[Show abstract][Hide abstract] ABSTRACT: To explore the relationships of family and cognitive factors to aggression as reported by parents and teachers.
Data regarding different types of aggressive behavior were collected from parents and teachers of 165 school-age (7-11 years old) children referred to a study of attention-deficit/hyperactivity disorder and disruptive behavior. Structural equation modeling was used to examine the differential relationships of family and cognitive factors to aggression in the home and school settings.
Family risk factors influenced aggression reported at home and at school, whereas cognitive risk factors may exert their influence on aggression at school. Significant covariance between parent and teacher report of aggressive behavior was observed.
Intervention at the family level may serve to reduce aggressive behaviors in both home and school environments.
Journal of the American Academy of Child & Adolescent Psychiatry 04/2006; 45(3):355-63. · 6.97 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To provide preliminary psychometric data on the Children's Aggression Scale-Teacher Version (CAS-T), which was designed to assess severity and frequency of aggressive, as distinct from nonaggressive, disruptive behaviors.
The CAS-T has 23 items representing five domains: Verbal aggression, Aggression against objects and animals, Provoked physical aggression, Unprovoked physical aggression, and Use of weapons. The CAS-T was completed for 273 nonreferred boys and 67 clinically referred children (60 boys; 7 girls). Coefficient alpha was assessed separately in clinical and nonreferred groups. Validity was evaluated by comparing CAS-T scores of children with different disruptive behavior disorder diagnoses and by examining the relationship of CAS-T scores to other parent and teacher ratings.
The scale as a whole had excellent reliability as measured by coefficient alpha. Children with conduct disorder were rated significantly higher than those with oppositional defiant disorder, attention-deficit/hyperactivity disorder, and no disruptive behavior disorder diagnosis. Further, patterns of correlations with other rating scales provide strong support for the convergent and discriminant validity of the CAS-T.
The CAS-T may fill a gap in that it distinguishes among various types and severity of aggression, as distinct from oppositional-defiant behaviors.
Journal of the American Academy of Child & Adolescent Psychiatry 09/2003; 42(8):965-71. · 6.97 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Previous findings suggest a relationship between childhood aggression, parental history of aggression and central serotonin (5-HT) function. The present study extended these findings by examining the impact of childhood aggression and central 5-HT function on the incidence of psychopathology in first- and second-degree relatives of pre-pubertal children with disruptive behavior disorders. Family history of psychopathology was obtained for 58 aggressive and 44 non-aggressive clinically referred children who were further sub-divided based on central 5-HT function. Central 5-HT function was assessed by measuring the prolactin response to a 1 mg/kg oral dose of d,l-fenfluramine. Aggressive children with low-prolactin responses to fenfluramine had a significantly greater incidence of first- and second-degree relatives with aggressive and antisocial characteristics compared to both non-aggressive children and aggressive children with high-prolactin responses. No group differences were found in the frequency of relatives with symptoms of cognitive impairment or inattention and hyperactivity. These data suggest that there are both familial and non-familial forms of aggression in children, and that only the familial type is associated with reduced 5-HT function.
Psychiatry Research 09/2003; 119(3):205-16. · 2.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This preliminary study evaluated a method for assessing central noradrenergic function in children via the growth hormone response to a single dose of the alpha-2 adrenergic receptor agonist guanfacine and examined whether this measure distinguishes between attention deficit hyperactivity disorder (ADHD) boys with and without reading disabilities (RD).
Plasma growth hormone was assessed before and after the oral administration of guanfacine and placebo in boys with ADHD who were divided into subgroups based on the presence (n = 3) or absence (n = 5) of RD.
Guanfacine and placebo conditions did not differ at baseline, but peak growth hormone was significantly higher following guanfacine. The increase in growth hormone following guanfacine was significantly greater in boys without RD as compared to those with RD, with no overlap between the groups.
Consistent with findings using peripheral measures of noradrenergic function, these preliminary data suggest that ADHD boys with and without RD may differ in central noradrenergic function.
Journal of Child and Adolescent Psychopharmacology 02/2003; 13(3):283-94. · 2.77 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To provide preliminary psychometric data on the Children's Aggression Scale-Parent Version (CAS-P), which assesses severity, frequency, pervasiveness, and diversity of aggressive, as distinct from nonaggressive, disruptive behaviors.
