Anne M. Schell

A prospective study of hyperactive boys with conduct problems and normal boys: adolescent and adult criminality.

OBJECTIVE To examine the relationship between attention deficit disorder with hyperactivity in childhood and criminality in adolescence and adulthood in 89 hyperactive and 87 normal control subjects. METHOD In this prospective study, adolescent follow-up intervals ranged from 13 to 21 years and adult follow-up ranged from 18 to 23 years. The official arrest records for all subjects were obtained. RESULTS Hyperactive subjects had significantly higher juvenile (46% versus 11%) and adult (21% versus 1%) arrest rates. Juvenile and adult incarceration rates were also significantly higher. Childhood conduct problems predicted later criminality, and serious antisocial behavior in adolescence predicted adult criminality. CONCLUSIONS Hyperactive children are at risk for both juvenile and adult criminality. The risk for becoming an adult offender is associated with conduct problems in childhood and serious antisocial behavior (repeat offending) in adolescence. Hyperactive children who do not have conduct problems are not at increased risk for later criminality.

The psychological significance of human startle eyeblink modification: a review.

The human startle eyeblink reflex is reliably modified by both cognitive and emotional processes. This review provides a comprehensive survey of the current literature on human startle modification and its psychological significance. Issues raised for short lead interval startle inhibition include its interpretation as a measure of protection of processing, sensorimotor gating and early attentional processing. For long lead interval effects, interpretations related to attentional and emotional processing are discussed. Also reviewed are clinical applications to information processing dysfunctions in the schizophrenia spectrum disorders, and to emotional processing disorders. Finally, an integrative summary that incorporates most of the cognitive findings is presented and directions for future research are identified regarding both cognitive and emotional modification of startle.

Modification of the acoustic startle-reflex eyeblink: A tool for investigating early and late attentional processes

The present experiment examined the sensitivity of short and long lead interval startle eyeblink modification to attentional processing. