LIST REFERENCES LIST REFERENCES A) ABSTRACT ONLINE 2690364 I) 1991 188686 B) 1990...91 560767 J) *SUM EFG 3115778 C) 1985...91 2277087 K) *ON A&D&I&J 15 D) ATTENTION DEFICIT D... 2781 L) ATTENTION 13672 E) ADUL... 3110594 M) NEUROPSYCHOLOGICAL ... 4498 F) RESIDUAL... 4113 N) ORGANIC MENTAL DISO... 2831 G) FUNCTIONAL RESIDUAL... 1071 O) *ON A&L&M 200 H) *SUM FG 5184 P) *ON A&D&M 70 *** *** *****AMERICAN JOURNAL OF DISEASES OF CHILDREN***** (REFERENCE 1 OF 52) 88130899 Frank Y Ben-Nun Y Toward a clinical subgrouping of hyperactive and nonhyperactive attention deficit disorder. Results of a comprehensive neurological and neuropsychological assessment. Am J Dis Child 1988 Feb;142(2):153-5 We studied 32 boys with attention deficit disorder (ADD)--21 with hyperactivity, and 11 without hyperactivity. The ADD group with hyperactivity had significantly more neurological and cognitive abnormalities and a higher frequency of prenatal and neonatal abnormalities. It seems that hyperactivity is an important determinant of the degree of neurological and cognitive involvement in children with ADD. It also seems that a cause of "early" brain insult is more likely when hyperactivity is present. Institutional address: Unit of Child Neurology Meir General Hospital Tel Aviv (Israel) University. *****AMERICAN JOURNAL OF PSYCHIATRY***** (REFERENCE 2 OF 52) 91206602 Biederman J Newcorn J Sprich S Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. Am J Psychiatry 1991 May;148(5):564-77 OBJECTIVE: Attention deficit hyperactivity disorder is a heterogeneous disorder of unknown etiology. Little is known about the comorbidity of this disorder with disorders other than conduct. Therefore, the authors made a systematic search of the psychiatric and psychological literature for empirical studies dealing with the comorbidity of attention deficit hyperactivity disorder with other disorders. DATA COLLECTION: The search terms included hyperactivity, hyperkinesis, attention deficit disorder, and attention deficit hyperactivity disorder, cross-referenced with antisocial disorder (aggression, conduct disorder, antisocial disorder), depression (depression, mania, depressive disorder, bipolar), anxiety (anxiety disorder, anxiety), learning problems (learning, learning disability, academic achievement), substance abuse (alcoholism, drug abuse), mental retardation, and Tourette's disorder. FINDINGS: The literature supports considerable comorbidity of attention deficit hyperactivity disorder with conduct disorder, oppositional defiant disorder, mood disorders, anxiety disorders, learning disabilities, and other disorders, such as mental retardation, Tourette's syndrome, and borderline personality disorder. CONCLUSIONS: Subgroups of children with attention deficit hyperactivity disorder might be delineated on the basis of the disorder's comorbidity with other disorders. These subgroups may have differing risk factors, clinical courses, and pharmacological responses. Thus, their proper identification may lead to refinements in preventive and treatment strategies. Investigation of these issues should help to clarify the etiology, course, and outcome of attention deficit hyperactivity disorder. Institutional address: Pediatric Psychopharmacology Unit Massachusetts General Hospital Boston 02114. (REFERENCE 3 OF 52) 91103354 Biederman J Faraone SV Keenan K Steingard R Tsuang MT Familial association between attention deficit disorder and anxiety disorders. Am J Psychiatry 1991 Feb;148(2):251-6 BACKGROUND AND METHOD: This study tested hypotheses about patterns of familial association between attention deficit disorder (ADD) and anxiety disorders among 356 first-degree relatives of 73 clinically referred children with ADD and 26 normal comparison children. Through structured diagnostic interviews with trained raters, relatives were assessed for adult and childhood psychopathology. After stratifying the sample of ADD probands into those with anxiety disorders and those without, the authors examined patterns of aggregation of ADD and anxiety disorders in the relatives of these probands as well as in the relatives of the normal comparison subjects. RESULTS: Familial risk analyses revealed that 1) familial risk for anxiety disorders was higher among all ADD probands than among the normal subjects; 2) familial risk for ADD was similar in the relatives of the ADD probands and of the probands with ADD and anxiety disorder; 3) the relatives of the ADD probands with and without anxiety disorders were at greater risk for ADD than the relatives of the normal subjects; 4) the risk for anxiety disorders was two times higher in the relatives of the probands who had ADD with anxiety disorder than in those of the ADD probands without anxiety disorders; and 5) there was a tendency for ADD probands' relatives who themselves had ADD to have a higher risk for anxiety disorders than ADD probands' relatives who did not have ADD (cosegregation). CONCLUSIONS: The results were most consistent with the hypotheses indicating that ADD and anxiety disorders segregate independently in families. Institutional address: Pediatric Psychopharmacology Unit Massachusetts General Hospital Boston 02114. (REFERENCE 4 OF 52) 91083111 Faraone SV Biederman J Keenan K Tsuang MT A family-genetic study of girls with DSM-III attention deficit disorder. Am J Psychiatry 1991 Jan;148(1):112-7 OBJECTIVE: The authors evaluated family-genetic risk factors in girls with attention deficit disorder and compared these results to findings in the authors' previous study of boys with attention deficit disorder. METHOD: Twenty-one girls with attention deficit disorder and 20 normal comparison girls were consecutively ascertained from a pool of existing and new referrals from a pediatric psychopharmacology unit and a medical pediatric unit of the same urban hospital. First-degree relatives of the attention deficit disordered girls (N = 69) and of the normal girls (N = 71) were also assessed. Both groups of girls and their relatives were evaluated on the basis of structured diagnostic interviews conducted by raters who were blind to the clinical status of the probands. RESULTS: The relatives of the girls with attention deficit disorder had higher risks for attention deficit disorder, antisocial disorders, major depression, and anxiety disorders. The higher risk for attention deficit disorder could not be accounted for by gender or generation of relative, age of proband, social class, or family intactness. These findings are highly consistent with the findings in the authors' previous study of boys with attention deficit disorder, which was conducted with identical methods. CONCLUSIONS: This study provides further support for the validity of the diagnosis of attention deficit disorder in girls and suggests that the genders share a common biological substrate. Institutional address: Child Psychiatry Service Massachusetts General Hospital Boston 02114. (REFERENCE 5 OF 52) 86266090 Voeller KK Right-hemisphere deficit syndrome in children. Am J Psychiatry 1986 Aug;143(8):1004-9 The author describes 15 children with behavioral disturbances, a characteristic neuropsychological profile, and neurological findings consistent with right-hemisphere damage or dysfunction. Almost all of the children had attention deficit disorder. Some were obtuse or unable to interpret social cues, others could not express their feelings but appeared to be sensitive and aware of the emotions of others. The older children were generally in psychotherapy or counseling but responded poorly, suggesting that a different approach to treatment may be indicated. *****ANNALS OF NEUROLOGY***** (REFERENCE 6 OF 52) 89075730 Trommer BL Hoeppner JA Lorber R Armstrong KJ The go-no-go paradigm in attention deficit disorder. Ann Neurol 1988 Nov;24(5):610-4 We administered the go-no-go paradigm to 44 boys with attention deficit disorder (ADD) and 32 control subjects who did not have ADD. This task requires a subject to emit a simple motor response to one cue while inhibiting the response in the presence of another cue. Commission errors suggest impulsivity, and omission errors suggest inattention. ADD subjects made more total errors than did control subjects (p less than 0.03), and