The familial association of tourette's disorder and ADHD: The impact of OCD symptoms

Tourette's disorder (TD) frequently co‐occurs with attention‐deficit/hyperactivity disorder (ADHD) and obsessive compulsive disorder (OCD). While the relationship between TD and OCD suggests that they share etiological factors, the exact relationship between TD and ADHD is less clear. The goal of the current analyses was to understand better the familial relationship between DSM‐IV ADHD and TD. Direct interview diagnostic data from a case–control study of 692 relatives of 75 comorbid TD and ADHD (TD + ADHD), 74 TD without ADHD (TD Only), 41 ADHD without TD (ADHD Only), and 49 control probands were analyzed. Hierarchical loglinear modeling was used to explore association patterns between TD, ADHD, and OCD or sub‐clinical OCD (OCD/OCDsub) diagnoses among the 190 affected probands and their 538 relatives. The presence of OCD or OCDsub diagnosis in a proband was associated with a significantly increased risk of comorbid TD + ADHD in his/her relatives. The finding of an association between TD, ADHD and a proband OCD/OCDsub diagnosis was unexpected. The current results suggest that TD, ADHD, and OCD symptoms have overlapping neurobiology when occurring in families of TD and/or ADHD probands. © 2011 Wiley‐Liss, Inc.     

FACIAL EXPRESSION RECOGNITION BY PEOPLE WITH MÖBIUS SYNDROME

We present an investigation of facial expression recognition by three people (BC, LP, and NC) with Mobius syndrome, a congenital disorder producing facial paralysis. The participants were asked to identify the emotion displayed in 10 examples of facial expressions associated with each of 6 basic emotions from the Ekman and Friesen (1976) series. None of the three people with Möbius syndrome was significantly impaired on this task. On a second test of facial expression recognition using computer-morphed facial expressions, NC showed a statistically significant impairment, BC a borderline deficit, and LP was unimpaired. However, even when impairments were found, people with Möbius syndrome still recognised many of the facial expressions shown to them. The recognition of facial expressions by people who have never been able to produce such signals on their own faces demonstrates that the ability to produce facial expressions is not a necessary prerequisite of their recognition.     

Evidence of exposure to aristolochic acid in patients with urothelial cancer from a Balkan endemic nephropathy region of Romania

Recently, chronic Aristolochia poisoning was found responsible for the aetiology of Balkan endemic nephropathy (BEN) in Croatia, Serbia, and Bosnia, and diet was the likely route of exposure to aristolochic acid (AA). BEN, often associated with an increased incidence of upper urinary tract carcinoma (UUC), also affects residents of certain rural villages in Romania. AA is a nephrotoxin and human carcinogen that forms DNA adducts after metabolic activation, which induce characteristic TP53 mutations in urothelial tumours. Here we present the first evidence linking AA exposure to UUC in residents of an endemic region in the Romanian Mehedinti County. DNA was extracted from kidney and tumour tissue of seven patients who underwent nephroureterectomy for UUC and resided in BEN villages (endemic group). Five patients with UUC from nonendemic villages served as controls. AA‐DNA adducts (7‐(deoxyadenosin‐N⁶‐yl)‐aristolactam I), established biomarkers of AA exposure, were identified by ³²P‐postlabelling in renal DNA of six patients from the endemic group and in one of the nonendemic group (adduct levels ranged from 0.3 to 6.5 adducts per 10⁸ nucleotides). Additionally, an A to T transversion in TP53, a base substitution characteristic of AA mutagenic activity was found in urothelial tumour DNA of one patient from the endemic group. Our results provide a molecular link to the cause of urothelial tumours in BEN regions of Romania indicating that AA is the common aetiological agent for BEN across its numerous geographical foci. Environ. Mol. Mutagen., 2012. © 2012 Wiley Periodicals, Inc.     

Youth Top Problems and Early Treatment Response to the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents

Child Psychiatry & Human Development - The Top Problems assessment is an idiographic measure of client concerns that may allow clinicians to identify early treatment response. Few studies have...     

Outcomes Accountability Systems for Early Childhood Disruptive Behaviors: A Scoping Review of Availability

