Pharmacotherapy with the mentally retarded: Implications for clinical psychologists

Preliminary study of imipramine in profoundly retarded residents

This was a double-blind, placebo-controlled crossover trial of imipramine (3 mg/kg/day) in 10 profoundly retarded residents. Two groups were formulated: one with depressivelike (or affective) symptoms and one with acting-out behaviors. Measures of drug response included ratings of ward behavior using the Aberrant Behavior Checklist, interval samples of behavior in the living units, and observations of behavior in a playroom situation. Results indicated that the drug caused behavioral deterioration in the Irritability, Lethargy/social withdrawal, and Hyperactivity dimensions of the rating scale, irrespective of subgroup. In addition, gross motor activity was significantly increased on the wards due to imipramine, and it was found that the affective group became less active and the acting-out group more active during free play. Physical side effects were uncommon. These unexpected adverse behavioral effects were discussed with respect to dosage and diagnostic considerations.

Pimozide treatment in disruptive severely retarded patients

Eight severely retarded residents took part in a double blind, placebo controlled trial of pimozide. The drug did not alter behavioural adjustment as assessed by behaviour observations. However, ratings on a standardised checklist of aberrant behaviour showed significant drug-induced improvements on two dimensions (Irritability and Hyperactivity/non-compliance). Learning performance, as assessed by a discrimination learning task, was not affected by the drug.

Chlorpromazine effects on stereotypic and conditioned behaviour of severely retarded patients--a pilot study

An attempt was made to test the hypothesis that anti-psychotic medication may induce adaptive changes by suppressing stereotypic behaviour. Six profoundly retarded residents were selected for the presence or absence of stereotypic behaviour and tested in a placebo controlled, cross-over study. Chlorpromazine caused noticable drowsiness in all subjects over the 2-week drug period. Body rocking was significantly suppressed in the wards, but other clinical behaviours were not influenced by the drug. Performance on an operant conditioning task was significantly impaired in most subjects. Body rocking, which was also assessed during operant responding, was unrelated to presence or absence of clinical stereotypy, observed on the wards. The results were discussed in terms of chlorpromazine's clinical effects and improved ways of assessing the hypothesis that anti-psychotic drugs may enhance adaptive behaviour in some retarded individuals.

Recent technological advancements in the treatment of enuresis. Theory and commercial devices

Antienuretic devices sold commercially symbolize the progression in technological improvements from historical to modem treatment approaches. Underlying these advancements are theoretical changes in operant psychology, through whose applications the science in psychophysiology has become prominent. This article traces the treatment of enuresis through its early developmental stages, identifying psychophysiology as a cognitive problem, to modem inventions of mechanical devices and the shifts in operant paradigms to accommodate them. Implications for criteria in selecting effective antienuretic devices are also reviewed, as are problems engendered with the competitive market.

RETRACTED: Effects of methylphenidate on the fixed-ratio performance of mentally retarded children

This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the Editor-in-Chief based on the outcome of a report conducted by the National Institute of Mental Health (NIMH) in 1987 that was recently brought to the attention of the journal by R.T. Warne. Based on allegations of scientific fraud against Stephen Breuning, the NIMH conducted a full investigation into the alleged scientific misconducted on two grants, which funded multiple publications, one of which was this article. The NIMH report concluded that “all of these review publications relied heavily on Dr. Breuning's own work which the Panel concluded was not carried out as reported. The publications, therefore, must be regarded as scientifically unsound and seriously misleading.” Pharmacology, Biochemistry and Behaviour are therefore retracting this article on the grounds of scientifically unsound and misleading data and conclusions. The full NIMH investigatory report can be located here: NIMH-Breuning-Investigation-final-report.pdf (kindly provided by R.T. Warne)