more ADD subjects made multiple errors (p less than 0.001). Within the ADD group, the nonhyperactive (ADDnoH) subjects were characterized by a high number of commission errors early, and significant improvement with practice (p less than 0.01). In contrast, the hyperactive ADD subjects (ADD/H) did not differ from control subjects in number of early commission errors, but differed from both control subjects and ADDnoH subjects in their failure to improve with practice. In addition, the incidence of omission errors was highest in the ADD/H group. This paradigm can be easily incorporated into the assessment of children with suspected ADD and provides an objective measure of inattention and impulsivity. Our data provide cognitive support for the empirical distinction between hyperactive and nonhyperactive children with ADD. Institutional address: Department of Pediatrics Northwestern University Medical School Evanston IL 60201. *****ARCHIVES OF GENERAL PSYCHIATRY***** (REFERENCE 7 OF 52) 91298842 Biederman J Faraone SV Keenan K Tsuang MT Evidence of familial association between attention deficit disorder and major affective disorders. Arch Gen Psychiatry 1991 Jul;48(7):633-42 With the use of family study methods and assessments by "blinded" raters, we tested hypotheses about patterns of familial association between DSM-III attention deficit disorder (ADD) and affective disorders (AFFs) among first-degree relatives of clinically referred children and adolescents with ADD (73 probands, 264 relatives) and normal controls (26 probands, 92 relatives). Among the 73 ADD probands, 24 (33%) met criteria for AFFs (major depression, n = 15 [21%]; bipolar disorder, n = 8 [11%]; and dysthymia, n = 1 [1%]). After stratification of the ADD sample into those with AFFs (ADD + AFF) and those without AFF (ADD), familial risk analyses revealed the following: (1) the relatives of each ADD proband subgroup were at significantly greater risk for ADD than were relatives of normal controls; (2) the age-corrected morbidity risk for ADD was not significantly different between relatives of ADD and ADD + AFF (27% vs 22%); however, these two risks were significantly greater than the risk to relatives of normal controls (5%); (3) the risk for any AFF (bipolar disorder, major depressive disorder, or dysthymia) was not significantly different between relatives of ADD probands and ADD + AFF probands (28% and 25%), but these two risks were significantly greater than the risk to relatives of normal controls (4%); (4) ADD and AFFs did not cosegregate within families; and (5) there was no evidence for nonrandom mating. These findings are consistent with the hypothesis that ADD and AFFs may share common familial vulnerabilities. Institutional address: Pediatric Psychopharmacology Unit Massachusetts General Hospital Boston 02114. (REFERENCE 8 OF 52) 91083465 Rounsaville BJ Anton SF Carroll K Budde D Prusoff BA Gawin F Psychiatric diagnoses of treatment-seeking cocaine abusers. Arch Gen Psychiatry 1991 Jan;48(1):43-51 In a sample of 298 cocaine abusers seeking inpatient (n = 149) or outpatient (n = 149) treatment, rates of psychiatric disorders were determined by means of the Schedule for Affective Disorders and Research Diagnostic Criteria. Overall, 55.7% met current and 73.5% met lifetime criteria for a psychiatric disorder other than a substance use disorder. In common with previous reports from clinical samples of cocaine abusers, these overall rates were largely accounted for by major depression, minor bipolar conditions (eg, hypomania, cyclothymic personality), anxiety disorders, antisocial personality, and history of childhood attention deficit disorder. Affective disorders and alcoholism usually followed the onset of drug abuse, while anxiety disorders, antisocial personality, and attention deficit disorder typically preceded drug abuse. Institutional address: Department of Psychiatry Yale University New Haven Conn. *****CLINICAL PEDIATRICS***** (REFERENCE 9 OF 52) 89250106 Blondis TA Accardo PJ Snow JH Measures of attention deficit. Part II: Clinical perspectives and test interpretation. Clin Pediatr (Phila) 1989 Jun;28(6):268-76 After a detailed behavioral and developmental history has been supplemented by the use of formal questionnaires, the diagnosis of an attentional disorder can be further clarified by the judicious selection of psychoeducational and pediatric physical and neurodevelopmental examinations. The most common difficulty in the interpretation of psychoeducational test subscores and profiles is the significant overlap between the patterns generated by attentional deficits and those associated with memory-based learning disabilities. Certain other medical and behavioral conditions need to receive careful consideration prior to finalizing the diagnosis of Attention Deficit Hyperactivity Disorder (ADHD). A thorough but focused general examination coupled with the pediatric neurodevelopmental examination can contribute to this differentiation. Institutional address: Department of Child Health University of Missouri-Columbia. *****EPILEPSIA***** (REFERENCE 10 OF 52) 91122019 Henriksen O Education and epilepsy: assessment and remediation. Epilepsia 1990;31 Suppl 4:S21-5 Learning difficulties in children with epilepsy may be caused by brain damage and should be investigated. In many cases, however, seizures and/or electroencephalographic (EEG) findings are the only signs of pathology. Frequency and type of seizures may be determining factors that should, if necessary, be evaluated by long-term EEG monitoring, preferably during school performance or in conjunction with neuropsychological assessment. This may prove that subclinical epileptiform discharges in the EEG can adversely affect the child's performance. Secondary psychological problems in epilepsy patients, combined with side effects of antiepileptic drugs, may cause or heighten learning problems. Prophylactic control of seizures with one appropriate drug may alleviate learning problems. Computerized neuropsychological testing with simultaneous EEG recording may reveal the influence of epileptiform discharges on cognitive function and also help to evaluate the effects of antiepileptic drugs. Objective assessment of subclinical epileptiform activity makes it easier to treat the pathology identified by the EEG with optimal dosage of the most appropriate drug. A balance is required because epileptiform discharges and even occasional seizures may be less disabling than side effects from large doses of several drugs. Information to the school and the parents concerning the patient's abilities and limitations may be as important as seizure control. Specialized teaching should be started early, when necessary, with the patient integrated into a normal school if possible. However, good functioning in a special school is preferable to marginal functioning in a normal school. Institutional address: National Center for Epilepsy Sandvika Norway. *****PEDIATRICS***** (REFERENCE 11 OF 52) 91351781 Liu C Robin AL Brenner S Eastman J Social acceptability of methylphenidate and behavior modification for treating attention deficit hyperactivity disorder. Pediatrics 1991 Sep;88(3):560-5 The social acceptability of methylphenidate, behavior modification, and methylphenidate plus behavior modification was evaluated. Fifty mothers of children with attention deficit hyperactivity disorder (ADHD) and 50 control mothers, along with 21 children with ADHD and 20 control children, read a case vignette of an 8-year-old boy with ADHD and descriptions of the three treatment conditions. Subjects then rated the acceptability of each treatment. The mothers of children with ADHD were reassessed 3.5 months later, after experience with interventions for their children. Both ADHD and control families rated behavior modification as the most acceptable, methylphenidate as least acceptable, and the combined condition intermediate between the other two. At follow-up, there was a significant improvement in the acceptability of methylphenidate and the combined condition. The increased acceptability of methylphenidate at follow-up was related to increases in parents' knowledge about ADHD but not to the significant improvements that