Formal thought disorder in pediatric complex partial seizure disorder

We compared the formal thought disorder ratings of 27 children with complex partial seizure disorder, 31 schizophrenic children and 58 normal children. The epileptic children with fullscale IQ scores below 100 had significantly more formal thought disorder than normal children with a similar IQ. The severity of their formal thought disorder was related to the age of seizure onset, seizure control and a diagnosis of schizophrenia spectrum disorder. The schizophrenic children had thought disorder irrespective of IQ scores. The cognitive correlates of their formal thought disorder scores differed from those of the epileptic children. Possible anatomical substrates of thought disorder in childhood complex partial seizure disorder and schizophrenia are discussed.

Understanding of simple and complex emotions in non-retarded children with autism

Non-retarded autistic children are compared to normal controls on measures of emotion expression and recognition. In general, autistic subjects recounted appropriate examples of simple and complex emotions, and accurately labeled relatively ambiguous affect expression in pictures. Autistic children manifested some difficulty talking about socially derived emotions, pride and embarrassment. They required more time and more prompts, their responses were more tentative and "scripted", and they displayed limited understanding of the salience of others in embarrassing situations. Results are discussed in relation to theory of mind impairment and compensation strategies in autism.

Out of sight or out of mind? Another look at deception in autism

The penny-hiding game is a deception game that occurs naturally in parent-child and child-child interaction. It involves minimal linguistic demands, and is lots of fun. Oswald and Ollendick (1989) employed it with subjects with autism and reported an impaired capacity for deception. They also found that this correlated with performance on both a false belief ("theory of mind") test as well as various measures of social behaviour. The experiment reported here set out to replicate Oswald and Ollendick's important results, and then extend them by using a new technique for error analysis. We succeeded in replicating the autism-specific deception impairment as well as the finding that deception capacity correlates highly with performance on a false belief test. In addition, the new analytic technique discriminated the group with autism from controls more clearly than the traditional index of deception. Specifically, subjects with autism, whilst fully capable of enjoying the game as a game of object occlusion (keeping things out of sight), failed to perceive the game as a game of information occlusion (keeping things out of mind), unlike normal children or subjects with a mental handicap of an equivalent or lower mental age. The dissociation in autism between occluding objects vs occluding information is discussed in relation to other research showing that subjects with autism are impaired in understanding the principle that "seeing leads to knowing".

Understanding drawings and beliefs: a further test of the metarepresentation theory of autism: a research note

Leslie (1987, Psychological Review, 94, 412-426) proposed that the "theory of mind" deficit in autism was the result of a metarepresentation impairment. Studies employing False Photograph or Belief tests have shown that in autism the deficit is restricted to representing mental representations, and does not extend to representing pictorial representations. In this study, we tested this claim further using a False Drawing test. Subjects with autism performed at the same level as mentally handicapped or normal 4-year-old subjects on the False Drawing test, but significantly worse on the False Belief test. This confirmed the specificity of the deficit in autism.

Interviews with children who experienced major life stress: family and child attributes that predict resilient outcomes

Demographically comparable groups of children exposed to major life-stress, with stress resilient (SR) and stress affected (SA) outcomes at ages 10 to 12, were interviewed to assess perceptions of their caregiving environments, peer relationships, and themselves. SR children compared with SA children reported more: (1) positive relationships with primary caregivers, (2) stable family environments, (3) inductive and consistent family discipline practices, and (4) positive expectations for their futures. SR girls viewed their mothers as more nurturing than did SA girls. Perceptions of fathers, quality of peer relationships, and global self-concept did not differentiate the groups. A discriminant function analysis identified four variables that correctly classified 74% of the subjects as SR or SA. Findings support the view that caregiver-child relationships play a key role in moderating children's developmental outcomes under conditions of high stress.

