生活事件、行为特征与急性脑血管病的关系

目的探讨生活事件、行为特征与急性脑血管病的关系。方法采用生活事件量表(LES)、A型行为问卷(TABQ)对急性脑血管病患者(n=68)和正常对照者(n=68)进行测评。结果脑梗死组和脑出血组患者负性生活事件总分均值均明显高于对照者(P＜0．01);脑出血组患者A型行为问卷评分,总分均值明显高于对照者(P＜0．05)。结论脑血管病患者经历的负性生活事件较多,A型行为类型与脑出血的发病有关。     

A型行为与精神分裂症（附200例临床分析）

采用问卷法评估２００例精神分裂症患者与１２０例健康人的行为类型，结果显示，精神分裂症患者以Ｂ型行为多见，对Ａ型和Ｂ型行为患者的临床上差异进行比较，结果表明Ａ型行为患者具有起病晚而急，阳性家族较少，社会心理因素明显，临床表现以敌对猜疑等阳性症状多见，以及疗效较好等特点。     

人格特征与疾病关系的研究

人格特征与疾病之间具有紧密联系。本文首先回顾了A型人格与冠心病、C型人格与癌症的相关研究，然后着重介绍了一种新的危险因素——D型人格，并对其与心血管疾病的关系进行了简要论述，最后本文提出了一些干预措施。     

A型行为的不良行为特征在脑梗死发生及发展中的作用

目的 探讨A型行为的不良行为特征在脑梗死(CI)发生及发展中的作用.方法 对100例CI患者和107例无血液病和肿瘤的对照者进行A型行为评定量表测定,并同时对两组人员的血管内皮细胞损伤的血浆标志物内皮素(ET)和血栓调节蛋白(TM)含量进行测定;再根据A型行为问卷调查结果,分别对CI组和对照组患者,以及在同一血压水平的CI患者按照个体的行为特征进行分组,然后对其血浆标志物浓度进行相关分析.结果 CI患者中有40%为A型行为类型;具有A型行为不良行为特征的CI患者的血浆ET(CT1亚组:52.68±3.47)和TM(CT1组:89.78±2.15)浓度不仅高于同型的非CI者(ET:57.82±1.83;TM:36.05±1.07)(均P<0.05),且高于同一血压水平的非不良行为特征的CI患者(均P<0.01).结论 A型行为是CI易患的行为类型.A型行为的不良行为特征对CI的发生及发展有影响.纠正A型行为不良行为特征对预防CI有重要意义.     

缺血性脑血管疾病患者A型行为因子分析

为进一研究缺血性脑血管疾病与Ａ型行为的关系。方法用《Ａ型行为问卷》评定缺血性脑血管疾病患者和健康人各１１２例，作对照研究，并对该问卷中６０个项目题逐项分析。结果病例组ＴＨ、ＣＨ及ＴＨ＋ＣＨ计分高于对照组（Ｐ＜０．０５）和（Ｐ＜０．０１）；项目分析ＴＨ有二项，ＣＨ有六项，两者有显著差异（Ｐ＜０．０５）或（Ｐ＜０．０１）。结论Ａ型行为是缺血性脑血管疾病易患的行为模式，某些因子在该病的发生中可能占主导地位。     

Inhibition and executive functioning in Type A and ADHD boys

The present study was aimed at clarifying the standing of Type A behavior, as measured by behavioral observations, relative to Attention Deficit Hyperactivity Disorder (ADHD), using measures of inhibitory control and executive functioning. The study sample included 20 boys exhibiting Type A behavior, 21 boys exhibiting Type B behavior and 14 boys diagnosed with ADHD, ranging in age from 7 to 12 years. The results of the present study showed that the Type A children differed from Type B children on two time-related variables, response latency and reaction time, in accordance with the view of Type As as time-urgent and impatient. Furthermore, in comparisons with the ADHD group, the Type A boys were found to be superior on several performance tasks, such as Go/no-go omissions, time reproduction, story recall and memory for sequences of hand movements, although similarities between Type A and ADHD boys were evidenced in terms of response latency and reaction time. In other words, although Type A boys were similar to ADHD boys in terms of overt displays of time-urgency and impatience, Type As do not display deficits with regard to executive functioning, of the kind often found when ADHD children are compared with normal controls. It may thereby be concluded that Type A behavior and hyperactivity/ADHD appear to be well differentiated except with regard to what may be interpreted as impatience. Speculations concerning differing origins of overtly similar characteristics of Type A behavior and ADHD should be considered in future research.     