occurred in the children's hyperactive behavior. Institutional address: Psychology Division Children's Hospital of Michigan Detroit 48201. *** *** *****ALCOHOLISM, CLINICAL AND EXPERIMENTAL RESEARCH***** (REFERENCE 12 OF 52) 91090224 Nanson JL Hiscock M Attention deficits in children exposed to alcohol prenatally. Alcohol Clin Exp Res 1990 Oct;14(5):656-61 Twenty children with fetal alcohol syndrome or fetal alcohol effect (FAS/FAE) were compared with 20 attention deficit disorder (ADD) children and 20 normal controls on three experimental tasks designed to isolate four different components of attention. Parents completed three questionnaires regarding their child's activity level and overall functioning, and the children completed a short form of an IQ test. The children in each group ranged from 5 to 12 years. Results indicate that although the children with FAS/FAE are significantly more impaired intellectually, their attentional deficits and behavioral problems are similar to those of children with ADD. These findings imply that the treatments known to facilitate learning in children with ADD may also benefit children with FAS/FAE. Institutional address: Alvin Buckwold Centre University Hospital Saskatoon Canada. *****COMPREHENSIVE PSYCHIATRY***** (REFERENCE 13 OF 52) 91160254 Cadoret RJ Stewart MA An adoption study of attention deficit/hyperactivity/aggression and their relationship to adult antisocial personality. Compr Psychiatry 1991 Jan-Feb;32(1):73-82 This study used an adoption design to investigate the relationships among genetic background, environmental factors, and clinical outcome of attention deficit/hyperactivity, aggressivity, and adult antisocial personality (ASP) in a sample of 283 male adoptees. A biologic parent adjudged to be delinquent or to have an adult criminal conviction predicted increased attention deficit/hyperactivity in the adopted away sons, as well as increased adult ASP diagnosis. Aggressivity in the adoptee was predicted by attention deficit/hyperactivity, and aggressivity in turn predicted increased adult ASP. Environmental factors of socioeconomic status (SES), and psychiatric problems in adoptive family members correlated significantly with various clinical outcomes of aggressivity, attention deficit/hyperactivity, and ASP. The results suggest that attention deficit/hyperactivity should be considered a syndrome that has a variety of correlated behaviors, such as aggressivity, and that each of these correlated behaviors is influenced by different genetic and environmental factors and their interactions. Depending on the mix of factors, adult ASP can be one of the outcomes. Institutional address: Department of Psychiatry University of Iowa College of Medicine Iowa City. *****DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY***** (REFERENCE 14 OF 52) 91257444 de Rijk-van Andel JF Catsman-Berrevoets CE van Hemel JO Hamers AJ Clinical and chromosome studies of three patients with Smith-Magenis syndrome. Dev Med Child Neurol 1991 Apr;33(4):343-7 The authors report three patients with Smith-Magenis syndrome; only 21 patients with this syndrome have been described previously in the literature. The syndrome is related to a deletion of chromosome 17p11 x 2, and differs from Miller-Dieker syndrome on clinical criteria and in that the latter is related to a deletion of 17p13 x 3. Institutional address: Department of Neurology Westeinde Hospital The Hague The Netherlands. *****INTERNATIONAL JOURNAL OF THE ADDICTIONS***** (REFERENCE 15 OF 52) 91365538 Glenn SW Parsons OA Prediction of resumption of drinking in posttreatment alcoholics. Int J Addict 1991 Feb;26(2):237-54 The ability of five factors (depressive symptomatology, neuropsychological performance, psychosocial maladjustment, previous treatment history, and childhood attention deficit disorder symptomatology) to predict relapse was examined in a follow-up experimental design. Fifty-eight male and 45 female alcoholics were interviewed immediately following release from inpatient treatment units. Fourteen months later, 41 subjects (41%) were classified as resumers; 62 (59%) were abstainers. Resumers showed significantly poorer scores than abstainers on all five of the predictor variables. Discriminant function analysis resulted in 75% correct classification of resumers and abstainers (chi 2 = 22.1, p less than .001). Stepwise multiple regression resulted in isolation of depressive symptomatology as the best single predictor of relapse. Institutional address: Oklahoma Center for Alcohol and Drug-Related Studies University of Oklahoma Health Sciences Center Oklahoma City 73104. *****INTERNATIONAL JOURNAL OF NEUROSCIENCE***** (REFERENCE 16 OF 52) 86058353 Tarter RE Hegedus AM Neurological mechanisms underlying inheritance of alcoholism vulnerability. Int J Neurosci 1985 Oct;28(1-2):1-10 Evidence accrued during the past two decades points to a genetic predisposition for alcoholism. The biological expression of the genetic vulnerability, however, is unknown. This discussion addresses the neurological manifestation of alcoholism vulnerability, including the biochemical, physiological and behavioral characteristics which appear to be associated with an increased risk for alcoholism. *****JOURNAL OF ABNORMAL CHILD PSYCHOLOGY***** (REFERENCE 17 OF 52) 91324601 Einfeld S Hall W Levy F Hyperactivity and the fragile X syndrome. J Abnorm Child Psychol 1991 Jun;19(3):253-62 Workers who have claimed an association between Fragile X [fra(x)] Syndrome and Hyperactivity and aggressive behavior have done so despite the lack of controlled studies using standard diagnostic criteria. Accordingly, we provided a controlled test of the hypothesis that individuals with the fra(x) Syndrome are more hyperactive and have more symptoms of aggression than other mentally retarded individuals. The test formed part of a study to assess autistic behavior in fra(x) individuals. A sample of fra(x) individuals was obtained from the register of a clinical genetics unit and individually matched for age, sex, and IQ with mentally retarded individuals selected from assessment centres. Forty-five pairs of fra(x) cases and control individuals were compared on criteria which reflected DSM-III concepts of hyperactivity and on criteria reflecting aggressive behavior. The comparison failed to find a higher prevalence of these symptoms in the fra(x) group. An analysis of the study's statistical power suggested that it is unlikely that the investigation failed to detect a large to medium difference between fra(x) individuals and control individuals in the symptoms investigated. Institutional address: Department of Psychiatry University of Sydney Australia. (REFERENCE 18 OF 52) 89175800 McGee R Williams S Moffitt T Anderson J A comparison of 13-year-old boys with attention deficit and/or reading disorder on neuropsychological measures. J Abnorm Child Psychol 1989 Feb;17(1):37-53 This study compared 13-year-old boys with attention deficit disorder (ADD) and/or reading disability (RD), and controls with neither disorder on a battery of verbal and nonverbal neuropsychological measures. The aim was to examine whether ADD was associated with a qualitatively distinct pattern of deficits compared with RD. None of the measures differentiated the boys with ADD-only from the controls; the only deficit associated with ADD was slightly lower IQ. RD, on the other hand, was associated with deficits in memory and verbal skills. Institutional address: Department of Pediatrics and Child Health University of Otago Dunedin New Zealand. (REFERENCE 19 OF 52) 89175793 Moffitt TE Silva PA Self-reported delinquency, neuropsychological deficit, and history of attention deficit disorder. J Abnorm Child Psychol 1988 Oct;16(5):553-69 This study was designed to evaluate the possibility that a pattern of cognitive deficit is associated with delinquent behavior, while avoiding some of the methodological problems of previous research. The Self-Report Early Delinquency instrument and a research battery of neuropsychological tests were administered blindly to an unselected cohort of 678 13-year-olds. Because the diagnosis of attention deficit disorder (ADD) was found at markedly elevated rates in the backgrounds of these