-
R E Mattison
[show abstract]
[hide abstract]
ABSTRACT: Characteristics were investigated for 169 special education students referred to a child psychiatrist consultant. There was a common occurrence of learning or language disorders, predominance of attention deficit/hyperactivity disorder, severity and complexity of psychopathology, and undertreatment. The teachers especially asked about diagnosis, behavioral management, and medication and also about issues involving learning and language disorders.
Child and Adolescent Psychiatric Clinics of North America 02/2001; 10(1):67-82, viii. · 2.60 Impact Factor
-
R E Mattison
[show abstract]
[hide abstract]
ABSTRACT: To provide clinicians with current information to assist in their consultations to schools on 4 major topics that are unique to the school environment and of serious concern to educators: absenteeism, disciplinary referrals, retention (non-promotion), and dropping out.
Computer literature searches and the major journals of the various school disciplines were used to identify empirically based articles with sound methodology. Information on each of the 4 issues is presented as general characteristics, characteristics of psychopathology, prevention and treatment, and implications for consultation.
Findings are largely general, with little specific information on level of intelligence, learning disorders, psychopathology, or family stressors. Students under each topic have varied presentations. However, many pupils with absenteeism, disciplinary referrals, or retention appear to be characterized by chronic and serious academic and/or behavior problems, all of which can predate dropping out.
Considerable research is still needed on all 4 school issues, especially psychopathology. Nevertheless, consultants can reasonably first help schools to identify students at risk for the 4 outcomes, followed by appropriate screening/evaluation to indicate more clearly their true intervention needs. The ongoing process can further educate school staff about psychiatric disorders in their most problematic students.
Journal of the American Academy of Child & Adolescent Psychiatry 05/2000; 39(4):402-13. · 6.44 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To study the long-term stability of Child Behavior Checklist (CBCL) profile types, which represent children's overall patterns of single and comorbid scale elevations.
Profile types were determined for 623 outpatient children at referral and then at mean follow-up 4.8 years later, and their continuity was determined.
At baseline 37.5% of the children were classified by a profile type, and 41.9% of these originally classified children continued to be classified at follow-up. The average odds ratio for a child continuing as a specific CBCL profile type from baseline to follow-up was 8.2. When children changed from one specific profile type to another, they usually continued in the same broad externalizing or internalizing category. Children who were not classified by a profile type at baseline generally remained unclassified.
Stability findings for CBCL profile types appeared good and were similar to past longitudinal results for CBCL scales and DSM diagnoses. These profile types may prove an important empirical method for addressing the problem of comorbid clinical pictures.
Journal of the American Academy of Child & Adolescent Psychiatry 07/1999; 38(6):700-7. · 6.44 Impact Factor
-
R E Mattison
[show abstract]
[hide abstract]
ABSTRACT: The three-year usage of psychotropic medication was investigated for the first time in elementary school students classified by the special education category serious emotional disturbance. Almost 40% of the original 89 students were on a medication at baseline, primarily stimulants (26%), and multiple medications were not common (17%). Over the three time points of followup, 52% of the constant 54 students used a medicine at least once, principally stimulants followed by, in descending order, antipsychotics, antidepressants, and Clonidine. The order of distribution was constant at each point of follow-up. Only 24% received a medication at all three time points (rarely the same specific medicine), and only 9% received therapy at each time. Overall, 41% of the ongoing students received no medication or therapy over the course of the study. The medication needs, as well as the therapy needs, of this highly dysfunctional group of students appear unmet.
