Blink rate in pediatric complex partial seizure disorder

This study examined spontaneous blink rate, a putative measure of dopamine function, in 30 children with complex partial epilepsy and 61 normal children. The children with epilepsy had significantly lower blink rates than the normal children in a conversation and a verbal recall task, particularly if they had a schizophrenia-like psychosis, EEG evidence for left focal epileptic activity, illogical thinking, discourse deficits, and distractibility. They modulated their blink rates across a listening, a conversation, and a verbal recall task like the normal children. Given previously reported low blink rates in schizophrenic children, these findings suggest that children with complex partial epilepsy or schizophrenia might have similar biological features.

Partner support as a mediator of intervention outcome

Following up on previous work demonstrating that an intervention with at-risk mothers made a positive impact on the quality of mothers' partner support, responsiveness to the needs of the child, the child's expectation of being cared for, and child's response to a brief separation, the present paper examines whether quality of the mother's partner support mediated the impact of the intervention on these outcomes.

Relationship between 24-Hour Ambulatory Blood Pressure and Cognitive Function in Healthy Elderly People

This study explored the relationship between cognitive function and blood pressure (BP) in 84 women and 64 men, aged 55-79. Assessments were made of casual BP, 24-hour ambulatory BP, and cognitive function. Participants had no evidence of any health disorders, were taking no medication, and were primarily normotensive. By means of principal components analysis, the number of variables was reduced to three BP components of Level, Wake Variability, and Sleep Variability and four cognitive components of Psychomotor Speed/Cognitive Flexibility, Attention, Verbal Memory, and Short-term/Working Memory. Elevated ambulatory BP (level and variability) was associated with difficulties in Attention and Short-term/Working Memory. The fact that increased risk of poorer cognitive function may be related to BP in an elderly population with relatively low BP means that even moderate elevations in BP may be cause for concern.

Predicting posttraumatic stress symptoms in mothers and fathers of survivors of childhood cancers

OBJECTIVE

To predict posttraumatic stress symptoms in parents of survivors of childhood cancer, using as predictors the following: personality (trait anxiety); current family and individual variables (perceived life threat, perceived treatment intensity, life events, family functioning, and social support); posttreatment variables (time since treatment ended, child anxiety, medical sequelae); and treatment events (age at diagnosis, radiation therapy, intensity of treatment).

METHOD

Mothers and fathers of 6- to 20-year-old survivors of childhood cancer (n = 331 families) completed a questionnaire battery in this two-site study. The outcome variable was the Posttraumatic Stress Disorder Reaction Index. Multiple regressions and path analyses were used to test the model.

RESULTS

For both mothers and fathers, anxiety was the strongest predictor of posttraumatic stress symptoms. The current family and individual variables also contributed significantly, particularly with respect to the individual contributions of perceived life threat, perceived treatment intensity, and social support. Objective medical data did not contribute to posttraumatic stress symptoms.

CONCLUSIONS

Parental anxiety warrants attention throughout the course of treatment for childhood cancer and after treatment ends. Beliefs about past and present life threats associated with cancer treatment and family and social support are other important targets for intervention.

Affective valence and arousal in ADHD and normal boys during a startle habituation experiment

OBJECTIVE

To measure two dimensions of emotion (affective valence and arousal) in 29 boys with attention-deficit hyper-activity disorder (ADHD) and 32 normal boys.

METHOD

After a startle habituation experiment during which these subjects heard 40 startling sounds while watching a silent interesting movie, they were asked 12 questions (categorized a priori into questions relating to affective valence and to arousal) about their emotional reactions to these putatively unpleasant and pleasurable stimuli. Responses were recorded for the two dimensions of emotion, using two cartoon strips in each of which five expressions of a cartoon character varied linearly from happy to unhappy (affective valence dimension) and calm to excited (arousal dimension).

RESULTS

Factor analyses of the 12 responses revealed four factors in which the highest loadings were for affective valence to the startle responses, affective valence to the silent movie, arousal, and scary feelings. Relative to the normal group, the responses of the ADHD group were significantly biased toward pleasurable valence to the startling stimuli and to the silent movie, with a trend toward hypoarousal. Startle magnitude and habituation were similar in both groups. The normal tonic heart rate acceleration throughout the experimental session was not sustained in the ADHD group.

