Assumptions and beliefs in adolescents with anorexia nervosa and their mothers

A pilot study examined the specific cognitive content of female adolescents with anorexia nervosa. The relationship between daughter and mother concerns, and concerns in mothers, also were investigated. All participants completed a measure of assumptions and negative self-beliefs related to eating disorders. Adolescents with anorexia nervosa scored more highly on all subscales of the measure than nonclinical adolescent controls. There were significant daughter- mother relationships on two subscales in the clinical, but not the nonclinical, group. However, the two groups of mothers did not differ on any subscale. Possible explanations for the findings, and implications for treatment and research, are briefly considered.     

Prediction and constancy of cognitive-motivational structures in mothers and their adolescents

Three clinically-derived, cognitive-motivational structures were predicted in 68 adolescents from their caregiving situations as revealed in their mothers' interviews, elicited six years earlier. Basic to each structure is a motivational concern and its related social cognitive style, a style which corresponds to a Piagetian cognitive stage: concrete operational, intuitive or symbolic. Because these structure types parse a non-clinical population, current views of health and accordingly goals of treatment may need modification.The data for this investigation were drawn from the Family Socialization Project (at the Institute of Human Development at the University of California, Berkeley) directed by Diana Baumrind. The authors acknowledge the William T. Grant Foundation for its generous support of this project.     

Fluoxetine in children and adolescents with OCD: a placebo-controlled trial

OBJECTIVE: To examine the safety and efficacy of fluoxetine in child and adolescent obsessive-compulsive disorder (OCD). METHOD: Between 1991 and 1998, 43 patients were randomly assigned to fluoxetine or placebo for 8 weeks. Dosing was fixed for the first 6 weeks (up to 60 mg/day) and then could be increased to 80 mg/day. Responders entered an 8-week maintenance phase. The primary outcome measures were the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) and the Clinical Global Impression-Improvement (CGI-I) scale. Analyses were done on the intent-to-treat sample. RESULTS: Fluoxetine patients (n = 21) had significantly lower CY-BOCS scores than placebo patients (n = 22) after 16 (but not 8) weeks. Fluoxetine responders (n = 11) had significantly lower CY-BOCS scores than placebo responders (n = 7) after an additional 8 weeks of treatment. After 16 weeks, 57% of fluoxetine (versus 27% of placebo) patients were much or very much improved on the CGI-I scale (p <.05). No patient terminated the study because of adverse medication effects. CONCLUSION: Fluoxetine was well tolerated and effective for the treatment of child and adolescent OCD, but fluoxetine's full effect took more than 8 weeks to develop.     

Cross-informant agreement between adolescents with myelomeningocele and their parents

The development of self-management skills by adolescents with myelomeningocele is an ongoing process. Previous studies lack consensus about what data can be accurately obtained from adolescents. This cross-sectional study using a convenience sample of 66 adolescent-parent dyads evaluated whether adolescents with myelomeningocele and their parents are interchangeable reporters of data. Adolescents' ages ranged from 12 to 21 years with a mean of 16 years 2 months (SD 2y 8mo); 38 were female, 28 were male; 30% had thoracic lesions, 32% had lumbar lesions, 15% had lumbosacral lesions, 23% had sacral lesions, and 85% had ventriculoperitoneal shunts. In this analysis, participants reported activities (decision-making, household responsibility, and friendship activities) and select outcomes (functional status, self-management, and social competence) similarly. However, differences emerged in reports of beliefs (adolescent future expectations, family variables) and select developmental competencies (school, job, athletic, behavioral, attractiveness, and romantic appeal). Analysis using t-test and interclass correlations supported a pattern of adolescent-parent agreement in areas of observable behavior and differences in more subjective domains such as perception of developmental competencies.     

The relationship between clinical characteristics,metacognitive appraisals,and cognitive insight in patients with obsessive-compulsive disorder

Background: Cognitive insight, a recently developed insight measure, refers to metacognitive processes of the re-evaluation and correction of distorted beliefs and misinterpretations. However, to the best of the authors’ knowledge, no study has specifically examined cognitive insight, demographics, psychopathological variables, and distorted beliefs in OCD.

Aim: The aim of this research was to examine links between cognitive insight and demographics, clinical factors, and distorted beliefs among patients with OCD.

Method: Eighty-four consecutive outpatients with a diagnosis of OCD underwent a detailed clinical assessment for OCD, including the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS), Beck Cognitive Insight Scale (BCIS), Thought-Action Fusion Scale (TAFS), White Bear Thought Suppression Inventory, Metacognition Questioniarre-30 (MCQ-30), and a sociodemographic questionnaire. In addition, 82 control subjects matched for age, education, and gender were tested.

