-14 y of age). Anthropometric measurements (weight, height, Z-score of height, body mass index, and waist circumference) were performed. Eating behavior was assessed using the Eating in Absence of Hunger Questionnaire; the Child Eating Behavior Questionnaire; the Three Factor Eating Questionnaire, and the Food Reinforcement Value Questionnaire. Genotype of rs9939609 was determined by a Taqman assay. Association of rs9939609 with eating behavior was assessed using non-parametric tests. Allelic frequencies of rs9939609 were estimated as 77% for the A allele and 23% for the T allele. We found that normal-weight girl A carriers had higher scores of Satiety Responsiveness and Slowness on the Eating subscale. Normal-weight boy A carriers showed significantly higher scores on the Negative Affect and lower scores of the Desire to Drink subscale. In overweight children, A carriers showed higher scores on the Food Responsiveness, Emotional Overeating, Enjoyment of Food, and Food Choice subscales and lower scores on the Satiety- Responsiveness and Slowness in Eating subscales. In obese children, we found higher scores on the Cognitive Restrained subscale and lower Food Choice. The rs9939609 A allele of the FTO gene is associated with eating behavior traits and may predispose to obesity. Copyright © 2018 Elsevier Inc. All rights reserved.

SLC6A4 markers modulate platelet 5-HT level and specific behaviors of autism: a study from an Indian population.

PubMed

Jaiswal, Preeti; Guhathakurta, Subhrangshu; Singh, Asem Surindro; Verma, Deepak; Pandey, Mritunjay; Varghese, Merina; Sinha, Swagata; Ghosh, Saurabh; Mohanakumar, Kochupurackal P; Rajamma, Usha

2015-01-02

Presence of platelet hyperserotonemia and effective amelioration of behavioral dysfunctions by selective serotonin reuptake inhibitors (SSRI) in autism spectrum disorders (ASD) indicate that irregularities in serotonin (5-HT) reuptake and its homeostasis could be the basis of behavioral impairments in ASD patients. SLC6A4, the gene encoding serotonin transporter (SERT) is considered as a potential susceptibility gene for ASD, since it is a quantitative trait locus for blood 5-HT levels. Three functional polymorphisms, 5-HTTLPR, STin2 and 3'UTR-SNP of SLC6A4 are extensively studied for possible association with the disorder, with inconclusive outcome. In the present study, we investigated association of these polymorphisms with platelet 5-HT content and symptoms severity as revealed by childhood autism rating scale in ASD children from an Indian population. Higher 5-HT level observed in ASD was highly significant in children with heterozygous and homozygous genotypes comprising of minor alleles of the markers. Quantitative transmission disequilibrium test demonstrated significant genetic effect of STin2 allele as well as STin2/3'UTR-SNP and 5-HTTLPR/3'UTR-SNP haplotypes on 5-HT levels, but no direct association with overall CARS score and ASD phenotype. Significant genetic effect of the markers on specific behavioral phenotypes was observed for various sub-phenotypes of CARS in quantitative trait analysis. Even though the 5-HT level was not associated with severity of behavioral CARS score, a significant negative relationship was observed for 5-HT levels and level and consistency of intellectual response and general impression in ASD children. Population-based study revealed higher distribution of the haplotype 10/G of STin2/3'UTR-SNP in male controls, suggesting protective effect of this haplotype in male cases. Overall results of the study suggest that SLC6A4 markers have specific genetic effect on individual ASD behavioral attributes, might be through the modulation of 5-HT content. Copyright © 2014 Elsevier Inc. All rights reserved.

Behavioral measures and self-report of impulsivity in bipolar disorder: no association between Stroop test and Barratt Impulsiveness Scale.

PubMed

Strasser, Elisa Sophie; Haffner, Paula; Fiebig, Jana; Quinlivan, Esther; Adli, Mazda; Stamm, Thomas Josef

2016-12-01

Impulsivity as a tendency to act quickly without considering future consequences has been proposed as a dimensional factor in bipolar disorder. It can be measured using behavioral tasks and self-report questionnaires. Previous findings revealed patients to show worse performance on at least one behavioral measure of impulsivity. Additionally, self-reported impulsivity seems to be higher among bipolar patients, both parameters being possibly associated with a more severe course of illness. In this study, our primary aim was to investigate the relationship between these two constructs of impulsivity among bipolar patients. A total of 40 euthymic patients with bipolar disorder (21 female, 22 Bipolar I) and 30 healthy controls were recruited for comprehensive neuropsychological assessment. To assess inhibition control as a behavioral measure of impulsivity, the Stroop Color and Word Test (Stroop) was used. Additionally, both groups completed the Barratt Impulsiveness Scale (BIS) as a self-report of impulsivity. To compare the groups' performance on the Stroop and ratings on the BIS, the non-parametric Mann-Whitney U test was used. Within the bipolar group, we additionally examined the possibility of an association between Stroop performance and BIS total scores using Pearson's Correlation r. Patients and controls differed significantly on the Stroop and BIS, with patients performing worse on the Stroop and scoring higher on the BIS. However, there was no association between the Stroop and BIS within the bipolar group. As an exploratory analysis, a positive correlation between Stroop performance and number of episodes was found. Further, we detected a statistical trend in the direction of poorer Stroop performance among patients treated with polypharmacy. Both difficulties with behavioral inhibition and self-reported impulsivity were observed to be higher in bipolar patients than controls in the current study. However, within the patient group we did not observe an association between patients' behavioral performance and self-report. This indicates that the parameters likely constitute distinct, dimensional factors of bipolar disorder. In future research, studies with larger samples should investigate which of the two markers constitutes the better marker for the illness and is more suitable to differentiate the most severe patients.

Diagnostic performance and optimal cut-off scores of the Massachusetts youth screening instrument-second version in a sample of Swiss youths in welfare and juvenile justice institutions.

PubMed

Dölitzsch, Claudia; Leenarts, Laura E W; Schmeck, Klaus; Fegert, Jorg M; Grisso, Thomas; Schmid, Marc

2017-02-08

There is a growing consensus about the importance of mental health screening of youths in welfare and juvenile justice institutions. The Massachusetts Youth Screening Instrument-second version (MAYSI-2) was specifically designed, normed and validated to assist juvenile justice facilities in the United States of America (USA), in identifying youths with potential emotional or behavioral problems. However, it is not known if the USA norm-based cut-off scores can be used in Switzerland. Therefore, the primary purpose of the current study was to estimate the diagnostic performance and optimal cut-off scores of the MAYSI-2 in a sample of Swiss youths in welfare and juvenile justice institutions. As the sample was drawn from the French-, German- and Italian-speaking parts of Switzerland, the three languages were represented in the total sample of the current study and consequently we could estimate the diagnostic performance and the optimal cut-off scores of the MAYSI-2 for the language regions separately. The other main purpose of the current study was to identify potential gender differences in the diagnostic performance and optimal cut-off scores. Participants were 297 boys and 149 girls (mean age = 16.2, SD = 2.5) recruited from 64 youth welfare and juvenile justice institutions (drawn from the French-, German- and Italian-speaking parts of Switzerland). The MAYSI-2 was used to screen for mental health or behavioral problems that could require further evaluation. Psychiatric classification was based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime version (K-SADS-PL). The MAYSI-2 scores were submitted into Receiver-Operating Characteristic (ROC) analyses to estimate the diagnostic performance and optimal 'caution' cut-off scores of the MAYSI-2. The ROC analyses revealed that nearly all homotypic mappings of MAYSI-2 scales onto (cluster of) psychiatric disorders revealed above chance level accuracy. The optimal 'caution' cut-off scores derived from the ROC curve for predicting (cluster of) psychiatric disorders were, for several MAYSI-2 scales, comparable to the USA norm-based 'caution' cut-off scores. For some MAYSI-2 scales, however, higher optimal 'caution' cut-off scores were found. With adjusted optimal 'caution' cut-off scores, the MAYSI-2 screens potential emotional or behavioral problems well in a sample of Swiss youths in welfare and juvenile justice institutions. However, as for choosing the optimal 'caution' cut off score for the MAYSI-2, both language as well as gender seems to be of importance. The results of this study point to a compelling need to test the diagnostic performance and optimal 'caution' cut-off scores of the MAYSI-2 more elaborately in larger differentiated language samples in Europe.

Importance of stability of early living arrangements on behavior outcomes of children with and without prenatal drug exposure.

PubMed

Bada, Henrietta S; Langer, John; Twomey, Jean; Bursi, Charlotte; Lagasse, Linda; Bauer, Charles R; Shankaran, Seetha; Lester, Barry M; Higgins, Rosemary; Maza, Penelope L

2008-06-01

We evaluated whether living arrangements of children with or without prenatal drug exposure would be associated with their behavior outcomes and adaptive functioning. A total of 1388 children with or without prenatal cocaine or opiate exposure were enrolled in a longitudinal cohort study at 1 month of age, were seen at intervals, tracked over time for their living situation, and evaluated for behavior problems and adaptive functioning at 3 years of age. The Child Behavior Checklist and Vineland Adaptive Behavior Scales were administered. Using multiple regression models, we determined the factors that would predict behavior problems and adaptive functioning. Of the children enrolled, 1092 children were evaluated. Total and externalizing behavior problems T scores of children in relative care were lower (better) than those in parental care; externalizing behavior scores were lower than those in nonrelative care (p < .05). Total behavior problem scores increased 2.3 and 1.3 points, respectively, with each move per year and each year of Child Protective Services involvement. Compared to children in nonrelative care, those in parental or relative care had higher (better) scores in the Vineland Adaptive Behavior Scales total composite (p < .023), communication (p < .045), and daily living (p < .001). Each caretaker change was associated with a decrease of 2.65 and 2.19 points, respectively, in communication and daily living scores. Children's living arrangements were significantly associated with childhood behavior problems and adaptive functioning. The instability of living situation was also a significant predictor of these outcomes. While family preservation continues to be the goal of the child welfare system, expediting decision toward permanency remains paramount once children are placed in foster care.

The Role of Social-Emotional and Social Network Factors in the Relationship Between Academic Achievement and Risky Behaviors.

PubMed

Wong, Mitchell D; Strom, Danielle; Guerrero, Lourdes R; Chung, Paul J; Lopez, Desiree; Arellano, Katherine; Dudovitz, Rebecca N

2017-08-01

We examined whether standardized test scores and grades are related to risky behaviors among low-income minority adolescents and whether social networks and social-emotional factors explained those relationships. We analyzed data from 929 high school students exposed by natural experiment to high- or low-performing academic environments in Los Angeles. We collected information on grade point average (GPA), substance use, sexual behaviors, participation in fights, and carrying a weapon from face-to-face interviews and obtained California math and English standardized test results. Logistic regression and mediation analyses were used to examine the relationship between achievement and risky behaviors. Better GPA and California standardized test scores were strongly associated with lower rates of substance use, high-risk sexual behaviors, and fighting. The unadjusted relative odds of monthly binge drinking was 0.72 (95% confidence interval, 0.56-0.93) for 1 SD increase in standardized test scores and 0.46 (95% confidence interval, 0.29-0.74) for GPA of B- or higher compared with C+ or lower. Most associations disappeared after controlling for social-emotional and social network factors. Averaged across the risky behaviors, mediation analysis revealed social-emotional factors accounted for 33% of the relationship between test scores and risky behaviors and 43% of the relationship between GPA with risky behaviors. Social network characteristics accounted for 31% and 38% of the relationship between behaviors with test scores and GPA, respectively. Demographic factors, parenting, and school characteristics were less important explanatory factors. Social-emotional factors and social network characteristics were the strongest explanatory factors of the achievement-risky behavior relationship and might be important to understanding the relationship between academic achievement and risky behaviors. Published by Elsevier Inc.

Surgery for Drug-Resistant Epilepsy in Children.

