Attention deficit,conduct, oppositional,and anxiety disorders in children: III. Laboratory differences

Children aged 5–13 years with DSM-III diagnoses of Attention Deficit (ADDH), Anxiety, (ANX), or Conduct plus ADDH (HC) Disorder and matched normal controls were compared on a set of laboratory measures of impulsivity, arousal, motor performance, activity level, and cognition, and on behavior ratings during testing. While ANX patients did not differ from their controls, ADDH and HC patients did on Verbal IQ, most of the behavior ratings, and on about one-third of the test variables. ANX patients were about 1 year older, and more likely to be female, than ADDH and HC patients. When age, sex, and verbal IQ effects were partialed out, very few differences among the three diagnostic groups remained. The importance of precise control of such variables is emphasized and the impact of the failure to do so in past studies is discussed. The question is raised whether the deficit in verbal IQ is not so much a defect of matching as the essential feature of ADDH from which most of the other commonly reported cognitive symptoms stem.This research was supported by the Medical Research Council of New Zealand.     

Multiple family therapy in a residential setting for adolescents*

Treating severely disturbed adolescents in a residential setting without including the family seems impossible. Several ways of letting the family participate in the clinical treatment are discussed. The focus of this article lies in multiple family therapy: groups of family members, adolescents and staff are treating each other. The objects of these meetings are manifold: to modify the stereotyped views that all the participants have of each other, to reduce the isolation of the family which is created by their child's admission, to stimulate interaction and mutual correction between family members, adolescents and staff, and to create a warm-up for and understanding of family system therapy. These multiple family sessions, which take place in a clinic with sixty disturbed adolescents, have a strong influence on the entire therapeutic process. Their impact is felt in the group psychotherapy, psychodrama and other forms of therapy.     

Comparing psychological and pharmacological treatments for hyperkinetic boys and their classmates

This study compares the short-term effects of methylphenidate and of teacher consultation on the on task behavior of diagnosed hyperkinetic outpatient boys and selected classmates. Statistically significant treatment effects were found for both drug treated and behaviorally treated hyperkinetic boys; the size of these effects did not differ between the two types of treatment. Within the behavioral group, the treatment effect spilled over, so that there was also a significant treatment effect on overactive classmates of the behaviorally treated hyperkinetic children and a trend toward a significant treatment effect on their average classmates. Some implications of the findings are discussed.This study was supported by grant number MH-22659 from the National Institute of Mental Health.     

The importance of behavioral and cognitive factors in heterosexual-social anxiety1

Subject groups were classified on the basis of behavioral ratings for degree of anxiety exhibited and level of social skill displayed during a simulated dating interaction. Subjects were then asked to view and evaluate their own skill performance and the performance of bogus subjects during the same interaction when presented on videotapes. All subject groups were accurate in rating the performance of the bogus subjects but the high anxious/high skill subjects underestimated (in comparison to judge's ratings) their own skill while high anxious/low skill subjects accurately assessed their poor performance. Implications of the establishment of two types of heterosexual-socially anxious subjects were drawn for both clinical practice and research.     

Spatial working memory and inhibition of return

Recently we showed that maintaining a location in spatial working memory affects saccadic eye movement trajectories, in that the eyes deviate away from the remembered location (Theeuwes, Olivers, & Chizk, 2005). Such saccade deviations are assumed to be the result of inhibitory processes within the oculomotor system. The present study investigated whether this inhibition is related to the phenomenon of inhibition of return (IOR), the relatively slow selection of previously attended locations as compared with new locations. The results show that the size of IOR to a location was not affected by whether or not the location was kept in working memory, but the size of the saccade trajectory deviation was affected. We conclude that inhibiting working memory-related eye movement activity is not the same as inhibiting a previously attended location in space.     

Perception of illumination direction in images of 3-D convex objects: influence of surface materials and light fields

We investigated the perception of illumination direction in images of 3-D convex objects under variations of light field and surface material properties. In a first experiment, we used an illumination-matching procedure in order to measure observers' ability to estimate the direction of illumination in images of 3-D polyhedra rendered under different light fields and illumination directions. Match deviations were larger in frontal direction than in rear directions, mainly counterclockwise in azimuth component, and diverged, in elevation component, from the image plane. In a second experiment, we examined whether the direction estimate was affected by the surface material type (BRDF), the light field, and the illumination direction. Angular deviations varied with material surface type and were largest in the test elevation direction 0 degrees. Elevation component deviations also differed with surface type and were larger in hemispherical diffuse lighting than in collimated lighting. These results suggest that the direction estimation is better with images of evenly distributed intensity gradients than with those of drastically varying gradients, and that the visual system may not take intensity variations due to the surface material or the light field into account in estimating the direction of illumination.     

Accuracy of drawing in a dual-task and resistance-to-distraction study: motor or attention deficit?

To determine whether manual incoordination is caused by attention deficit or not, we used an accuracy drawing task as a primary task in dual-task and resistance-to-distraction studies, and examined if thus measured attention could differentiate inattention (IA) and combined (CO) subtypes of ADHD. The secondary tasks and distractions failed to lower the primary task performance in IA, CO and control groups. We also compared the impairment scores of the accuracy drawing tasks from the Movement Assessment Battery for Children [Henderson, S. E., & Sugden, D. A. (1992). Movement assessment battery for children. London: Psychological Corporation.] between the groups with attention deficit hyperactivity disorder (ADHD) and/or developmental coordination disorder-inaccurate drawing type (DCD-ID). There were no group differences in the impairment score between the control and the ADHD groups, and between ADHD and ADHD plus DCD-ID groups. We concluded that inaccurate drawing is not caused by attention deficit, but that it is a manifestation of a motor deficit as a separate entity from attention deficit.     

Vanishing white matter disease: a review with focus on its genetics

Leukoencephalopathy with vanishing white matter (VWM) is an autosomal recessive brain disorder, most often with a childhood onset. Magnetic resonance imaging and spectroscopy indicate that, with time, increasing amounts of cerebral white matter vanish and are replaced by fluid. Autopsy confirms white matter rarefaction and cystic degeneration. The process of localization and identification of the first two genes related to VWM, EIF2B5 and EIF2B2, was facilitated by two founder effects in the Dutch population. EIF2B5 and EIF2B2 encode the epsilon and beta subunits of translation initiation factor eIF2B. Soon it was shown that mutations in all five eIF2B subunit genes can cause VWM. EIF2B is essential for the initiation of translation of RNA into protein and is involved in regulation of the process, especially under stress conditions, which may explain the sensitivity to stress conditions observed in VWM patients. The pathophysiology of the disease is still poorly understood.