No abstract

Objective:To determine response of low-IQ children with attention deficit hyperactivity disorder (ADHD) symptoms to methylphenidate (MPH). Methods:An aggregated analysis was conducted in 90 children with low IQ who received the same dose regimen of MPH in three independent, placebo-controlled studies. Active drug and placebo were given from 2 to 4 weeks each. Outcome measures included teacher and parent ratings on standardized behavior scales (mean n = 84), performance on computer-controlled cognitive-motor tests (n = 62), and measures of cardiovascular response (n = 85). Results:Both teachers and parents rated the children consistently as being improved on subscales assessing attention, overactivity, and conduct problems. Some 44% of the subjects showed at least a 30% reduction compared with placebo on teacher ratings. MPH improved accuracy on several cognitive tests, response speed was increased on some, and seat activity declined for one of three tests; heart rate was mildly increased (3.9 beats/minute) with MPH. Analyses of IQ and mental age as moderator variables suggested that lower functional level (especially lower IQ) may be associated with a less favorable response to MPH. Conclusions:Children with low IQ and ADHD clearly respond to MPH, but their rate of beneficial response appears to be well under that of normal-IQ children and more varied. Different attentional mechanisms may moderate response to psychostimulants.

Previous research has shown that burnout in staE members at psychiatric hospitals is significantly associated with state anxiety and collegial support. The directionality of these relationships may be inferred using a cross-lagged panel design. To do this, 35 staffmembers representing various clinical disciplines completed measures of burnout, support, and anxiety twice, eight months apart. Burnout comprised three factors: emotional exhaustion, depersonalization, and personal accomplishment. Findings from one cross-lagged panel suggested that emotional exhaustion c a m state. anxiety. The second panel showed that lack of collegial support caused depersonalization. Understanding causes and effects of burnout for inpatient psychiatric staff may lead to training and resource development that will improve the quality of their work environment.

The Nisonger Child Behavior Rating Form (NCBRF) has been used in several large studies of risperidone in children with low IQs (36-84) and disruptive behavior disorders (conduct disorder and oppositional defiant disorder). We wanted to develop a companion instrument for assessing 'typically developing' children and adolescents. In this study, we modified the NCBRF and obtained parent ratings on 485 typically developing children attending regular classes. We also obtained parent ratings on 46 children with conduct disorder and oppositional defiant disorder. Factor analyses of the ratings produced a single Positive Social subscale (10 items) and six Problem Behavior subscales (54 items): (i) Conduct Problems, (ii) Oppositional, (iii) Hyperactive, (iv) Inattentive, (v) Withdrawn/Dysphoric, and (vi) Overly Sensitive. Comparison of the school and disruptive behavior disorder groups showed large and significant differences, providing evidence of criterion validity for the Conduct Problem and Oppositional subscales, and on a Disruptive Total composite. Analysis for age and sex effects showed no main effects and no interaction of age and sex. Norms were presented. The factor structure of problem behavior tends to differ in significant ways between typically developing children and children having developmental disabilities. Like its predecessor, the NCBRF-TIQ (for typical IQ) is in the public domain and is available free to researchers and clinicians for assessment and treatment.

No abstract