Comorbidity of attention Deficit Hyperactivity Disorder and Post-Traumatic Stress Disorder

Attention Deficit Hyperactivity Disorder (ADHD) and Post-Traumatic Stress Disorder (PTSD) show a high degree of comorbidity in traumatized children. Two hypotheses may help explain this relationship: children with ADHD are at higher risk for trauma due to their impulsivity, dangerous behaviors, and parents who may have a genetic predisposition for impairment of their own impulse control; and hyperarousal induced by severe trauma and manifested by hypervigilance and poor concentration may impair attention to create an ADHD-like syndrome. Four illustrative cases are presented, and implications for treatment are discussed.     

Integrating Treatment of Posttraumatic Stress Disorder and Substance Use Disorder

Historically, administrators and clinicians have been hesitant to address posttraumatic stress disorder (PTSD) in the treatment of substance use disorders (SUDs). However, research shows that SUD treatment recruitment and outcomes may be adversely affected if co‐occurring PTSD is left untreated. The authors provide guidelines for screening and assessment, treatment services, and workforce and organizational development that are designed to facilitate integrated PTSD–SUD treatment. Case examples illustrate the necessary precautions related to and the potential benefits of integrating treatment of PTSD and SUD.     

Emotional Disorder

In this paper I aim to provide a characterisation of emotional disorder. I begin by criticising the thought that an agent can be judged to be experiencing an emotional disorder if his emotion causes him some type of harm. This then leads me to develop the claim that emotional disorder relates to sufficiently inappropriate emotion, where (sufficiently) inappropriate emotion relates to emotion that fails to be (sufficiently) responsive to the agent's beliefs and/or desires. Finally, I conclude the paper by suggesting that if an essentially non‐cognitivist conception of emotion is accepted then – on the characterisation of emotional disorder that I defend – there may exist strong grounds for thinking that cognitive therapy will be an inappropriate form of treatment in cases of emotional disorder.¹     

Attention Deficit Disorder,Anxiety Disorder,and Learning Disabilities

Abstract

This article details an individualized psychoeducational model designed to treat a child with interrelated psychological and developmental issues whose psychic functioning was deteriorating within the traditional educational system. The team had leeway to function outside of the educational system to create an individualized, remedial, psychoeducational program. At the time we began the program, her diagnostic picture included: Anxiety Disorder, Attention Deficit/Hyperactivity Disorder, and Learning Disabilities. The treatment team consisted of an education specialist, two additional part-time teachers, a clinical social worker, an occupational therapist, a consulting senior child psychoanalyst, and the child's mother. The results at the close of the first school year are examined. Perspectives informing the psychoanalytic aspects of this case include Winnicottian and Fairbairnian Object Relations Theory and therapeutic milieu model.     

Eating Disorder Recovery

Abstract

Qualitative studies addressing the eating disorder recovery process from the client's point of view are notably absent in the literature. For this case study, we conducted a retrospective examination of the recovery process, as recounted by a 37-year-old female who was diagnosed with anorexia nervosa, binge eating/purging subtype at the age of 30. Two in-person interview sessions provided insight into coping skills, multidisciplinary intervention strategies, and long-term treatment challenges. In sum, the client's perspective can add new information to the understanding of eating disorder recovery from feminist and other theoretical frameworks.     

创伤后应激障碍与物质使用障碍共病的病因学及其启示

创伤后应激障碍与物质使用障碍共病率高,现有的治疗方法疗效差,总结20年来创伤后应激障碍与物质使用障碍共病研究中病因学方面的新认识,通过对病因的哲学思考可以为今后的治疗方向提供一条思路:两病同治;应提倡药物治疗、认知干预和社会支持综合的治疗手段.     