Agreement between parents' reports and adolescents' self-reports of problem behavior

Parents' reports and adolescents' self-reports of problem behaviors in 883 11-19-year-olds from the general population were compared. Correlations between both informants' CBCL syndrome scores ranged from 0.27 to 0.56. Adolescents reported many more problems than their parents did about them. Discrepancies were larger for externalizing than for internalizing problems, were larger for girls than for boys and increased with age. The findings indicated that adolescents, especially as they grow older, are indispensable informants on their own problem behaviors.

The relative effects of maternal and child problems on the quality of attachment: a meta-analysis of attachment in clinical samples

In this meta-analysis of 34 clinical studies on attachment the hypothesis is tested that maternal problems such as mental illness lead to more deviating attachment classification distributions than child problems such as deafness. A correspondence analysis on 21 North American studies with normal subjects produced a baseline against which the clinical samples could be evaluated. Separate analyses were carried out on studies containing the traditional A, B, C classifications and on studies that also included the recently discovered D or A/C category. Results show that groups with a primary identification of maternal problems show attachment classification distributions highly divergent from the normal distributions, whereas groups with a primary identification of child problems show distributions that are similar to the distributions of normal samples. The introduction of the D or A/C classifications (about 15% in normal samples) reveals an overrepresentation of D or A/C in the child problem groups, but the resulting distribution still is much closer to the normal distributions compared to the samples with maternal problems. In clinical samples, the mother appears to play a more important role than the child in shaping the quality of the infant-mother attachment relationship.

"Theory of mind" in Asperger's syndrome

Two studies are reported in which the ability of people with Asperger's syndrome to understand problems of the type "Peter thinks that Jane thinks that ..." tested. The results showed that in contrast to younger or more handicapped autistic individuals, Asperger subjects were able to solve problems of the type just outlined, i.e. that they possessed a second-order theory of mind. When asked to explain their solutions however, they typically did not use mental state terms but did not differ in this respect either from non-handicapped or socially impaired, chronic schizophrenic controls. The implications of the results for current cognitive theories of autistic impairment are discussed.

Thirty years of research on developmental neurolinguistics

A body of medically important work has accumulated in the field of developmental neurolinguistics in the 30 years since Lenneberg set forth a research agenda for that field, consisting of the following: (1) the physiologic specialization or endowment for speech; (2) the genetic origin or natural history of vocalization and speech; (3) the nature of prelinguistic behavior, making possible the detection of any environmental (social) influences; (4) the development of motor-speech organization from birth; and (5) the limiting effects of deficient intelligence, hearing, and environmental stimulation. Subsequent study of these questions has established a genetic, neuroanatomic, and functional basis for such outwardly disparate disorders as dyslexia, stuttering, autism, and delayed language. Studies of emergent motor behavior suggest that babbling may index a state of neural maturation favoring expression of spoken languages. Based on studies of the congenitally deaf, mentally retarded, and other clinical populations it is now considered possible to detect early warning signs of developmental language disorders during the first year of life based on analyses of vocal turn-taking, gesturing, and utterance complexity.

A longitudinal perspective on adolescent substance abuse

The links between adolescent substance abuse and adult alcohol and drug misuse and dependence are now well established. The vast majority of adult substance misusers start in their adolescent years. This, and the emotive nature of adolescent substance abuse generated an increased and justifiable interest in substance abuse in adolescent populations, that began in the early 1970s. This paper reviews the most relevant recent literature relating to the subject especially that which had a longitudinal design. It covers epidemiology, antecedents, course and outcome, psychopathology, treatment and prevention. Ideas for further longitudinal research are suggested.

Autistic social dysfunction: some limitations of the theory of mind hypothesis

This study examined the extent to which the social disabilities found in autism can be accounted for by the "Theory of Mind" hypothesis. Items related to social development from the Vineland Adaptive Behavior Scales were administered to 29 CA-, MA- and IQ-matched pairs of young autistic and non-autistic, developmentally disabled children. These items were evaluated in relation to expected ages of acquisition based on the Vineland standardization database. Our results indicate that the social dysfunction in autism affects very basic and early emerging social behaviors which are typically present prior to the time at which even the earliest precursors of a theory of mind apparently emerge.