Early childhood disruptive behaviors are common mental health problems among American youth, and if poorly-managed, pose costly psychological and societal burdens. Outcomes accountability systems in clinical practice are vital opportunities to optimize early intervention for common mental health problems; however, such systems seem rare. A scoping review was conducted to summarize the current availability of outcomes accountability systems in clinical programs addressing early childhood disruptive behaviors, particularly in the US. We used PsycINFO to identify peer-reviewed literature published in English from 2005 to 2021, from which we selected 23 publications from the US, UK, and Netherlands on outcomes accountability systems within clinical programs treating common childhood mental health problems. Only 3 out of 23 publications described outcomes accountability efforts specifically for early childhood problems. Within the 3 studies, only one UK-based study specifically targeted early childhood disruptive behaviors. We did not find publications specifically describing outcomes accountability efforts in US-based clinical programs to treat early childhood disruptive behaviors. There are multi-level challenges preventing changes to the prevalent US model of paying a fee for each unit of child mental healthcare, with little regard for patient outcomes. However, opportunities exist to improve US-based accountability efforts; from top-down expansion of financial incentives, accountability initiatives, and PDT evidence-based practices to an iterative, bottom-up development of meaningful outcomes measurement by providers. Greater adoption of outcomes monitoring in US clinical practice for common mental health problems can optimize management of early childhood disruptive behaviors and mitigate long-term societal and economic burdens.

     

Design and fabrication of the radial and ulnar wrist articulating control orthoses

Study DesignCase series.IntroductionPain and injury at the radial and ulnar aspects of the wrist due to overuse or trauma are commonly treated in hand therapy clinics.Purpose of StudyDescribe two orthoses that allow targeted rest and recovery of involved anatomical structure(s) while preserving function of surrounding uninvolved structures in patients who have sustained overuse or traumatic injury at the radial or ulnar aspect of the wrist.MethodsOutline the fabrication of the Ulnar-Wrist Articulating Control Orthosis (U-WACO) and Radial-Wrist Articulating Control Orthosis (R-WACO) as well as presents case examples for each orthosis.ResultsThe U-WACO and R-WACO designs may improve comfort, compliance, and functional ability to complete daily tasks while allowing targeted rest and recovery of involved anatomical structure(s) at the radial and ulnar aspects of the wrist due to overuse or trauma.ConclusionDynamic orthoses that allow for movement in one plane while restricting movement in another may overcome the shortcomings of some static orthotic designs.     

Surviving in the mainstream: Capacity of children with autism spectrum disorders to perform academically and regulate their emotions and behavior at school

This study compares teachers’ perceptions of students with autism spectrum disorders (ASD) to their perceptions of typically developing students with regard to capacity to perform academically and regulate emotions and behavior in mainstream classrooms. A case-control research design was used to compare teacher ratings of academic performance and classroom emotional and behavioral regulation of 28 students with ASD (with average range IQ) and 51 age- and gender-matched typically developing (TD) students drawn from the same mainstream classrooms. Teachers rated students with ASD as exhibiting behavioral and emotional difficulties (including attention difficulties, anxiety, depression, oppositional and aggressive behaviors) to a significantly higher level than their typically developing peers. Fifty-four percent of students with ASD were rated as under-achieving academically as compared to 8% of typically developing students. Students with ASD seem to be underperforming relative to their level of ability and are struggling to maintain their attention and regulate their emotions and behaviors in mainstream classrooms, despite receiving a range of specialist support services in the classroom. Consideration needs to be given to investigating alternative models of supporting these students in mainstream classrooms and assisting them to develop strategies to cope with the student role.     

Randomized trial of law enforcement training on autism spectrum disorders

The core symptoms of autism spectrum disorders (ASD) are likely to affect interactions between law enforcement officers and persons with ASD. If law enforcement officers are not trained to identify and appropriately respond to persons with ASD, it is possible that officers may exacerbate a situation, resulting in unnecessary trauma, injury, or fatality. The purpose of the current study was to evaluate the effectiveness of a method of law enforcement training on persons with ASD. A total of 82 law enforcement officers participated in this randomized, waitlist-controlled, between-groups study. The results revealed significant differences in change scores between groups, with the training group scoring considerably better than the control group at posttest. Subsequently, the control group completed training and likewise showed significant improvement. However, despite the significant gains in knowledge following training, posttests scores for participants in both groups did not indicate mastery of the training material. The implications of these findings are discussed.     

Angelman syndrome: evolution of the phenotype in adolescents and adults

Individuals with Angelman syndrome (AS) have severe learning disability,* ataxia, seizures, dysmorphic facies, a happy, sociable disposition, and inability to speak. Most of the literature concerning the clinical features of AS has concentrated on younger children. This study aimed to look at the natural history of AS by documenting the clinical features in a group of 28 adolescents and adults with AS (12 males, 16 females; age range 16 to 40 years). Specific aspects studied included physical characteristics, general health, mobility, seizure disorder, behaviour and communication, and self-help skills. Problems seen in this older group of individuals differed significantly from those typically observed in younger children. The incidence of scoliosis and joint contractures increased with age. Facial features were more striking in adults. Hyperactivity and concentration improved and the sociable disposition persisted. There were subtle clinical differences between the groups of individuals with different underlying genetic abnormalities. Information obtained from this study is relevant to diagnosis and management of older individuals with AS.