delinquents, the possibility was examined that the neuropsychological deficits of delinquents might be limited to delinquents with histories of ADD. Although delinquents with past ADD were more cognitively impaired than non-ADD delinquents, both groups scored significantly below nondelinquents on verbal, visuospatial, and visual-motor integration skills. In addition, ADD delinquents scored poorly on memory abilities. Subjects with ADD who had not developed delinquent behavior were not as cognitively impaired as ADD delinquents, suggesting that it is the specific comorbidity of ADD and delinquency that bears neuropsychological study. Institutional address: Department of Psychology University of Wisconsin Madison 53706. *****JOURNAL OF ABNORMAL PSYCHOLOGY***** (REFERENCE 20 OF 52) 89360199 Frost LA Moffitt TE McGee R Neuropsychological correlates of psychopathology in an unselected cohort of young adolescents. J Abnorm Psychol 1989 Aug;98(3):307-13 Members of a birth cohort were assessed for psychopathology and neuropsychological dysfunction at age 13. Ss who met DSM-III criteria for a single disorder, multiple disorders, and no disorder were compared on 5 composite neuropsychological measures. The multiple disorders group performed significantly worse than did the nondisordered group on the Verbal, Visuospatial, Verbal Memory, and Visual-Motor Integration factors. They also showed the highest rate of neuropsychological impairment. The attention-deficit disorder group performed significantly worse than did the nondisordered group on the Verbal Memory and Visual-Motor Integration factors, and the anxiety disorder group performed significantly worse than did the nondisordered group on the Visual-Motor Integration factor. Results suggest that neuropsychological dysfunction is more often associated with multiple rather than single, psychiatric disorders in adolescents. The problem of comorbidity in studies of neuropsychological function in childhood and adolescent psychopathology is highlighted. *****JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY***** (REFERENCE 21 OF 52) 91276917 Klein RG Mannuzza S Long-term outcome of hyperactive children: a review. J Am Acad Child Adolesc Psychiatry 1991 May;30(3):383-7 Reports of adolescent outcome in attention deficit hyperactivity disorder have uniformly indicated high rates of behavioral problems including cognitive impairment. Dysfunction is markedly reduced in adulthood, but the pattern of outcome remains unchanged except for failure to document cognitive deficits. In adulthood, dysfunction is characterized by antisocial personality and substance (nonalcohol) use disorders. These are in turn associated with criminality. The little existing information on girls with attention deficit hyperactivity disorder does not suggest a worse outcome than for boys. Attempts to identify the children most likely to have a poor outcome have been largely unsuccessful. Institutional address: New York State Psychiatric Institute New York 10032. (REFERENCE 22 OF 52) 90354319 Loge DV Staton RD Beatty WW Performance of children with ADHD on tests sensitive to frontal lobe dysfunction. J Am Acad Child Adolesc Psychiatry 1990 Jul;29(4):540-5 The performances of 20 children with attention deficit hyperactivity disorder (ADHD) were compared with those of 20 matched normal controls on a battery of neuropsychological tests. The ADHD children exhibited impaired function in reading comprehension, verbal learning and memory, and on the Information, Arithmetic, Digit Span, Block Design, and Coding subtests of the Wechsler Intelligence Scale for Children-Revised, but they performed nearly normally on measures of verbal and design fluency and on the Wisconsin Card Sorting Test. The hypothesis that disturbances in frontal lobe function related to impulse control may be responsible for the cognitive impairments observed in ADHD was not supported. Inability to control and direct attention appears to be more central to the pathophysiology of this disorder. Institutional address: Department of Psychology North Dakota State University Fargo. (REFERENCE 23 OF 52) 90008721 Vitiello B Ricciuti AJ Stoff DM Behar D Denckla MB Reliability of subtle (soft) neurological signs in children. J Am Acad Child Adolesc Psychiatry 1989 Sep;28(5):749-53 Reliability and stability of neurological "subtle" ("soft") signs were assessed in 54 psychiatric patients and 25 normal children, aged 5-17 years, using the revised Neurological Examination for Subtle Signs (NESS). Acceptable interrater reliability (kappa greater than or equal to 0.50, or intraclass correlation coefficient greater than or equal to 0.70) was found for 40 of the 64 items tested. Test- retest reliability at 2 weeks was unsatisfactory for most of the categorically scored items, including some "classic" subtle signs such as overflows or dysrhythmias. Continuous items, such as time needed to perform 20 consecutive movements, remained mostly stable at retest. A practicing effect was evident only in the graphesthesia test. Overall internal consistency was good (Cronbach's alpha = 0.74). Given the poor stability of overflows and dysrhythmias, researchers and clinicians should rely more on subtle signs that can be assessed on continuous scales. *****JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS***** (REFERENCE 24 OF 52) 91324291 Aman MG Turbott SH Prediction of clinical response in children taking methylphenidate. J Autism Dev Disord 1991 Jun;21(2):211-28 Twenty-six children having Attention Deficit Hyperactivity Disorder were tested before and after treatment with methylphenidate. In addition to standardized parent and teacher rating scales, each child was assessed on a variety of psychomotor tests with an emphasis on attentional constructs. Relatively few of the performance tests, administered prior to medication, predicted clinical response to medication. However, chronological age and performance on a memory distraction task and on the Graduated Holes Task (Klove, 1963) were moderately correlated with clinical outcome. Using stepwise multiple regression analyses to predict outcome, age and the psychomotor tasks predicted about 50% of outcome variance. There was virtually no relationship between clinical change and change on the performance tests. Findings are discussed with respect to results from previous prediction studies, theoretical models of drug response, and clinical management. Institutional address: Nisonger Center for Mental Retardation and Developmental Disabilities Ohio State University Columbus 43210-1296. *****JOURNAL OF CHILD NEUROLOGY***** (REFERENCE 25 OF 52) 91161912 Denckla MB Attention deficit hyperactivity disorder-residual type. J Child Neurol 1991;6 Suppl:S44-50 Evidence for the persistence into adult life of attention deficit hyperactivity disorder (ADHD) has accumulated in publications of the past two decades. As reviewed here, retrospective and longitudinal data suggest that a residual type of ADHD (ADHD-RT) can be recognized. Diagnostic historical interview and checklist criteria, primarily the Utah set developed by Wender and colleagues, have been proposed. The difficulties of obtaining reliable and valid historical information, which are greater than those encountered in diagnosing childhood cases, add to the desirability of some direct examination for ADHD-RT. It is proposed herein that assessment of the neuropsychological domain of executive function--broader than, yet encompassing, several facets of attention--offers opportunities for documentation of the cognitive correlates of ADHD-RT, its responsiveness to therapeutic intervention, and clues as to its neurobiological foundation. Institutional address: Developmental Neurobehavior Clinic Kennedy Institute Baltimore MD 21205. (REFERENCE 26 OF 52) 91161911 Hynd GW Lorys AR Semrud-Clikeman M Nieves N Huettner MI Lahey BB Attention deficit disorder without hyperactivity: a distinct behavioral and neurocognitive syndrome. J Child Neurol 1991;6 Suppl:S37-43 This study examined the issue as to whether or not children carefully diagnosed as having either attention deficit disorder with hyperactivity (ADDH) or without hyperactivity (ADDnoH) could be distinguished on selected