Recent developments in life-event research and their relevance for the study of addictions

The idea that stressful life events can on occasions contribute to the development of addictive disorders is fairly well-accepted within both clinical and research communities. However, little support is available: research is sparse and investigators have generally neglected methodological refinements and innovations in the broader field of life-event research. Some of these developments are discussed, especially as they relate to the measurement of the meaning of life events. Findings from research based on such techniques are summarized, and their relevance for the study of addictions discussed under three headings: specification of life events, vulnerability, and diagnostic specificity.

Domain specificity in conceptual development: neuropsychological evidence from autism

To understand some aspects of conceptual development it is necessary to take cognitive architecture into account. For this purpose, the study of normal development is often not sufficient. Fortunately, one can also study neurodevelopmental disorders. For example, autistic children have severe difficulties developing certain kinds of concepts but not others. We find that whereas autistic children perform very poorly on tests of the concept, believes, they are at or near ceiling on comparable tasks that test understanding of pictorial representation. A similar pattern was found in a second study which looked at understanding of a false map or diagram: normal 4-year-olds showed a marked advantage in understanding a false belief over a false map, while the autistic subjects performed better on the map. These findings suggest that the concept, believes, develops as a domain-specific notion that is not equatable with "having a picture (map or diagram) in the head." This result supports the existence of a specialized cognitive mechanism, which subserves the development of folk psychological notions, and which is dissociably damaged in autism. We extend these ideas to outline a new model of the development of false belief performance.

Development of conduct problems and peer rejection in preschool children: a social systems analysis

The development of impulsive-aggressive problem behavior and peer rejection was examined in sixty 4- to 5-year-old boys from low-income family backgrounds. Children's sociometric status and behavioral adjustment were assessed longitudinally at the beginning and end of the preschool year, and related to measures of peer interaction at three different points in time. Boys identified as socially rejected and aggressive in the beginning of the year were highly likely to be identified as such at the end of the year. Early in the preschool year, these children contributed to their own rejection by initiating socially aversive exchanges with peers. Although peers clearly perceived these problems, they did not reciprocate with counteraggression at first. However, as time passed, peers began to actively victimize these children, and most of the aggression on the part of victims became reactive in nature. Thus, the current findings strongly support a transactional model of the development of early peer rejection and conduct problems.

The relation between attachment and knowledge of self and mother in one to three-year-old infants

The relation between attachment to mother and knowledge of self and mother in 2 domains was assessed in 1- to 3-year-old infants. Infants' featural knowledge was measured by featural recognition, name, possession, and gender. In this domain, no difference between the 2 attachment classifications was obtained at 1 year of age, but significant and increasingly large differences between securely and insecurely attached infants were found at 2 and 3 years of age. The second domain measured infants' actions on self and mother in the context of symbolic play. Regardless of age, infants who were securely attached to mother acted on self and mother with greater complexity than did infants who were insecurely attached. Attachment was related equally to the complexity of infants' knowledge of self and mother. These data were discussed in the context of the development of infants' internal working models of attachment and the onset of representational ability.

Young children's views about conflict with peers: a comparison of the daughters and sons of depressed and well women

Forty five-year-olds were interviewed about conflict with peers, based on a simulated dispute between two glove puppets. Recommendations about tactics to be used in resolving conflicts were affected by the child's gender and experience of being cared for by a depressed mother. In particular, the daughters of depressed women were less likely than other children to recommend aggressive solutions to peer conflict; in contrast, the sons of depressed women were more likely than others to advocate aggression. Girls in general recommended more socialized tactics than boys did.