CONCLUSIONS

The self-reports of affective valence biased in the direction of pleasure and away from displeasure and the trend toward hypoarousal suggest an emotional dysfunction in ADHD.

Predictors of posttraumatic stress symptoms in childhood cancer survivors

OBJECTIVE

The diagnosis and treatment of childhood cancer are extremely stressful experiences, with psychological sequelae which can persist many years after the end of treatment. This study investigated the relative contributions of general anxiety, treatment intensity, medical sequelae of treatment, and the subjective appraisal of life threat and treatment intensity to later posttraumatic stress symptoms, such as intrusive memories, avoidance, and hypervigilance.

METHOD

One hundred eighty-six childhood cancer survivors ages 8 through 20 years, off of treatment for more than 1 year, and their parents completed questionnaires. Medical sequelae of treatment and intensity of treatment were rated by a pediatric oncologist.

RESULTS

Significant, independent predictors of persistent posttraumatic stress symptoms included: 1) the survivor's retrospective subjective appraisal of life threat at the time of treatment, and the degree to which the survivor experienced the treatment as "hard" or "scary"; 2) the child's general level of anxiety; 3) history of other stressful experiences; 4) time since the termination of treatment (negative association); 5) female gender; and 6) family and social support. Mother's perception of treatment and life threat contributed to anxiety and subjective appraisal for the survivor, but did not independently contribute to posttraumatic stress symptoms.

CONCLUSIONS

Symptoms of posttraumatic stress seem to decrease with time, but are persistent in a subset of childhood cancer survivors. Other than time and gender, the predictors of posttraumatic stress symptoms are primarily subjective factors (ie, anxiety and subjective appraisal) rather than objective stressors of treatment and medical sequelae.

Actions of serotonergic agents on hypothalamic-pituitary-adrenal axis activity in the rat

1. The effects of ipsapirone, nefazodone, tiaspirone, BMS-20661, buspirone and gepirone on the hypothalamic-pituitary-adrenal (HPA) axis were studied. These drugs were selected because they have serontonin 1A (5-HT1A) receptor-binding capability and have the potential for therapeutic activity in the treatment of major affective or anxiety disorders or both. 2. Plasma corticosterone level was used as the end point for determining the effect of each drug on the HPA axis. Each drug increased the plasma corticosterone levels in a dose-dependent manner. The ED50 values were 0.8 mg/kg for BMS-20661, 3.5 mg/kg for gepirone, 3.9 mg/kg for buspirone, 5.3 mg/ kg for tiaspirone, 10.5 mg/kg for ipsapirone and 73.5 mg/kg for nefazodone. Ipsapirone and buspirone were more efficacious than the other four drugs. 3. The effect of a 10-mg/kg (35 mg/kg for nefazodone) test dose of each drug reached a peak between 30 min and 1 hr, and plasma corticosterone levels generally returned to control levels after 2 hr. 4. When the drugs were given 30 min before decapitation, in conjunction with a rotatory stress, BMS-20661 significantly inhibited the stress-induced rise, whereas ipsapirone and gepirone caused a significant increase in plasma corticosterone levels. However, when the drugs were given 2 hr before decapitation, nefazodone caused a significant decrease, whereas ipsapirone, BMS-20661 and gepirone produced significant increases in HPA axis activity. An 0800 hr dose of 0.1 mg/kg of dexamethasone suppressed the 1500 hr HPA activity by 73.1%. The 0.1-mg/kg dose of dexamethasone significantly reduced the drug-activated HPA axis activity of all of the drugs from their saline-control levels. The rank order, from least to greatest inhibitory effect, produced by this dexamethasone treatment on the drug-control levels was gepirone (-42.6%), tiaspirone (-48.9%), buspirone (-56.1%), nefazodone (-68.5%), insapirone (-70.0%), and BMS-20661 (-74.3%).

Event-related potential correlates of linguistic information processing in schizophrenics

Event-related potentials (ERPs) were recorded from adult schizophrenics and age- and education-matched normal controls during performance of an idiom recognition task involving judgments of the meaningfulness of idiomatic, literal, and nonsense phrases. Schizophrenics produced more errors and had prolonged reaction times while attempting to correctly differentiate meaningful from meaningless phrases. An ERP correlate of that deficit was a larger than normal N400 to idioms and literals, with no difference in N400 amplitude to nonsense phrases. This result was interpreted as evidence that the influence of the linguistic context provided by the first word of two-word idiomatic and literal phrases is reduced in schizophrenia. Schizophrenics also showed reduced amplitude P300.