城乡儿童血铅含量对智力、行为、学习影响及“剂量-效应”关系的研究

目的研究城乡儿童血铅水平的差异;血铅水平对儿童智力、行为、感觉统合发育、学习成绩等影响的“剂量－效应”关系。方法随机整群抽取城市和农村1所小学三～五年级儿童各100名作为研究对象,在严格质量控制下,测定全静脉血铅含量,同时进行儿童行为、智力、儿童感觉统合能力评定并进行学习成绩评价。结果高血铅检出率为23％,其中城市儿童检出率为29％,农村儿童检出率为17％,城市儿童血铅含量高于农村儿童（P〈0．001）;高血铅组儿童行为异常检出率41．3％,非高血铅儿童行为异常检出率为10．39％,有非常显著性差异（P〈0．01）。高血铅对总智商损害：200－499μg／L组重于100～199μg／L（P〈0．001）;对语言智商的损害：200～499μg／L组重于100～199μg／L组（P〈0．01）;对操作智商损害：100～199μg／L重于〈99gg／L组（P〈0．01）。儿童感觉统合失调发生率血铅％99μg／L组、100～199μg／L、200～499μg／L组分别为7．5％、40．26％、100％。对学习成绩的影响：血铅100～199μg／L组重于血铅〈99μg／L组（P〈0．01）;当血铅在100～199μg／L,200～499μg／L时数学成绩均明显低于语文成绩（P〈0．001;P〈0．05）。结论城市在校小学生的血铅含量水平明显高于农村在校小学生的血铅含量水平;高血铅含量对操作智商损害早于言语智商;对数学成绩的影响早于对语文成绩的影响;血铅含量对智力、行为、感觉统合发育、学习成绩的影响存在明显的“剂量－效应”关系。     

The role of the mother-child relationship in the route from child ADHD to adolescent symptoms of depressed mood

We attempt to explain the co-variation between ADHD and symptoms of depressed mood, focusing on the family context and testing whether the mother-child relationship mediates or moderates the link between child ADHD and youth depressed mood symptoms. In a longitudinal study, we used mother and youth reports for 596 Swedish youth, 50% boys, from a community sample at 10, 15, and 18 years of age. The results did not support the mediation hypothesis. Only one moderation effect was found. Mother-child conflicts in mid-adolescence, as rated by mothers, increased symptoms of depressed mood symptoms in late adolescent only for youth with high levels of hyperactivity symptoms. However, depressed mood symptoms at age 18 were predicted by low mother-child involvement in mid-adolescence, over and above the effects of inattention symptoms. This latter finding was consistent across mother and youth ratings of the relationship. Implications of these results are discussed.     

Derivation and Validation of a Phenoconversion-Related Pattern in Idiopathic Rapid Eye Movement Behavior Disorder

Background

Idiopathic rapid eye movement sleep behavior disorder (iRBD) represents the prodromal stage of α-synucleinopathies. Reliable biomarkers are needed to predict phenoconversion.

Objective

The aim was to derive and validate a brain glucose metabolism pattern related to phenoconversion in iRBD (iRBDconvRP) using spatial covariance analysis (Scaled Subprofile Model and Principal Component Analysis [SSM-PCA]).

