Family Impact of Tourette's Syndrome

Tourette's syndrome (TS) is a neuropsychological disorder characterized by vocal and motor tics. TS is also associated with several behavior disorders such as Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, conduct disorder, and Obsessive-Compulsive Disorder. We examined the impact of Tourette's syndrome with and without comorbid psychiatric disorders on the family. TS complicated by comorbid disorders had a greater impact on the family than uncomplicated TS. Tourette's symptom severity was significantly correlated with the level of impact on the family and with the number of comorbid disorders. TS is a disorder with effects that extend beyond motor and vocal tics.     

创伤后应激障碍的动物模型及其神经生物学机制

创伤后应激障碍是指个体由于经历对生命具有威胁的事件或严重的创伤,导致症状长期持续的精神障碍。研究创伤后应激障碍的主要动物模型为条件性恐惧和应激敏感化模型。研究表明,创伤后应激障碍中长时程留存的恐惧性记忆、高唤醒等症状与大脑杏仁核、内侧前额叶皮层和海马三个脑区及下丘脑-垂体-肾上腺轴负反馈功能增强密切相关。其中杏仁核活动增强是条件性恐惧记忆获得、保持和表达的关键神经基础。内侧前额叶皮层对杏仁核的去抑制及海马向杏仁核传递的威胁性环境信息,促进创伤后应激障碍症状的出现。在经历创伤应激后糖皮质激素受体的上调及多巴胺活动的增强是创伤后应激障碍产生的主要神经基础。对创伤后应激障碍的药物治疗研究证明多巴胺D2受体在改善患者症状中的作用比较重要,但仍需作更深入的探索     

Parental Attributions of the Causes of Their Children's Behavior

We investigated causal attributions parents made regarding their children's best and worst behavior while the children were taking methylphenidate (MPH) for Attention-Deficit Hyperactivity Disorder (ADHD). Twenty-six parents were surveyed each week for six weeks using the Parent Attribution Scale-Revised. This scale measures parents' attributions of the causes for their children's behavior when taking MPH to treat symptoms of ADHD. When attributing causes for best behavior, the parents rated their children's effort most often followed by their own effort and the positive medication effects. When attributing causes for worst behavior, the parents rated their children's lack of effort most often followed by inadequate medication effects and their own lack of effort. Our study suggests that parents rate effort most often when making attributions for their children's best and worst behavior. When making attributions for best behavior only, parents saw no difference between their own efforts and the effects of medication. When making attributions for worst behavior only, parents were more likely to blame their children's lack of effort and the ineffectiveness of medication more often than their own lack of effort.     

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.     

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.     

Fast screening of eating disorders among patients with bipolar disorder: Validation of the French version of BEDS questionnaire

IntroductionThe prevalence and morbidity of eating disorders (ED) is high in patients with bipolar disorder (BD). Simple tools are necessary to easily and rapidly screen for ED in bipolar patients.ObjectiveThe aim of this study was to validate the French version of Bipolar Eating Disorder Scale (BEDS-F).MethodED and BD diagnoses were established with a structured-interview in 80 patients according to the DSM-IV criteria. The BEDS was translated into French using appropriate methods. Patients were administered the following scales: BEDS-F, SCOFF, Bulimic Investigatory Test Edinburgh (BITE) and Eating Disorder Inventory-two (EDI-2).ResultsBEDS-F score were significantly higher in bipolar patients with ED. The BEDS-F showed high feasibility (no omission response), excellent discriminating abilities (ROC AUC = 0.97) with a sensibility of 98% and specificity of 85% for BEDS ≥ 11, high internal consistency (Cronbach's alpha coefficient = 0.86) and test-retest reliability (ICC = 0.99). No floor/ceiling effect was observed. The BEDS-F sensitivity was equivalent to that of the BITE and EDI-2 subscale B. The BEDS-F specificity was slightly lower than that of the EDI-2 subscale B, but equivalent to that of BITE.ConclusionThe BEDS-F is a valid scale for fast ED screening in patients with bipolar disorder, and easier to administer than other currently used scales.     

季节性情感障碍存在记忆损伤吗？

季节性情感障碍(Seasonal Affective Disorder, SAD)与轻度到中度的临床抑郁有类似的症状,它通常发生于季节性日照不足的地区。造成该障碍的一个可能原因是褪黑素分泌不足。与非季节性抑郁相比, 季节性抑郁的记忆损伤尚未得到充分研究。以往的研究也发现了一些类似于非季节性抑郁的记忆损伤, 但通常很少达到统计的显著性, 且其采用的测验任务也缺乏分辨力, 未能对损伤进行足够的细节描述。这里对有关文献做一个综述。     

Elevated attention deficit hyperactivity disorder symptoms in children who stutter

PurposeThis study described the proportion of children who stutter who exhibit Attention Deficit Hyperactivity Disorder (ADHD) symptoms, manifesting in inattentive and hyperactive/impulsive behaviours. Children who stutter with these challenging behaviours may not respond as quickly and successfully to stuttering treatment. A preliminary exploration of differences in treatment responsiveness for children with and without ADHD symptoms was undertaken.MethodParticipants were 185 preschool children who stutter who had completed stuttering therapy within 3 months prior to study commencement. Differences between groups of children who stutter with and without elevated ADHD symptoms were investigated, in terms of pre-treatment stuttering features (stuttering severity and typography), demographic variables (age at onset, time between onset and commencement of therapy, family history and sex) and treatment data (post-treatment stuttering severity and number of sessions to achieve discharge criteria).ResultsOne-half (50%) of participants exhibited elevated ADHD symptoms. These children required 25% more clinical intervention time to achieve successful fluency outcomes than children without elevated ADHD symptoms. Findings suggest that more ADHD symptoms, increased pre-treatment stuttering severity, and male sex were associated with poorer responsiveness to stuttering treatment.ConclusionThe large proportion of children exhibiting elevated ADHD symptoms, and the increase in clinical contact time required in this subgroup to achieve successful fluency outcomes, is suggestive of the need for clinicians to tailor stuttering intervention to address these concomitant behaviour challenges. Findings support the use of careful caseload management strategies to account for individual differences between children, and strengthen prognostic information available to parents and clinicians.     

Infant motor skill predicts later expressive language and autism spectrum disorder diagnosis

Motor difficulties may be an early Autism Spectrum Disorder (ASD) risk indicator and may predict subsequent expressive language skills. Further understanding of motor functioning in the first year of life in children with ASD is needed. We examined motor skills in 6-month-olds (n = 140) at high and low familial risk for ASD using the Peabody Developmental Motor Scales (Grasping, Visual-Motor Integration, and Stationary subscales). In Study 1, motor skill at 6 months predicted ASD status at 24–36 months; ASD was associated with poorer infant motor skills. In Study 2, motor skill at 6 months predicted expressive language at 30 and 36 months. Findings provide evidence that vulnerability in motor function early in development is present in ASD. Findings highlight the importance of developmental monitoring in high-risk infants and possible cascading effects of early disruption in motor development.     

Moral mires and the grip of the group: Morality as internalized group norms

I argue that morality is a set of internalized group norms. It is a reliable guide in a complex social world where group status and membership are not guaranteed by birth, but have to be asserted and maintained continuously. Morality is acquired through the process of socialization when children learn in their experience with peers, from observation of adults, and by instructional stories, such as fairy tales. Failure to internalize group norms results in a clinical condition of Psychopathy, or Antisocial Personality Disorder. Research into Antisocial Personality Disorder suggests that likely pathways of group norm internalization are states of arousal associated with social situations.