cognitive, academic, rapid naming, and behavioral measures. Employing a previously validated multimodal, multi-informant diagnostic process that results in reliable clinical diagnoses, 10 ADDH and 10 ADDnoH children were examined. While no significant differences in cognitive ability were noted between groups, significant underachievement was found in the children diagnosed as ADDnoH, particularly in mathematics achievement. The ADDnoH children were also significantly slower on rapid naming tasks than the ADDH children. Further, 60% of the ADDnoH children had a codiagnosis of a developmental reading or arithmetic disorder while none of the ADDH children received such a codiagnosis. Conversely, 40% of the ADDH children had a codiagnosis of conduct disorder and were rated by their parent as significantly more motorically active, impulsive, and deviant in the demonstration of age-appropriate social skills. These findings are discussed as they relate to the notion that children with attention deficit disorder may suffer from a right hemispheric syndrome. Institutional address: Department of Special Education University of Georgia Athens GA 30602. (REFERENCE 27 OF 52) 87252004 Gascon GG Johnson R Burd L Central auditory processing and attention deficit disorders. J Child Neurol 1986 Jan;1(1):27-33 Nineteen children who met criteria for attention deficit disorder (ADD) received neurodevelopmental attention testing and central auditory processing (CAP) tests. The CAP tests consisted of the Staggered Spondaic Word (SSW) test and the Willeford battery of tests. Teacher and parent questionnaires (originally devised at the Learning Disabilities Clinic, The Children's Hospital, Boston) were obtained. There was a very high concordance between the questionnaires and the CAP tests, but a low concordance between the neurodevelopmental measures and the questionnaires. After treatment with central nervous system stimulants, there was again a high concordance between teacher/parent reports and CAP measures, and less than 50% concordance between neurodevelopmental measures and teacher/parent observations. We conclude that the SSW and Willeford battery are sensitive performance indicators of attention disorder. Furthermore, these tests are more useful in titrating response to CNS stimulants than neurodevelopmental assessments and provide objective support for the subjective teacher and parent observations. *****JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES***** (REFERENCE 28 OF 52) 90186946 Szatmari P Offord DR Siegel LS Finlayson MA Tuff L The clinical significance of neurocognitive impairments among children with psychiatric disorders: diagnosis and situational specificity. J Child Psychol Psychiatry 1990 Jan;31(2):287-99 The overall objective of this paper is to assess the clinical significance of neurocognitive impairments (NCI) among children with psychiatric disorders. One hundred and fifty-three children referred to a mental health clinic underwent neuropsychological testing. Their parents were interviewed to obtain background information and data on their children's behavior. Parents and teachers also filled out behavior checklists. The results suggest that neurocognitive impairments are: (1) more strongly associated with externalizing rather than internalizing psychiatric diagnoses; and (2) are correlated with psychiatric symptoms at school, but not at home. The implications for understanding the impact of neurocognitive impairments on the situational specificity of psychiatric symptoms are discussed. Institutional address: Department of Psychiatry McMaster University Hamilton Ontario Canada. *****JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY***** (REFERENCE 29 OF 52) 89139805 Spreen O The relationship between learning disability, emotional disorders, and neuropsychology; some results and observations. J Clin Exp Neuropsychol 1989 Jan;11(1):117-40 Emotional disorders may precede learning disabilities, follow learning disabilities, or occur at the same time. This paper discusses evidence supporting each of these hypotheses, focussing on the possibility that both learning disabilities and emotional disorders, or at least some subforms of them, may have a common origin in neurological dysfunction. A model of interaction of the many factors involved in both the development and the persistence across age for both learning disabilities and emotional disorders is presented and avenues of research are discussed. Data from a 15-year follow-up study which illustrate some of these complex relationships are presented. Institutional address: Department of Psychology University of Victoria B.C. Canada. (REFERENCE 30 OF 52) 87222959 Klove H Activation, arousal, and neuropsychological rehabilitation. J Clin Exp Neuropsychol 1987 Jun;9(3):297-309 This paper addresses the concept of arousal and the role of the reticular system in producing the orienting response. For patients with deviant autonomic responses, the use of central neuropharmacological stimulants is considered. Their therapeutic value is discussed in relation to hyperactive children and individual adult cases of the posttraumatic syndrome consequent upon traffic accidents. *****JOURNAL OF CLINICAL PSYCHOLOGY***** (REFERENCE 31 OF 52) 89359934 Gorenstein EE Mammato CA Sandy JM Performance of inattentive-overactive children on selected measures of prefrontal-type function. J Clin Psychol 1989 Jul;45(4):619-32 Several theorists have suggested that childhood inattention- overactivity ("attention deficit disorder," "hyperactivity") may arise from a deficit in the inhibitory mechanisms of the prefrontal cortex. Accordingly, it was hypothesized that inattentive-overactive children would exhibit prefrontal-type deficits on several relevant neuropsychological measures. Subjects were 21 elementary school pupils who had been referred for disruptive behavior problems and who had been rated as high in inattention-overactivity. Controls were 26 age-matched normal children from the same school. It was found that the Inattentive-Overactive group, relative to the Control group, performed in the direction of prefrontal-type deficit on three measures that have an empirical history of discriminating patients with prefrontal lesions from controls: Perseverative errors on the Wisconsin Card Sorting Test, errors on the sequential Matching Memory Task, and Necker Cube reversals. On three theoretical indices of prefrontal-type deficit--Trailmaking, the Stroop Color-Word Test, and a sequential memory task for children--the Inattentive-Overactive group also exhibited predicted deficits. There were no differences between groups on the WISC-R Vocabulary subtest. The results of the study are generally compatible with a prefrontal-deficit theory of inattention-overactivity. However, the presence of other deficits cannot be ruled out nor can an organic cause be inferred from these findings alone. Institutional address: Department of Psychology Columbia University New York NY 10027. *****JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY***** (REFERENCE 32 OF 52) 91294373 Gualtieri CT Keenan PA Chandler M Clinical and neuropsychological effects of desipramine in children with attention deficit hyperactivity disorder. J Clin Psychopharmacol 1991 Jun;11(3):155-9 Desipramine is a tricyclic antidepressant with demonstrated efficacy for some children with attention deficit hyperactivity disorder (ADHD). In this controlled study, clinical improvement was noted in a group of 12 ADHD children. There also were neuropsychological effects associated with desipramine treatment: a small but significant decline in motor performance and an improvement in long-term verbal memory. The decline in motor performance may be of only limited clinical significance, but it is an effect that desipramine seems to share with other tricyclic antidepressants. The improvement in memory performance is an effect it shares with the psychostimulants. Institutional address: North Carolina Neuropsychiatry Chapel Hill 27516. *****JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY***** (REFERENCE 33 OF 52) 91072767 Fischer M Barkley RA Edelbrock CS Smallish L The adolescent outcome of hyperactive children diagnosed by research criteria: II. Academic, attentional, and neuropsychological status. J Consult Clin Psychol 1990 Oct;58(5):580-8 One hundred hyperactive children meeting research diagnostic criteria and 60 community control children were followed prospectively over an 8-year period into adolescence. Younger (12-14 years) and older (15- 20 years) groups were tested on measures of academic skills, attention and impulse control, and select frontal lobe functions. At follow-up, hyperactive Ss demonstrated impaired academic achievement, impaired attention and impulse control, and greater off-task, restless, and vocal behavior during an academic task, compared with control Ss. The limited set of frontal lobe measures did not differentiate the groups. Age did not interact with group membership. However, several measures showed age-related declines in both groups. It is concluded that hyperactive children may remain chronically impaired in academic achievement, inattention, and behavioral disinhibition well into their late adolescent years. Institutional address: Section of Neuropsychology Medical College of Wisconsin Milwaukee 53226. (REFERENCE 34 OF 52) 89175706 Schaughency EA Lahey BB Hynd GW Stone PA Piacentini JC Frick PJ Neuropsychological test performance and the attention deficit disorders: clinical utility of the Luria-Nebraska Neuropsychological Battery-Children's Revision. J Consult Clin Psychol 1989 Feb;57(1):112-6 The Luria-Nebraska Neuropsychological Battery-Children's Revision (LNNB-CR) was administered to 54 clinic-referred children aged 8-12 years. Children reliably diagnosed as attention deficit disorder with hyperactivity were compared with children diagnosed as attention deficit disorder without hyperactivity and with a clinic control group diagnosed with internalizing disorders. Both attention deficit disorder groups were lower than the control group in verbal and Full Scale IQ scores but did not differ from one another. The groups did not differ significantly on any of the LNNB-CR clinical scales, on the right or left hemisphere scores, or on the pathognomonic score using analyses of variance or analyses of covariance with both Full Scale IQ and age as covariates. These findings failed to support the hypothesis that attention deficit disorder, either with or without hyperactivity, is associated with neuropsychological dysfunction as measured by the LNNB-CR. *****JOURNAL OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS***** (REFERENCE 35 OF 52) 90308000 Vitiello B Stoff D Atkins M Mahoney A Soft neurological signs and impulsivity in children. J Dev Behav Pediatr 1990 Jun;11(3):112-5 To evaluate the relationship between soft neurological signs and various proposed dimensions of impulsivity (behavioral and cognitive), 31 boys (6-13 years, mean +/- SD 10.1 +/- 1.8) with disruptive behavior disorders, and 45 age-matched boys without DSM- III-R pathology, were independently assessed on clinical ratings of impulsivity, a battery of cognitive tests intended to score impulsive responding, and a neurological examination for soft signs. After being corrected for age, neurological soft signs correlated positively with impulsive responding on the Matching Familiar Figures Test (inpatients and normals) and the Continuous Performance Test (in normals), but not with IQ or clinical impulsivity rating scores. These findings suggest a relationship between neurological dysfunction/immaturity and performance on specific tasks requiring response inhibition, thus adding value to the cognitive assessment of impulsivity. Institutional address: Department of Psychiatry Medical College of Pennsylvania Philadelphia. (REFERENCE 36 OF 52) 89123874 Trommer BL Hoeppner JB Lorber R Armstrong K Pitfalls in the use of a continuous performance test as a diagnostic tool in attention deficit disorder [see comments] J Dev Behav Pediatr 1988 Dec;9(6):339-45 Although automated continuous performance tests (CPT) are gaining popularity as aids to the diagnosis of attention deficit disorder (ADD), little is known of their validity in this context. Our preliminary experience with a commercially available visual CPT indicated that as many as a third of children meeting the DMS-III criteria for ADD may score well enough on this measure to escape detection. We therefore analyzed the results of neuropsychological testing as well as CPT performance in 14 ADD children and six non-ADD children in an effort to determine whether CPT performance might reflect higher level cognitive variables other than attention and/or impulsivity. We found that those ADD children classified as "abnormal" on the basis of the CPT scored significantly below those classified as "normal" on measures of abstract reasoning and logical problem solving, simple verbal reasoning, nonverbal problem solving, and simple arithmetic skills. The non-ADD group contained a high proportion (83%) of subjects with CPT performance outside of the normal range. These data suggest that CPT may yield both false negative and false positive results when used as screening tools for ADD, and we recommend therefore that caution be used in their interpretation. Institutional address: Department of Pediatrics Northwestern University Medical School Evanston Hospital Illinois 60201. *****JOURNAL OF LEARNING DISABILITIES***** (REFERENCE 37 OF 52) 91225595 Klorman R Cognitive event-related potentials in attention deficit disorder. J Learn Disabil 1991 Mar;24(3):130-40 Cognitive event-related potentials (ERPs) have been used to aid in the interpretation of findings that children with Attention Deficit Disorder (ADD) make more errors and react more slowly than nondisabled controls in tests of sustained attention. Coincident with their abnormally poor performance, children with ADD have smaller late positive components of the ERP (especially a wave known as P3b) than their peers with psychiatric diagnoses. Notably, stimulant administration improves the performance of children with ADD and enlarges the amplitude of the late positive waves of their ERPs. These findings are interpreted as reflecting reduced capacity allocation, which, in turn, is increased by stimulant medications. Research on memory scanning suggests that children with ADD are deficient in energetic aspects of information processes and that their excessive slowness in reaction time tests involves stages following memory search and decision, that is, motor processes. The same factors seem to be involved in the amelioration of performance by stimulants, which speed up motor responses but do not affect the latency of P3b. Research on ERPs during selective attention also points to possible disturbances in this aspect of processing, but further research in this area is needed. Institutional address: Department of Psychology University of Rochester NY 14627. (REFERENCE 38 OF 52) 90038922 Hynd GW Nieves N Connor RT Stone P Town P Becker MG Lahey BB Lorys AR Attention deficit disorder with and without hyperactivity: reaction time and speed of cognitive processing. J Learn Disabil 1989 Nov;22(9):573-80 This study addressed the issue as to whether children reliably diagnosed as attention deficit disordered with hyperactivity (ADD/H) and without hyperactivity (ADD/WO) differed significantly from each other and a clinic control (CC) population on speed and efficiency of cognitive processing. From an outpatient clinic population, 43 ADD/H and 22 ADD/WO children were examined. An analysis of mean reaction time and speeded classification task performance revealed significant group effects on both mean reaction time and on a measure of within- subject variability. ADD/H children performed significantly more slowly and variably than the CC children on several of the speeded classification tasks. However, the ADD/WO group was not distinguished on any measure. Thus, while children may be reliably diagnosed as ADD/H or ADD/WO using behavioral measures, it would appear that they cannot be distinguished on these neurocognitive tasks. Issues related to childhood psychopathology and the neuropsychological basis of ADD/H are discussed. *****OFFENTLICHE GESUNDHEITSWESEN***** (REFERENCE 39 OF 52) 89296174 Astor-Schuster K [Minimal cerebral dysfunction and partial disorders of performance in children] MCD