Results: BCIS-self-certainty scores were all substantially higher in subjects with remitted and unremitted OCD than in healthy comparison subjects, while BCIS-composite scores were significantly lower in both patient groups than controls. Obsession and compulsion severity had significant effects on BCIS scores. In addition, it was found that the specific symptoms were linked to self-certainty scores. Self-reflectiveness and composite scores had positive correlations with the sub-scale scores of the MCQ-30, while the TAF-morality score was positively correlated with self-certainty scores.

Conclusion: The results demonstrated poor cognitive insight among remitted and unremitted OCD patients. In addition, the present study suggested significant associations between sociodemographic and clinical features and dysfunctional appraisals. Cognitive-behavioural techniques aimed at enhancing cognitive insight may be beneficial for patients with OCD, particularly patients who have prominent dysfunctional beliefs.     

Neurological signs and cognitive performance distinguish between adolescents with and without psychosis

Neurological and cognitive aspects of adolescent psychotic disorders are understudied. The authors assessed 19 adolescents with psychosis and 16 healthy comparison subjects using the Neurological Evaluation Scale (NES) and age-appropriate Wechsler intelligence quotient (IQ) scales. NES scores were highest and IQ scores were lowest among subjects with psychosis. Subjects with psychosis did not demonstrate age-related decreases in NES score. The combination of NES and IQ scores predicted both the presence of psychosis and psychiatric diagnosis. There were no relationships between medication status and either NES or IQ scores. These results support a broadly conceived neurodevelopmental formulation of adolescent psychotic disorders.     

亚临床强迫症与首发强迫症患者抑制功能比较

目的比较亚临床强迫症、首发强迫症患者与正常对照抑制功能的差异。方法采用连线测验（TMT）、Stroop测验、威斯康星卡片分类测验（WCST）评估35例亚临床强迫症和35例首发强迫症患者,以及年龄和教育程度匹配的35例正常对照。结果（1）与正常对照比较,亚临床强迫组wCST测验中WCST完成分类数、WCST正确数,Stroop测验中读字色（Stroop-CW）的正确数,TMT测验中TMT-B完成时间测验成绩明显低于正常对照组,差异有统计学意义（P〈0．05）,与强迫症患者组比较差异无统计学意义（P〉0．05）;与正常对照比较,强迫症患者组Stroop测验中Stroop-CW错误数、TMT测验中TMT-A完成时间成绩明显差于正常组,差异具有统计学意义（P〈0．05）,与亚临床强迫症组比较差异有统计学意义（P〈0．01）;（2）相关分析显示,强迫症组患者组的病程与TMT-B完成时间呈正相关（r=0．277,P=0．004）。结论亚临床强迫症和首发强迫症患者存在抑制功能受损,执行功能损害在强迫症发生发展中起着重要作用。     

青少年认知偏差和心理健康的关系

目的探讨青少年认知偏差的特点及其与心理健康关系。方法以中小学生认知调查量表、中国中学生心理健康量表为工具,随机抽取广州市3所中学653例中学生进行研究。结果（1）认知偏差问题总体检出率为35．4％,严重认知偏差检出率为2．9％,“过度完美”、“苛求善待”是主要认知偏差问题;（2）中度以上心理健康问题检出率为4．3％,较严重的心理健康问题检出率为0．15％,“情绪不良”、“学习压力”、“适应不良”是主要心理健康问题;（3）认知偏差与心理健康相关显著,维护自我、获得关注、苛求善待、消极态度对心理健康有预测作用,联合解释率是16．7％。结论青少年认知偏差与心理健康之间存在显著负相关,本研究提示可利用认知调节来提高中学生的心理健康水平。     

The relationship of cognitive confidence to OCD symptoms

The role of meta-memory and meta-cognition in obsessive–compulsive disorder (OCD) symptoms and checking was examined in a student sample, using the memory and cognitive confidence scale (MACCS; Nedeljkovic, M., & Kyrios, M. (2007). Confidence in memory and other cognitive processes in obsessive-compulsive disorder. Behaviour Research and Therapy, 45, 2899–2914). Confirmatory factor analysis supported the MACCS's previously reported structure, and hierarchical regression supported its relationship to OCD symptom severity over-and-above depression and other OCD-related beliefs. Specifically, general confidence in memory was found to be a unique predictor of overall OCD severity. Implications for theory and research are discussed.     