PubMed

Dwivedi, Rekha; Ramanujam, Bhargavi; Chandra, P Sarat; Sapra, Savita; Gulati, Sheffali; Kalaivani, Mani; Garg, Ajay; Bal, Chandra S; Tripathi, Madhavi; Dwivedi, Sada N; Sagar, Rajesh; Sarkar, Chitra; Tripathi, Manjari

2017-10-26

Neurosurgical treatment may improve seizures in children and adolescents with drug-resistant epilepsy, but additional data are needed from randomized trials. In this single-center trial, we randomly assigned 116 patients who were 18 years of age or younger with drug-resistant epilepsy to undergo brain surgery appropriate to the underlying cause of epilepsy along with appropriate medical therapy (surgery group, 57 patients) or to receive medical therapy alone (medical-therapy group, 59 patients). The patients in the medical-therapy group were assigned to a waiting list for surgery. The primary outcome was freedom from seizures at 12 months. Secondary outcomes were the score on the Hague Seizure Severity scale, the Binet-Kamat intelligence quotient, the social quotient on the Vineland Social Maturity Scale, and scores on the Child Behavior Checklist and the Pediatric Quality of Life Inventory. At 12 months, freedom from seizures occurred in 44 patients (77%) in the surgery group and in 4 (7%) in the medical-therapy group (P<0.001). Between-group differences in the change from baseline to 12 months significantly favored surgery with respect to the score on the Hague Seizure Severity scale (difference, 19.4; 95% confidence interval [CI], 15.8 to 23.1; P<0.001), on the Child Behavior Checklist (difference, 13.1; 95% CI, 10.7 to 15.6; P<0.001), on the Pediatric Quality of Life Inventory (difference, 21.9; 95% CI, 16.4 to 27.6; P<0.001), and on the Vineland Social Maturity Scale (difference, 4.7; 95% CI, 0.4 to 9.1; P=0.03), but not on the Binet-Kamat intelligence quotient (difference, 2.5; 95% CI, -0.1 to 5.1; P=0.06). Serious adverse events occurred in 19 patients (33%) in the surgery group, including hemiparesis in 15 (26%). In this single-center trial, children and adolescents with drug-resistant epilepsy who had undergone epilepsy surgery had a significantly higher rate of freedom from seizures and better scores with respect to behavior and quality of life than did those who continued medical therapy alone at 12 months. Surgery resulted in anticipated neurologic deficits related to the region of brain resection. (Funded by the Indian Council of Medical Research and others; Clinical Trial Registry-India number, CTRI/2010/091/000525 .).

Hunger: its impact on children's health and mental health.

PubMed

Weinreb, Linda; Wehler, Cheryl; Perloff, Jennifer; Scott, Richard; Hosmer, David; Sagor, Linda; Gundersen, Craig

2002-10-01

Hunger, with its adverse consequences for children, continues to be an important national problem. Previous studies that document the deleterious effects of hunger among children cannot distinguish child from family hunger and do not take into account some critical environmental, maternal, and child variables that may influence child outcomes. This study examines the independent contribution of child hunger on children's physical and mental health and academic functioning, when controlling for a range of environmental, maternal, and child factors that have also been associated with poor outcomes among children. With the use of standardized tools, comprehensive demographic, psychosocial, and health data were collected in Worcester, Massachusetts, from homeless and low-income housed mothers and their children (180 preschool-aged children and 228 school-aged children). Mothers and children were part of a larger unmatched case-control study of homelessness among female-headed households. Hunger was measured by a set of 7 dichotomous items, each asking the mother whether she has or her children have experienced a particular aspect of hunger during the past year--1 concerns food insecurity for the entire family, 2 concern adult hunger, and 4 involve child hunger. The items, taken from the Childhood Hunger Identification Project measure, are summed to classify the family and divided into 3 categories: no hunger, adult or moderate child hunger, or severe child hunger (indicating multiple signs of child hunger). Outcome measures included children's chronic health condition count using questions adapted from the National Health Interview Survey, Child Health Supplement, and internalizing behavior problems and anxiety/depression, measured by the Child Behavior Checklist. Additional covariates included demographic variables (ie, age, gender, ethnicity, housing status, number of moves, family size, income), low birth weight, child life events (ie, care and protection order, out of home placement, abuse, severe life events count), developmental problems (ie, developmental delay, learning disability, emotional problems), and mother's distress and psychiatric illness. Multivariate regression analyses examined the effect of child hunger on physical and mental health outcomes. The average family size for both preschoolers and school-aged children was 3; about one third of both groups were white and 40% Puerto Rican. The average income of families was approximately $11 000. Among the school-aged children, on average 10 years old, 50% experienced moderate child hunger and 16% severe child hunger. Compared with those with no hunger, school-aged children with severe hunger were more likely to be homeless (56% vs 29%), have low birth weights (23% vs 6%), and have more stressful life events (9 vs 6) when compared with those with no hunger. School-aged children with severe hunger scores had parent-reported anxiety scores that were more than double the scores for children with no hunger and significantly higher chronic illness counts (3.4 vs 1.8) and internalizing behavior problems when compared with children with no hunger. There was no relationship between hunger and academic achievement. Among preschool-aged children, who averaged 4 years of age, 51% experienced moderate child hunger and 8% severe child hunger. For preschoolers, compared with children with no hunger, severe hunger was associated with homelessness (75% vs 48%), more traumatic life events (8.5 vs 6), low birth weight (23% vs 6%), and higher levels of chronic illness and internalizing behavior problems. Mothers of both preschoolers and school-aged children who reported severe hunger were more likely to have a lifetime diagnosis of posttraumatic stress disorder. For school-aged children, severe hunger was a significant predictor of chronic illness after controlling for housing status, mother's distress, low birth weight, and child live events. For preschoolers, moderate hunger was a significant predictor of health conditions while controlling for potenns while controlling for potential explanatory factors. For both preschoolers and school-aged children, severe child hunger was associated with higher levels of internalizing behavior problems. After controlling for housing status, mother's distress, and stressful life events, severe child hunger was also associated with higher reported anxiety/depression among school-aged children. This study goes beyond previous research and highlights the independent relationship between severe child hunger and adverse physical health and mental health outcomes among low-income children. Study findings underscore the importance of clinical recognition of child hunger and its outcomes, allowing for preventive interventions and efforts to increase access to food-related resources for families.

Military Working Dog Assessment 2: The Use of an Open Field to Assess Sound-Associated Anxiety

DTIC Science & Technology

2013-02-25

Leussis M, Bolivar V. 2006. Habituation in rodents: A review of behavior, neurobiology, and genetics . Neuroscience and biobehavioral reviews. 30(7...Table 2. The scoring rubric for generation of anxiety scores. Anxiety Expression of anxiety behaviors 1 None; No anxiety behaviors 2

Effects of stocking density and string provision on welfare-related measures in commercial broiler chickens in windowed houses.

PubMed

Bailie, C L; Ijichi, C; O'Connell, N E

2018-05-01

Lower stocking densities (SD) are sometimes used in windowed houses for broilers as part of systems designed to produce high-welfare products. However, there is little scientific information on the effects of SD on welfare-related measures in broilers in windowed houses, and on whether these effects are influenced by environmental enrichment. Commercial windowed broiler chicken houses were assigned to 4 target SD (30, 32, 34, and 36 kg/m2) and 2 levels of access to string [+S (one piece per 1,000 birds/house), -S] in a 4 × 2 factorial arrangement. Treatments were applied in one of 4 houses on each of 2 farms, and replicated over 10 production cycles. Levels of lying behavior, apparent fear-related behavior, and gait score were observed in wk 3 to 5. The incidence and severity of dermatitis lesions were assessed at d 30 and at slaughter. Environmental and production performance parameters also were measured. No significant treatment effects were obtained for levels of lying or fear-related behavior, final body weight, presence of dermatitis lesions at slaughter, or percentage of downgraded carcasses. There were no significant treatment effects on measures of gait, but the percentage of birds with a gait score of ≥2 tended to increase at higher SD. The severity of dermatitis lesions at d 30 increased with increasing SD, and was significantly greater at densities of 34 and 36 kg/m2 than of 30 kg/m2. Litter moisture content was not significantly affected by treatment, which may have reflected a numerical decline in water consumption with increasing SD. Results suggest that increasing SD is a risk factor for more severe dermatitis; however, increasing density from 30 to 32 kg/m2 did not significantly affect this variable. In addition, the proportion of lame birds, levels of lying behavior, and performance were not significantly affected by increasing SD. Providing suspended string at typical commercial levels did not have beneficial effects on welfare-related measures, and further research should perhaps investigate effects of greater levels of provision.

Parental adjustment, parenting attitudes and emotional and behavioral problems in children with selective mutism.

PubMed

Alyanak, Behiye; Kılınçaslan, Ayşe; Harmancı, Halime Sözen; Demirkaya, Sevcan Karakoç; Yurtbay, Tülin; Vehid, Hayriye Ertem

2013-01-01

The present study investigated emotional and behavioral problems in children with selective mutism (SM) along with the psychological adjustment and parenting attitudes of their mothers and fathers. Participants included 26 children with SM (mean age = 8.11 ± 2.11 years), 32 healthy controls (mean age = 8.18 ± 2.55 years) and the parents of all children. Children with SM displayed higher problem scores than controls in a variety of emotional and behavioral parameters. They predominantly displayed internalizing problems, whereas aggressive and delinquent behavior was described among a subsample of the children. Significant differences existed between the SM and control groups only in paternal psychopathology, which included anxiety and depression. They did not differ with respect to maternal psychological distress or mother or father reported parental attitudes. Another important result of the present study was that the severity of emotional and behavioral problems of children with SM was correlated with maternal psychopathology but not paternal psychopathology. Copyright © 2012 Elsevier Ltd. All rights reserved.

Clinical observation, pharmacotherapy and referral on discharge of patients with anxiety disorder in a psychiatric emergency service.

PubMed

Pailhez, Guillem; Majó, Albert; Córcoles, David; Ginés, José M; Arcega, José M; Castaño, Juan; Merino, Ana; Bulbena, Antonio; Pérez, Víctor

2015-01-01

To analyze factors associated with clinical observation, pharmacotherapy and referral on discharge of patients with anxiety disorder (AD) seeking care at a psychiatric emergency unit. A total of 5003 consecutive visits were reviewed over a three-year period at a psychiatric emergency service in a tertiary university hospital. Data collected included sociodemographic and clinical information as well as the Global Assessment of Functioning (GAF) and the Severity Psychiatric Illness (SPI) scale scores. Of all the visits, 992 (19.8%) were diagnosed of AD. Of these, 19.6% required clinical observation and 72.2% were referred to a psychiatrist at discharge. Regression analysis showed that referral to psychiatry was associated with being male, native, psychiatric background, greater severity, lower global functioning, and behavioral disorders. Clinical observation (in a box) was associated with being female, greater severity, and psychotic or behavioral symptoms. Prescription of benzodiazepines was associated with anxiety, no history of addiction, and lower global functioning. Antidepressants were associated with being a native, anxiety with no history of addiction, and lower functioning. Antipsychotics were associated with being native, psychiatric background (not addiction), anxiety, and lower functioning. Behavior, psychiatric background and illness severity were determinants of referral to a specialist. Besides these, psychotic symptoms and non-specific clinical symptoms were determinants of observation. Drug prescription in AD is less frequent if the main complaint is not anxiety and depends more on the level of functioning than on that of severity.

Androgen deficiency: association with increased anxiety and depression symptom severity in anorexia nervosa.

PubMed

Miller, Karen K; Wexler, Tamara L; Zha, Alicia M; Lawson, Elizabeth A; Meenaghan, Erinne M; Misra, Madhusmita; Binstock, Anna B; Herzog, David B; Klibanski, Anne

2007-06-01

Anorexia nervosa is associated with a high prevalence of psychiatric comorbidities, including anxiety and depression, and with endocrine dysfunction, including relative androgen deficiency compared with healthy young women. Because androgens are known to affect mood and behavior, we hypothesized that low endogenous androgen production in anorexia nervosa would predict anxiety and depression severity. Serum androgen levels and severity of depression (Hamilton Rating Scale for Depression) and anxiety (Hamilton Rating Scale for Anxiety) were measured in 43 community-dwelling women with DSM-IV-defined anorexia nervosa from May 2004 to July 2006. Strong inverse associations were observed between both total and free testosterone and anxiety and depression severity, independent of weight. Free testosterone was also inversely associated with 4 eating-disordered thinking and behavior subscales of the Eating Disorder Inventory 2 (EDI-2). Mean free testosterone blood levels were lower in women with clinically significant anxiety and in women with clinically significant depression, compared with those without. In stepwise regression models, free testosterone was an important predictor of anxiety and depression severity. EDI-2 ineffectiveness, perfectionism, interpersonal distress, and social insecurity scores were also inversely associated with androgen levels, independent of weight. Our data suggest that low androgen levels may contribute to anxiety, depression, and eating-disordered thinking and behavior in women with anorexia nervosa and form the basis for future studies to investigate the effectiveness of androgen replacement therapy. ClinicalTrials.gov identifier NCT00089843.

