Heart rate reactivity in attention deficit disorder subgroups

Beat-to-beat heart rate (HR) was analyzed for 9 contiguous seconds in a warned reaction time (RT) paradigm. Imperative stimuli were tones of three intensity levels (55, 78, and 100 db); a visual warning signal occurred 5 sec before tone onset. Baseline and reward conditions were run. Normal controls were contrasted with three Attention Deficit Disorder (ADD) subgroups: ADD-only, ADD with hyperactivity (ADDH), ADD with hyperactivity and aggression (ADDHA). The ADD subgroups were predicted to show less deceleration in HR because of their problem sustaining readiness to respond. Significant sex x group differences in HR levels and change scores were found. Overall, girls had higher HR levels than boys and the ADD-only group (boys and girls) had lower HRs than the other ADD groups. But, the ADD-only boys had more marked deceleration to the warning signal and acceleration to the tones than the other ADD boys, whereas the ADD-only girls were no more reactive than the ADDH and ADDHA girls. Control girls had the highest HR levels and were the most reactive to stimuli. Control boys and ADD-only boys had similar HR levels and reaction patterns. ADD-only girls appear to be underaroused, whereas ADD-only boys do not. Results suggest that cardiac measures can provide external validation of disruptive and nondisruptive ADD subtypes.     

Posttraumatic stress disorder: A sensitization reaction

This article discusses past research bearing on the question of the etiology of Posttraumatic Stress Disorder (PTSD). It argues that PTSD can be adequately accounted for by a process of emotional sensitization and that this is a more parsimonious explanation than the two-factor learning theory of Mowrer, now postulated by several writers. In brief, the etiology and subsequent development of PTSD is viewed as the result of the sensitization of fear/anxiety which is linked to a variety of to be conditional stimuli by both backward and forward association: these become conditional stimuli (CSi) once paired with the instigating circumstances. It is furthermore assumed that PTSD will not occur in the absence of a genetic susceptibility that may vary from zero to absolute certainty. Thus far, our evidence is limited to a sensitivity to loud sounds, but it is highly probable that touch and other sensory systems are involved (not necessarily in parallel). The fact that abuse often leads to behavioral disorders, including sexually seductive behaviors in children sexually abused, requires a recognition that emotional reactions other than fear may be sensitized. Fear in combination with pleasure or pleasure alone coupled with a loss of self-esteem may explain these acting-out behaviors.     

Encoding distinctiveness and the encoding shift penalty in children and adults

This study determined some of the reasons for developmental differences in retrieval variability. The critical manipulation involved the use of semantic orienting questions at both acquisition and retrieval for elementary school children (7 and 10 years of age) and adults. The retrieval questions biased the sampling of cue information compatible or incompatible with the information sampled in acquisition. The recall difference that resulted is the Encoding Shift Penalty. Experiment 1 manipulated encoding distinctiveness at acquisition and the delay between acquisition and retrieval. Experiment 2 varied acquisition encoding constraint and employed two retrieval trials varying the kind of retrieval question. Among other findings, the results suggest that (1) the acquisition encoding of adults is more distinctive than is that of children; (2) encoding distinctiveness affects the probability of sampling and resampling compatible cue information, and the identification of target event information once cue comptibility is ensured at retrieval; and (3) incompatible initial samples of retrieval cue information for children may interfere with their ability to resample successfully.     

Children's comprehension of presupposed information: Logical and pragmatic inferences to speaker belief

This study explored the ability of young children (5 and 8 years old) to make presuppositional inferences to a speaker's belief in uttering a sentence. Presuppositional information is the information a speaker believes to be common between himself and the hearer. The information is cued by a speaker either logically, by the use of specific lexical items, or pragmatically, by the use of an utterance in violation of conventional rules of conversation. Comprehension of the information may require a reading of the context of utterance. Kindergarten and thirdgrade children and adults were read paragraphs containing both logical and pragmatic presuppositional information, as well as a sentence that could be treated in a logical or a pragmatic manner depending on the context of utterance. The results showed that both groups of children and the adults could make presuppositional inferences to a speaker's belief, and that the responses of the children and adults were context sensitive.     

Developmental differences in recall: Encoding or retrieval?

First- and fifth-grade children and college adults (ages 6, 10, and 18 years, respectively) were presented a 30-item set of pictures to recall in a 4-trial study-test procedure. The stimuli were presented in one of three ways (encoding condition): randomly, blocked (according to categories), or sort (the subject was given the stimuli in random order and asked to sort them into categories). Recall was either free, cued, or constrained (retrieval condition). Results indicated that maximum adult recall was a function of the interaction of encoding and retrieval conditions, and that first- and fifth-grader's recall was influenced by retrieval conditions but not by encoding conditions. The blocked and sort encoding conditions did result in increased clustering relative to random encoding at all three ages, however. It was concluded that encoding conditions influence recall only as they effect the use of retrieval strategies.     