Methods

Seventy-six consecutive iRBD patients (70 ± 6 years, 15 women) were enrolled in two centers and prospectively evaluated to assess phenoconversion (30 converters, 73 ± 6 years, 14 Parkinson's disease and 16 dementia with Lewy bodies, follow-up time: 21 ± 14 months; 46 nonconverters, 69 ± 6 years, follow-up time: 33 ± 19 months). All patients underwent [¹⁸F]FDG-PET (¹⁸F-fluorodeoxyglucose positron emitting tomography) to investigate brain glucose metabolism at baseline. SSM-PCA was applied to obtain the iRBDconvRP; nonconverter patients were considered as the reference group. Survival analysis and Cox regression were applied to explore prediction power.

Results

First, we derived and validated two distinct center-specific iRBDconvRP that were comparable and significantly able to predict phenoconversion. Then, SSM-PCA was applied to the whole set, identifying the iRBDconvRP. The iRBDconvRP included positive voxel weights in cerebellum; brainstem; anterior cingulate cortex; lentiform nucleus; and middle, mesial temporal, and postcentral areas. Negative voxel weights were found in posterior cingulate, precuneus, middle frontal gyrus, and parietal areas. Receiver operating characteristic analysis showed an area under the curve of 0.85 (sensitivity: 87%, specificity: 72%), discriminating converters from nonconverters. The iRBDconvRP significantly predicted phenoconversion (hazard ratio: 7.42, 95% confidence interval: 2.6–21.4).

Conclusions

We derived and validated an iRBDconvRP to efficiently discriminate converter from nonconverter iRBD patients. [¹⁸F]FDG-PET pattern analysis has potential as a phenoconversion biomarker in iRBD patients. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.     

A Comparison Study of Psychiatric and Behavior Disorders and Cognitive Ability Among Homeless and Housed Children

This study examined the association of homelessness and related factors with child psychiatric and behavior disorders (diagnosed with structured diagnostic interviews) and child cognitive ability (on the Kaufman Brief Intelligence Test) in a randomly selected sample of 157 homeless children and their mothers and a comparison of 61 housed children and their mothers. Homeless children had more disruptive behavior disorders and lower cognitive scores than housed children. In multivariate analyses, maternal verbal scores and child nonverbal scores were associated with child verbal ability; maternal education, homelessness, and child nonverbal scores were related to child behavior disorders. ManSoo Yu is affiliated with the Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE, USA. Carol S. North is affiliated with the Department of Psychiatry, University of Texas Southwestern Medical Center and North Texas VA Health Care System, Dallas, TX, USA. Patricia D. LaVesser is affiliated with the Program of Occupational Therapy, School of Medicine, Washington University, St. Louis, MO, USA. Victoria A. Osborne is affiliated with George Warren Brown School of Social Work, Washington University, St. Louis, MO, USA Edward L. Spitznagel is affiliated with the Department of Mathematics and Biostatistics, Washington University, St. Louis, MO, USA.     

Autism spectrum disorder and the student teacher relationship: A comparison study with peers with intellectual disability and typical development

This study examined relations among behavior problems, social skills, and student–teacher relationships within a sample of children (mean age 8) with autism spectrum disorders or ASD (n = 36) and comparison samples of children with typical development (n = 91) or with intellectual disability (n = 38.) Student–teacher relationships (STRs) for children with ASD appeared to be qualitatively different from those of similarly aged children with ID or typical development. The STRs for children with ASD were considerably poorer, with less closeness and more conflict, than in the two comparison groups. Within the group with ASD, teacher-reported child externalizing behavior and social skills accounted for significant variance in the total score on the Student Teacher Relationship Scale. Conflict was predicted only by externalizing behavior, whereas closeness was predicted by social skills; level of autistic mannerisms negatively related to the teacher's perception of closeness. Findings address the implications for transition to early schooling for children with ASD.     

