A dynamic developmental theory of attention-deficit/hyperactivity disorder (ADHD) predominantly hyperactive/impulsive and combined subtypes

Attention-deficit/hyperactivity disorder (ADHD) is currently defined as a cognitive/behavioral developmental disorder where all clinical criteria are behavioral. Inattentiveness, overactivity, and impulsiveness are presently regarded as the main clinical symptoms. The dynamic developmental behavioral theory is based on the hypothesis that altered dopaminergic function plays a pivotal role by failing to modulate nondopaminergic (primarily glutamate and GABA) signal transmission appropriately. A hypofunctioning mesolimbic dopamine branch produces altered reinforcement of behavior and deficient extinction of previously reinforced behavior. This gives rise to delay aversion, development of hyperactivity in novel situations, impulsiveness, deficient sustained attention, increased behavioral variability, and failure to "inhibit" responses ("disinhibition"). A hypofunctioning mesocortical dopamine branch will cause attention response deficiencies (deficient orienting responses, impaired saccadic eye movements, and poorer attention responses toward a target) and poor behavioral planning (poor executive functions). A hypofunctioning nigrostriatal dopamine branch will cause impaired modulation of motor functions and deficient nondeclarative habit learning and memory. These impairments will give rise to apparent developmental delay, clumsiness, neurological "soft signs," and a "failure to inhibit" responses when quick reactions are required. Hypofunctioning dopamine branches represent the main individual predispositions in the present theory. The theory predicts that behavior and symptoms in ADHD result from the interplay between individual predispositions and the surroundings. The exact ADHD symptoms at a particular time in life will vary and be influenced by factors having positive or negative effects on symptom development. Altered or deficient learning and motor functions will produce special needs for optimal parenting and societal styles. Medication will to some degree normalize the underlying dopamine dysfunction and reduce the special needs of these children. The theory describes how individual predispositions interact with these conditions to produce behavioral, emotional, and cognitive effects that can turn into relatively stable behavioral patterns.     

Nonparametric IRT: Testing the bi-isotonicity of isotonic probabilistic models (ISOP)

Nonparametric tests for testing the validity of polytomous ISOP-models (unidimensional ordinal probabilistic polytomous IRT-models) are presented. Since the ISOP-model is a very general nonparametric unidimensional rating scale model the test statistics apply to a great multitude of latent trait models. A test for the comonotonicity of item sets of two or more items is suggested. Procedures for testing the comonotonicity of two item sets and for item selection are developed. The tests are based on Goodman-Kruskal's gamma index of ordinal association and are generalizations thereof. It is an essential advantage of polytomous ISOP-models within probabilistic IRT-models that the tests of validity of the model can be performed before and without the model being fitted to the data. The new test statistics have the further advantage that no prior order of items or subjects needs to be known.     

Confirmation and reduction: a Bayesian account

Various scientific theories stand in a reductive relation to each other. In a recent article, we have argued that a generalized version of the Nagel-Schaffner model (GNS) is the right account of this relation. In this article, we present a Bayesian analysis of how GNS impacts on confirmation. We formalize the relation between the reducing and the reduced theory before and after the reduction using Bayesian networks, and thereby show that, post-reduction, the two theories are confirmatory of each other. We then ask when a purported reduction should be accepted on epistemic grounds. To do so, we compare the prior and posterior probabilities of the conjunction of both theories before and after the reduction and ask how well each is confirmed by the available evidence.     

Isotonic ordinal probabilistic models (ISOP)

The concept of an ordinal instrumental probabilistic comparison is introduced. It relies on an ordinal scale given a priori and on the concept of stochastic dominance. It is used to define a weakly independently ordered system, or isotonic ordinal probabilistic (ISOP) model, which allows the construction of separate sample-free ordinal scales on a set of subjects and a set of items. The ISOP-model is a common nonparametric theoretical structure for unidimensional models for quantitative, ordinal and dichotomous variables.Fundamental theorems on dichotomous and polytomous weakly independently ordered systems are derived. It is shown that the raw score system has the same formal properties as the latent system, and therefore the latter can be tested at the observed empirical level.I wish to thank 3 reviewers and 2 editors who contributed a lot to the readability and precision of the article.     

Übertragung und Übertragungsneurose

The authors investigate Freud's concepts of transference, transference neurosis and their mutual relationship. They discuss the current criticism made on the concept of transference neurosis and raise the question, why patients accept the analyst's interpretations? They suggest understanding transference neurosis as conscious manifestations of transference referring to the analyst which are the outcome of successive interpretations of the type "just-like" followed, changed, and removed again by "just-like-it-was"-interpretations. They conclude that the patient does accept these interpretations not for reasons that are rational, but for reasons pertaining the transference situation.