Distinguishing learning-disabled and emotionally disturbed children on the WISC-R.

Isolated the distinctive WISC-R subtest patterns that would differentiate the performance of emotionally disturbed and learning-disabled children. A stepwise discriminant analysis was used to evaluate the subtest scores of 60 learning-disabled 6–13 yr olds and a matched sample of 60 emotionally disturbed children. Four subtests of the WISC-R differentiated significantly between diagnostic categories. Learning-disabled Ss performed predictively poorer on the Block Design, Picture Arrangement, and Object Assembly subtests and higher on Vocabulary than their emotionally disturbed counterparts. Results are interpreted as a deficit in perceptual organization for children with specific learning problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The classification of child psychopathology: A review and analysis of empirical efforts.

Reviews empirically derived syndromes of child behavior problems, and identifies those having counterparts in 2 or more studies. A distinction between broad-band and narrow-band syndromes was made. Broad-band undercontrolled and overcontrolled syndromes and narrow-band aggressive, delinquent, hyperactive, schizoid, anxious, depressed, somatic, and withdrawn syndromes were found in diverse samples of disturbed children. Two other broad-band and 6 other narrow-band syndromes were found in a few studies. Test–retest reliabilities and stabilities of syndrome scores were more adequate than interrater reliabilities. Cross-instrument and cross-population consistencies corroborated some empirically derived syndromes but the lack of independent criteria for categorizing disturbed children made it difficult to establish criterion-referenced validity. Because categorization of children by syndromes has been limited primarily to the broad-band undercontrolled–overcontrolled dichotomy, it is suggested that more efforts are needed to translate syndromes into categories for use by practitioners and researchers. It is concluded that further work in this area should be systematically linked to the existing mental health system and to efforts at reforming this system. (98 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal zinc indices and small babies

Recent studies have shown that the persistence of the cavum septi pellucidi beyond the neonatal period is a marker of cerebral dysgenesis. It has been suggested that the finding of a persistent cavum vergae is also a marker of disturbed brain development. In order to investigate this hypothesis we reviewed 161 brain magnetic resonance imaging scans from normal individuals for the presence of cavum septi pellucidi or cavum vergae, or both. In the 34 prospectively obtained normal adults, there were no individuals with either a cavum septi pellucidi or cavum vergae. In the "defined" normal subjects 3 of 127 individuals (2.4%) had a cavum septi pellucidi whereas a cavum vergae was noted in 26 of 127 (20.5%). We next reviewed the neuroimaging studies of 249 children and adults evaluated for mental retardation or developmental delay. A cavum septi pellucidi was found in 38 of 249 (15.3%) and a cavum vergae in 48 of 249 (19.3%) of these patients. A cavum septi pellucidi and cavum vergae were found together in 19 of 249 (7.6%). We interpret these data as showing that the cavum septi pellucidi is rarely seen in normal individuals although the cavum vergae is seen with the same frequency in normal and retarded populations. Thus we conclude that the cavum septi pellucidi serves as a significant marker of cerebral dysfunction manifested by neurodevelopmental abnormalities while the cavum vergae alone does not identify individuals at risk for cognitive delays.     

The selection of habitats among the monogenea

The pressures responsible for the selection of "non-ectoparasitic" habitats in the Monogenea are discussed. It is suggested that certain monogeneans have become internal to reduce the pressures exerted by predators of ectoparasites rather than to avoid competition with other ectoparasites or to have access to better resources. The fact that these movements have concerned the Monopisthocotylea rather than the Polyopisthocotylea could be related to the different mode of invasion by oncomiracidia in these two groups. When Monogenea are internal in "non-fish" hosts, it is suggested that this has allowed them to survive the colonisation of terrestrial environments by vertebrates, a process of coevolution which was disturbed by lateral transfers.     

The Self and Object Representations of Narcissistically Disturbed Children: An Empirical Investigation.