A Positive Aspect of Caregiving: The Influence of Social Support on Caregiving Gains for Family Members of Relatives with Schizophrenia

This study examines family members' caregiving gains as a result of caring for their relatives with schizophrenic spectrum disorders, and the influence of formal and informal social support on these positive experiences. The results from interviews with 560 family members support that the experience of caregiving gains is prevalent. Moreover, formal support from mental health professionals through information sharing and collaborative interactions with family members, and informal support from other family members, support group participation, and contributions from the relative with mental illness all have significant, positive associations with family members' experiences of caregiving gains.     

A comparison of developmental versus functional assessment in the rehabilitation of young children

Background: The purpose of this study was to explore the differences in and potential uses of information derived from developmental vs. functional assessment during the acute rehabilitation of very young children with acquired brain injury. Both methods of assessment are typically used during hospitalization in order to assist in developing individualized goals and outcome measures. With the trend of shortened hospital stays, effective assessment for determining optimal treatment goals and outcomes becomes increasingly important. The results from a developmental and a functional assessment obtained on 23 inpatient children below 6 years of age who had experienced either an acquired brain injury or encephalitis were compared. The data was collected through a retrospective chart review spanning 4 years.

Methods and outcome measures: Each child received a cognitive and a language test using either the Early Learning Accomplishment Profile (E-LAP) or the Learning Accomplishment Profile Diagnostic (LAP-D) for the developmental assessment measure. The Functional Independence Measure for Children (WeeFIM) was used as a functional assessment. Summary statistics and frequencies were calculated for variables including age and diagnosis. Partial Pearson correlations and 95% confidence intervals were calculated between the functional and developmental assessments, adjusting for the amount of time between administrations of the two exams. Pearson correlations were computed between length of hospital stay and performance on the developmental and functional quotients.

Results: Moderate, statistically significant Pearson partial correlations were found between the E-LAP/LAP-D cognitive quotient and the WeeFIM cognitive quotient (r?=?0.42, 95% CI (0, 0.72)), the E-LAP/LAP-D language quotient and the WeeFIM cognitive quotient (r?=?0.55, 95% CI (0.17, 0.79)) and the E-LAP/LAP-D cognitive quotient and the WeeFIM total quotient (r?=?0.50, 95% CI (0.10, 0.76)). An inverse correlation was found between the length of stay and the E-LAP/LAP-D cognitive quotient (r?=??0.68, 95% CI (?0.86, ?0.34)) as well as the E-LAP/LAP-D language quotient (r?=??0.61, 95% CI (?0.83, ?0.23)).

Conclusions: The moderate but limited correlations between developmental and functional assessments may be attributed to differences in the two forms of assessment including the test items, their administration and scoring. While both forms of assessment were thought to be useful for developing individualized treatment goals and measuring outcomes, there were advantages and disadvantages to each.     

Parental Mental Disorders and Suicidal Behavior in the Nigerian Survey of Mental Health and Well-Being

The objective of this study was to determine which parental mental disorders predict offspring suicidal behavior in a general adult population sample of a sub-Saharan African country. The World Health Organization Composite International Diagnostic Interview, version 3 was used to assess respondents' suicidal behaviors as well as psychopathology in their parents. The effects of parental disorders in predicting offspring suicide ideation and attempts were examined in a series of bivariate and multivariate models. Sections on suicidality were administered to the entire sample (n = 6752), but associations with parental psychopathology were examined in a subsample of respondents (n = 2143). Lifetime prevalence (95% confidence interval) of suicide ideation, plans, and attempts was 3.2% (1.4–6.5), 1.0% (0.4–7.5), and 0.7% (0.5–1.0) respectively. Parental panic disorder and substance abuse were associated with suicide ideation in offspring, but only parental panic disorder was linked to suicide attempts. Parental panic disorder predicted the onset and persistence of suicide ideation and attempts and also which persons with suicide ideation go on to make a suicide attempt. This study further affirms findings from previous studies of the role of disorders characterized by anxiety and impulse control in suicide attempts and as being a probable link in the transmission of suicidal behavior to offspring.     