Chaos, Hubbub, and Order Scale and Health Risk Behaviors in Adolescents in Los Angeles.

PubMed

Chatterjee, Avik; Gillman, Matthew W; Wong, Mitchell D

2015-12-01

To determine the relationship between household chaos and substance use, sexual activity, and violence-related risk behaviors in adolescents. We analyzed cross-sectional data among 929 high-school students in Los Angeles who completed a 90-minute interview that assessed health behaviors and household chaos with the 14-question Chaos, Hubbub, and Order Scale (CHAOS). Using the generalized estimating equation and adjusting for personal, parental, and family covariates, we examined associations of CHAOS score with substance use, sexual activity, and violent behavior outcome variables. We also examined the role of depression and school engagement as mediators. Mean (SD) age of the 929 students was 16.4 (1.3) years, 516 (55%) were female, and 780 (84%) were Latino. After adjustment, compared with students with CHAOS score 0, those students with the greatest scores (5-14) had ORs of 3.1 (95% CI 1.1-8.7) for smoking, 2.6 (95% CI 1.6-4.4) for drinking, 6.1 (95% CI 1.8-21) for substance use at school, and 1.9 (95% CI 1.1-3.3) for fighting in the past 12 months. Associations between CHAOS score and sexual risk and other violent behaviors were not significant. Depression and school engagement attenuated the associations. In this group of adolescents, greatest CHAOS score was associated with increased odds of risky health behaviors, with depression and school engagement as potential mediators. In the future, CHAOS score could be measured to assess risk for such behaviors or be a target for intervention to reduce chances of engaging in these behaviors. Copyright © 2015 Elsevier Inc. All rights reserved.

Comparison of an expert system with other clinical scores for the evaluation of severity of asthma.

PubMed

Gautier, V; Rédier, H; Pujol, J L; Bousquet, J; Proudhon, H; Michel, C; Daurès, J P; Michel, F B; Godard, P

1996-01-01

"Asthmaexpert" was produced at the special request of several clinicians in order to obtain a better understanding of the medical decisions taken by clinical experts in the management of asthmatic patients. In order to assess the severity of asthma, a new score called Artificial Intelligence score (AI score), produced by Asthmaexpert, was compared with three other scores (Aas, Hargreave and Brooks). One hundred patients were enrolled prospectively in the study during their first consultation in the out-patient clinic. Distribution of severity level according to the different scores was studied, and the reliability between AI and other scores was evaluated by Kappa and MacNemar tests. Correlations with functional parameters were performed. The AI score assessed higher levels of severity than the other scores (Kappa = 18, 28 and 10% for Aas, Hargreave and Brooks, respectively) with significant MacNemar test in all cases. There was a significant correlation between AI score and forced expiratory volume in one second (FEV1) (r = 0.73). These data indicate that the AI score is a severity score which defines higher levels of severity than the chosen scores. Correlations for functional parameters are good. This score appears easy to use for the first consultation of an asthmatic patient.

Impact of pavement conditions on crash severity.

PubMed

Li, Yingfeng; Liu, Chunxiao; Ding, Liang

2013-10-01

Pavement condition has been known as a key factor related to ride quality, but it is less clear how exactly pavement conditions are related to traffic crashes. The researchers used Geographic Information System (GIS) to link Texas Department of Transportation (TxDOT) Crash Record Information System (CRIS) data and Pavement Management Information System (PMIS) data, which provided an opportunity to examine the impact of pavement conditions on traffic crashes in depth. The study analyzed the correlation between several key pavement condition ratings or scores and crash severity based on a large number of crashes in Texas between 2008 and 2009. The results in general suggested that poor pavement condition scores and ratings were associated with proportionally more severe crashes, but very poor pavement conditions were actually associated with less severe crashes. Very good pavement conditions might induce speeding behaviors and therefore could have caused more severe crashes, especially on non-freeway arterials and during favorable driving conditions. In addition, the results showed that the effects of pavement conditions on crash severity were more evident for passenger vehicles than for commercial vehicles. These results provide insights on how pavement conditions may have contributed to crashes, which may be valuable for safety improvement during pavement design and maintenance. Readers should notice that, although the study found statistically significant effects of pavement variables on crash severity, the effects were rather minor in reality as suggested by frequency analyses. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Subjective Postural Vertical Determined in Patients with Pusher Behavior During Standing.

PubMed

Bergmann, Jeannine; Krewer, Carmen; Selge, Charlotte; Müller, Friedemann; Jahn, Klaus

2016-06-01

The subjective postural vertical (SPV), i.e., the perceived upright orientation of the body in relation to gravity, is disturbed in patients with pusher behavior. So far, the SPV has been measured only when these patients were sitting, and the results were contradictory as regards the side of the SPV deviation. The objective was to investigate the SPV in patients with different degrees of severity of pusher behavior while standing. Eight stroke patients with pusher behavior, ten age-matched stroke patients without pusher behavior, and ten age-matched healthy control subjects were included. The SPV (SPV error, SPV range) was assessed in the pitch and the roll planes. Pusher behavior was classified with the Burke Lateropulsion Scale (BLS). In the pitch plane, the SPV range was significantly larger in pusher patients than in patients without pusher behavior or healthy controls. The SPV error was similar for groups. In the roll plane, the SPV error and the SPV range were significantly larger and more ipsilesionally tilted in the pusher group than in the other two groups. There was a significant correlation between the SPV error in the roll plane and the BLS score. The study revealed that patients with pusher behavior had an ipsilesional SPV tilt that decreased with decreasing severity of the behavior. The large uncertainty in verticality estimation in both planes indicates that their sensitivity for the perception of verticality in space is generally disturbed. These findings emphasize the importance of specific rehabilitation approaches to recalibrate the impaired inner model of verticality.

Eating competence of Hispanic parents is associated with attitudes and behaviors that may mediate fruit and vegetable-related behaviors of 4th grade youth.

PubMed

Lohse, Barbara; Cunningham-Sabo, Leslie

2012-10-01

Parent self-efficacy, outcome expectancies, and behaviors toward cooking and fruits and vegetables mediate children's eating. Eating competence, an intra-individual approach to food-related attitudes and behaviors, is associated with healthful outcomes but has not been studied as a moderator of parent food-related behaviors that mediate healthful eating in 4th grade children. Parents (n = 339; 78% Hispanic, 89% female) of 4th graders who participated in an impact study of the Cooking with Kids curriculum in Santa Fe, NM schools eligible for Supplemental Nutrition Assistance Program Education completed the following surveys: Satter eating competence inventory for low-income (ecSI/LI) (16 items, Likert scale, possible score 0-48); modeling behaviors related to food preparation and fruits/vegetables (11 items, Likert scale, possible score 0-33); self-efficacy/outcome expectancies (SE/OE) (12 items, Likert scale, possible score 12-60); and availability of fruits/vegetables (20 items, possible score 0-20). Higher scores indicate more desired behaviors. The mean ecSI/LI score was 33.6 ± 8.5; 59% were eating competent, i.e., ecSI/LI ≥ 32. Eating-competent parents demonstrated more modeling (16.3 ± 5.0 vs. 14.0 ± 4.3; P < 0.001), greater SE/OE (53.7 ± 10.1 vs. 51.2 ± 8.5; P = 0.03), and greater in-home fruit/vegetable availability (12.7 ± 3.0 vs. 11.9 ± 3.2; P = 0.02). Two clusters of modeling behavior were defined: achievers and strivers. Modeling achievers (34.9 ± 6.9) were more eating competent (P < 0.001) than strivers (30.3 ± 8.9). Eating competence moderated parent food-related behaviors. Measuring eating competence may contribute to understanding parent behavior as a mediator in school-based nutrition interventions.

Beyond Behavioral Inhibition: A Computer Avatar Task Designed to Assess Behavioral Inhibition Extends to Harm Avoidance.

PubMed

Allen, Michael Todd; Jameson, Molly M; Myers, Catherine E

2017-01-01

Personality factors such as behavioral inhibition (BI), a temperamental tendency for avoidance in the face of unfamiliar situations, have been identified as risk factors for anxiety disorders. Personality factors are generally identified through self-report inventories. However, this tendency to avoid may affect the accuracy of these self-report inventories. Previously, a computer based task was developed in which the participant guides an on-screen "avatar" through a series of onscreen events; performance on the task could accurately predict participants' BI, measured by a standard paper and pencil questionnaire (Adult Measure of Behavioral Inhibition, or AMBI). Here, we sought to replicate this finding as well as compare performance on the avatar task to another measure related to BI, the harm avoidance (HA) scale of the Tridimensional Personality Questionnaire (TPQ). The TPQ includes HA scales as well as scales assessing reward dependence (RD), novelty seeking (NS) and persistence. One hundred and one undergraduates voluntarily completed the avatar task and the paper and pencil inventories in a counter-balanced order. Scores on the avatar task were strongly correlated with BI assessed via the AMBI questionnaire, which replicates prior findings. Females exhibited higher HA scores than males, but did not differ on scores on the avatar task. There was a strong positive relationship between scores on the avatar task and HA scores. One aspect of HA, fear of uncertainty was found to moderately mediate the relationship between AMBI scores and avatar scores. NS had a strong negative relationship with scores on the avatar task, but there was no significant relationship between RD and scores on the avatar task. These findings indicate the effectiveness of the avatar task as a behavioral alternative to self-report measures to assess avoidance. In addition, the use of computer based behavioral tasks are a viable alternative to paper and pencil self-report inventories, particularly when assessing anxiety and avoidance.

Non-native Listeners’ Recognition of High-Variability Speech Using PRESTO

PubMed Central

Tamati, Terrin N.; Pisoni, David B.

2015-01-01

Background Natural variability in speech is a significant challenge to robust successful spoken word recognition. In everyday listening environments, listeners must quickly adapt and adjust to multiple sources of variability in both the signal and listening environments. High-variability speech may be particularly difficult to understand for non-native listeners, who have less experience with the second language (L2) phonological system and less detailed knowledge of sociolinguistic variation of the L2. Purpose The purpose of this study was to investigate the effects of high-variability sentences on non-native speech recognition and to explore the underlying sources of individual differences in speech recognition abilities of non-native listeners. Research Design Participants completed two sentence recognition tasks involving high-variability and low-variability sentences. They also completed a battery of behavioral tasks and self-report questionnaires designed to assess their indexical processing skills, vocabulary knowledge, and several core neurocognitive abilities. Study Sample Native speakers of Mandarin (n = 25) living in the United States recruited from the Indiana University community participated in the current study. A native comparison group consisted of scores obtained from native speakers of English (n = 21) in the Indiana University community taken from an earlier study. Data Collection and Analysis Speech recognition in high-variability listening conditions was assessed with a sentence recognition task using sentences from PRESTO (Perceptually Robust English Sentence Test Open-Set) mixed in 6-talker multitalker babble. Speech recognition in low-variability listening conditions was assessed using sentences from HINT (Hearing In Noise Test) mixed in 6-talker multitalker babble. Indexical processing skills were measured using a talker discrimination task, a gender discrimination task, and a forced-choice regional dialect categorization task. Vocabulary knowledge was assessed with the WordFam word familiarity test, and executive functioning was assessed with the BRIEF-A (Behavioral Rating Inventory of Executive Function – Adult Version) self-report questionnaire. Scores from the non-native listeners on behavioral tasks and self-report questionnaires were compared with scores obtained from native listeners tested in a previous study and were examined for individual differences. Results Non-native keyword recognition scores were significantly lower on PRESTO sentences than on HINT sentences. Non-native listeners’ keyword recognition scores were also lower than native listeners’ scores on both sentence recognition tasks. Differences in performance on the sentence recognition tasks between non-native and native listeners were larger on PRESTO than on HINT, although group differences varied by signal-to-noise ratio. The non-native and native groups also differed in the ability to categorize talkers by region of origin and in vocabulary knowledge. Individual non-native word recognition accuracy on PRESTO sentences in multitalker babble at more favorable signal-to-noise ratios was found to be related to several BRIEF-A subscales and composite scores. However, non-native performance on PRESTO was not related to regional dialect categorization, talker and gender discrimination, or vocabulary knowledge. Conclusions High-variability sentences in multitalker babble were particularly challenging for non-native listeners. Difficulty under high-variability testing conditions was related to lack of experience with the L2, especially L2 sociolinguistic information, compared with native listeners. Individual differences among the non-native listeners were related to weaknesses in core neurocognitive abilities affecting behavioral control in everyday life. PMID:25405842

The relationships between behavioral addictions and the five-factor model of personality.