The scale has 33 items representing five domains: Verbal Aggression, Aggression Against Objects and Animals, Provoked Physical Aggression, Unprovoked Physical Aggression, and Use of Weapons. The CAS-P was completed for 73 clinically referred children. Validity was evaluated dimensionally by examining the relationship of CAS-P scores to other parent and teacher rating scales, and categorically by comparing scores of children with attention-deficit hyperactivity disorder (ADHD) alone, oppositional defiant disorder, and conduct disorder.
The scale as a whole had excellent internal consistency (alpha = .93). Children with conduct disorder were rated significantly higher than those with oppositional defiant disorder, who were rated significantly higher than those with ADHD alone. The CAS-P did not distinguish clinical control children from those with ADHD only. Correlations with other rating scales provide further support for the validity of the CAS-P.
The CAS-P assesses distinct components of aggressive behavior and may fill a gap in that it distinguishes among various types and severity of aggressive behaviors, and the settings in which they take place.
Journal of the American Academy of Child & Adolescent Psychiatry 04/2002; 41(3):245-52. · 6.97 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The progression to adult antisocial behavior is the least desirable developmental trajectory for children with ADHD. An unremitting pattern of physical aggression appears of great import when predicting long-term outcome. However, a profile characterized by behavioral and cognitive impulsivity and emotional lability may indicate a greater likelihood of the progression to adult antisocial behavior and violent impulse-control disorders. This constellation of behaviors appears to be, at least in part, mediated by brain serotonergic systems. The contribution of cognitive impairments, as manifested by executive function deficits, diminished moral reasoning, and impaired empathic ability, to the emergence and persistence of antisocial behavior has yet to be discerned.
Annals of the New York Academy of Sciences 07/2001; 931:84-96. · 4.38 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Data indicate that diminished central serotonergic (5-HT) function is related to aggression in adults, but discrepant findings in children suggest that age or the presence of attention-deficit/hyperactivity disorder (ADHD) may influence this relationship. This study examined whether age or ADHD affects the association between 5-HT and aggression in 7-11-year old clinically-referred boys. Forty-six boys were divided into non-aggressive ADHD, aggressive ADHD, and aggressive non-ADHD groups based on responses to interviews and ratings of behavior. Central 5-HT function was assessed by measuring the prolactin response to a 1-mg/kg oral dose of D,L-fenfluramine. There was no significant difference in the prolactin response across the three groups of boys. Furthermore, when examined dimensionally, prolactin response was largely unrelated to ratings of aggression, even after controlling for ADHD. Finally, age was not associated with prolactin response, and had no effect on the relationship between prolactin response and aggression. This study provides further evidence that there is no clear relationship between central 5-HT function and aggression in disruptive boys. Moreover, these data do not confirm the hypothesis that age or the presence of ADHD influence the relationship between 5-HT and childhood aggression.
Psychiatry Research 03/2001; 101(1):1-10. · 2.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The present investigation examined factors that predict physical aggression in children with attention-deficit/hyperactivity disorder (ADHD). Stepwise, multiple regression-analyses were used to examine predictors of children's physical aggression as rated by parents at a 1-year follow-up point and by teachers at both 1- and 2-year follow-up points. Early parent and teacher ratings of verbal aggression (ie, cursing, teasing, and threatening) accounted for the greatest proportion of the variance in physical aggression ratings obtained at follow-up. None of the other predictor variables, including early ratings of physical aggression and ADHD behaviors, contributed significant additional variance beyond that accounted for by early verbal aggression ratings. Temporal and cross-informant analyses revealed that the relationship between verbal aggression and later physical aggression was situation-specific for teacher ratings but not parent ratings. Although physical aggression may emerge early in development, these data suggest that verbal aggression represents a stable, temperamental characteristic that may be of greater value than early physical aggression for predicting later physically aggressive acts.
[Show abstract][Hide abstract] ABSTRACT: To examine concordance between parent and teacher reports of DSM-IV attention-deficit/hyperactivity disorder (ADHD) and its symptoms.
Parents and teachers of 74 clinically referred children were interviewed using the ADHD module of the Diagnostic Interview Schedule for Children. Parent-teacher agreement for the diagnosis of ADHD and its subtypes, as defined in DSM-IV, as well as parent-teacher concordance of in-school ADHD symptoms, was examined.
Agreement between parents and teachers was found to be relatively poor, with virtually no agreement for individual ADHD subtypes. Diagnoses based on either parent or teacher report frequently yielded a diagnosis of either inattentive or hyperactive-impulsive subtype of ADHD. However, when cross-informant data were used to form diagnoses, these subtypes became relatively rare, with most cases meeting criteria for ADHD combined type. In addition, parent reports of in-school behavior were more highly correlated with their own reports of their child's behavior at home than with teacher reports of their child's behavior in school.