Predicting patterns of interaction between children with cerebral palsy and their mothers

Children with cerebral palsy (CP) have often been described as passive communicators. Their familiar conversation partners tend to direct and control interaction. Such conversation patterns may have various precursors: children's motor impairment, their intelligibility difficulties, and/or their level of cognitive development. To test the comparative influence of these factors, measures of motor function, speech, communication, cognitive and language skills were applied in 40 children (18 males, 22 females) with CP who were aged from 2 years 8 months to 10 years. These variables were correlated with measures relating to interaction patterns to investigate whether individual features predicted communication style. In this group, poor speech intelligibility was the main predictor of restrictive communication patterns, such as fewer child-initiated conversation exchanges, more simple child communicative acts such as yes/no answers and acknowledgements of the other partner's messages. Results support the provision of therapy to increase children's intelligibility, whether spoken or augmented, such as the introduction of communication aids and training programmes for parents.     

氯丙咪嗪对强迫症认知功能的影响

目的探讨氯丙咪嗪对强迫症患者认知功能的影响。方法对符合DSM-IV及ICD-10强迫症诊断标准的37例强迫症患者在治疗前、治疗10周后分别采用神经心理测验（包括知识、算术、数字符号、木块拼图、数字广度、逻辑记忆、视觉记忆、Stroop test、词汇流畅、划痕测验A、B,汉诺塔、威斯康辛卡片分类改良版进行评定。将37例健康人在年龄、性别、受教育年限与强迫症组匹配后作为正常对照组,在同期做同样的神经心理测验。结果经氯丙咪嗪治疗10周后,强迫症患者大部分神经心理测验指标（包括注意,记忆,执行功能,语言和非语言表达等）都有统计学意义的改善。结论氯丙咪嗪可以改善强迫症患者的认知功能。     

缺血性脑血管病患者血管因素与认知功能障碍的关系研究

目的分析缺血性脑血管病患者血管因素与认知功能障碍的相关性。方法我院2014-09—2015-03收治的90例缺血性脑血管病患者为研究对象,并分为轻危组、中危组及高危组,经颅脑多普勒超声测定患者脑血管血流动力学,采取蒙特利尔量表评估患者认知功能,分析缺血性脑血管病患者血管因素与认知功能障碍的关系。结果高危组患者认知功能低于轻危组,以动物命名试验、图形描画、数字交替试验、言语复述、语言流畅、延迟记忆、警觉性、计算力、时间定向等方面评分降低明显;高危组较轻危组及中危组右侧大脑中动脉流速明显上升;3组仅大脑左侧基底动脉平均血流速度对比差异有统计学意义(P0.05);高危组与中危组、轻危组对比,频谱异常率对比差异有统计学意义(P0.05)。结论缺血性脑血管病患者脑血管损伤对患者认知功能可产生严重影响,是造成脑血管病患者出现认知及记忆障碍的相关原因,随着血管危险因素的增多,患者认知功能障碍越明显。     

A behavioral exploration of dependent and independent mildly mentally retarded adolescents and their mothers

A study was conducted on behavioral differences between dependent and independent mildly mentally retarded adolescents and their mothers. Twelve dependent and 12 independent adolescent-mother pairs separately engaged in a videotaped problem solving task. These videotapes were subjected to a behavioral coding system consisting of five domains, i.e., problem solving, positive verbal, negative verbal, positive nonverbal, and negative non-verbal. Differential profiles were not evident between the two groups for either adolescents or their mothers. However, there were notable differences between a more stringently defined subset of dependent and independent adolescents and between their mothers. The subset of independent adolescent were more verbal and active in problem-solving than the dependent adolescents; the dependent subset exhibited a greater rate of negative non-verbal behavior; and mothers of the independent subset presented more positive non-verbal behaviors than did the mothers of the dependent subset.     

Autism spectrum traits in children and adolescents with obsessive-compulsive disorder (OCD)

OBJECTIVE: Assess the prevalence of autistic traits (AST) in pediatric obsessive-compulsive disorder (OCD) and relate them to OCD co-morbidity and compare them with published normative data. METHODS: Pediatric patients with obsessive-compulsive disorder (n=109) according to the DSM-IV were studied using parent ratings of the Autistic Symptom/Syndrome Questionnaire to assess AST symptoms as a continuous rather than categorical trait. The KSADS, a semi-structured psychiatric interview, was used for the psychiatric diagnostic evaluation. Also, the Children's Yale-Brown Obsessive-Compulsive Scale was used to assess OCD severity and other clinical features. RESULTS: AST was common among our patients. Symptom scores were highest in cases with co-morbid Autistic Spectrum Disorders, but cases with other co-morbidities as tics/Tourette and attention/behavioral disorders also scored higher. All sub-groups, including OCD without these co-morbidities scored higher than the Swedish normative group. Using ANOVA, co-morbid ASD and tics/Tourette (plus a term for gender by tic interaction indicating that girls with tics scored high, otherwise low) and pathological doubt contributed (R2=.41) to the AST-traits, while OCD severity and co-morbid anxiety- and depressive disorders did not. CONCLUSION: AST traits are prevalent in OCD and seem to be intricately associated with the co-morbidities as well as the OCD syndrome itself. The findings might have implication for our nosological understanding of OCD which currently is discussed.     