PubMed

Andreassen, Cecilie Schou; Griffiths, Mark D; Gjertsen, Siri Renate; Krossbakken, Elfrid; Kvam, Siri; Pallesen, Ståle

2013-06-01

Aims Although relationships between addiction and personality have previously been explored, no study has ever simultaneously investigated the interrelationships between several behavioral addictions, and related these to the main dimensions of the five-factor model of personality. Methods In this study, 218 university students completed questionnaires assessing seven different behavioral addictions (i.e., Facebook addiction, video game addiction, Internet addiction, exercise addiction, mobile phone addiction, compulsive buying, and study addiction) as well as an instrument assessing the main dimensions of the five-factor model of personality. Results Of the 21 bivariate intercorrelations between the seven behavioral addictions, all were positive (and nine significantly). The results also showed that (i) Neuroticism was positively associated with Internet addiction, exercise addiction, compulsive buying, and study addiction, (ii) Extroversion was positively associated with Facebook addiction, exercise addiction, mobile phone addiction, and compulsive buying, (iii) Openness to experience was negatively associated with Facebook addiction and mobile phone addiction, (iv) Agreeableness was negatively associated with Internet addiction, exercise addiction, mobile phone addiction, and compulsive buying, and (v) Conscientiousness was negatively associated with Facebook addiction, video game addiction, Internet addiction, and compulsive buying and positively associated with exercise addiction and study addiction. Conclusions The positive associations between the seven behavioral addictions suggest one or several underlying pathological factors. Hierarchical multiple regressions showed that personality traits explained between 6% and 17% of the variance in the seven behavioral addictions, suggesting that personality to a varying degree explains scores on measures of addictive behaviors.

High-fat diet exacerbates cognitive rigidity and social deficiency in the BTBR mouse model of autism.

PubMed

Zilkha, N; Kuperman, Y; Kimchi, T

2017-03-14

The global increase in rates of obesity has been accompanied by a similar surge in the number of autism diagnoses. Accumulating epidemiological evidence suggest a possible link between overweight and the risk for autism spectrum disorders (ASD), as well as autism severity. In laboratory animals, several studies have shown a connection between various environmental factors, including diet-induced obesity, and the development of autism-related behaviors. However, the effect of high-fat or imbalanced diet on a pre-existing autism-like phenotype is unclear. In this study, we employed the BTBR inbred mouse strain, a well-established mouse model for autism, to assess the impact of inadequate fattening nutrition on the autism-related behavioral phenotype. Male mice were fed by high-fat diet (HFD) or control balanced diet (control) from weaning onward, and tested in a series of behavioral assays as adults. In addition, we measured the hypothalamic expression levels of several genes involved in oxytocin and dopamine signaling, in search of a possible neurobiological underlying mechanism. As an internal control, we also employed similar metabolic and behavioral measures on neurotypical C57 mice. Compared to control-fed mice, BTBR mice fed by HFD showed marked aggravation in autism-related behaviors, manifested in increased cognitive rigidity and diminished preference for social novelty. Moreover, the total autism composite (severity) score was higher in the HFD group, and positively correlated with higher body weight. Finally, we revealed negative correlations associating dopamine signaling factors in the hypothalamus, to autism-related severity and body weight. In contrast, we found no significant effects of HFD on autism-related behaviors of C57 mice, though the metabolic effects of the diet were similar for both strains. Our results indicate a direct causative link between diet-induced obesity and worsening of a pre-existing autism-related behavior and emphasize the need for adequate nutrition in ASD patients. These findings might also implicate the involvement of hypothalamic dopamine in mediating this effect. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

Animal-assisted activity and emotional status of patients with Alzheimer's disease in day care.

PubMed

Mossello, Enrico; Ridolfi, Alessandro; Mello, Anna Maria; Lorenzini, Giulia; Mugnai, Francesca; Piccini, Carolina; Barone, Domenico; Peruzzi, Anna; Masotti, Giulio; Marchionni, Niccolò

2011-08-01

Preliminary studies suggest beneficial effects of animal-assisted activities (AAA) on behavioral and psychological symptoms of dementia (BPSD), but data are inconsistent. This study aimed to assess the effect of AAA with dogs on cognition, BPSD, emotional status and motor activity in severe Alzheimer's disease (AD). Ten patients attending an Alzheimer Day Care Center (ADCC) participated in a repeated measures study, which included: two weeks' pre-intervention, three weeks' control activity with plush dogs (CA), and three weeks' AAA. Cognitive function (Severe Impairment Battery), mood (Cornell Scale for Depression in Dementia; CSDD), BPSD (Neuropsychiatric Inventory; NPI) and agitation (Cohen-Mansfield Agitation Inventory; CMAI) were assessed at baseline and after each period. Observed Emotion Rating Scale (OERS) for emotional status, Agitated Behavior Mapping Instrument (ABMI) and a checklist for motor activity were completed across the study periods, both during intervention sessions and after three hours. Cognition and NPI were unchanged across the study. Declines in the CMAI and CSDD scores after AAA were not significant, while the NPI anxiety item score decreased in comparison with CA (CA 3.1±2.3, AAA 1.5±2.7, p = 0.04). OERS "sadness" decreased (p = 0.002), while "pleasure" (p = 0.016) and "general alertness" (p = 0.003) increased during AAA compared with CA sessions, and observed sadness remained lower after three hours (p = 0.002). Motor activity increased significantly during AAA. In this sample of severe AD patients in ADCC, AAA was associated with a decrease in anxiety and sadness and an increase in positive emotions and motor activity in comparison with a control activity.

Motor cortex inhibition

PubMed Central

Isaacs, K.M.; Augusta, M.; MacNeil, L.K.; Mostofsky, S.H.

2011-01-01

Objective: Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset behavioral diagnosis in which children often fail to meet age norms in development of motor control, particularly timed repetitive and sequential movements, motor overflow, and balance. The neural substrate of this motor delay may include mechanisms of synaptic inhibition in or adjacent to the motor cortex. The primary objective of this study was to determine whether transcranial magnetic stimulation (TMS)–evoked measures, particularly short interval cortical inhibition (SICI), in motor cortex correlate with the presence and severity of ADHD in childhood as well as with commonly observed delays in motor control. Methods: In this case-control study, behavioral ratings, motor skills, and motor cortex physiology were evaluated in 49 children with ADHD (mean age 10.6 years, 30 boys) and 49 typically developing children (mean age 10.5 years, 30 boys), all right-handed, aged 8–12 years. Motor skills were evaluated with the Physical and Neurological Examination for Subtle Signs (PANESS) and the Motor Assessment Battery for Children version 2. SICI and other physiologic measures were obtained using TMS in the left motor cortex. Results: In children with ADHD, mean SICI was reduced by 40% (p < 0.0001) and less SICI correlated with higher ADHD severity (r = −0.52; p = 0.002). Mean PANESS motor development scores were 59% worse in children with ADHD (p < 0.0001). Worse PANESS scores correlated modestly with less SICI (r = −.30; p = 0.01). Conclusion: Reduced TMS-evoked SICI correlates with ADHD diagnosis and symptom severity and also reflects motor skill development in children. PMID:21321335

The reliability and validity of the Tokyo Autistic Behaviour Scale.

PubMed

Kurita, H; Miyake, Y

1990-03-01

The Tokyo Autistic Behavior Scale (TABS) consisting of 39 items provisionally grouped in four areas--interpersonal-social relationship, language-communication, habit-mannerism and others--is an instrument used by a child's caretaker to rate the child's autistic behaviors on a 3-point scale. Test-retest reliability was satisfactory (i.e., an r for a total score was .94). Among six DSM-III diagnostic groups, infantile autism showed a significantly higher total TABS score than the other five groups, and a taxonomic validity coefficient was .54. An r between total scores of the TABS and the Childhood Autism Rating Scale--Tokyo Version was .59. The area scores showed a lower validity than the total score. The TABS appears to be a useful instrument to assess autistic behavior.

Associations of Gross Motor Delay, Behavior, and Quality of Life in Young Children With Autism Spectrum Disorder.

PubMed

Hedgecock, James B; Dannemiller, Lisa A; Shui, Amy M; Rapport, Mary Jane; Katz, Terry

2018-04-01

Young children with autism spectrum disorder (ASD) often have gross motor delays that may accentuate problem daytime behavior and health-related quality of life (QoL). The objective of this study was to describe the degree of gross motor delays in young children with ASD and associations of gross motor delays with problem daytime behavior and QoL. The primary hypothesis was that Gross motor delays significantly modifies the associations between internalizing or externalizing problem daytime behavior and QoL. This study used a cross-sectional, retrospective analysis. Data from 3253 children who were 2 to 6 years old and who had ASD were obtained from the Autism Speaks Autism Treatment Network and analyzed using unadjusted and adjusted linear regression. Measures included the Vineland Adaptive Behavior Scales, 2nd edition, gross motor v-scale score (VABS-GM) (for Gross motor delays), the Child Behavior Checklist (CBCL) (for Problem daytime behavior), and the Pediatric Quality of Life Inventory (PedsQL) (for QoL). The mean VABS-GM was 12.12 (SD = 2.2), representing performance at or below the 16th percentile. After adjustment for covariates, the internalizing CBCL t score decreased with increasing VABS-GM (β = - 0.64 SE = 0.12). Total and subscale PedsQL scores increased with increasing VABS-GM (for total score: β = 1.79 SE = 0.17; for subscale score: β = 0.9-2.66 SE = 0.17-0.25). CBCL internalizing and externalizing t scores decreased with increasing PedsQL total score (β = - 0.39 SE = 0.01; β = - 0.36 SE = 0.01). The associations between CBCL internalizing or externalizing t scores and PedsQL were significantly modified by VABSGM (β = - 0.026 SE = 0.005]; β = - 0.019 SE = 0.007). The study lacked ethnic and socioeconomic diversity. Measures were collected via parent report without accompanying clinical assessment. Cross motor delay was independently associated with Problem daytime behavior and QoL in children with ASD. Gross motor delay modified the association between Problem daytime behavior and QoL. Children with ASD and co-occurring internalizing Problem daytime behavior had greater Gross motor delays than children without internalizing Problem daytime behavior; therefore, these children may be most appropriate for early physical therapist evaluation.

Women's perceptions of their male batterers' characteristics and level of violence.

PubMed

Torres, Sara; Han, Hae-Ra

2003-01-01

This article describes the characteristics of male perpetrators of domestic violence and their relationship to the level of violence. The data about the male partners obtained from 151 battered women were used for this analysis. Using multiple regression, demographic variables and three behavioral indicators, including use of alcohol before a violent episode, history of arrests, and the generality of violence, were examined together for their relationship with the violence scores. With the level of violence as measured by the Conflict Tactics Scale (CTS) as the dependent variable, demographic variables explained 19.1% of the variability, with the behavioral indicators accounting for an additional 4.6% of the variability. Several research and clinical implications are addressed.

Behavioral therapy for treatment of stereotypic movements in nonautistic children.