und Teilleistungsstorungen bei Kindern. Off Gesundheitswes 1989 May;51(5):245-9 (Published in German) On-target examination of children has been increasingly revealing minimal cerebral dysfunction (MCD) and in some cases also partial disturbances of performance. Both the aetiology and the symptomatic are not uniform, especially with MCD. There is a predominance of overlapping between MCD and the partial performance disturbances. Case reports are presented as selections from the enormous variety of possible disturbances, partly supplemented by drawings. There are neither any suitabloe screening methods nor any causal treatment for both disturbances. Nevertheless, most surprising results can be achieved by symptomatic treatment if suitable measures are carried out with great intensity and for a prolonged period. *****PERCEPTUAL AND MOTOR SKILLS***** (REFERENCE 40 OF 52) 91246546 Cakirpaloglu P Radil T Some neuropsychological and psychological parameters in children with minimal brain dysfunction: a transcultural comparison. Percept Mot Skills 1991 Feb;72(1):80-2 Performances of groups of second grade elementary school boys with Minimal Brain Dysfunction (ns = 34) and matched with normal boys (ns = 30) were studied using mostly psychometric criteria in Prague, Czechoslovakia and Skopje, Macedonia. Boys with brain dysfunctions scored more poorly than normal ones at both places, but normal boys from both cultures did not differ. Information-processing capability (derived from Wechsler scale) was lower and its rank among disordered features higher among Skopje boys, probably because organized care for minimal brain dysfunctioning children was relatively lower. Institutional address: Institute of Physiology Czechoslovak Academy of Sciences Prague. (REFERENCE 41 OF 52) 91044829 Levinson HN The diagnostic value of cerebellar-vestibular tests in detecting learning disabilities, dyslexia, and attention deficit disorder. Percept Mot Skills 1990 Aug;71(1):67-82 Neurological and optokinetic measures of cerebellar-vestibular (CV) dysfunctioning were shown to be of significant diagnostic value in differentiating between learning disabled subjects and controls matched for chronological age, sex, handedness, IQ, and background (ns = 35). Although traditionally used electronystagmographic positional and caloric parameters were not similarly discriminating, quantitative measures of vertical nystagmus in various eyes-closed positions appeared to have diagnostic potential and were related significantly to such CV-determined neurological signs as positive monopedal Romberg. As a substantial majority of learning disabled (82.9%) evidenced ADD-like symptoms and since learning disabled subsamples with and without Attention Deficit Disorder (ADD) shared similar coexisting symptoms and CV signs, it appeared probable that learning disabilities and ADD were reflections of the same underlying CV determinants. Institutional address: New York University Medical Center. (REFERENCE 42 OF 52) 90259634 Grant ML Ilai D Nussbaum NL Bigler ED The relationship between continuous performance tasks and neuropsychological tests in children with attention-deficit hyperactivity disorder. Percept Mot Skills 1990 Apr;70(2):435-45 We examined the relationship between measures of sustained attention and impulsivity, as obtained by computerized continuous performance tasks of the Gordon Diagnostic System and a battery of intellectual, achievement, and neuropsychological tests. Subjects were 119 boys (between the ages of 6 yr., 0 mo. and 12 yr., 11 mo.), diagnosed with Attention-deficit Hyperactivity Disorder, using DSM-III or DSM-III--R criteria. Only two measures, the number of correct responses for Vigilance and Distractibility tasks, correlated consistently with other measures (e.g., intellectual measures, the WRAT--R Arithmetic subtest, Beery Test of Visual and Motor Integration, and various sensory-motor variables from the Halstead-Reitan Neuropsychological Battery). The results suggest a unique contribution of continuous performance tasks in the measurement of attention, in a population of children with ADHD, which is not assessed by more traditional tests. Institutional address: Austin Neurological Clinic TX 78765. *****PRAXIS DER KINDERPSYCHOLOGIE UND KINDERPSYCHIATRIE***** (REFERENCE 43 OF 52) 91312833 Bunk D Schall U [The effectiveness of the Background Interference Procedure in psychiatric differential diagnosis of organic brain damage in children] Die Effizienz des Hintergrund-Interferenz-Verfahrens in der psychiatrischen Differentialdiagnose hirnorganischer Schaden bei Kindern. Prax Kinderpsychol Kinderpsychiatr 1991 Apr;40(4):134-7 (Published in German) The Background Interference Procedure (BIP) is an improved psychological test to discriminate brain damaged and non brain damaged adults. In the present study the efficiency of the BIP was compared to the psychometric standard for children, the Gottinger Formenreproduktions-Test, in a sample of 14 girls and 26 boys between 7 and 13 years with minimal brain dysfunction. The background interference condition increased significantly the error rate for the reproduction of the test items, and the BIP yielded a significant concurrent validity with neurological criteria. In particular, an impaired motor coordination was effectively predicted. It is concluded that the BIP is an efficient psychometric aid for determining the organic contribution to psychiatric syndromes in children. Institutional address: Klinik fur Kinder- und Jugendpsychiatrie Universitat Gesamthochschule Essen. *****PROGRESS IN NEURO-PSYCHOPHARMACOLOGY AND BIOLOGICAL PSYCHIATRY***** (REFERENCE 44 OF 52) 91334829 Srinivas NR Hubbard JW Quinn D Korchinski ED Midha KK Extensive and enantioselective presystemic metabolism of dl-threo- methylphenidate in humans. Prog Neuropsychopharmacol Biol Psychiatry 1991;15(2):213-20 1. Two pilot studies were carried out to investigate the enantioselective pharmacokinetics of methylphenidate (MPH) in children with attention deficit-hyperactivity disorder (ADHD). A more definitive study, which included administration of an intravenous dose, was carried out in healthy young men. 2. Serial plasma samples were harvested from predose to 8 hours in the first pilot study, predose to 12 hours in the second pilot study and predose to 16 hours in the definitive study. Plasma levels of the separate isomers d-MPH and 1-MPH were determined by an enantioselective gas chromatographic method. 3. In the first pilot study, 6 boys with ADHD each received his regular dose of MPH (10mg n = 5, 5mg n = 1), which contained equal proportions of d-MPH and 1-MPH in an immediate release formulation (MPH-IR). No MPH was detectable in the predose plasma. Thereafter, plasma levels of the more active d-MPH were 4 to 10 fold higher than those of 1-MPH. Plasma levels of 1-MPH were so low that it was not possible to monitor them beyond 4 hours in some children. 4. In the second pilot study, 5 boys and 1 girl with ADHD each received their regular dose (20mg) of a slow release formulation (MPH- SR). No MPH was detectable in the predose plasma. Thereafter, plasma levels of the more active d-MPH were 5 to 10 fold higher than those of 1-MPH. It was possible to monitor plasma levels of 1-MPH over the full 12 hour period of study in 5 of the 6 children.