Prevalence of ADHD and comorbid disorders among elementary school children screened for disruptive behavior

In the context of a school-based prevention of conduct disorder program, 7,231 first- through fourth-grade children were screened for cross-setting disruptive behavior. Frequencies of DSM-III-R psychiatric disorders and patterns of comorbidity were assessed. We also examined the association of psychiatric diagnosis with child and parent characteristics to determine differential risk based on diagnostic subgroups. Attention deficit hyperactivity disorder (ADHD) and oppositional-defiant disorder (ODD) were the most frequent diagnoses. Mood and anxiety disorders were infrequent as single diagnoses. Patterns of comorbidity demonstrated that both externalizing and internalizing disorders commonly cooccurred with ADHD. More severe degrees of psychopathology and psychosocial risk accrued to the subgroup of youths with ADHD plus a comorbid externalizing disorder.This study was supported by grant MN-46584 from the National Institute of Mental Health.     

Antenatal caregiving representations and perinatal behavior in mothers with severe lifetime psychopathology

Psychopathology poses a risk for optimal parenting. The current study explored antenatal caregiving representations as markers for later risk of nonoptimal maternal behavior among mothers with severe mental illness. Sixty-five mothers diagnosed with psychosis, bipolar disorder, depression (psychopathology group), and nonclinical controls participated in a longitudinal study from pregnancy to 16 weeks after birth. Mental health diagnoses and caregiving representations were assessed during pregnancy. Maternal behavior was assessed during the 5-min recovery phase of the still-face paradigm at 16 weeks. Mothers with psychopathology reported significantly higher levels of “heightened” caregiving representations (i.e., separation anxiety from the child) than did controls. The only significant diagnostic group difference in perinatal maternal behavior was that mothers diagnosed with depression exhibited more overriding-intrusive behavior than did nonclinical control mothers. Regression modeling results showed that antenatal caregiving representations of “role reversal” predicted significantly lower levels of sensitivity and higher levels of overriding-intrusive behavior independent of the effect of psychopathology. The findings can be interpreted in the context of representational transformation to motherhood during pregnancy. The results provide preliminary evidence for the potential of a new questionnaire measure of caregiving representations as a screening instrument for antenatal representational risk.     

Context-processing deficits in schizophrenia: diagnostic specificity, 4-week course,and relationships to clinical symptoms

Previous research on schizophrenia suggests that context-processing disturbances are one of the core cognitive deficits present in schizophia. However, it is not clear whether such deficits are specific to schizophrenia as compared with other psychotic disorders. To address this question, the authors administered a version of the AX Continuous Performance Test designed to assess context processing in a sample of healthy controls, patients with schizophrenia, and patients with other psychotic disorders. Participants were tested at index (when medication naive and experiencing their first contact with psychiatric services) and 4 weeks later, following medication treatment. At index, patients with schizophrenia and the psychotic comparison group demonstrated similar impairments in context processing. However, context-processing deficits improved in the psychotic comparison group at 4 weeks but did not improve in patients with schizophrenia.     

A population-based study of the association between pathological gambling and attempted suicide

The association between pathological gambling and attempted suicide was examined using data from a prevalence study conducted in Edmonton, Alberta, Canada. The sample size was 7,214, the questionnaire was the Diagnostic Interview Schedule, and diagnoses were made on a lifetime basis according to DSM-III criteria. Logistic regression analysis was performed, with attempted suicide as the dependent variable. The odds ratio for pathological gambling was statistically significant (odds ratio = 4.91; 95% confidence interval = [1.41,17.1]) when major depression was the only comorbid mental disorder in the model. As terms for additional mental disorders were included, pathological gambling ceased to be statistically significant. It was concluded that a history of pathological gambling is associated with previous attempted suicide, and that the association may be due to a common factor--"mental illness."     

Psychotherapy Process Measure Research and the Evaluation of Psychotherapy Orientation: A Narrative Analysis

This article discusses the need for a systematic method that enables researchers to evaluate integrative therapy approaches using a range of therapy process measures. The Narrative System Process Coding (NPCS; Angus, Hardtke, & Levitt, 1996) is proposed as such a method, and is applied with the Experiencing Scale (Klein, Mathieu, Gendlin, & Keisler, 1970) and the Levels of Client Perceptual Processing (LCPP; Toukmanian, 1986) to three brief good outcome integrative therapy modalities to illustrate this need. The study found higher Experiencing Scale scores to be most strongly related to an experiential approach to therapy and to the NPCS internal narrative processes. Higher LCPP scores were most strongly related to the NPCS reflexive narrative process and to a perceptual-processing approach. The discussion initiates a discourse on the importance of explicating process measures' origins when comparing different therapy approaches in order to allow for the meaningful consolidation of process research findings.     

Common and specific cognitive deficits in schizophrenia: relationships to function

The goals of the present study were to assess the interrelationships among tasks from the MATRICS and CNTRACS batteries, to determine the degree to which tasks from each battery capture unique variance in cognitive dysfunction in schizophrenia, and to determine the ability of tasks from each battery to predict functional outcome. Subjects were 104 schizophrenia patients and 132 healthy control subjects recruited as part of the CNTRACS initiative. All subjects completed four CNTRACS tasks and two tasks from the MATRICS battery: Brief Assessment of Cognition in Schizophrenia Symbol Coding and the Hopkins Verbal Learning Test. Functional outcome was also assessed in the schizophrenia subjects. In both the patient and control groups, we found significant intercorrelations between all higher order cognitive tasks (episodic memory, goal maintenance, processing speed, verbal learning) but minimal relationships with the visual task. For almost all tasks, scores were significantly related to measures of functional outcome, with higher associations between CNTRACS tasks and performance-based measures of function and between one of the MATRICS tasks and self-reported functioning, relative to the other functioning measures. After regressing out variance shared by other tasks, we continued to observe group differences in performance among task residuals, particularly for measures of episodic memory from both batteries, although these residuals did not correlate as robustly with functional outcome as raw test scores. These findings suggest that there exists both shared and specific variance across cognitive tasks related to cognitive and functional impairments in schizophrenia and that measures derived from cognitive neuroscience can predict functional capacity and status in schizophrenia.     

Crisis,Biology, Ecology: A New Starting-Point for Phenomenology?

The crisis of European sciences in Husserl’s late work diagnoses Galilean science as specifically and necessarily losing touch with the intuitive evidence that would legitimate it due to its reliance on a formal-mathematical conceptual apparatus. While the vast majority of Husserl’s late work was focussed on a critique of the formal-mathematical paradigm of the physical science of nature, at several points the possibility of biology as the exemplary science is raised to suggest that the lack of a reliance on formal-mathematical conceptual language would mean that a systemic crisis would not occur in such a case. This investigation considers the grounds for the expectation that biology would not engender a crisis, suggests that a paradigmatic role for ecology would more adequately address this expectation, and finally claims that the question of the relation between a specific exemplary science and transcendental phenomenology is not fully resolved even in this case.