Parental Depression and Child Behavior Problems: A Pilot Study Examining Pathways of Influence

Parents of children with autism spectrum disorders (ASD) have higher rates of depressive symptoms than parents of typically developing children and parents of children with other developmental disorders. Parental depressive symptoms are strongly associated with problem behaviors in children; however, the mechanisms through which parental depression influences child behavior in families of children with ASD are unclear. The purpose of this study was to examine the relationship between parental depression and child behavior problems among families of children with ASD, more specifically to investigate the mediating variables that may explain the processes through which parental depression and child behavior problems are associated. The sample consisted of 33 parents of children with ASD (ages 2 to 5 years old). Findings suggested that authoritative parenting style significantly mediated the relationship between parental depression and behavior problems. This study highlights the importance of considering parental mental health and its impact on parenting behavior in interventions targeting child behavior problems.     

The Effect of Parenting Stress on Child Behavior Problems in High-Risk Children with Prenatal Drug Exposure

Objective To examine the relationship between early parenting stress and later child behavior in a high-risk sample and measure the effect of drug exposure on the relationship between parenting stress and child behavior. Methods A subset of child-caregiver dyads (n = 607) were selected from the Maternal Lifestyle Study (MLS), which is a large sample of children (n = 1,388) with prenatal cocaine exposure and a comparison sample unexposed to cocaine. Of the 607 dyads, 221 were prenatally exposed to cocaine and 386 were unexposed to cocaine. Selection was based on the presence of a stable caregiver at 4 and 36 months with no evidence of change in caregiver between those time points. Results Parenting stress at 4 months significantly predicted child externalizing behavior at 36 months. These relations were unaffected by cocaine exposure suggesting the relationship between parenting stress and behavioral outcome exists for high-risk children regardless of drug exposure history. Conclusions These results extend the findings of the relationship between parenting stress and child behavior to a sample of high-risk children with prenatal drug exposure. Implications for outcome and treatment are discussed. Portions of the data were previously presented at the 11th Annual Research Symposium on Mental Health Sciences, The Warren Alpert Medical School of Brown University, Providence, RI and at the 25th Annual Society for Developmental and Behavior Pediatrics Meeting in Providence, RI.     

Prevalence of the Child Behavior Checklist-pediatric bipolar disorder phenotype in a German general population sample

BACKGROUND: In children with pediatric bipolar disorder (PBD), a consistent pattern of elevations in inattention/hyperactivity, depression/anxiety, and aggression has been identified on the Child Behavior Checklist (CBCL-PBD profile). In Germany, no epidemiological study has included PBD to date. OBJECTIVES: To estimate the six-month prevalence of the CBCL-PBD profile in Germany in a large normative general population sample, and to examine subjects with CBCL-PBD profile with regard to symptoms assumed to coexist with PBD (e.g., suicidality, decreased need for sleep, and hypersexuality). METHODS: We studied a nationwide representative general population sample of 2,856 children and adolescents aged 4-18 years. RESULTS: A total of 21 subjects [0.7% of the sample; 95% confidence interval (CI) = 0.5-1.1] met the criteria for the CBCL-PBD phenotype. CBCL-PBD subjects were more pervasively disturbed than clinical controls (n = 118; 4.1% of total sample; 95% CI = 3.4-4.9), demonstrated in significantly more social problems and delinquent behavior, and showed significantly higher rates of suicidality, decreased need for sleep and hypersexual behavior. CONCLUSIONS: The prevalence of CBCL-PBD subjects in the general German population compares to rates of PBD in US and Dutch epidemiological samples. Regardless of whether these subjects are affected by 'real' PBD or 'severe, pervasive ADHD' with pronounced emotional dysregulation, they constitute a group of seriously disturbed children and adolescents. The high rate of suicidality among CBCL-PBD subjects emphasizes the need for the identification and adequate treatment of children meeting this profile.