Trajectories of Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder Symptoms as Precursors of Borderline Personality Disorder Symptoms in Adolescent Girls

Little empirical evidence exists regarding the developmental links between childhood psychopathology and borderline personality disorder (BPD) in adolescence. The current study addresses this gap by examining symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) as potential precursors. ADHD and BPD share clinical features of impulsivity, poor self-regulation, and executive dysfunction, while ODD and BPD share features of anger and interpersonal turmoil. The study is based on annual, longitudinal data from the two oldest cohorts in the Pittsburgh Girls Study (N = 1,233). We used piecewise latent growth curve models of ADHD and ODD scores from age 8 to 10 and 10 to 13 years to examine the prospective associations between dual trajectories of ADHD and ODD symptom severity and later BPD symptoms at age 14 in girls. To examine the specificity of these associations, we also included conduct disorder and depression symptom severity at age 14 as additional outcomes. We found that higher levels of ADHD and ODD scores at age 8 uniquely predicted BPD symptoms at age 14. Additionally, the rate of growth in ADHD scores from age 10 to 13 and the rate of growth in ODD scores from 8 to 10 uniquely predicted higher BPD symptoms at age 14. This study adds to the literature on the early development of BPD by providing the first longitudinal study to examine ADHD and ODD symptom trajectories as specific childhood precursors of BPD symptoms in adolescent girls.     

Worry and Rumination in Generalized Anxiety Disorder and Obsessive Compulsive Disorder

Ample work has already been conducted on worry and rumination as negative thought processes involved in the etiology of most of the anxiety and mood related disorders. However, minimal effort has been exerted to investigate whether one type of negative thought process can make way for another type of negative thought process, and if so, how it subsequently results in experiencing a host of symptoms reflective of one or the other type of psychological distress. Therefore, the present study was taken up to investigate whether rumination mediates the relationship between worry and generalized anxiety disorder (GAD), and between worry and obsessive compulsive disorder (OCD) in two clinical groups. Self-report questionnaires tapping worry, rumination, generalized anxiety disorder (GAD), and obsessive compulsive disorder (OCD) were administered to a clinical sample of 60 patients aged 30–40. Worry, rumination, generalized anxiety disorder (GAD), and obsessive compulsive disorder (OCD) correlated substantially with each other, however, rumination did not mediate the relationship between worry and generalized anxiety disorder (GAD) and between worry and obsessive compulsive disorder (OCD). We also analyzed differences of outcome variables within two clinical groups. These results showed that worry and rumination were significantly different between GAD and OCD groups.     

Cognitive-Behavioral Treatment of Obsessive-Compulsive Disorder

Cognitive-behavioral therapy can be effective for many clients who have obsessive-compulsive disorder. Despite its effectiveness, many treatment guidelines fail to describe cognitive-behavioral therapy procedures in adequate detail. The present paper will review the literature on cognitive-behavioral therapy for OCD in an attempt to provide concise, meaningful guidelines for the psychological treatment of this disorder. Cognitive-behavioral therapy includes four general components: initial preparation for therapy, development of applied coping skills, exposure with ritual prevention, and relapse prevention. The four general treatment components are described, and clinical examples are provided.     

强迫症病理的认知–行为研究述评

认知–行为领域对强迫症(OCD)的病理进行了深入的探索。强迫症的认知–行为理论认为功能失调性信念、应对策略及中和行为对强迫症的发生和维持有重要作用; 强迫症的安全动机模型把强迫行为归因于安全动机系统不能产生停止安全防卫行为的信号, 在此基础上有研究表明, 在做停止强迫行为的决策时, 强迫症患者依赖于主观停止标准, 导致决策困难, 延长了强迫行为持续的时间。通过整理近年来此领域的研究, 认为趋–避冲突存在于一些强迫症患者中, 且可能是导致强迫症的又一重要因素。     

惊恐障碍的认知偏向研究

文章综述了惊恐障碍患者对威胁性信息的注意偏向、解释偏向、记忆偏向等认知偏向。对威胁性信息的优先注意激发焦虑体验,对模糊信息的灾难化解释增加焦虑水平,对引起焦虑感信息的记忆保持促使惊恐体验更易于提取,这3种认知偏向促使具有焦虑倾向的个体对惊恐障碍更易感,也是惊恐障碍形成和保持的关键因素     

A Case of Obsessive-Compulsive Disorder

This article presents the case of a 51-year old woman with obsessive-compulsive disorder. “Caroline” reported obsessions of harming people secondary to spreading her “bad energy,” which is experienced as dust on her hands and in her mouth. To prevent harm coming to others she mentally “vacuums” the dust, creates mental protective barriers around nearby people and avoids touching others for fear of transmitting her bad energy. Although she reported a childhood onset of obsessions and compulsions, it exacerbated in the context of multiple stressors 4 years prior to seeking treatment. Her Yale-Brown Obsessive Compulsive Scale total score was in the moderate range at intake. Predisposing, precipitating, and maintaining factors are described in addition to the specific symptom presentation.     

