Attention deficit disorder with hyperactivity and methylphenidate: The effects of dose and mastery level on children's learning performance

This investigation examined the relationship between methylphenidate (MPH) and the learning and recall of paired associations by children with attention deficit disorder with hyperactivity (ADDH). Forty-five children with ADDH were randomly assigned to one of three groups (novel, partial mastery, and mastery learning) that varied in the amount of previous learning of paired associations and participated in a double-blind, placebo-control, repeated-measures-across-dose (crossover) design. Each child received four doses of MPH (5 mg, 10 mg, 15 mg, and 20 mg) and a placebo in a random, counterbalanced sequence. The results indicated that both the rate of acquisition and accuracy in learning paired associations were significantly, but differentially, affected by MPH dose and the degree of learning mastery. The implications of these results for psychopharmacological research and the monitoring of psychostimulant effects on children's learning performance in academic settings are discussed.The authors wish to acknowledge and express their sincere appreciation to the graduate and undergraduate student members of the Children's Learning Clinic.     

Child Behavior Profile types in a general population sample of boys 6 to 11 years old

Characteristics of Child Behavior Profile (CBP) types were studied in a general population sample of 202 boys aged 6 to 11 years. Parents completed the Child Behavior Checklist and teachers simultaneously rated the Teacher's Report Form. Overall, 39.7% of the boys were classified within a CBP type: 28.8% Internalizing and 10.9% Externalizing. The most common specific type was Somatic Complaints. Teachers rated the Externalizing CBP boys as showing robust externalizing behaviors in school. Also, boys with Externalizing profile types showed severe degrees of psychopathology in both home and school environments. An intraclass correlation of 35 or greater was found to identify boys with sufficiently severe psychopathology to warrant further clinical evaluation. Findings in this general population sample appear consistent with previous results in outpatient samples, and extend our understanding of the validity and clinical value for CBP types.     

A neuroscience model of stuttering

Using motor control systems analysis and a reductionist approach, we provide a unified model of stuttering. This model views stuttering as a momentary instability in a complex multiloop control system. The model predicts the temporal conditions under which this instability will occur. Furthermore, these temporal conditions account for the efficacy of fluency-evoking maneuvers, therapy, and the variability of speech output in stutterers.     

Identifying depression in children: A comparison of alternative selection criteria

This study evaluated commonly used methods of identifying depressed children and examined the extent to which the conclusions about correlates of dysfunction vary among different selection criteria. Child psychiatric patients (N=237,ages 7–12) and their parents participated and completed measures to permit identification of depressed children on the basis of three separate criteria, including selfreport scores on the Children's Depression Inventory, parent-reported scores for the same measure, and a DSM-III diagnosis of major depression. The study examined whether depressed and nondepressed children, defined separately by the different criteria, differed in a variety of depression-related symptoms, cognitive processes, and social activity. The results indicated little overlap in the persons identified as depressed on the basis of child-or parent-completed CDI scores or DSM-III diagnosis. Depressed and nondepressed children tended to differ across all domains (depression-related symptoms, cognitive processes, and social activity) for each selection criterion. However, significant differences were evident in these domains only when the selection criterion and other domains were assessed with the same informant (e.g., self-report) and hence shared a common method (rater) component. The findings underscore the potential influence that method factors may have in influencing the conclusions that are drawn regarding the correlates of childhood depression.Completion of this research was supported by a Research Scientist Development Award (MH00353) and by a grant (MH35408) from the National Institute of Mental Health. The author is grateful to Debra Bass, Antoinette Rodgers, and Todd Siegel for assistance with this project.     

Hans Zacharias Hoxter: Building Counseling Internationally

Counseling is an international phenomenon. This interview presents the lifework of Hans Hoxter and illustrates how the American counseling movement affects and is affected by multinational and multicultural conceptions.     

Relationship of severity of dementia to caregiving stressors

In studies of individual differences and longitudinal changes in stress and coping among dementia caregivers, assessing severity of patient impairment is critically important. It is proposed that with the progression of dementia, cognitive impairment may steadily increase, but other stressful behavioral symptoms peak at various stages of dementia. Cross-sectional data from 49 caregiving families and longitudinal follow-up data from 48 families suggest that instrumental self-care deficits begin early in dementia, and basic self-care deficits increase with dementia severity, but that many distressing behavioral symptoms decrease in late dementia. Assessments of dementia patient severity should be multidimensional, and increases and decreases in various dementia patient stressors over time should be considered as factors influencing caregiver coping.     

Frontal lobe dysfunction and memory impairment in patients with chronic progressive multiple sclerosis

Deficits in semantic encoding have been described in patients with frontal lobe disease who also show memory impairments. As a group, patients with multiple sclerosis (MS) exhibit memory impairment, fail to make effective use of semantic encoding to aid memory, and perform poorly on verbal fluency and concept formation tests which are sensitive to frontal lobe damage. In the present study the semantic encoding capacity of MS patients was measured using a modification of Wicken's release from proactive interference (PI) paradigm. Individual patients varied considerably in the severity of their impairments on verbal fluency, verbal recognition memory and on Wisconsin Card Sorting Task, but even patients who evidenced both memory impairment and signs of frontal lobe dysfunction showed normal release from PI after a categorical shift. Memory disturbances in MS are unlikely to result from an incapacity for semantic encoding, which seems preserved in MS, but may arise instead from deficits in processing information rapidly.