Some problems of Wilson's disease

The Leipzig Center for Wilson's Disease in the GDR is charged with the registration and diagnosis of all homozygous Wilson gene carriers, the clarification of all suspected cases, including the heterozygote test, and the co-ordination of long-term treatment. At present, there are 78 recorded Wilson gene carriers living. On the basis of our own comprehensive observations and investigations over prolonged periods of time, questions concerning pathogenesis, genetics, diagnosis and therapeutic measures, including their side-effects, are dealt with.     

Development and Implementation of a Transdiagnostic,Stepped-Care Approach to Treating Emotional Disorders in Children via Telehealth

Stepped-care interventions may increase the accessibility of evidence-based treatments but remain relatively underexplored in the child mental health literature. Further, while the feasibility and efficacy of stepped-care interventions have been examined for specific diagnoses or classes or disorders, transdiagnostic stepped-care interventions have not yet been developed. We discuss the development and initial implementation of a transdiagnostic approach to emotional disorders using the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C; Ehrenreich-May et al., 2018). A case series is presented to illustrate the delivery of UP-C stepped care (UPC-SC) via telehealth, using a collaborative decision-making process to inform step-up/step-down decisions. Lessons learned are discussed to guide refinements of UPC-SC and inform a larger trial.     

Correlations for organizational,nonorganizational, and intrinsic religiosity with social support among intercollegiate athletes

The present study was a preliminary examination of the correlations among organizational, nonorganizational, and intrinsic religiosity and social support as measured by the Duke Religion Index and the Nonsupport scale of the Personality Assessment Inventory for 105 intercollegiate athletes (51 women). Scores among these measures were not correlated (-.05 to -.14).     

The role of oral language revisited: a comment on the NICHD Early Child Care Research Network (2005)

This article comments on the discussion of S. A. Storch and G. J. Whitehurst's literacy development model in the article by the National Institute of Child Health and Human Development (NICHD) Early Child Care Research Network (ECCRN). Specifically, this comment focuses on concerns raised by the NICHD ECCRN that Storch and Whitehurst's model does not afford an important role to oral language in the development of early reading skill. Four important issues are presented that provide a serious and careful challenge to the model and conclusions of the NICHD ECCRN's report.     

Treating Childhood Anxiety in Schools: Service Delivery in a Response to Intervention Paradigm

Millions of youth who attend schools in the United States suffer from clinically significant anxiety. Left untreated, these students often experience significant disruptions in their academic, social, and family functioning. Fortunately, promising treatments exist for childhood anxiety that are amenable for delivery in school settings. However, educational law and new service delivery paradigms such as response-to-intervention (RtI) affect the delivery of anxiety interventions. In light of extant laws and practices that govern education, this article discusses the provision of supportive services to address childhood anxiety. Specifically, this article reviews how RtI, the Individuals with Disabilities Education Improvement Act, and Section?504 of the Rehabilitation Act guide service delivery and subsequently impact school-based anxiety treatments. Suggestions are provided to address childhood anxiety within a framework that allows for graduated and fluid service delivery.     

Early childhood trichotillomania: Initial considerations on phenomenology,treatment, and future directions

Historically, trichotillomania (TTM) in young children (0–3 years old) generally has been considered to be a benign habit that is clinically distinct from the TTM seen in older children and adults. However, early childhood TTM can be an impairing pathological disorder that merits formal intervention. The present article reviews the extant literature on TTM in young children, highlighting the limited available phenomenological data. We discuss a behavioral approach to conceptualization and treatment, highlighting core intervention strategies in three early childhood TTM cases seen in our clinic. We conclude by discussing areas in need of further empirical attention.     

Does d-Cycloserine Augmentation of CBT Improve Therapeutic Homework Compliance for Pediatric Obsessive–Compulsive Disorder?

Clinical studies in adults and children with obsessive–compulsive disorder (OCD) have shown that d-cycloserine (DCS) can improve treatment response by enhancing fear extinction learning during exposure-based psychotherapy. Some have hypothesized that improved treatment response is a function of increased compliance and engagement in therapeutic homework tasks, a core component of behavioral treatment. The present study examined the relationship between DCS augmented cognitive-behavioral therapy (CBT) and homework compliance in a double-blind, placebo controlled trial with 30 youth with OCD. All children received 10 CBT sessions, the last seven of which included exposure and response prevention paired with DCS or placebo dosed 1 h before the session started. Results suggested that DCS augmented CBT did not predict improved homework compliance over the course of treatment, relative to the placebo augmented CBT group. However, when groups were collapsed, homework compliance was directly associated with treatment outcome. These findings suggest that while DCS may not increase homework compliance over time, more generally, homework compliance is an integral part of pediatric OCD treatment outcome.     

Evidence-Based Assessment in Children and Adolescents with Obsessive–Compulsive Disorder

The assessment of varied psychiatric disorders, including obsessive–compulsive disorder (OCD), is shifting towards the use of evidence-based assessments (EBAs). This shift has fostered the development, validation and adaptation of several measures to rate obsessive–compulsive symptoms and other related problematic areas such as functional impairment or family attitudes among others. The aim of this paper is to present a systematic review of psychometric studies on pediatric OCD-specific measures to classify these according to assessment evidence-based criteria. Selection criteria that determined which studies were included in the review were: (1) analyzing an OCD measure and (2) including participants’ age being 18 years or younger. The literature search procedure was conducted in Medline, PsycINFO, PsycARTICLES, ERIC, Cochrane Library, and Scholar Google databases and enabled us to locate 42 studies which analyzed psychometric properties of 14 OCD measures studied in children and adolescents. Instruments were grouped into the following assessment areas: symptom presence and severity, functional impairment, family functioning and cognitive dimensions of OCD. Psychometric data regarding internal structure, internal consistency, reliability, validity and diagnostic precision were also reported. Further, measures were classified as well-established, approaching well-established and promising assessments in terms of reliability and validity. We concluded that the assessment of OCD in pediatric populations is a growing field that in a short-medium term could provide a wide variety of EBAs for the evaluation obsessive–compulsive symptoms and other OCD-related dimensions. The paper concludes by highlighting directions for future research.     

Profile Analysis of Psychological Symptoms Associated With Misophonia: A Community Sample

Misophonia is characterized by extreme aversive reactions to certain classes of sounds. It has recently been recognized as a condition associated with significant disability. Research has begun to evaluate psychopathological correlates of misophonia. This study sought to identify profiles of psychopathology that characterize misophonia in a large community sample. A total of N = 628 adult participants completed a battery of measures assessing anxiety and anxiety sensitivity, depression, stress responses, anger, dissociative experiences, obsessive-compulsive symptoms and beliefs, distress tolerance, bodily perceptions, as well as misophonia severity. Profile Analysis via Multidimensional Scaling (PAMS) was employed to evaluate profiles associated with elevated misophonia and those without symptoms. Three profiles were extracted. The first two accounted for 70% total variance and did not show distinctions between groups. The third profile accounted for 11% total variance, and showed that misophonia is associated with lower obsessive-compulsive symptoms for neutralizing, obsessions generally, and washing compared to those not endorsing misophonia, and higher levels of obsessive-compulsive symptoms associated with ordering and harm avoidance. This third profile extracted also showed significant differences between those with and without misophonia on the scale assessing physical concerns (that is, sensitivity to interoceptive sensations) as assessed with the ASI-3. Further research is called for involving diagnostic interviewing and experimental methods to clarify these putative mechanisms associated with misophonia.