儿童青少年品行障碍研究综述

对品行障碍的界定 ,已经形成共识是 :(1)品行障碍的发病对象是 18岁以下的青少年 ;(2 )品行障碍是一种问题行为 ;(3)这种问题行为是与社会规范和社会基本准则相背离的 ,是个体社会化不良的结果 ,个体社会化的程度和水平是品行障碍的主要诊断标准。在个体社会化的进程中 ,涉及的往往是个体与社会、与他人的关系 ,这就为品行障碍的研究提供了一个基本的研究视角 ,研究者们正是基于对以上两组相互关系的认识对品行障碍加以分类 ,一是三分法 ,将品行障碍分为反社会性行为、攻击性行为和对抗性行为 ;一是二分法 ,将品行障碍分为反社会性行为和攻…     

Developmental Co-ordination Disorder and Emerging Adulthood: Not Just a Motor Disorder

This paper discusses the focus of the special edition on emerging adulthood in DCD and how the different papers present the increasing awareness not only of the disorder but the continuation of difficulties into adulthood. It highlights the varying presentation at this stage and the impact these difficulties have on quality of life. Finally, it calls for further research to be undertaken to increase the understanding of DCD for both clinicians and researchers.     

Common Genetic and Environmental Influences on Major Depressive Disorder and Conduct Disorder

The evidence for common genetic and environmental influences on conduct disorder (CD) and major depressive disorder (MDD) in adolescents was examined. A sample of 570 monozygotic twin pairs, 592 dizygotic twin pairs, and 426 non-twin siblings, aged 12-18 years, was recruited from the Colorado Twin Registry. For the past year data, there was a significant correlation between the genetic influences on MDD and CD and, for the lifetime data, there was a significant correlation between the genetic influences on MDD and CD, and a significant correlation between the nonshared environmental influences on MDD and CD. Our results suggest that some genetic factors will increase an individual's vulnerability to both MDD and CD in adolescence.     

What's in a Disorder

Abstract

This paper analyzes the emergence of two FDA-approved products to treat “sexual disorders”: Viagra, a drug prescribed for the treatment of erectile dysfunction, and the Eros, a device prescribed for the treatment of female sexual dysfunction. Through an analysis of advertising and promotional materials for Viagra and the Eros, we argue that these pharmaceutical devices and the discourses they circulate reinforce normative gender ideals by enacting dominant cultural narratives of masculinity, femininity, and male and female sexuality. These cultural narratives of normative gender structure sexuality in such a way that reinforces certain kinds of masculinity, femininity, and (hetero)sexuality, thereby rendering “atypical” gender and sexual expressions, desires, and appearances invisible and marginal. We argue that these constructions reify cultural ideologies about “what counts” as legitimate and appropriate sexuality and that these constructions have profound implication for social actors, sexologists, and therapists.     

Parental Attention Deficit Disorder

abstract   This essay considers the moral status of certain practices that aim to enhance offspring traits. I develop an objection to offspring enhancement that draws on an account of the role morality of parents. I work out an account of parental ethics by reference to premises about child development and to observations about parenting culture in the United States. I argue that excellence in parenthood consists in a dual responsibility both to guide children toward the good life and to accept them as they are. I conclude that prenatal manipulation of healthy and normal characteristics in human offspring fails to balance the dispositional extremes of control and restraint to which many parents today are susceptible. I apply this account of good parenting to the challenging case of height enhancement for short but otherwise healthy children. Finally, I reply to objections, first, about the phenomenology of bearing normative obligations to people who do not yet exist and, second, about the moral logic of criticizing embryo selection in the context of assisted reproduction when we accept child selection in the context of adoption.     

强迫症的元认知研究:进展与趋势

该文分析了强迫症患者在现实监控、知道感、元认知信念和责任控制等方面的研究,发现缺乏对不同类型强迫症元认知差异的研究、被试选取的典型性和代表型有待提高,现实监控障碍的身心原因尚不明确、责任-控制障碍形成的机制研究不足.指出元认知干预的强迫症治疗范式、强迫症与其他精神症元认知障碍的比较、强迫症元认知的认知神经科学探索和强迫性网络使用的元认知机制等是未来研究的趋势.