Journal of Child and Adolescent Psychopharmacology 02/1999; 9(3):149-55. · 2.88 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To identify reasons for discrepancies between parent and child reports of child/adolescents's psychiatric symptoms, parents and adolescents (51 pairs) were asked to guess what the other would answer to questions from the PC-DISC about the adolescent's psychiatric symptoms, and to explain why they expected disagreement when the answer they provided for the other was different from their own. Adolescents' explanations for expecting (1) parental denial of symptoms the adolescent reported were: the parent was unaware of, forgot about, assumed the adolescent could not have, or trivialized the symptom; and (2) parental report of symptoms the adolescent denied were: the parent misread or exaggerated the adolescent's symptom, had too high expectations for the adolescent's behavior, put a negative label on or did not trust the adolescent. Parents' reasons for expecting their children to (1) deny symptoms the parents reported were: the adolescent did not remember how s/he felt, lied, did not recognize or minimized the importance or frequency of the symptom; and (2) report symptoms the parents denied were: the adolescent lied, exaggerated the importance of or interpreted the symptom differently.
Journal of Abnormal Child Psychology 11/1995; 23(5):641-59. · 3.09 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Sixty-nine children with attention deficit hyperactivity disorder (ADHD) underwent blind methylphenidate trials. 36 had ADHD alone (with or without a learning disability) and 33 had additional neurodevelopmental disorders. Of the children with ADHD alone, 88 per cent improved significantly on methylphenidate. This did not differ significantly from the 69 per cent response rate for children with ADHD and other neurodevelopmental disorders. The results confirm and add to the research literature indicating that ADHD children who are of preschool age and/or who have co-existing neurological disorders may benefit from methylphenidate.
Developmental Medicine & Child Neurology 01/1995; 36(12):1099-107. · 2.92 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The primary purpose of this study was to determine basic psychosocial characteristics for adolescent socially and emotionally disturbed (SED) boys.
Boys aged 12 to 16 years who were recommended for SED placement were compared with same-aged boys recommended for other educational intervention. The main measures were the Kiddie SADS-E interview and Achenbach's parent Child Behavior Checklist and Teacher Report Form scales.
The adolescent SED boys were found to have normal intelligence, high rates of family stressors, predominantly DSM-III externalizing disorders, serious dysfunction according to checklist ratings by both teachers and parents, and little current community mental health intervention. They were significantly different from the comparison group on several variables: lower socioeconomic status, more abuse experience, greater diagnostic comorbidity, higher Axis V clinician ratings, and higher teacher ratings on externalizing scales.
Findings are similar to those for other age-gender groups of SED students. One implication is the need for more private child psychiatrists to become involved in the collaborative treatment of this complex and seriously ill group of special education students. Consequently, a second implication is to increase the experience of child psychiatry trainees in dealing with the many consultative needs of SED students and staff.
Journal of the American Academy of Child & Adolescent Psychiatry 12/1993; 32(6):1223-8. · 6.44 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Characteristics of Child Behavior Profile (CBP) types were studied in a general population sample of 202 boys aged 6 to 11 years. Parents completed the Child Behavior Checklist and teachers simultaneously rated the Teacher's Report Form. Overall, 39.7% of the boys were classified within a CBP type: 28.8% Internalizing and 10.9% Externalizing. The most common specific type was Somatic Complaints. Teachers rated the Externalizing CBP boys as showing robust externalizing behaviors in school. Also, boys with Externalizing profile types showed severe degrees of psychopathology in both home and school environments. An intraclass correlation of .35 or greater was found to identify boys with sufficiently severe psychopathology to warrant further clinical evaluation. Findings in this general population sample appear consistent with previous results in outpatient samples, and extend our understanding of the validity and clinical value for CBP types.
Journal of Abnormal Child Psychology 01/1990; 17(6):597-607. · 3.09 Impact Factor
-
R E Mattison
[show abstract]
[hide abstract]
ABSTRACT: The first step in the pediatric management of anxiety disorders is to determine whether a child or adolescent has acute, situational anxiety symptoms or a pervasive, chronic anxiety disorder. Such anxiety symptoms can most frequently be handled with reassurance and practical advice to the child and the parents, and followed by monitoring. However, if an anxiety disorder is suspected, then referral to a mental health professional is in order for confirmation of the diagnosis and institution of comprehensive treatment. Medication currently has a limited role in the treatment of any anxiety disorder, although psychopharmacologic treatment may become part of the overall care of obsessive-compulsive disorder in the future. Pediatricians may wish to learn more about behavioral-cognitive treatment approaches used by mental health professionals in the treatment of anxiety symptoms and disorders in children and adolescents. An excellent general text has been edited by R. Gittelman, Anxiety Disorders of Childhood.