Formal thought disorder and psychopathology in pediatric primary generalized and complex partial epilepsy

OBJECTIVE

To examine whether formal thought disorder and psychopathology occurred in children with complex partial seizures (CPS) rather than children with primary generalized epilepsy with absences (PGE) or nonepileptic children.

METHOD

Formal thought disorder was coded in 30 children with CPS, 24 children with PGE, and 61 nonepileptic children, and structured interview-based psychiatric diagnoses were obtained for the epileptic subjects.

RESULTS

The CPS subjects had significantly more illogical thinking than the PGE and nonepileptic children. The severity of their illogical thinking was related to global cognitive dysfunction and a schizophrenia-like psychosis. Age of onset and seizure control, however, were significantly associated with the severity of illogical thinking in the PGE group. One or more psychiatric diagnoses were found in 63% of the CPS and 54% of the PGE patients, particularly if they had global cognitive deficits.

CONCLUSION

Illogical thinking, associated with cognitive dysfunction or schizophrenia-like symptoms, might be a feature of pediatric CPS. Psychopathology might be related to global cognitive dysfunction in pediatric CPS and PGE.

Modification of hypothalamic-pituitary-adrenocortical activity by serotonergic agents in the rat

The effects of tandospirone, enciprazine, gepirone, buspirone (5-HT1A agents) and carvotroline (5-HT2) on hypothalamic-pituitary-adrenocortical activity (HPA) activity were studied. These drugs increased the plasma corticosterone levels in a dose-dependent manner. Their ED50 values were 3.8, 31.8, 3.1, 3.4 and 7.0 mg/kg, respectively. Drug effects peaked between 30 min and 1 h, and plasma corticosterone levels returned to control levels after 2 h. When the drugs were given in conjunction with a rotatory stress, gepirone and enciprazine increased and carvotroline decreased plasma corticosterone levels. Dexamethasone (0.1 mg/kg) pretreatment reduced drug-activated HPA axis activity.

Developmental outcomes in children receiving resection surgery for medically intractable infantile spasms

Two-year postsurgical developmental outcomes were assessed in 24 children with infantile spasms who underwent resective surgery. The mean age of onset of infantile spasms was 12.0 weeks and the mean age at surgery was 20.8 months. Developmental outcomes were assessed using the Vineland Adaptive Behavior Scales (VABS). There was a significant increase in developmental level at 2 years postsurgery compared with presurgical levels. At 2 years postsurgery only one of the children in this series was severely retarded. The developmental outcomes of patients in the series were better than those in prior studies of symptomatic patients receiving medical treatment for infantile spasms. It is surprising that the children in the UCLA series frequently had developmental outcomes equal to and sometimes superior to other groups of children with infantile spasms, since all the UCLA patients were symptomatic, had neurologic deficits and had failed to respond to adrenocorticotrophic hormone (ACTH) and antiepileptic drugs. The 2-year postsurgery developmental outcomes were best for the children who received surgery when they were relatively young and who had the highest level of developmental attainments presurgically.

Stability and change over time in cognitive level of children with delays

Cognitive and family data on 82 children with developmental delays were collected in an 8-year longitudinal study. Child measures included the Gesell and the UCLA Temperament Scale administered at child age 3 and the Stanford Binet, administered at child ages 6 and 11. Family measures included SES, level of maternal education, and factor scores reflecting family accommodation or adaptation at the three time points. Although cognitive scores for the group were stable, use of a random coefficient regression technique documented differences in the decline of cognitive scores over time. Examination of change scores identified increasing, stable, and decreasing patterns of change. There were significant correlations between change in IQ, entering DQ, and Easy and Difficult temperaments.

Continuous-processing--related event-related potentials in children with attention deficit hyperactivity disorder

Visual information processing in children with attention deficit hyperactivity disorder (ADHD) was studied using event-related potentials recorded during two versions of the Continuous Performance Task (CPT). ADHD children made more errors, and had longer reaction times than normal children on both the single- and dual-target CPT. Event-related potential waveforms were normal in the ADHD children with reference to early processing stages, i.e., contingent negative variation, P1-N1 laterality, and processing negativities, suggesting that ADHD children did not differ in their level of preparedness or their ability to mobilize resources for target identification and categorization. With respect to later processing, P3 amplitude was reduced in the ADHD group, whereas P3 latency was longer than normal. ADHD children had a diminished late frontal negative component, suggestive of reduced involvement in postdecisional processing.