PubMed

Miller, Jonathan M; Singer, Harvey S; Bridges, Dana D; Waranch, H Richard

2006-02-01

Although typically described in autistic, mentally retarded, and sensory-deprived individuals, motor stereotypies also occur in normal children. In this preliminary report, the behavior modification techniques of habit reversal and differential reinforcement of other behavior were evaluated as a therapeutic modality for the suppression of stereotypic movements in nonautistic subjects. Twelve children, ages 6 to 14 years, with physiologic stereotypies were treated using a standardized treatment protocol. Clinical outcomes were based on differences between assessments obtained at baseline and on telephone follow-up. Evaluation scales included measures of the frequency, intensity, interference, and number of stereotypies (Stereotypy Severity Scale motor portion and Stereotypy Linear Analog Scale) and assessment of global function (Child Global Assessment Scale and Stereotypy Severity Scale global portion). The results were correlated with the child's level of motivation and the number of treatment sessions. After a mean follow-up of 12.1 months, motor stereotypies showed significant improvement on the Stereotypy Linear Analog Scale and Stereotypy Severity Scale total score, P = .009 and P = .046, respectively. Both scales showed a relationship between the number of treatment sessions attended and a reduction in movements. The Child Global Assessment Scale also improved with therapy, but there was no correlation with the number of treatment sessions. Highly motivated patients had greater improvement on the Stereotypy Linear Analog Scale and Stereotypy Severity Scale scales compared with less motivated patients, but motivation had no impact on the Child Global Assessment Scale. The combined use of habit reversal and differential reinforcement of other behavior is beneficial in reducing motor stereotypies in nonautistic children.

Relationship between early motor milestones and severity of restricted and repetitive behaviors in children and adolescents with autism spectrum disorder.

PubMed

Uljarević, Mirko; Hedley, Darren; Alvares, Gail A; Varcin, Kandice J; Whitehouse, Andrew J O

2017-06-01

This study explored the relationships between the later age of achievement of early motor milestones, current motor atypicalities (toe walking), and the severity of restricted and repetitive behaviors (RRBs) in individuals with autism spectrum disorder (ASD). Parents of 147 children and adolescents with ASD (M age  = 8.09 years, SD = 4.28; 119 males) completed an early developmental milestones questionnaire and the Social Responsiveness Scale as a measure of Insistence on Sameness (IS) and Repetitive Mannerisms (RM). Two hierarchical regression analyses were conducted to test whether RM and IS behaviors were predicted by early motor milestones, or current toe walking. The final model predicting RM accounted for 15% of the variance (F = 3.02, p = .009), with toe walking as a unique and independent predictor of RM scores (t = 3.568, p = .001). The final model predicting IS accounted for 19.1% of variance in IS scores (F = 4.045, p = .001), with chronological age (CA) (t = 2.92, p = .004), age when first standing (t = 2.09, p = .038), and toe walking (t = 2.53, p = .013) as unique independent predictors. Toe walking (t = 2.4, p = .018) and age when first sitting (t = 2.08, p = .04) predicted the severity of RRBs on the Autism Diagnostic Observation Schedule (F = 2.334, p = .036). Our study replicates previous findings on the relationship between concurrent motor impairments and RRBs, and provides the first evidence for the association between RRBs and age of attainment of early motor milestones. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1163-1168. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Development of a novel score for the prediction of hospital mortality in patients with severe sepsis: the use of electronic healthcare records with LASSO regression.

PubMed

Zhang, Zhongheng; Hong, Yucai

2017-07-25

There are several disease severity scores being used for the prediction of mortality in critically ill patients. However, none of them was developed and validated specifically for patients with severe sepsis. The present study aimed to develop a novel prediction score for severe sepsis. A total of 3206 patients with severe sepsis were enrolled, including 1054 non-survivors and 2152 survivors. The LASSO score showed the best discrimination (area under curve: 0.772; 95% confidence interval: 0.735-0.810) in the validation cohort as compared with other scores such as simplified acute physiology score II, acute physiological score III, Logistic organ dysfunction system, sequential organ failure assessment score, and Oxford Acute Severity of Illness Score. The calibration slope was 0.889 and Brier value was 0.173. The study employed a single center database called Medical Information Mart for Intensive Care-III) MIMIC-III for analysis. Severe sepsis was defined as infection and acute organ dysfunction. Clinical and laboratory variables used in clinical routines were included for screening. Subjects without missing values were included, and the whole dataset was split into training and validation cohorts. The score was coined LASSO score because variable selection was performed using the least absolute shrinkage and selection operator (LASSO) technique. Finally, the LASSO score was evaluated for its discrimination and calibration in the validation cohort. The study developed the LASSO score for mortality prediction in patients with severe sepsis. Although the score had good discrimination and calibration in a randomly selected subsample, external validations are still required.

Eating behaviors in obese children with pseudohypoparathyroidism type 1a: a cross-sectional study.

PubMed

Wang, Lulu; Shoemaker, Ashley H

2014-01-01

Children with pseudohypoparathyroidism type 1a (PHP-1a) develop early-onset obesity. These children have decreased resting energy expenditure but it is unknown if hyperphagia contributes to their obesity. We conducted a survey assessment of patients 2 to 12 years old with PHP-1a and matched controls using the Hyperphagia Questionnaire (HQ) and Children's Eating Behavior Questionnaire (CEBQ). Results of the PHP-1a group were also compared with an obese control group and normal weight sibling group. We enrolled 10 patients with PHP-1a and 9 matched controls. There was not a significant difference between the PHP-1a group and matched controls for total HQ score (p = 0.72), Behavior (p = 0.91), Drive (p = 0.48) or Severity (p = 0.73) subset scores. There was also no difference between the PHP-1a group and matched controls on the CEBQ. In a secondary analysis, the PHP-1a group was compared with obese controls (n = 30) and normal weight siblings (n = 6). Caregivers reported an increased interest in food before age 2 years in 6 of 10 PHP-1a patients (60%), 9 of 30 obese controls (30%) and none of the siblings (p = 0.04). The sibling group had a significantly lower Positive Eating Behavior score than the PHP-1a group (2.6 [2.4, 2.9] vs. 3.5 [3.1, 4.0], p < 0.01) and obese controls (2.6 [2.4, 2.9] vs. 3.4 [2.6, 3.8], p = 0.04), but there was not a significant difference between the PHP-1a and obese controls (p = 0.35). The sibling group had a lower Desire to Drink score than both the PHP-1a group (1.8 [1.6, 2.7] vs. 4.3 [3.3, 5.0], p < 0.01) and obese controls (1.8 [1.6, 2.7] vs. 3.3 [3.0, 4.0], p < 0.01) but there was not a significant difference between the PHP-1a and obese control Desire to Drink scores (p = 0.11). Patients with PHP-1a demonstrate hyperphagic symptoms similar to matched obese controls.

Eating behaviors in obese children with pseudohypoparathyroidism type 1a: a cross-sectional study

PubMed Central

2014-01-01

Background Children with pseudohypoparathyroidism type 1a (PHP-1a) develop early-onset obesity. These children have decreased resting energy expenditure but it is unknown if hyperphagia contributes to their obesity. Methods We conducted a survey assessment of patients 2 to 12 years old with PHP-1a and matched controls using the Hyperphagia Questionnaire (HQ) and Children’s Eating Behavior Questionnaire (CEBQ). Results of the PHP-1a group were also compared with an obese control group and normal weight sibling group. Results We enrolled 10 patients with PHP-1a and 9 matched controls. There was not a significant difference between the PHP-1a group and matched controls for total HQ score (p = 0.72), Behavior (p = 0.91), Drive (p = 0.48) or Severity (p = 0.73) subset scores. There was also no difference between the PHP-1a group and matched controls on the CEBQ. In a secondary analysis, the PHP-1a group was compared with obese controls (n = 30) and normal weight siblings (n = 6). Caregivers reported an increased interest in food before age 2 years in 6 of 10 PHP-1a patients (60%), 9 of 30 obese controls (30%) and none of the siblings (p = 0.04). The sibling group had a significantly lower Positive Eating Behavior score than the PHP-1a group (2.6 [2.4, 2.9] vs. 3.5 [3.1, 4.0], p < 0.01) and obese controls (2.6 [2.4, 2.9] vs. 3.4 [2.6, 3.8], p = 0.04), but there was not a significant difference between the PHP-1a and obese controls (p = 0.35). The sibling group had a lower Desire to Drink score than both the PHP-1a group (1.8 [1.6, 2.7] vs. 4.3 [3.3, 5.0], p < 0.01) and obese controls (1.8 [1.6, 2.7] vs. 3.3 [3.0, 4.0], p < 0.01) but there was not a significant difference between the PHP-1a and obese control Desire to Drink scores (p = 0.11). Conclusions Patients with PHP-1a demonstrate hyperphagic symptoms similar to matched obese controls. PMID:25337124

Do self- or parent-reported dietary, physical activity, and sedentary behaviors predict worsening obesity in children?

PubMed

Dorsey, Karen B; Mauldon, Maria; Magraw, Ruth; Yu, Sunkyung; Krumholz, Harlan M

2010-10-01

To determine whether information gathered during routine healthcare visits regarding obesity related risk factors and risk behaviors predicts increases in BMI z-score over time among overweight and obese children. Medical records from 168 overweight and 441 obese patients seen for repeated visits between September 2003 and April 2006 were examined for reported dietary, physical activity, and sedentary behaviors, family history of obesity and diabetes mellitus, documented Acanthosis nigricans, and BMI values. Random-effects regression analysis was done to determine whether demographic, familial, or behavioral data predicted changes in BMI z-score over time. The presence of A nigricans and a family history of obesity were associated with an increase in BMI z-score (beta=0.56, SE=0.09, P<.001 and beta=0.31, SE=0.13, P=.021). These risk factors explained 8% and 7% of the variation in BMI z-score respectively. Self- or parent-reported dietary and physical activity behaviors did not predict change in BMI z-score. Our findings suggest that the risk factors and self- or parent-reported risk behaviors routinely assessed by pediatric clinicians have limited ability to predict future growth trends, demonstrating the difficulty in determining which patients have the greatest risk of progression of obesity. Copyright (c) 2010 Mosby, Inc. All rights reserved.

Discrepancy of performance among working memory-related tasks in autism spectrum disorders was caused by task characteristics, apart from working memory, which could interfere with task execution.

PubMed

Nakahachi, Takayuki; Iwase, Masao; Takahashi, Hidetoshi; Honaga, Eiko; Sekiyama, Ryuji; Ukai, Satoshi; Ishii, Ryouhei; Ishigami, Wataru; Kajimoto, Osami; Yamashita, Ko; Hashimoto, Ryota; Tanii, Hisashi; Shimizu, Akira; Takeda, Masatoshi

2006-06-01

Working memory performance has been inconsistently reported in autism spectrum disorders (ASD). Several studies in ASD have found normal performance in digit span and poor performance in digit symbol task although these are closely related with working memory. It is assumed that poor performance in digit symbol could be explained by confirmatory behavior, which is induced due to the vague memory representation of number-symbol association. Therefore it was hypothesized that the performance of working memory task, in which vagueness did not cause confirmatory behavior, would be normal in ASD. For this purpose, the Advanced Trail Making Test (ATMT) was used. The performance of digit span, digit symbol and ATMT was compared between ASD and normal control. The digit span, digit symbol and ATMT was given to 16 ASD subjects and 28 IQ-, age- and sex-matched control subjects. The scores of these tasks were compared. A significantly lower score for ASD was found only in digit symbol compared with control subjects. There were no significant difference in digit span and working memory estimated by ATMT. Discrepancy of scores among working memory-related tasks was demonstrated in ASD. Poor digit symbol performance, normal digit span and normal working memory in ATMT implied that ASD subjects would be intact in working memory itself, and that superficial working memory dysfunction might be observed due to confirmatory behavior in digit symbol. Therefore, to evaluate working memory in ASD, tasks that could stimulate psychopathology specific to ASD should be avoided.

BASIC Computer Scoring Program for the Leadership Scale for Sports.

ERIC Educational Resources Information Center

Garland, Daniel J.

This paper describes a computer scoring program, written in Commodore BASIC, that offers an efficient approach to the scoring of the Leadership Scale for Sports (LSS). The LSS measures: (1) the preferences of athletes for specific leader behaviors from the coach; (2) the perception of athletes regarding the actual leader behavior of their coach;…

Reliability and Construct Validity of Scores on the Behavioral Competence Inventory: A Measure of Adaptive Functioning.