These data suggest that the diagnosis of ADHD inattentive or hyperactive-impulsive subtype based on data from a single informant may be of questionable validity, and they point to the importance of using multiple informants when diagnosing this disorder in clinically referred samples.
Journal of the American Academy of Child & Adolescent Psychiatry 04/2000; 39(3):308-13. · 6.97 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Data suggest that children with reading disability (RD) and non-RD children with attention-deficit/hyperactivity disorder (ADHD) may comprise distinct subgroups. Research has been hampered by variance in definitional criteria, which results in the study of different subgroups of children. Using cluster analysis, this study empirically divided children with ADHD (N = 54), based on their Full Scale IQ (FSIQ) and reading ability. Four distinct subgroups emerged in which cognitive, behavioral, and neurochemical function was compared. Cluster 1 was of average FSIQ and reading scores; Cluster 2 was of average FSIQ but showed impairment in reading; Cluster 3 had high FSIQ and reading scores; and Cluster 4 had low scores in both domains. The groups had different patterns of cognitive, behavioral, and neurochemical function, as determined by discrepancies in Verbal-Performance IQ, academic achievement scores, parent aggression ratings, and a measure of noradrenergic function. These distinctions are discussed with regard to etiology, treatment, and long-term outcome.
Journal of learning disabilities 01/2000; 33(3):297-307. · 1.77 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To provide a review of psychological tests often used with children and adolescents.
A description of how psychological tests are used and how to interpret various types of scores is provided. Subsequently, psychological tests used to assess intelligence, academic achievement, neuropsychological functions, and personality are reviewed.
There are numerous well-normed, reliable, and valid instruments that are available for assessing intellectual and academic functioning in children and adolescents. Neuropsychological tests, designed to assess objectively a wide range of cognitive functions, are available and extremely useful for designing treatment plans for patients with cognitive difficulties. Despite their popularity, most projective tests have relatively weak psychometric data supporting their reliability and/or validity.
Psychological testing provides objective measures of behavior that are of considerable utility for evaluating children and adolescents. However, psychological test data, in isolation, will rarely be adequate for providing a DSM diagnosis, and test scores are best interpreted in the context of other clinical data. Psychological test data can be very useful for developing a comprehensive treatment plan that addresses the patient's cognitive and emotional needs.
Journal of the American Academy of Child & Adolescent Psychiatry 07/1998; 37(6):575-84. · 6.97 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Data in animals and adults indicate that central serotonergic (5-HT) function may be involved in the development of alcohol abuse. Despite this, studies exploring this mechanism in individuals at risk for alcoholism are scant. This study used a fenfluramine (FEN) challenge procedure to investigate the relationship between risk for alcoholism and 5-HT function in 7- to 11-year-old boys with attention-deficit hyperactivity disorder (ADHD). The prolactin (PRL) and cortisol (CORT) responses to FEN were examined in 10 sons of alcoholic fathers (FA+) and 30 sons of nonalcoholic fathers (FA-). The FA+ group had a significantly greater CORT, but not PRL, response to FEN relative to the FA- group. The discrepancy between the CORT and PRL responses may be due to the different mechanisms that underlie their 5-HT stimulated release. This suggests that, among ADHD boys, those at familial risk for alcohol abuse may differ from those who are not at risk in 5-HT function.
[Show abstract][Hide abstract] ABSTRACT: ObjectiveTo examine noradrenergic (NA) function in children with attention-deficit hyperactivity disorder (ADHD) by replicating and expanding upon a previous finding that ADHD children with and without reading disabilities (RD) differ in plasma levels of the NA metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG).MethodPlasma levels of MHPG were compared in ADHD children who were subdivided on the basis of the presence or absence of RD. Subsequently, this replication sample was combined with a previously studied sample to further explore the relationship between plasma MHPG levels and measures of cognitive function in children with ADHD.ResultsPlasma levels of MHPG were significantly lower in ADHD children without RD, compared with those with RD, replicating a previously published finding. Analyses in the combined sample indicated that, among children with ADHD, plasma MHPG levels were inversely associated with measures of academic achievement and verbal processing, but not parent or teacher ratings of behavior or continuous performance test measures of attention and impulsivity.ConclusionsThese data indicate that children with ADHD are not homogeneous with regard to NA function and that neurochemical variation is closely associated with differences in clinical characteristics of the children.