Family responses to children with early developmental delays. II: Accommodation intensity and activity in early and middle childhood

Families were interviewed about functional accommodations made to sustain daily routines for a child with disabilities. Accommodation intensities were unchanged from ages 3 to 7 and declined from 7 to 11. However, number of accommodation types increased dramatically from 3 to 11. By late childhood, on average, families broadened the scope of their accommodations but reduced the intensity with which they made them. Accommodations are a continuing feature of family adaptation to developmental disabilities in late childhood rather than a feature of certain developmental periods. They are most consistently associated with child characteristics that directly impact the daily routine.

Conversational repair in schizophrenic and normal children

OBJECTIVE

Children acquire the skills to monitor the adequacy of their spoken message and to self-initiate repair strategies that modify the message during early, middle, and late childhood. To characterize further the communication deficits of childhood-onset schizophrenia, this study compared self-initiated repair strategies in schizophrenic and normal children and their relationship with formal thought disorder, discourse deficits, and distractibility.

METHOD

Measures of self-initiated repair, formal thought disorder, and cohesion were coded in 32 schizophrenic and 47 normal children, aged 5.6 to 12.4 years, from speech samples elicited with the Story Game.

RESULTS

The schizophrenic children used some repair strategies (false starts, fillers, referential revision) more infrequently than the normal children. Within the schizophrenic group, the children who were receiving neuroleptic medication underutilized repair and had more discourse deficits than the unmedicated patients. Loose associations and distractibility were associated with increased use of false starts but not fillers.

CONCLUSIONS

In addition to formal thought disorder and discourse deficits, schizophrenic children underutilize self-initiated repair when presenting their thoughts to the listener, particularly if they are being treated with neuroleptics, a potential sign of increased clinical morbidity. Impoverished communication skills might reflect negative signs in childhood-onset schizophrenia.

Blink rate in children with attention-deficit-hyperactivity disorder

Spontaneous blink rate, a noninvasive measure of dopamine function, was coded in 28 children with attention-deficit-hyperactivity disorder (ADHD) and in 47 normal children during a listening, a conversation, and a verbal recall task. Unlike the normal children, the children with ADHD did not increase their blink rates significantly across these three tasks. The ADHD subjects were were not on stimulants had significantly lower blink rates than the normal children during verbal recall. The ADHD subjects on stimulants, however, had significantly higher blink rates than the normal subjects during the listening task. These preliminary findings are discussed in light of their potential implications for theories on neurotransmitter dysfunction and arousal in ADHD.

First record of Aedes albopictus from New Jersey

In early August 1995, Aedes albopictus was detected in a light trap collection at a coastal location of Monmouth County, NJ. Larval surveillance indicated the species was breeding in a variety of containers over an area of at least 1.0 km2. This New Jersey record currently represents the northernmost breeding population of Ae. albopictus on the eastern seaboard. The collection site is very close to the 0 degree C daily mean January isotherm that has been used as a conservative estimate for the northern limit of this mosquito's overwintering range.

Effect sizes and p values: what should be reported and what should be replicated?

Despite publication of many well-argued critiques of null hypothesis testing (NHT), behavioral science researchers continue to rely heavily on this set of practices. Although we agree with most critics' catalogs of NHT's flaws, this article also takes the unusual stance of identifying virtues that may explain why NHT continues to be so extensively used. These virtues include providing results in the form of a dichotomous (yes/no) hypothesis evaluation and providing an index (p value) that has a justifiable mapping onto confidence in repeatability of a null hypothesis rejection. The most-criticized flaws of NHT can be avoided when the importance of a hypothesis, rather than the p value of its test, is used to determine that a finding is worthy of report, and when p approximately equal to .05 is treated as insufficient basis for confidence in the replicability of an isolated non-null finding. Together with many recent critics of NHT, we also urge reporting of important hypothesis tests in enough descriptive detail to permit secondary uses such as meta-analysis.

Screening by the prostate-specific antigen test: what do the patients know?