ERIC Educational Resources Information Center

Jarjoura, David; Hartman-Stein, Paula; Speight, Joan; Reuter, Jeanette

1999-01-01

Examined the reliability and construct validity in an older adult population (n=149 older adults and their informants) of scores on the Behavioral Competence Inventory (BCI) (P. Hartman-Stein). Results indicate that scores on the BCI's seven scales show adequate internal consistencies and represent seven overlapping but distinct constructs in this…

A cluster-analytic approach towards multidimensional health-related behaviors in adolescents: the MoMo-Study

PubMed Central

2012-01-01

Background Although knowledge on single health-related behaviors and their association with health parameters is available, research on multiple health-related behaviors is needed to understand the interactions among these behaviors. The aims of the study were (a) to identify typical health-related behavior patterns in German adolescents focusing on physical activity, media use and dietary behavior; (b) to describe the socio-demographic correlates of the identified clusters and (c) to study their association with overweight. Methods Within the framework of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) and the “Motorik-Modul” (MoMo), 1,643 German adolescents (11–17 years) completed a questionnaire assessing the amount and type of weekly physical activity in sports clubs and during leisure time, weekly use of television, computer and console games and the frequency and amount of food consumption. From this data the three indices ‘physical activity’, ‘media use’ and ‘healthy nutrition’ were derived and included in a cluster analysis conducted with Ward’s Method and K-means analysis. Chi-square tests were performed to identify socio-demographic correlates of the clusters as well as their association with overweight. Results Four stable clusters representing typical health-related behavior patterns were identified: Cluster 1 (16.2%)—high scores in physical activity index and average scores in media use index and healthy nutrition index; cluster 2 (34.6%)—high healthy nutrition score and below average scores in the other two indices; cluster 3 (18.4%)—low physical activity score, low healthy nutrition score and very high media use score; cluster 4 (30.5%)—below average scores on all three indices. Boys were overrepresented in the clusters 1 and 3, and the relative number of adolescents with low socio-economic status as well as overweight was significantly higher than average in cluster 3. Conclusions Meaningful and stable clusters of health-related behavior were identified. These results confirm findings of another youth study hence supporting the assumption that these clusters represent typical behavior patterns of adolescents. These results are particularly relevant for the characterization of target groups for primary prevention of lifestyle diseases. PMID:23273134

Stability and Change in the Behavioral Development of Premature Infants.

ERIC Educational Resources Information Center

Mitchell, Sandra K.; Telzrow, Robert W.

The Brazelton Neonatal Behavioral Assessment Scale (BNBAS) was administered to a group of 73 premature infants at approximately 34, 36, and 40 weeks of gestational age. Six behavioral cluster scores and one reflex cluster score were computed for each examination. Repeated measures analyses of variance showed significant steady improvement on all…

Examining the Effects of Stereotype Threat on Test-Taking Behaviors

ERIC Educational Resources Information Center

Scherbaum, Charles A.; Blanshetyn, Victoria; Marshall-Wolp, Elizabeth; McCue, Elizabeth; Strauss, Ross

2011-01-01

This study examines the relationship between stereotype threat and individual test-taking behaviors. Previous research has examined the impact of stereotype threat on test scores, but little research has examined the impact of stereotype threat on the test-taking behaviors impacting those scores. Using a pre-post experimental design, stereotype…

Behavior, Social Competence, and Voice Disorders in Childhood and Adolescence.

PubMed

Krohling, Lívia Lima; Pereira de Paula, Kely Maria; Behlau, Mara Suzana

2016-11-01

This study aimed to verify the relationships among voice change complaints, indicators of competence, and behavioral problems in children and adolescents. This is a prospective study. A sample of 103 parents/guardians completed the Child Behavior Checklist for ages 6-18 years. The mean age and gender were very similar between the participants with and without voice complaints. Regarding the competences, no differences were found between the participants with and without voice complaints. The group with voice complaints presented higher total scores and T-scores in the both anxiety/depression and somatic complaints domains and in the internalising, externalizing, and total scales. The total scores and T-scores on the internalising, externalizing, and total scales, as well as those of their domains (anxiety/depression, somatic complaints, social problems, thought problems, attention problems, rule-breaking behavior, and aggressive behavior), differed between children and adolescents with and without voice complaints. Children and adolescents with complaints of voice disorder demonstrate a potential risk of developing emotional/behavioral problems. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Efficiency of two constructs called "fear of disease" and "perceived severity of disease" on the prevention of gastric cancer: Application of protection motivation theory

PubMed Central

Baghiani- Moghadam, Mohamad Hosein; Seyedi-Andi, Seyed Jalil; Shokri-Shirvani, Javad; Khafri, Sorayya; Ghadimi, Reza; Parsian, Hadi

2015-01-01

Background: Among all cancers, malignancies of gastrointestinal tract are the most common cancer among Iranian population. Dietary behavior is thought to be the most important risk factor in gastric cancer. Fear and perceived severity are two important constructs of the protection motivation theory (PMT). Despite the evidence of the impact of these two constructs in modifying dietary habits against gastric cancer, their efficiency is not well established. Therefore, the present study was designed to determine the efficiency of the mentioned constructs. Methods: This cross-sectional study was performed on 360 participants (180 males and 180 females) aged over 30 years old who presented to health centers in Babol, Iran in 2014. They were selected by a cluster sampling method in a population covered by health centers in Babol. Data collection was done using a questionnaire with acceptable reliability and validity, designed by a researcher based on two constructs of protection motivation theory. The data were analyzed by SPSS Version 20 using descriptive and analytical statistics such as ANOVA, linear and logistic regression analysis. Results: The participants who entered in the study achieved 38.6 and 69.7% of the scores of fear and perceived severity, respectively. There was a significant difference between perceived severity with level of education (p<0.05). There was a significant inverse correlation between perceived severity with nutritional high risk behavior associated with gastric cancer in the significant level of 0.05 (r=-0.165). The constructs of perceived severity and fear predicted 38% of the variance of nutritional high risk behaviors associated with gastric cancer. Conclusion: Constructs of fear and perceived severity of protection motivation theory with predicting 38% of the variance of nutritional high risk behaviors had an effective role against gastric cancer and may help in the design and implementation of educational programs for the prevention of gastric cancer. PMID:26644893

Efficiency of two constructs called "fear of disease" and "perceived severity of disease" on the prevention of gastric cancer: Application of protection motivation theory.

PubMed

Baghiani-Moghadam, Mohamad Hosein; Seyedi-Andi, Seyed Jalil; Shokri-Shirvani, Javad; Khafri, Sorayya; Ghadimi, Reza; Parsian, Hadi

2015-01-01

Among all cancers, malignancies of gastrointestinal tract are the most common cancer among Iranian population. Dietary behavior is thought to be the most important risk factor in gastric cancer. Fear and perceived severity are two important constructs of the protection motivation theory (PMT). Despite the evidence of the impact of these two constructs in modifying dietary habits against gastric cancer, their efficiency is not well established. Therefore, the present study was designed to determine the efficiency of the mentioned constructs. This cross-sectional study was performed on 360 participants (180 males and 180 females) aged over 30 years old who presented to health centers in Babol, Iran in 2014. They were selected by a cluster sampling method in a population covered by health centers in Babol. Data collection was done using a questionnaire with acceptable reliability and validity, designed by a researcher based on two constructs of protection motivation theory. The data were analyzed by SPSS Version 20 using descriptive and analytical statistics such as ANOVA, linear and logistic regression analysis. The participants who entered in the study achieved 38.6 and 69.7% of the scores of fear and perceived severity, respectively. There was a significant difference between perceived severity with level of education (p<0.05). There was a significant inverse correlation between perceived severity with nutritional high risk behavior associated with gastric cancer in the significant level of 0.05 (r=-0.165). The constructs of perceived severity and fear predicted 38% of the variance of nutritional high risk behaviors associated with gastric cancer. Constructs of fear and perceived severity of protection motivation theory with predicting 38% of the variance of nutritional high risk behaviors had an effective role against gastric cancer and may help in the design and implementation of educational programs for the prevention of gastric cancer.

Corticosteroid therapy in regressive autism: a retrospective study of effects on the Frequency Modulated Auditory Evoked Response (FMAER), language, and behavior

PubMed Central

2014-01-01

Background Up to a third of children with Autism Spectrum Disorder (ASD) manifest regressive autism (R-ASD).They show normal early development followed by loss of language and social skills. Absent evidence-based therapies, anecdotal evidence suggests improvement following use of corticosteroids. This study examined the effects of corticosteroids for R-ASD children upon the 4 Hz frequency modulated evoked response (FMAER) arising from language cortex of the superior temporal gyrus (STG) and upon EEG background activity, language, and behavior. An untreated clinical convenience sample of ASD children served as control sample. Methods Twenty steroid-treated R-ASD (STAR) and 24 not-treated ASD patients (NSA), aged 3 - 5 years, were retrospectively identified from a large database. All study participants had two sequential FMAER and EEG studies;Landau-Kleffner syndrome diagnosis was excluded. All subjects’ records contained clinical receptive and expressive language ratings based upon a priori developed metrics. The STAR group additionally was scored behaviorally regarding symptom severity as based on the Diagnostic and Statistical Manual IV (DSM-IV) ASD criteria list. EEGs were visually scored for abnormalities. FMAER responses were assessed quantitatively by spectral analysis. Treated and untreated group means and standard deviations for the FMAER, EEG, language, and behavior, were compared by paired t-test and Fisher’s exact tests. Results The STAR group showed a significant increase in the 4 Hz FMAER spectral response and a significant reduction in response distortion compared to the NSA group. Star group subjects’ language ratings were significantly improved and more STAR than NSA group subjects showed significant language improvement. Most STAR group children showed significant behavioral improvement after treatment. STAR group language and behavior improvement was retained one year after treatment. Groups did not differ in terms of minor EEG abnormalities. Steroid treatment produced no lasting morbidity. Conclusions Steroid treatment was associated with a significantly increased FMAER response magnitude, reduction of FMAER response distortion, and improvement in language and behavior scores. This was not observed in the non-treated group. These pilot findings warrant a prospective randomized validation trial of steroid treatment for R-ASD utilizing FMAER, EEG, and standardized ASD, language and behavior measures, and a longer follow-up period. Please see related article http://www.biomedcentral.com/1741-7015/12/79 PMID:24885033

Effects of music on assertive behavior during exercise by middle-school-age students.

PubMed

Mills, B D

1996-10-01

The purpose of this study was to assess the association of a particular style of music and assertive behavior in middle-school-aged students during exercise. Participants were students enrolled in a public middle school (Grades 6, 7, and 8, N = 502). A statistically significant relationship was found between the number of assertive behaviors occurring while listening to fast tempo music and grades and between difference scores and grades. Difference scores were obtained by subtracting the number of assertive behaviors occurring while listening to fast tempo music from those while listening to slow tempo music. Discriminant function analysis showed the number of assertive behaviors when listening to fast tempo music and difference scores were predictive of membership by grade. The higher the more assertive behaviors were emitted when listening to fast tempo music.