氟伏沙明与氯米帕明治疗青少年强迫症的对照研究

目的 比较氟伏沙明与氯米帕明治疗青少年期强迫症的疗效和不良反应.方法 共纳入强迫症患者42例,随机分为氟伏沙明组和氯米帕明组,疗程8周.应用耶鲁-布朗强迫症量表(Y-BOCS)、汉密尔顿焦虑量表(HAMA)评定疗效,治疗中需处理的不良反应症状量表(TESS)评价不良反应.结果 氟伏沙明组治疗总有效率86.4％,氯米帕明组治疗总有效率86.4％,两组比较差异无统计学意义(P＞0.05).两组治疗后第4、8周末Y-BOCS评分、HAMA评分与治疗前比较差异有显著统计学意义(P＜0.01).氟伏沙明组与氯米帕明组不良反应发生率差异有统计学意义(P＜0.05).结论 氟伏沙明对于青少年期强迫症状的治疗是安全有效的.     

Relationships between task-oriented postural control and motor ability in children and adolescents with Down syndrome

Individuals with Down syndrome (DS) have been characterized by greater postural sway in quiet stance and insufficient motor ability. However, there is a lack of studies to explore the properties of dynamic postural sway, especially under conditions of task-oriented movement. The purpose of this study was to investigate the relationships between task-oriented postural control and motor ability in children and adolescents with DS. The participants were 23 children and adolescents with DS (DS group, M±SD age, 14.4±2.8 years) and 18 age- and gender-matched peers (M±SD age, 13.8±3.6 years). A force plate was used to collect postural data represented by center of pressure (COP) parameters. Postural measurements were conducted for both groups in quiet standing with eyes open and with eyes closed, and also while throwing a ball at erect standing. Assessments of motor ability were only applied to the DS group by using two dimensions of the original version of Gross Motor Function Measure and 4 subtests of the Bruininks Oseretsky Test of Motor Proficiency, second edition. The results showed that while the participants with DS showed greater displacement and higher velocity of COP sways at quiet standing, they exhibited smaller COP displacement in anterior/posterior direction during throwing the ball. Three areas of motor ability, including standing motor skills, walk/run/jump motor skills and muscle strength, were found to make a significant contribution to the displacement and velocity of postural sway during the voluntary movement. It is suggested that future research should focus on investigating the definite underlying mechanism of postural sway during movement and the influence of increasing motor ability on the reactive postural sway in this population.     

Specific cognitive dysfunction in children with epileptic mothers

Specific cognitive abilities and motor function were investigated at 5.5 years in 104 children with epileptic mothers and in 105 control children, all with normal general intelligence. The majority (89 per cent) of the children of epileptic mothers had been exposed to anti-epileptic drugs during pregnancy, most commonly phenytoin (69 per cent). Maternal seizures had occurred during pregnancy in 52 per cent. A significant difference, with poorer performance in the study group, was found in block design (WPPSI) and auditory closure (ITPA). Significantly more study than control children had some type of specific cognitive dysfunction. Within the study group, increased risk was associated with maternal partial seizures, with seizures occurring during pregnancy, and with low paternal education, but not with exposure to anti-epileptic drugs. Three possible mechanisms of this effect are suggested: subtle brain-damage associated with fetal asphyxia during the mothers' generalized convulsions; genetically transmitted brain abnormalities; and psychosocial disadvantage limiting partner choice.     

Relationships between neuropathology and cognitive functioning in temporal lobectomy patients.

Cognitive functions were examined before operation and 4 weeks after operation with respect to pathology in 40 patients who underwent temporal lobectomy for epilepsy. Hippocampal sclerosis was associated with febrile convulsions, an earlier onset of regular seizures, poorer preoperative intelligence and with a tendency towards greater cognitive improvement across the operation than found in patients with tumour-like malformations or non-specific pathology. Damage to the amygdala was associated with a poorer outcome for the retention in memory of verbal and non-verbal material. The absence of any specific abnormality in the resected tissue was not associated with a poorer cognitive outcome 4 weeks after the operation.