(ABSTRACT TRUNCATED AT 250 WORDS) Institutional address: College of Pharmacy University of Saskatchewan Saskatoon Canada. (REFERENCE 45 OF 52) 85167167 Ferguson HB Simeon JG Evaluating drug effects on children's cognitive functioning. Prog Neuropsychopharmacol Biol Psychiatry 1984;8(4-6):683-6 In our studies of drug therapy in child psychiatry disorders, we have been using a battery of tests to monitor any effects of medication on the various components of cognitive processing. Our intention was to measure skills required by the children for successful classroom performance. We have used this test battery approach in open clinical trials of bupropion (Wellbutrin) and of alprazolam (Xanax) with child psychiatry patients. On no single test was the effect of bupropion vs placebo significant; however, there was no indication of any cognitive deterioration with bupropion. Group performance with alprazolam was more variable, and again no individual test showed significant changes with medication. These initial applications of the cognitive battery indicate that bupropion, a new antidepressant and alprazolam, an anxiolytic have no adverse effects on cognition at therapeutically effective doses. *****PSYCHIATRIC CLINICS OF NORTH AMERICA***** (REFERENCE 46 OF 52) 86259374 Becker B Kay GG Neuropsychological consultation in psychiatric practice. Psychiatr Clin North Am 1986 Jun;9(2):255-65 A specialty area with historical roots in behavioral neurology as well as experimental and clinical psychology, clinical neuropsychology offers a unique contribution to psychiatric practice in the form of consultation regarding cognitive, perceptual, and motor functioning. Using quantified, standardized, and repeatable measures, this comprehensive assessment can be helpful in identifying cortical dysfunction, in measuring decline or recovery, and in assessing response to treatment. (REFERENCE 47 OF 52) 86093991 Rubinstein B Shaffer D Organicity in child psychiatry. Signs, symptoms, and syndromes. Psychiatr Clin North Am 1985 Dec;8(4):755-77 The diagnosis of organicity in child psychiatry requires a high index of suspicion. For the beginning clinician, the idea that there are specific signs and symptoms associated with organicity has a certain appeal. However, a careful review of the literature reveals that except for a few instances, there are no specific signs, symptoms, or syndromes of organicity. Children with organic brain damage tend to exhibit the whole range of behavioral symptoms. The diagnosis of organicity can be supported with a thorough medical and psychiatric examination. The use of psychological testing to diagnose brain damage is unwise. Psychological tests can best be used as guides for the detection of associated learning problems and for the evaluation of outcome. The development of new laboratory techniques such as computerized EEGs and brain imaging seem promising aides for the future, but their exact role has not yet been established. There is suggestive evidence that children with organic brain disorders are more susceptible to environmental stresses, family disharmony, and toxicity from psychotropic medications. The attitude that the problems of the brain damaged child are fixed and untreatable seem unjustified. Psychotherapeutic and psychopharmacologic techniques are being developed to help the brain-damaged child and its family to cope with their handicaps. *****PSYCHIATRIE, NEUROLOGIE UND MEDIZINISCHE PSYCHOLOGIE***** (REFERENCE 48 OF 52) 85088985 Kinze W Barchmann H [Pediatric neuropsychiatric characteristics of behaviorally abnormal children] Zur kinderneuropsychiatrischen Charakteristik verhaltensauffalliger Kinder. Psychiatr Neurol Med Psychol (Leipz) 1984 Oct;36(10):618-20 (Published in German) By means of integrative medical-psychological examinations in children with abnormal behaviour we found pathological signs in the ratings of parents and teachers, in the concentration efficiency, in the rate of impulsivity and in those cases in which there were mild symptomes of brain damage in the early childhood. In the intellectual and motorial efficiencies and in selfratings we could'nt establish any change compared with normal population. *****PSYCHIATRY***** (REFERENCE 49 OF 52) 91219532 Weinstein CS Seidman LJ Feldman JJ Ratey JJ Neurocognitive disorders in psychiatry: a case example of diagnostic and treatment dilemmas. Psychiatry 1991 Feb;54(1):65-75; discussion 76-7 We present a case example that illustrates the diagnostic and treatment difficulties engendered by adult psychiatric patients with primary behavioral problems and neurocognitive disorders. In the case cited, the neuropsychological evaluation plays a significant role in reconceptualizing a patient who had accrued multiple psychiatric diagnoses including schizophrenia, borderline personality, and impulse control disorder. Formal examination revealed deficits in language, executive, and attentional functions that were far greater than had been expected and led to a major change in treatment strategy, including successful trial of imipramine and nadolol and more structured milieu therapy. The cognitive deficit and intrapsychic conflict models are used to demonstrate the critical aspects of our diagnostic reclassification of the patient to Neurodevelopmental Disorder of Unknown Etiology and Auditory Attention Deficit Disorder. Institutional address: Department of Psychiatry Cambridge Hospital Harvard Medical School MA 02139. *****RECENT DEVELOPMENTS IN ALCOHOLISM***** (REFERENCE 50 OF 52) 86206996 Alterman AI Tarter RE An examination of selected typologies. Hyperactivity, familial, and antisocial alcoholism. Recent Dev Alcohol 1986;4:169-89 In exploring potential alcoholism typologies, this chapter critically examines findings of adoption, high-risk, and familial alcoholism studies and studies of psychiatric syndromes in alcoholic individuals and their families. The adoption studies revealed that familial alcoholism and childhood conduct disorder and hyperactivity are associated with subsequent alcoholism. However, the relationship between childhood hyperactivity and alcoholism is probably coincidental to the conjoint presence of aggressive and antisocial behaviors in the same individuals. Psychiatric diagnosis and family psychiatric history studies suggest a synergistic relationship between alcoholism and sociopathy. Clinical studies of familial and antisocial alcoholism indicate that both are associated with early onset, more severe alcoholism, and poorer treatment outcome. Both meet clinical criteria for an alcoholism typology, although the evidence is more compelling for antisocial alcoholism. The findings of metabolic, electrophysiological, and neuropsychological differences between high- and low-risk subjects are of potential import, although their present significance is uncertain. Further clinical evaluation of antisocial and familial alcoholism and their relationship to each other is necessary. High risk and familial alcoholism findings may be confounded by the subjects's antisocial characteristics. *****SCHWEIZERISCHE MEDIZINISCHE WOCHENSCHRIFT. JOURNAL SUISSE DE MEDECINE***** (REFERENCE 51 OF 52) 86179743 Frei H [The "clumsy" child: differential diagnosis and therapeutic indications. A review] Das "ungeschickte" Kind: Differentialdiagnose und Therapieindikationen. Eine Ubersicht. Schweiz Med Wochenschr 1986 Mar 8;116(10):294-9 (Published in German) In "clumsy" children, minimal cerebral palsy, isolated muscle hypotonia, disorders of sensory integration and behavior disturbances can be distinguished as separate clinical syndromes. A review is presented of investigative techniques, diagnostic criteria, treatment indications and prognosis in these patients. *****ZEITSCHRIFT FUR KINDER- UND JUGENDPSYCHIATRIE***** (REFERENCE 52 OF 52) 88266270 Lempp R [Is minimal brain dysfunction really only an empty phrase? A scientific theoretical problem] Ist die MCD tatsachlich nur eine Leerformel? Ein wissenschaftstheoretisches Problem. Z Kinder Jugenpsychiatr 1988 Mar;16(1):31-6 (Published in German) The book Die minimale cerebrale Dysfunction-Eine Eine Leerformel (Minimal Cerebral Dysfunction-An Empty Phrase) by Esser and Schmidt is critically reviewed, with reference being made to numerous clinical studies that have confirmed the existence of the syndrome minimal cerebral dysfunction (also called fruhkindlich exogenes Psychosyndrom in German). The reviewer's fundamental objection is to the "exact-science" methods used in the study: Such methods are inappropriate for confirming or disproving the existence of a psychosyndrome that has grown out of clinical experience. The reduction in the number of items that is dictated by an exact-science approach is diametrically opposed to the overall assessment of the psychopathological picture common in clinical practice. In many areas of psychology and psychiatry, restricting oneself to a study of only those factors that can be counted or measured also places limitations on the amount of information that can be gained. Institutional address: Abteilung fur Kinder- und Jugendpsychiatrie der Eberhard-Karls-Universitat Tubingen.