Moderators and predictors of response to behavior therapy for tics in Tourette syndrome

PubMed Central

Woods, Douglas W.; Piacentini, John; Wilhelm, Sabine; Peterson, Alan L.; Katsovich, Lily; Dziura, James; Walkup, John T.; Scahill, Lawrence

2017-01-01

Objective: To examine moderators and predictors of response to behavior therapy for tics in children and adults with Tourette syndrome and chronic tic disorders. Methods: Data from 2 10-week, multisite studies (1 in children and 1 in adults; total n = 248) comparing comprehensive behavioral intervention for tics (CBIT) to psychoeducation and supportive therapy (PST) were combined for moderator analyses. Participants (177 male, 71 female) had a mean age of 21.5 ± 13.9 years (range 9–69). Demographic and clinical characteristics, baseline tic-suppressing medication, and co-occurring psychiatric disorders were tested as potential moderators for CBIT vs PST or predictors of outcome regardless of treatment assignment. Main outcomes measures were the Yale Global Tic Severity Scale Total Tic score and the Clinical Global Impression–Improvement score assessed by masked evaluators. Results: The presence of tic medication significantly moderated response to CBIT vs PST (p = 0.01). Participants showed tic reduction after CBIT regardless of tic medication status, but only participants receiving tic medication showed reduction of tics after PST. Co-occurring psychiatric disorders, age, sex, family functioning, tic characteristics, and treatment expectancy did not moderate response. Across both treatments, greater tic severity (p = 0.005) and positive participant expectancy (p = 0.01) predicted greater tic improvement. Anxiety disorders (p = 0.042) and premonitory urge severity (p = 0.005) predicted lower tic reduction. Conclusions: Presence of co-occurring attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, or anxiety disorders did not moderate response to CBIT. Although participants on tic medication showed improvement after CBIT, the difference between CBIT and PST was greater for participants who were not on tic-suppressing medication. ClinicalTrials.gov identifiers: The child and adult CBIT studies are listed on clinical trials.gov (NCT00218777 and NCT00231985, respectively). Classification of evidence: This study provides Class I evidence that CBIT is effective in reducing tic severity across subgroups of patients with chronic tic disorders, although the difference between treatments was smaller for participants on tic-suppressing medications, suggesting reduced efficacy in this subgroup. PMID:28202705

Moderators and predictors of response to behavior therapy for tics in Tourette syndrome.

PubMed

Sukhodolsky, Denis G; Woods, Douglas W; Piacentini, John; Wilhelm, Sabine; Peterson, Alan L; Katsovich, Lily; Dziura, James; Walkup, John T; Scahill, Lawrence

2017-03-14

To examine moderators and predictors of response to behavior therapy for tics in children and adults with Tourette syndrome and chronic tic disorders. Data from 2 10-week, multisite studies (1 in children and 1 in adults; total n = 248) comparing comprehensive behavioral intervention for tics (CBIT) to psychoeducation and supportive therapy (PST) were combined for moderator analyses. Participants (177 male, 71 female) had a mean age of 21.5 ± 13.9 years (range 9-69). Demographic and clinical characteristics, baseline tic-suppressing medication, and co-occurring psychiatric disorders were tested as potential moderators for CBIT vs PST or predictors of outcome regardless of treatment assignment. Main outcomes measures were the Yale Global Tic Severity Scale Total Tic score and the Clinical Global Impression-Improvement score assessed by masked evaluators. The presence of tic medication significantly moderated response to CBIT vs PST ( p = 0.01). Participants showed tic reduction after CBIT regardless of tic medication status, but only participants receiving tic medication showed reduction of tics after PST. Co-occurring psychiatric disorders, age, sex, family functioning, tic characteristics, and treatment expectancy did not moderate response. Across both treatments, greater tic severity ( p = 0.005) and positive participant expectancy ( p = 0.01) predicted greater tic improvement. Anxiety disorders ( p = 0.042) and premonitory urge severity ( p = 0.005) predicted lower tic reduction. Presence of co-occurring attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, or anxiety disorders did not moderate response to CBIT. Although participants on tic medication showed improvement after CBIT, the difference between CBIT and PST was greater for participants who were not on tic-suppressing medication. The child and adult CBIT studies are listed on clinical trials.gov (NCT00218777 and NCT00231985, respectively). This study provides Class I evidence that CBIT is effective in reducing tic severity across subgroups of patients with chronic tic disorders, although the difference between treatments was smaller for participants on tic-suppressing medications, suggesting reduced efficacy in this subgroup. © 2017 American Academy of Neurology.

Trial of CBT for impulse control behaviors affecting Parkinson patients and their caregivers

PubMed Central

Okai, David; Askey-Jones, Sally; Samuel, Michael; O’Sullivan, Sean S.; Chaudhuri, K. Ray; Martin, Anne; Mack, Joel; Brown, Richard G.

2013-01-01

Objective: To test the effects of a novel cognitive-behavioral therapy (CBT)–based intervention delivered by a nurse therapist to patients with Parkinson disease (PD) with clinically significant impulse control behaviors (ICB). Methods: This was a randomized controlled trial comparing up to 12 sessions of a CBT-based intervention compared to a waiting list control condition with standard medical care (SMC). A total of 27 patients were randomized to the intervention and 17 to the waiting list. Patients with a Mini-Mental State Examination score of <24 were excluded. The coprimary outcomes were overall symptom severity and neuropsychiatric disturbances in the patients and carer burden and distress after 6 months. Secondary outcome measures included depression and anxiety, marital satisfaction, and work and social adjustment in patients plus general psychiatric morbidity and marital satisfaction in carers. Results: There was a significant improvement in global symptom severity in the CBT intervention group vs controls, from a mean score consistent with moderate to one of mild illness-related symptoms (χ2 = 16.46, p < 0.001). Neuropsychiatric disturbances also improved significantly (p = 0.03), as did levels of anxiety and depression and adjustment. Measures of carer burden and distress showed changes in the desired direction in the intervention group but did not change significantly. General psychiatric morbidity did improve significantly in the carers of patients given CBT. Conclusions: This CBT-based intervention is the first to show efficacy in ICB related to PD in terms of patient outcomes. The hoped-for alleviation of carer burden was not observed. The study demonstrates the feasibility and potential benefit of a psychosocial treatment approach for these disturbances at least in the short term, and encourages further larger-scale clinical trials. Classification of evidence: The study provides Class IV evidence that CBT plus SMC is more effective than SMC alone in reducing the severity of ICB in PD, based upon Clinical Global Impression assessment (χ2 = 16.46, p < 0.001): baseline to 6-month follow-up, reduction in symptom severity CBT group, 4.0–2.5; SMC alone group, 3.7–3.5. PMID:23325911

Reward-Seeking Behavior in Human Narcolepsy

PubMed Central

Dimitrova, Alexandra; Fronczek, Rolf; Van der Ploeg, Janneke; Scammell, Thomas; Gautam, Shiva; Pascual-Leone, Alvaro; Lammers, Gert Jan

2011-01-01

Study Objectives: The hypocretin system enhances signaling in the mesolimbic pathways regulating reward processing and addiction. Because individuals with narcolepsy with cataplexy have low hypocretin levels, we hypothesized that they may be less prone to risk- and reward-seeking behaviors, including substance abuse. Design: Endpoints were performance on an array of psychometric tests (including the Eysenck Impulsiveness Scale, the Zuckerman Sensation Seeking Scale, the Gormally Binge Eating Scale, and the Beck Depression and Anxiety Inventory) and on the Balloon Analogue Risk Task (BART). Setting: Tertiary narcolepsy referral centers in Leiden (The Netherlands) and Boston (USA). Patients: Subjects with narcolepsy with cataplexy (n = 30), narcolepsy without cataplexy (n = 15), and controls (n = 32) matched for age, sex, and smoking behavior. Interventions: None. Measurements and Results: There was no difference in risk-taking behavior between narcolepsy with or without cataplexy and the control group, as measured using the BART and the array of questionnaires. However, subjects in the narcolepsy with cataplexy group had significantly higher scores on the Eysenck Impulsiveness Scale (p < 0.05), with 10.0% categorized as impulsive, compared to 6.7% of the narcolepsy without cataplexy group and none of the controls. Narcoleptics with cataplexy also scored significantly higher than controls on the Binge Eating Scale (p < 0.05), with moderate or severe binge eating in 23%. On the depression and anxiety scales, all narcolepsy patients, especially those with cataplexy, scored significantly higher than controls. Conclusions: We found that narcoleptics with or without cataplexy generally have normal risk-taking behavior, but narcoleptics with cataplexy were more impulsive and more prone to binge eating than patients without cataplexy and controls. Our findings shed new light on the relation between sleepiness and impulsiveness. Furthermore, rates of depression and anxiety were higher in all narcoleptic subjects. However, using the current methods, no evidence could be found to support the hypothesis that hypocretin deficiency would affect reward-processing in humans. Citation: Dimitrova A; Fronczek R; Van der Ploeg J; Scammell T; Gautam S; Pascual-Leone A; Lammers GJ. Reward-seeking behavior in human narcolepsy. J Clin Sleep Med 2011;7(3):293-300. PMID:21677900

Orthorexia nervosa: relationship with obsessive-compulsive symptoms, disordered eating patterns and body uneasiness among Italian university students.

PubMed

Brytek-Matera, Anna; Fonte, Maria Luisa; Poggiogalle, Eleonora; Donini, Lorenzo Maria; Cena, Hellas

2017-12-01

The present study aimed to investigate the relationship between ORTO-15 score and obsessive-compulsive symptoms, disordered eating patterns and body uneasiness among female and male university students and to examine the predictive model of ORTO-15 in both groups. One hundred and twenty students participated in the present study (mean age 22.74 years, SD 7.31). The ORTO-15 test, the Maudsley Obsessive-Compulsive Questionnaire, the Eating Attitudes Test-26 and the Body Uneasiness Test were used for the present study. Our results revealed no gender differences in ORTO-15 score. Our results show, rather unexpectedly, that in female students lower scores, corresponding to greater severity, were related to less pathological body image discomfort and obsessive-compulsive signs, while in male students, lower ORTO-15 scores were related to less pathological eating patterns, as behaviors and symptoms. Further studies regarding the relationship between ON and anorexia nervosa, as well as obsessive-compulsive symptoms, are needed to better understand the causality. Level of Evidence Level V, descriptive study.

Behavioral management in children with intellectual disabilities in a resource-poor setting in Barwani, India

PubMed Central

Lakhan, Ram

2014-01-01

Background: Management of behavioral problems in children with intellectual disabilities (ID) is a great concern in resource-poor areas in India. This study attempted to analyze the efficacy of behavioral intervention provided in resource-poor settings. Objective: This study was aimed to examine the outcome of behavioral management provided to children with ID in a poor rural region in India. Materials and Methods: We analyzed data from 104 children between 3 and 18 years old who received interventions for behavioral problems in a clinical or a community setting. The behavioral assessment scale for Indian children with mental retardation (BASIC-MR) was used to quantify the study subjects’ behavioral problems before and after we applied behavioral management techniques (baseline and post-intervention, respectively). The baseline and post-intervention scores were analyzed using the following statistical techniques: Wilcoxon matched-pairs signed-rank test for the efficacy of intervention; χ2 for group differences. Results: The study demonstrated behavioral improvements across all behavior domains (P < 0.05). Levels of improvement varied for children with different severities of ID (P = 0.001), between children who did and did not have multiple disabilities (P = 0.011). Conclusion: The outcome of this behavioral management study suggests that behavioral intervention can be effectively provided to children with ID in poor areas. PMID:24574557

Frontal behavioral syndromes in Prader-Willi syndrome.

PubMed

Ogura, Kaeko; Shinohara, Mayumi; Ohno, Kousaku; Mori, Etsuro

2008-08-01

Prader-Willi syndrome (PWS) is a genetically determined neurodevelopmental disorder presenting with behavioral problems including hyperphagia, emotional aberration, and compulsion-like behaviors. This combination of behavioral problems is likely to be caused by damage to the orbitofrontal cortices and anterior temporal lobes or to circuits involving them. To investigate the prevalence of eating and non-eating behavioral disturbances in PWS by using assessment tools developed originally for patients with frontotemporal dementia and with frontal lobe injury. The questionnaire consisted of 35 questions related to three categories of behavior: eating behaviors (including four domains: appetite, food preference, eating habits, and other oral behaviors), stereotypy (including four domains: roaming, speaking, movements, and daily rhythm), and collecting behaviors. It was administered in Japan to the parents of 250 individuals aged 1-42 years with a clinical diagnosis of PWS. The prevalence rates of symptoms in all categories were high. Each domain involved in eating behaviors was significantly correlated with stereotypy and collecting behaviors. The prevalence rates and severity scores of some eating and non-eating behaviors were higher in the older groups. Abnormal eating behaviors, stereotyped behaviors, and collecting behaviors were common in the PWS subjects. There was also a potential link between abnormal eating and non-eating behaviors related to frontal behavioral syndromes. It is likely that these behavioral abnormalities reflect dysfunction of the orbitofrontal cortices and anterior temporal lobes.