Debate and argument: on modularity and development in autism: a reply to Burack

Burack (this issue) reopens questions first raised by my 1989a article in this Journal, on whether children with autism have a specific delay in the development of a theory of mind, or whether the data reflect deviance rather than delay. His paper is of considerable value in highlighting points for debate. In my response, I focus on three issues: First, the logical possibility that delay and deviance can occur together. Second, the evidence that autism may instantiate this possibility. Finally, the important question of the modularity of theory of mind.

Combining discrepant diagnostic information from multiple sources: are complex algorithms better than simple ones?

Optimizing methods of combining discrepant diagnostic information from multiple sources is one of the more daunting tasks facing the field of child psychopathology. Several researchers have asserted that complex information-combining schemes, those in which certain information or sources of information are weighted differently from others, are preferable. This study provides theoretical and empirical evidence that simple information-combining schemes, those in which all information from all sources is weighted equally, will as a rule work as well as complex schemes and may even work better. The implications of these findings for diagnostic instrument and algorithm design are discussed. A two-step diagnostic procedure utilizing a simple information-combining scheme is presented.

DSM-III disorders from age 11 to age 15 years

Although research into the continuity of disorder from childhood to adolescence is sparse, results from both longitudinal and cross sectional studies suggest that the prevalence of disorder increases for girls but may remain more stable for boys. In this paper, the methodologies of two assessment phases of the Dunedin longitudinal study have been equated to estimate the continuity of DSM-III disorder from ages 11 to 15. Although the overall prevalence of disorder doubled between the ages, this was primarily because of an increase in nonaggressive conduct disorder and major depressive episode. The sex ratios in disorder had largely reversed from a male predominance at 11 to a female predominance at 15. In terms of persistence, over 40% of those with disorder at age 11 were also identified at age 15. However, over 80% of those identified with disorder at 15 did not have a history of disorder at 11. Significant sex differences were also found in the continuity of internalizing and externalizing disorders, with externalizing disorders showing more continuity for boys, and internalizing for girls. Logistic regression models were employed to evaluate the roles family background, academic and social competence, and early histories of behavior problems may play in the determination of disorder continuity.

Communication deficits and formal thought disorder in schizophrenic children

This study examined 31 schizophrenic children to determine if they used discourse devices that make speech coherence differently from sex and mental age matched normal children. It also investigated whether the discourse deficits of the schizophrenic children were related to clinical measures of formal thought disorder. Using Halliday and Hassan's analysis of cohesion, the authors found that schizophrenic children underutilize some discourse devices and overutilize others. Several of their discourse deficits were similar to those described in schizophrenic adults. The schizophrenic children, however, also had additional discourse deficits, which probably reflect developmental delays. The authors also demonstrated that the schizophrenic children with loose associations had different discourse deficits and discourse/IQ correlates than schizophrenic children without loose associations. The schizophrenic children receiving neuroleptic medication had lower loose associations scores than the unmedicated subjects. The authors discuss the possible confounding effect of medication and loose associations, as well as the developmental, cognitive, and clinical implications of the study's findings.

Views of problem drinking among Native American, Hispanic, and Anglo children

Native American, Hispanic, and Anglo sixth graders reacting to an example of teenage problem drinking expressed similar beliefs and attitudes in many respects. However, Native American children viewed the problem as less serious, subscribed more to a disease theory of alcoholism, attributed less causal responsibility to the individual, and adopted a less aggressive approach toward treatment than did Hispanic, and especially Anglo, children. Their less conventional value orientations accounted for all these differences except their stronger endorsement of a disease theory of problem drinking.

Aggregating data from multiple informants in child psychiatry epidemiological research

One of the issues confronting the field of child psychiatric epidemiology is devising ways to aggregate discrepant reports from multiple informants obtained in structured diagnostic assessments of children and adolescents. The present report uses data from an epidemiological community survey to attempt to address this issue. The results obtained through statistical procedures designed to identify the "optimal" informant for specific symptomatic criteria and diagnoses do not seem to offer a clear-cut advantage over a simple combinatorial rule that identifies symptomatic criteria as positive when they are acknowledged as positive by either parent or child informants.