Journal of the American Academy of Child & Adolescent Psychiatry 01/1998; · 6.97 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: ObjectiveTo explore the relationship between central serotonergic (5-HT) function and history of parental aggression in aggressive and nonaggressive boys with attention-deficit hyperactivity disorder (ADHD).MethodHistory of psychiatric symptoms was assessed in the biological parents of 41 boys with ADHD. The relationship between 5-HT function in aggressive and nonaggressive probands, as assessed via the prolactin response to fenfluramine (FEN) challenge, and parental history of aggression was examined.ResultsAggressive boys with a parental history of aggressive behavior had a significantly lower prolactin response to FEN challenge than aggressive boys without a parental history of aggression. Nonaggressive boys had a prolactin response midway between those of the two aggressive subgroups, and their prolactin response did not vary as a function of parental aggression. Children subdivided on the basis of parental history of other psychiatric symptoms did not differ in their response to the FEN challenge.ConclusionsThese data indicate an association between parent aggressive behavior and lower 5-HT function in aggressive boys with ADHD but do not indicate the extent to which this association is environmentally and/or genetically transmitted. There may be different neurochemical mechanisms in familial and nonfamilial aggressive children, which have clinical implications for pharmacological interventions.
Journal of the American Academy of Child & Adolescent Psychiatry 11/1997; · 6.97 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Not Available Bibtex entry for this abstract Preferred format for this abstract (see Preferences) Find Similar Abstracts: Use: Authors Title Return: Query Results Return items starting with number Query Form Database: Astronomy Physics arXiv e-prints
Annals of the New York Academy of Sciences 10/1996; 794:369-71. · 4.38 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The development of cognitive abilities associated with Luna's (1973) three functional units of the brain was investigated in a sample of 62 children, ages 7 to 11 years, and 16 adults, ages 21 to 48 years. Selective attention, associated primarily with Luria's sensory‐input unit, showed no demonstrable development within the age ranges studied. However, sustained attention, presumably mediated through Luria's arousal unit and its ascending fibers to the cortex, as well as response organization, associated with Luna's organization‐and‐ planning unit, did reflect differential development Capacity for sustained attention showed no appreciable development between 7 and 11 years of age, but there was significant growth in this ability between age 11 and adulthood. Response organization, on the other hand, was found to develop most rapidly between 7 and 11 years of age. These findings are partially consistent with Luria's model of neurodevelopment as well as with research investigating the functional and physiological maturation of various brain regions.
[Show abstract][Hide abstract] ABSTRACT: The primary purpose of this study was to assess the discriminant validity of attention-deficit hyperactivity disorder (ADHD) relative to well-defined groups of children with other psychiatric disorders.
Clinic-referred patients diagnosed as having ADHD without any other comorbid diagnosis (N = 13), were compared with patients with only anxiety disorders (N = 20), disruptive disorders other than ADHD (N = 15), and nonreferred controls (N = 18) on measures of cognitive and academic functioning, as well as on objective measures of attention, impulse control, and activity level.
All three patient groups were found to have cognitive and academic achievement difficulties relative to controls. However, the ADHD group was found to be inattentive and impulsive relative to the other patient groups and the nonreferred controls. Objective measurement of activity level distinguished the ADHD group from controls but not from the other two patient groups.
These data support the diagnostic validity of a small subgroup of ADHD children (i.e., those without comorbid diagnoses) and demonstrates, that as a group, these children can be distinguished from patients with anxiety as well as other disruptive disorders on objective test measures.
Journal of the American Academy of Child & Adolescent Psychiatry 10/1993; 32(5):1038-43. · 6.97 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Examined plasma catecholamine metabolite levels in 24 boys with attention-deficit hyperactivity disorder (ADHD) who were divided into subgroups based on the presence or absence of reading disabilities. The reading-disabled ADHD group had a significantly (p < .01) higher level of plasma 3-methoxy-4-hydroxyphenylglycol (MHPG), the metabolite of norepinephrine, but the groups diet not differ on the dopamine metabolite homovanillic acid (HVA). Furthermore, MHPG levels were correlated with measures of reading and spelling ability such that high MHPG was associated with poor academic achievement. These findings suggest that a fruitful approach to understanding the neural substrates of ADHD may be to focus on homogeneous subgroups defined according to individual symptom dimensions.
Journal of Clinical Child and Adolescent Psychology - J CLIN CHILD ADOLESC PSYCHOL. 01/1993; 22(2):219-225.