Children's recall of contextually integrable and nonintegrable episodic events

The hypothesis of this study is that children's deficiency in encoding input information may be attributed partially to a failure to fully integrate target and contextual information. Second and fourth grade children and college adults were shown sentences varying in internal integrability in a cued recall task for target nouns in the sentences. The sentences were internally semantically Congruous, Incongruous, or Anomalous. In acquisition, the subjects were told either to read the sentences (Read Encoding) or to rate the likelihood of the occurrence of the sentential event (Integration Encoding). The results showed large developmental differences in both levels of recall and the Congruity effect (superior recall for the Congruous relative to the Anomalous sentences) in the Read condition. These differences were minimized in the Integration condition. These patterns suggest young children are deficient in the contextual integration of episodic events, and, as a result, make inefficient use of semantic information in the encoding of input information.     

Use of the TAT in the assessment of DSM-IV cluster B personality disorders

The Social Cognition and Object Relations Scale (SCORS), developed by Western, Lohr, Silk, Kerber, and Goodrich (1985), is a diagnostic instrument used to assess an array of psychological functioning by using clinical narratives such as the Thematic Apperception Test (TAT; Murray, 1943) stories. This study investigated the utility of the SCORS to differentiate between Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) antisocial personality disorder (ANPD), borderline personality disorder (BPD), narcissistic personality disorder (NPD), and Cluster C personality disorder (CPD). A sample of 58 patients was separated into four groups: ANPD (n = 9), BPD (n = 21; 18 with a primary BPD diagnosis and 3 with prominent borderline traits who met 4 of the 5 DSM-IV criteria necessary for a BPD diagnosis), NPD (n = 16; 8 with a primary NPD diagnosis and 8 with prominent narcissistic traits who met 4 of the 5 DSM-IV criteria necessary for a NPD diagnosis), and CPD (n = 12). These groups were then compared on the 8 SCORS variables by using 5 TAT cards (1, 2, 3BM, 4, and 13MF). Spearman-Brown correction for 2-way mixed effects model of reliability for the 8 SCORS variables ranged from .70 to .95. The results of categorical and dimensional analyses indicate that (a) SCORS variables can be used to differentiate ANPD, BPD, and NPD; (b) the BPD group scored significantly lower (greater maladjustment) than did the CPD group on certain variables; (c) the BPD group scored significantly lower (greater maladjustment) than did the NPD group on all 8 SCORS variables; (d) the ANPD group scored significantly lower than did the NPD group on certain variables; (e) certain variables were found to be empirically related to the total number of DSM-IV ANPD, BPD, and NPD criteria; and (f) certain variables were found to be empirically related to Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) Personality disorder scales. The results of this study are discussed in terms of clinical utility, conceptual, and theoretical implications.     

The frequency and significance of additional self-reported psychiatric diagnoses in children with attention deficit disorder

The frequency of additional self-reported diagnoses in a large, heterogeneous sample of attention defiict disorder (ADD) children (N=182)was determined using the Diagnostic Interview for Children and Adolescents (DICA). Over half the children had additional DICA diagnoses, with oppositional disorder and anxiety/mood disorders the most frequent. ADD boys with internalizing-type diagnoses had lower verbal IQs and arithmetic scores and performed more poorly on attention tasks than those without; parents also rated them more adversely. Those with externalizing- type diagnoses were rated as more aggressive by teachers and had sociopathic, thrill- seeking profiles on paper-pencil self-ratings. Over 40% of the children were dyslexic or slow learners but they had no higher rate of DICA diagnoses than those who read adequately.This research was supported by NIMH grant R01-MH39189 and by the Marie Wilson Howells Fund. The authors are grateful to the Chid Study Center staff who assisted in recruiting and evaluating subjects and to the Behavioral Laboratory team members who collected and analyzed the data.     

Auditory stimulus intensity gradients and response to methylphenidate in ADD children

Using an auditory stimulus intensity paradigm, we obtained both event related potentials (ERPs) and press and release reaction times (RT) from a large sample of children with Attention Deficit Disorder (ADD). The ERP gradients to three tone intensities were used to classify the children as augmenters (steep gradients), moderates, or reducers (shallow or negative gradients). The RT data were used to classify the children as strong or sensitive, following neo-Pavlovian guidelines. The children were then cross-classified on these two dimensions and compared on cognitive, behavioral, and performance measures. The groups were also compared in response to two dosage levels of methylphenidate. Based on prior studies, we hypothesized that: 1. ERP augmenters would respond as well to the low as high dose but that reducers would respond better to high than low dose; and II. sensitive types (RT measure) would do better on the higher dose and strong types on the low dose. The first hypothesis was confirmed on a performance task but not on behavioral ratings. At the lower dose, augmenters improved most and reducers least on a 10-minute coding task presumed to require sustained attention. There was no support for the second hypothesis either in ratings or performance. The ERP augmentation measure was significantly related to teacher rated attentiveness; i.e., reducers and moderates were rated more adversely. The RT sensitivity measure tended to be related to achievement; i.e., strong types had lower reading and spelling scores. The ERP and RT sensitivity measures were not significantly correlated.