The aim of this study was to demonstrate a correlation between the clinical assessment of narcissistic personality disorder in children and underlying self and object relationships. D. Westen's Social Cognition and Object Relations Scale for the Thematic Apperception Test (1995; D. Westen, N. Lohr, K. Silk, K. Kerber, & S. Goodrich, 1985) was used to compare the object representations of two groups of referred latency-aged children, one for whom narcissistic issues were thought to be primary. Support for the clinical literature, which describes these children as lacking in empathy, struggling with self-esteem regulation, and in poor control of their impulses or aggression, was found. Additionally, a tendency to have a vulnerable sense of identity and to be preoccupied with seeking out and developing relationships with others was found to differentiate these children from peers with similar behavioral and diagnostic profiles. Results obtained have potential implications for the assessment and treatment of narcissistically disturbed children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social schemata of emotionally disturbed boys.

2 experiments, using Kuethe's techniques were designed to demonstrate that children defined as emotionally disturbed differ predictably from normal children in the ways they organize social stimuli. When emotionally disturbed and normal boys placed pairs of felt figures on flannel boards, normals placed child figures closer to mother than to father or peer figures; emotionally disturbed children did the reverse. When disturbed and normal boys replaced pairs of human and geometric figures previously set 15 in. apart, the disturbed boys replaced the human figures farther apart than the nonhuman figures significantly more often than did the normals. Results were interpreted as reflecting a tendency for emotionally disturbed children to construe people, and especially females, more negatively than do normal children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychoeducational assessment: A broader perspective.

The fields of mental health and education have mutual ties. When the resources and knowledge from both are pooled, as in some psychoeducational practices, comprehensive diagnostic and treatment programs become possible. While many assessment procedures have been labeled "psychoeducational," they vary from each other in significant ways to the extent that some even ignore or minimize the importance of affective behaviors during the evaluation. This article outlines a psychoeducational assessment approach for use with children and adolescents who display learning and adjustment problems. This approach stresses (a) affective as well as cognitive functioning and the intimate and dynamic relation between them, and (b) "process" rather than "achievement" test variables. Specific process variables pertaining to affective behaviors are described, and case material is included. (69 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Token reinforcements in the shaping of children's mealtime behaviour.

Shaping and subsequent extinction of acceptable mealtime behavior through selective token reinforcement was attempted with institutionalized, emotionally disturbed children. Results suggested the feasibility of utilizing individual judgements by staff personnel in behavior shaping and dispensing of reinforcements. In addition, control of mealtime behavior in some children was seen to vary as a function of the presentation or withholding of tokens. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Child and Adolescent Psychiatric Assessment (CAPA)

Great advances have been made during the last 20 years in the development of structured and semi-structured interviews for use with psychiatric patients. However, in the field of child and adolescent psychiatry there have been weaknesses in the specification and definition of both symptoms and the psychosocial impairments resulting from psychiatric disorder. Furthermore, most of the available interviews for use with children have been tied to a single diagnostic system (DSM-III, DSM-III-R, or ICD-9). This has meant that symptom coverage has been limited and nosological comparisons have been inhibited. The Child and Adolescent Psychiatric Assessment (CAPA) represents an attempt to remedy some of these shortcomings. This paper outlines the principles adopted in the CAPA to improve the standardization, reliability and meaningfulness of symptom and diagnostic ratings. The CAPA is an interviewer-based diagnostic interview with versions for use with children and their parents, focused on symptoms occurring during the preceding 3 month period, adapted for assessments in both clinical and epidemiological research.     

Effects of methylphenidate (ritalin) on paired-associate learning and porteus maze performance in emotionally disturbed children.

The stimulant drug methylphenidate was administered in a double-blind, placebo controlled study over a 10-day period to 81 children in 2 institutions. The children were deprived or emotionally disturbed, but none was known to be psychotic, brain damaged, or mentally retarded. Following tests, it was found that 2 children's anxiety scales and an impulsivity scale were unrelated to learning, and individual differences on these scales did not appear to be related to improvement on the drug. There was some indication that the greatest improvement on the mazes occurred for the children with lowest IQ. The results were interpreted as reflecting increased delay of impulsive discharge. Further research on the role of attention mechanisms in response to this drug is suggested. (30 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The deaf child's conception of physical causality.