Pediatric Annals 03/1989; 18(2):114, 116-7, 121. · 0.48 Impact Factor
-
R E Mattison
[show abstract]
[hide abstract]
ABSTRACT: The increasing risk of suicide among children and adolescents makes imperative the development of a set of appropriate and clinically significant predictors of suicide risk for that group. Of particular concern is the need to understand the role of anxiety psychopathology in suicidal children and the occurrence of suicidal behaviors in children with anxiety disorders. The author reviews the recent investigations assessing childhood and adolescent suicide risk and emphasizes the need to update our current methods in assessing both suicidal behavior and anxiety. Furthermore, he points out the need for prospective studies of anxiety disorders in children and adolescents to identify those children at risk for suicide and other psychopathology as they mature.
The Journal of Clinical Psychiatry 11/1988; 49 Suppl:9-11. · 5.80 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The Revised Behavior Problem Checklist (RBPC) was completed by parents and teachers for 105 child psychiatry outpatient boys aged 6 to 12 years. In addition, DSM-III diagnoses were determined independent of checklist results, and the children were divided into major diagnostic groups of externalizing, internalizing, and mixed disorders. Combined parent and teacher ratings proved more effective than separate ratings in distinguishing the externalizing and mixed groups from the internalizing group on the RBPC externalizing factors. The overall classification of individual boys with discriminant function analysis increased from 72% to 83% when the ratings of both parents, rather than one parent, were combined with teacher ratings. Enhancing diagnostic accuracy of type of psychiatric disorder by using combined parent and teacher behavior checklist ratings is discussed.
Journal of Abnormal Child Psychology 01/1988; 15(4):617-28. · 3.09 Impact Factor
-
Journal of the American Academy of Child & Adolescent Psychiatry 08/1987; 26(4):536-40. · 6.44 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Personality traits of 50 hemophilic boys were assessed with the Early School (ESPQ), Children's (CPQ), and High School (HSPQ) Personality Questionnaires. Compared to the norms for healthy, male age-mates, hemophiliacs were significantly more intelligent, stable, and secure. They did not deviate from the norm on the remaining eight traits assessed. The findings of higher intelligence may indicate that hemophilic boys are more motivated to excel intellectually because this avenue is more appropriate to them due to the risk of pain and disability from physical endeavors. Boys with severe hemophilia were significantly more self-controlled, serious, and submissive, compared to mild-to-moderate hemophiliacs. Possibly, this reflects the severe hemophiliacs' greater concern for the more serious nature of the medical sequelae they may experience from physical activity. Mild-to-moderate hemophiliacs were slightly below the norm on these traits, suggesting their attempt to overcompensate for or deny the physical implications of their hemophilia by being more assertive and impulsive.
Journal of Developmental & Behavioral Pediatrics 09/1986; 7(4):224-9. · 2.13 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We assessed the psychiatric histories and DSM-III diagnoses of all schoolchildren (N = 177) in one geographic area who were referred for potential placement in classes for children with social and emotional disturbances (SED). An extremely high prevalence of serious psychopathology was demonstrated among the entire group. In children aged 6–12 years, Attention Deficit Disorder was the most common diagnosis, while Affective Disorders were the most frequent in older children (13–18 years). The types of psychiatric disorders were similar but of significantly greater severity in children subsequently recommended for SED placement. The SED group had significantly more abused children and parents with psychiatric disorders. Nevertheless, a majority of the children had not received previous psychiatric care or special educational help.
Journal of the American Academy of Child Psychiatry 08/1986; 25(4):514-20.