Recognizing Disordered Eating in Primary Care Patients with Obesity

PubMed Central

Chacko, Sara A.; Chiodi, Sarah N.; Wee, Christina C.

2015-01-01

Objective In clinical practice, behavioral approaches to obesity treatment focus heavily on diet and exercise recommendations. However, these approaches may not be effective for patients with disordered eating behaviors. Little is known about the prevalence of disordered eating behaviors in primary care patients with obesity or whether they affect difficulty making dietary changes. Methods We conducted a telephone interview of 337 primary care patients aged 18–65 years with BMI≥35kg/m2 in Greater-Boston, 2009–2011 (58% response rate, 69% women). We administered the Three-Factor Eating Questionnaire R-18 (Scores 0–100) and the Impact of Weight on Quality of Life-Lite (IWQOL-lite) (Scores 0–100). We measured difficulty making dietary changes using four questions regarding perceived difficulty changing diet (Scores 0–10). Results 50% of patients reported high emotional eating (score>50) and 28% reported high uncontrolled eating (score>50). Women were more likely to report emotional [OR=4.14 (2.90, 5.92)] and uncontrolled eating [OR=2.11 (1.44, 3.08)] than men. African Americans were less likely than Caucasians to report emotional [OR=0.29 (95% CI: 0.19, 0.44)] and uncontrolled eating [OR=0.11 (0.07, 0.19)]. For every 10-point reduction in QOL score (IWQOL-lite), emotional and uncontrolled eating scores rose significantly by 7.82 and 5.48, respectively. Furthermore, participants who reported emotional and uncontrolled eating reported greater difficulty making dietary changes. Conclusions Disordered eating behaviors are prevalent among obese primary care patients and disproportionately affect women, Caucasians, and patients with poor QOL. These eating behaviors may impair patients' ability to make clinically recommended dietary changes. Clinicians should consider screening for disordered eating behaviors and tailoring obesity treatment accordingly. PMID:25572624

Increase in child behavior problems among urban Brazilian 4-year olds: 1993 and 2004 Pelotas birth cohorts

PubMed Central

Matijasevich, Alicia; Murray, Elizabeth; Stein, Alan; Anselmi, Luciana; Menezes, Ana M; Santos, Iná S; Barros, Aluísio JD; Gigante, Denise P; Barros, Fernando C; Victora, Cesar G

2014-01-01

Background There are an increasing number of reports on time trends in child and adolescent psychological problems but none from low- and middle-income countries, and very few covering the preschool period. The aim was to investigate changes in preschool behavioral/emotional problems in two birth cohorts from a middle-income country born 11 years apart. Methods We analyzed data from the 1993 and 2004 Pelotas birth cohort studies from Brazil. A subsample of 4-year olds from the 1993 cohort (634) and all 4-year olds from the 2004 cohort (3750) were assessed for behavioral/emotional problems through maternal report using the Child Behavior Checklist (CBCL). Response rates in these two population-based cohorts were above 90%. Results We found a significant increase in CBCL total problems, internalizing and externalizing mean scores over the 11-year period. For 1993 and 2004 Pelotas cohorts, respectively, CBCL mean values (SE) total problems scores were 27.9 (0.8) and 34.7 (0.3); for internalizing scores, 5.7 (0.2) and 6.3 (0.1) and for externalizing scores, 12.4 (0.4) and 15.5 (0.1). After adjusting for confounding variables, the largest increase from 1993 to 2004 was identified in the aggressive behavior syndrome score (Cohen's d = .50), followed by the externalizing problem score (Cohen's d = .40) and CBCL total problem score (Cohen's d = .36), respectively. The rise in child psychological problems was more marked in children from families with fewer assets and with less educated mothers. Conclusions Our findings provide evidence for a substantial increase in preschool behavioral problems among children in Brazil over an 11-year period. PMID:24735354

Trauma Exposure, PTSD, and HIV Sexual Risk Behaviors among Labor Migrants from Tajikistan

PubMed Central

Weine, Stevan; Bahromov, Mahbat; Loue, Sana; Owens, Linda

2012-01-01

Little is known about the role of trauma and PTSD symptoms in the context of migration-associated HIV risk behaviors. A survey of Tajik married male seasonal labor migrants in Moscow was completed by 200 workers from 4 bazaars and 200 workers from 18 construction sites as part of a mixed method (quantitative and qualitative) study. The mean PC-PTSD score was 1.2 with one-quarter of migrants scoring at or above the cutoff of 3 indicating likely PTSD diagnosis. PC-PTSD score was directly correlated with both direct and indirect trauma exposure, but PC-PTSD score did not predict either HIV sexual risk behaviors or HIV protective behaviors. HIV sexual risk behavior was associated with higher indirect trauma exposure. PC-PTSD score was associated with some indicators of increased caution (e.g. more talking with partners about HIV and condoms; more use of condom when drinking). Qualitative findings were used to illustrate the differences between direct and indirect traumas in terms of HIV sexual risk. The study findings call for future efforts to address labor migrant's mental health needs and to integrate trauma dimensions into HIV prevention. PMID:22261829

Trauma exposure, PTSD, and HIV sexual risk behaviors among labor migrants from Tajikistan.

PubMed

Weine, Stevan; Bahromov, Mahbat; Loue, Sana; Owens, Linda

2012-08-01

Little is known about the role of trauma and PTSD symptoms in the context of migration-associated HIV risk behaviors. A survey of Tajik married male seasonal labor migrants in Moscow was completed by 200 workers from 4 bazaars and 200 workers from 18 construction sites as part of a mixed method (quantitative and qualitative) study. The mean PC-PTSD score was 1.2 with one-quarter of migrants scoring at or above the cutoff of 3 indicating likely PTSD diagnosis. PC-PTSD score was directly correlated with both direct and indirect trauma exposure, but PC-PTSD score did not predict either HIV sexual risk behaviors or HIV protective behaviors. HIV sexual risk behavior was associated with higher indirect trauma exposure. PC-PTSD score was associated with some indicators of increased caution (e.g., more talking with partners about HIV and condoms; more use of condom when drinking). Qualitative findings were used to illustrate the differences between direct and indirect traumas in terms of HIV sexual risk. The study findings call for future efforts to address labor migrant's mental health needs and to integrate trauma dimensions into HIV prevention.

Associations between the HEXACO model of personality and gambling involvement, motivations to gamble, and gambling severity in young adult gamblers.

PubMed

McGrath, Daniel S; Neilson, Tessa; Lee, Kibeom; Rash, Christina L; Rad, Mandana

2018-05-30

Background and aims Substantial research has examined the role of personality in disordered gambling. The predominant model in this work has been the five-factor model (FFM) of personality. In this study, we examined the personality correlates of gambling engagement and gambling severity using a six-dimensional framework known as the HEXACO model of personality, which incorporates FFM characteristics with the addition of honesty-humility. In addition, the potential mediating role of gambling motives in the personality and gambling severity relationship was explored. Methods A sample of undergraduate gamblers (n = 183) and non-gamblers (n = 143) completed self-report measures of the Problem Gambling Severity Index (PGSI) and the Gambling Motives Questionnaire-Financial, as well as self- and observer report forms of the HEXACO-100. Results Logistic regression results revealed that scores on honesty-humility were positively associated with non-gambling over gambling status. Furthermore, it was also found that honesty-humility, agreeableness, and conscientiousness were each uniquely associated with PGSI severity scores. The results of the mediational analyses suggest that each personality factor has different gambling motivational paths leading to PGSI gambling severity. Discussion and conclusions The findings of this study contribute to the literature on behavioral addictions by providing an increased understanding of individual personality factors associated with likelihood of gambling, overall gambling severity, and gambling motives. Ultimately, these findings suggest that the honesty-humility dimension may be a target for the prevention efforts against problematic gambling outcomes.

Screening for Behavioral Risk: Identification of High Risk Cut Scores within the Social, Academic, and Emotional Behavior Risk Screener (SAEBRS)

ERIC Educational Resources Information Center

Kilgus, Stephen P.; Taylor, Crystal N.; von der Embse, Nathaniel P.

2018-01-01

The purpose of this study was to support the identification of Social, Academic, and Emotional Behavior Risk Screener (SAEBRS) cut scores that could be used to detect high-risk students. Teachers rated students across two time points (Time 1 n = 1,242 students; Time 2 n = 704) using the SAEBRS and the Behavioral and Emotional Screening System…

Protective Role of Parenting Attitude on the Behavioral and Neurocognitive Development of the Children from Economically Disadvantaged Families.

PubMed

Jung, Da-Eun; Bhang, Soo-Young; Lee, Won-Hye; Yoon, Hae-Joo; Jung, Hee-Yeon; Kim, Yeni

2018-06-01

Association between home environment and the behavioral and neurocognitive development of children from a community childcare center for low-income families was examined (aged 6 to 12 years, n=155). The parents performed a questionnaire on home environment (K-HOME-Q) to assess home environment including parenting attitude and the Child Behavior Checklist (K-CBCL). The children performed the Wechsler Intelligence (IQ) Scale, Stroop interference test (Stroop), word fluency test (WF), and design fluency test (DF) to assess their neurocognitive development. 'Nurturing of Development' and 'Variety of Language Interaction' scores from the K-HOME-Q, were inversely associated with total behavior problems, externalization, rule-breaking, and aggressive behavior subscales of K-CBCL, and 'Emotional atmosphere' and 'Tolerance toward the child' scores showed inverse associations with the total behavior problems, rule-breaking, aggressive behavior, and withdrawn/depressed subscales. Despite economic hardship, the mean scores of the neurocognitive tests were comparable to the average level of Korean children's normative sample. However, 'Nurturing of Development' and 'Tolerance toward the Child' score of K-HOME-Q were associated with better executive function (IQ, WF, DF). These results suggest that parental stimulation of development and tolerant parenting attitude may offer protection against the negative effects of suboptimal economic environment on children's behavior and neurocognitive development.

Effects of commercially produced almond by-products on chemotherapy-induced mucositis in rats

PubMed Central

Whittaker, Alexandra L; Zhu, Ying; Howarth, Gordon S; Loung, Chi S; Bastian, Susan E P; Wirthensohn, Michelle G

2017-01-01

AIM To determine if almond extracts reduce the severity of chemotherapy-induced mucositis as determined through biochemical, histological and behavioural markers. METHODS Intestinal mucositis is a debilitating condition characterized by inflammation and ulceration of the gastrointestinal mucosa experienced by cancer patients undergoing chemotherapy. Certain bioactive plant products have shown promise in accelerating mucosal repair and alleviating clinical symptoms. This study evaluated almond extracts for their potential to reduce the severity of chemotherapy-induced mucositis in Dark Agouti rats. Female Dark Agouti rats were gavaged (days 3-11) with either PBS, almond hull or almond blanched water extract at two doses, and were injected intraperitoneally with 5-fluorouracil (5-FU-150 mg/kg) or saline on day 9 to induce mucositis. Burrowing behavior, histological parameters and myeloperoxidase activity were assessed. RESULTS Bodyweight was significantly reduced in rats that received 5-FU compared to saline-treated controls (P < 0.05). Rats administered 5-FU significantly increased jejunal and ileal MPO levels (1048%; P < 0.001 and 409%; P < 0.001), compared to healthy controls. Almond hull extract caused a pro-inflammatory response in rats with mucositis as evidenced by increased myeloperoxidase activity in the jejunum when compared to 5-FU alone (rise 50%, 1088 ± 96 U/g vs 723 ± 135 U/g, P = 0.02). Other extract-related effects on inflammatory activity were minimal. 5-FU significantly increased histological severity score compared to healthy controls confirming the presence of mucositis (median of 9.75 vs 0; P < 0.001). The extracts had no ameliorating effect on histological severity score in the jejunum or ileum. Burrowing behavior was significantly reduced in all chemotherapy-treated groups (P = 0.001). The extracts failed to normalize burrowing activity to baseline levels. CONCLUSION Almond extracts at these dosages offer little beneficial effect on mucositis severity. Burrowing provides a novel measure of affective state in studies of chemotherapy-induced mucositis. PMID:29184703