In an attempt to assess their causal thinking relative to hearing children of normal emotional status and emotionally disturbed hearing children, the responses of 12 deaf children, aged 8-10 yr., to question dealing with physical causality were compared with those of groups of emotionally disturbed and undisturbed hearing children of similar age and intelligence. Questions asked were of 2 experience levels, depending upon the accessibility of the causal agent to direct experience. Each child was asked 8 questions at each level. It was found that: (a) Significant differences among groups appeared with items whose causal agents were not accessible to direct experience, (b) The "prelogical" responses of the deaf tend to be of a phenomenistic nature. Those of the emotionally disturbed and normals are more inclined toward the animistic and dynamic categories. (c) By the age of 12 yr. no measurable group differences appeared. (17 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Two siblings with recurrent cardiorespiratory arrest: Munchausen syndrome by proxy or child abuse?

The terms "Munchausen syndrome by proxy" or "Polle syndrome" have been used to describe children who are victims of parentally induced or fabricated illness. This report gives case histories of two siblings (a 7-month-old girl and a 4-year-old boy) with recurrent episodes of cardiorespiratory arrest that were induced by a mother who skillfully resuscitated the children and who demonstrated model parental behavior. Polygraphic monitoring with hidden camera was used to determine that the episodes of cardiorespiratory arrest were parentally induced in the infant. The 4-year-old sibling had previously undergone multiple diagnostic and surgical procedures. After the diagnosis was made in the infant, and the mother was no longer permitted to be alone with the children, neither child had further episodes. A psychologic profile of the mother is presented, and special features of these two and other cases in the literature are reviewed. These cases represent a form of child abuse. A parentally induced illness should be considered in the differential diagnosis of unusual illnesses with bizarre features, even when the parent's behavior appears exemplary.     

Use of behavioral techniques in a case of compulsive stealing.

Demonstrates the use of behavioral principles in the modification of a deviant behavior. The "compulsive" stealing of a 10-yr-old resident of a home for mildly disturbed children was successfully eliminated over a 3?-mo period. Records indicate that the behavior had been a source of difficulty for at least 5 yr. The behavior "therapy" was carried out in a field situation and made use of minimal professional time. The use of non-professional individuals in the observation, recording, and modification of behavior is demonstrated. Implications are discussed for the role of the professional consultant as instructor in the application of behavior principles. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Calcified thrombus in the inferior vena cava in infants and children

Calcified thrombi in the prerenal (suprarenal) segment of the inferior vena have a characteristic radiographic appearance that permits accurate "plain film" diagnosis. Most have been fortuitously discovered in infants and young children. None of the affected individuals has had clinical evidence of venous obstruction. Vena caval obstruction is usually incomplete. Uncalcified clot caudal to the calcified thrombus caused complete obstruction of the inferior vena cava and renal veins in one of our patients, a healthy infant; since collateral flow was adequate surgery was not advised. We believe that aggressive diagnostic and therapeutic measures are unnecessary in the management of infants and children with calcified thrombi in the inferior vena cava.     

Immunoglobulin therapy in Gilles de la Tourette syndrome

It has known for a long time that Sydenham's chorea and tics, as seen in Gilles de la Tourette's syndrome (GTS), are phenomenologically very similar. Tics may occur as symptoms of acute Sydenham's chorea or persist over years as residual symptoms. Investigating of children suffering from GTS, including obsessive-compulsive symptoms, have provided signs of a poststreptococcal autoimmune process but also shown that treatment based on immunological interventions has been effective. We treated a 14-year-old boy showing all diagnostic criteria of GTS, familial susceptibility, and an increase in the antibody titer of streptococcal antigens with 75 immunoglobulins i.v. over 5 days. Response to this therapy was good regarding motor tics, vocal tics, and behavioral symptoms such as disturbed impulse control which still persisted after 9 months. These findings and the successful therapy underline reports of the literature and point to a pathogenetic mechanism of an immunologically triggered disturbance of the striatal dopaminergic system, at least in a subgroup of GTS.     

Crime and psychopathology.