-
[show abstract]
[hide abstract]
ABSTRACT: Behavioral checklists were employed to identify the type and degree of psychopathology observed in 90 boys who were referred for possible placement in classrooms for the socially and emotionally disturbed (SED). School behavior was assessed by teachers completing the Conners Teacher Rating Scale, while behavior at home was rated by parents with the Child Behavior Checklist. The checklist findings from both environments showed the boys to have high levels of psychological disturbance, especially for externalizing factors such as hyperactivity, aggression, and conduct disorder. This was especially true for those boys for whom SED placement was recommended. Further, the clinical usefulness of these checklists was investigated as an adjunctive method for the determination of the need for SED placement. By the use of discriminant function analysis, about three-fourths of the boys recommended for SED placement were accurately identified; correct classification was maximized when parent and teacher checklists were employed together.
Journal of Abnormal Child Psychology 07/1986; 14(2):251-62. · 3.09 Impact Factor
-
Psychiatric medicine 02/1986; 4(2):149-64.
-
[show abstract]
[hide abstract]
ABSTRACT: Children with speech and language disorders have been found to have a prevalence rate of psychiatric disorder of 50%. The authors sought to develop an efficient screening procedure to distinguish such children who have psychiatric disorder and those who do not. Cutoff scores for easily administered parent and teacher behavior rating questionnaires were investigated in a population of 256 children with speech and language disorders and known presence or absence of psychiatric disorder. It was learned that when the questionnaires are used together, a cutoff score of 31 or greater on either questionnaires are used together, a cutoff score of 31 or greater on either questionnaire has a positive predictive value of 74.1% and a negative predictive value of 76.1%. This screening method shows promise in assisting speech pathologists in comprehensive evaluation and treatment planning for children with speech and language disorders.
Journal of Abnormal Child Psychology 04/1982; 10(1):25-32. · 3.09 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The behavioral symptoms of a population of children with speech and language disorders (with a mean age of approximately 6 years) were studied with a teacher and a parent questionnaire. A factor analysis produced similar factors for both questionnaires: Hyperactivity-Conduct, Affect, and Language. An Asocial factor was also found with the teacher questionnaire. The factors of this study were in good agreement with the general factors of "Aggression" and "Withdrawal" found in other quantitative studies. Mean factor score profiles were reported for this unique population of children.
Journal of Abnormal Child Psychology 10/1980; 8(3):323-38. · 3.09 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Forty-six children with pure speech disorders and 53 children with disorders of both speech and language were rated by parents and teachers for behavioral problems. Both parents and teachers rated the speech- and language-disordered children as having more severe and more frequent behavioral abnormalities, particularly hyperactive behaviors and developmental problems. Somatic complaints were more pronounced in the pure speech group. Conduct disorders, emotional problems, and poor relationships did not distinguish between the two groups. The importance of these findings for speech therapists and individuals working with speech- or language-impaired children is discussed.
Journal of Abnormal Child Psychology 07/1980; 8(2):245-56. · 3.09 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: One hundred children (mean age, 5 to 6 years) who were seen consecutively at a suburban speech and hearing clinic were systematically evaluated for speech and language disorders and psychiatric disorders. Fifty-three were found to have a psychiatric illness. The three groups were compared with the psychiatrically well group to ascertain factors associated with the presence of a psychiatric disorder. Significantly differentiating the ill group were more academic and classroom behavior problems and the presence of both speech and language problems. The two groups were not significantly different in intellectual retardation, hearing impairment, medical factors, nonlanguage development disorders, and a variety of family and demographic factors. Common in both groups were psychiatric illness in parents and first-degree relatives. The data indicate that children with speech and langauge disorders are highly at risk for the development of significant psychiatric problems, which suggests the need for proper screening and multimodal treatment planning.
Archives of General Psychiatry 05/1980; 37(4):423-6. · 12.02 Impact Factor
