The aim of this study was to investigate the relationship between callous-unemotional (CU) traits and response to rewards and discipline in adolescent boys using a mixed methods approach. Participants comprised 39 boys aged between 12 and 13 years and eight teachers. Quantitative findings showed that CU traits were significantly related to punishment insensitivity, controlling for conduct problems, autism symptoms and hyperactivity. In contrast, there was no significant association between CU traits and reward sensitivity. Qualitative analysis indicated that teachers view children high in CU traits as responsive to fewer reward and discipline strategies, and strategies need to be implemented and monitored with care to avoid unintended, undesirable outcomes. However, time-out, praise, support from other staff and maintaining a positive teacher-child relationship were identified as effective strategies. Findings emphasise the need to carefully select, modify and implement existing evidence-based classroom behaviour management strategies with high CU children.

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The paper describes the therapeutic programme of the Young People's Unit, Macclesfield. Admission is based on a therapeutic contract agreed with the youngster and family. Data on the first 150 admission to the Unit are presented. The information was collected from all referring agencies and a sample of youngsters and parents after an average period of two years since discharge. Results were similar to those of other follow-up studies of discharges from adolescent units, i.e. 78 per cent of neurotic disorders, 53 per cent of mixed neurotic and conduct disorders and 47 per cent of conduct disorders showed improvement. There was a high incidence of recurrence of the most significant presenting symptom (72 per cent). Nevertheless, referrers and youngsters showed a positive attitude to the treatment experience. The possible relationship of this to the contract system is discussed. A longer period of stay was found to correlate positively with improvement in conduct disorders. There is a need for further research into what aspects of a treatment milieu produce significant and lasting changes in conduct disorders.

An earlier paper described how the problem behaviours of adolescents who had experienced treatment at the Young People's Unit, Macclesfield changed. This paper describes the components of that experience, the clients' and referrers' evaluation of those components and their attitudes to the treatment received. The study occurred after an average post‐discharge period of two years. A factor analysis produced two main clusters of attitudes relating to “personal growth” and “valuing of the unit experience”. Youngsters with positive attitudes towards the experience had significantly better outcomes. This finding is compared with a study of approved school boys. It is suggested that the components of the Young Peoples' Unit may be more suited to the maturational tasks of adolescence. The findings refute the justification that residential units have helped personal growth despite the continuation of problem behaviour. The study has implications for Health Service planning for disturbed adolescents and for community agencies' attitudes to the use of residential treatment.

Most stimulants used to treat attention‐deficit/hyperactivity disorder are administered in the morning and absorbed in the upper gastrointestinal tract. DR/ER‐MPH (formerly HLD200), an evening‐dosed delayed‐release and extended‐release methylphenidate, is predicted to be absorbed in the proximal colon. The pharmacokinetic (PK) profile of DR/ER‐MPH is characterized by an 8‐ to 10‐hour delay in initial methylphenidate absorption and a subsequent gradual increase in plasma concentration, followed by a slow decline. To examine the relationship of absorption site to pharmacokinetics, the DR/ER‐MPH formulation was altered to release methylphenidate in the small intestine and distal colon. The 3 formulations were administered in an open‐label, 3‐way, crossover study in healthy adults (N = 18). Compared with the small intestine formulation, the PK profile of the proximal colon (DR/ER‐MPH) formulation exhibited a longer delay before initial methylphenidate absorption, decreased peak methylphenidate concentration, increased time to peak concentration, and decreased bioavailability; these characteristics were amplified in the distal colon formulation. Safety profiles fell within the expectations for methylphenidate products. Modeled PK profiles were similar between the small intestine formulation and a morning‐dosed extended‐release methylphenidate (both predicted to release methylphenidate in the upper gastrointestinal tract), providing additional evidence that the PK profile of DR/ER‐MPH is shaped by colonic absorption.