"This study investigated the relations between type of crime, age, intelligence, and degree of psychopathology, as measured by the MMPI F score. MMPIs were available from 190 white male court referrals who were nearly all classified as low socioeconomic status. It should be noted that one crime class (i.e., lewd acts on children) would have been excluded from the analysis if the usual criteria for discarding MMPIs had been used. A definite relationship between type of crime and degree of psychopathology was found. Individuals who commit sexual crimes appear to be the most seriously emotionally disturbed. No difference in mean F score between Ss released to the courts vs. those retained in the hospital was found." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disturbances of loudness perception

This article reviews information on some auditory disorders that have in common a disturbance in loudness perception. The perceptual disturbances in these disorders have interchangeably been labeled "hyperacusis," "dysacusis," or "phonophobia." Our question concerns whether the loudness disturbances associated with these auditory disorders are sufficiently different as not to justify the equivalence implied by the labelling. Emphasis is placed on those articles that have given clear accounts of the phenomenology of the disturbed perceptual experience and have offered testable hypotheses about the mechanisms underlying it. Hypotheses about the origins of disturbed loudness perception are compared with independent experimental and clinical evidence on those mechanisms. The disturbances of loudness perception that occur in cochlear hearing loss, facial nerve paralysis and stapedectomy, and in more "central" disorders are phenomenologically different, have different underlying mechanisms, and merit different labels that most of them do not currently receive.     

Clinical innovation and the mental health power structure: A social case history.

Traces the progress of innovative ideas in local mental health agencies to the level of action, showing the problems encountered by conflicting scientific, humanitarian ideals and politics. The case history of middle class parents of autistic children who tried to integrate their new ideas about the treatment of severly disturbed children into their local mental health power structure is presented. It is concluded that "United States mental health professions have developed viable community-based professional and lay power structures which are composed of mutually benefiting bureaucracies . . . . -and that= strengthening of the existing power structure is incompatible with innovation." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuropeptides and steroid hormones in arthritis

Primary afferent nociceptive and peptidergic efferent nerves are sensitized in arthritis and thus easily stimulated by mechanical and chemical stimuli. This leads to increased or disturbed release of neuropeptides from nerve terminals. This local (at the site of stimulation), expanded (expanded and additional receptive fields), and remote (cross-spinal reflexes) neuropeptide release leads to disturbed tissue homeostasis and neurogenic inflammation. In arthritis, raised levels of neuropeptides were detected in the synovial fluid, whereas nerve fibers were lacking in the synovial tissue. It has been hypothesized that cycles of nerve fiber destruction and degeneration follow the cycles of joint inflammation. This evidence suggests that the peripheral nervous system, through its neuropeptides, may contribute to the generation of inflammation, i.e., "neurogenic inflammation." Altered hypothalamic-pituitary-adrenocortical axis function and sex hormone status have been suggested to contribute to the development and persistence of arthritis. In particular, current evidence indicates that glucocorticoid secretion is closely and reciprocally interrelated with inflammation, and that an adrenal insufficiency is present in many forms of immune-mediated arthritis. Conversely, gonadal steroids seem to play a central role as predisposing factors in many forms of arthritis, with estrogens involved as immuno-enhancing hormones and androgens as natural immunosuppressors. Functional receptors for sex hormones have been described in cells involved in the immune response and, after activation, the hormone-receptor complex might modulate the expression of selected cytokines. The possibility of targeting the efferent nerves with specific peptides and replacement therapies with selected steroid hormones may represent a new and potentially efficient and natural system of modulation of the arthritis.     

Cues and clues to differential diagnosis in childhood autism.

There has been considerable disagreement as to the nature of autism. Since the problem has not yet been clearly defined, etiology remains nebulous, and treatment varies among therapists. An attempt is made to develop a definition of autism by drawing from a variety of reliable sources describing the disorder, and, with reference to these sources, some diagnostic procedures that seem to be effective are discussed. This suggested diagnostic assessment is based on observation, history taking, and a limited use of treatment technique. Diagnostic intervention in the form of intrusion and interaction is most instrumental in reaching diagnostic decisions. When tested in such areas as tactile, kinesthetic, and spatial intrusion, nonautistic children respond in a manner widely disparate from autistic children. No one single manifestation of an autisticlike response is a sufficient diagnostic clue; rather, there is a whole set of reactions upon which a clinical judgment rests. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)