BACKGROUND

Prostate cancer is the most common malignancy in men, and prostate cancer screening is recommended for all men over the age of 50. The use of the prostate-specific antigen (PSA) test for cancer screening is controversial.

METHODS

At two different Veterans Administration facilities, outpatients completed a 15-item questionnaire about their knowledge of the PSA test two weeks after receiving a screening test.

RESULTS

Demographic characteristics of the patients are described and examined in relation to the results of the PSA-test-knowledge questions. Over 50% of men had not heard of the PSA test and were unaware of receiving the test. Higher education level was the only predictor of PSA-test knowledge.

CONCLUSIONS

Either patients forget information about the PSA test or providers do not tell patients they are being screened for cancer. Further research and interventions are needed to improve patient knowledge and understanding about this prostate cancer screening test.

Office abortion services for women: private physician providers

Research suggests that private physician providers of office abortions and the women who seek their services are not included in nationwide surveys of abortion statistics. This study describes the demographic characteristics of private physicians and the prevalence of abortions performed in their offices in Los Angeles County, California, a state in which office abortions are prohibited by law. Factors that influence physicians' decisions to provide the service, as well as the age and ethnicity of the office abortion recipients, are examined. Of 1,004 California Medical Association members who practiced obstetrics and gynecology in Los Angeles County during 1990, 49% returned anonymous, confidential surveys. Seventy percent of physicians had performed at least one abortion in California, and 29% were currently providing this service in their offices. Physician gender, age, ethnicity, and religion were associated with performing abortions. The average abortion patient was not young and ethnic, but White, middle-class, and in her mid- to late twenties. The implications of these findings are discussed.

Exploring the concept of health among adolescents with diabetes using photography

The purpose of this study was to explore and describe the concept of health among adolescents with diabetes. Photography was used to facilitate communication. Participants were given Polaroid cameras with instructions to take pictures illustrating health. They were then asked to explain in writing how their pictures demonstrated the concept. The participants produced 46 pictures and 53 descriptive expressions, which were analyzed for content. Health was described as energy, positive feelings, absence of illness, strength, activity, fitness, mental ability, and relationships. There were also descriptions of what one does to be healthy, which included eating nutritious food, exercising, engaging in diabetes-related care, sleeping, studying, relaxing, maintaining hygiene, and obtaining shelter.

Programmed cell death enhances uniformity in rat cerebral hemispheres

Programmed cell death (apoptosis) in rat cerebral hemispheres (CH) reportedly occurs around postnatal day 7 and kills 15-75% of all cells whose continuing presence would be of disadvantage for the organism: neurons erroneously connected, or supranumerary neurons that do not find targets and are not protected by neurotrophins. In the present paper we report that apoptosis (or a concomitant phenomenon) reduces also variability (coefficient of variation, CV) of CH parameters: weight, DNA content and protein content (presented here as a percent of the mean of each of these parameters). Postapoptotic brains have significantly lower CV of these parameters than the preapoptotic brains. Presumably, this trend toward uniformity offers selective advantages (for rat) and established itself during evolution. The mechanisms and the control of this phenomenon are at present largely unknown.

The detection, quantification and partial characterisation of cathepsin B-like activity in human pathological synovial fluids

In this study, the levels of the cysteine proteinase--cathepsin B were measured in diseased synovial fluids using a steady state fluorometric assay. Cathepsin B-like activity was shown to be present in all the samples analysed, with the rheumatoid arthritic synovial fluids possessing significantly higher concentrations (mean value ca. 416 mg/l) than the osteoarthritic fluids (mean value ca. 142.4 mg/l). In addition, upon treatment with pepsin, all of the rheumatoid arthritis samples were shown to possess additional cathepsin B-like activity, suggesting the presence of a reservoir of latent precursor molecules. By utilising a recently developed biotinylated affinity label for cathepsin B-like proteinases and sheep anti-(human cathepsin B) antibodies, used in combination with SDS-PAGE and Western blotting, the rheumatoid arthritic synovial cathepsin B was shown to exist in two forms with apparent molecular masses of M(r) 29,000 and 42,000. We propose that the former is a functionally active proteinase, whereas the latter is a pepsin activatable proform which, when cleaved by this aspartyl proteinase, is converted into a catalytically competent species of M(r) 20,000.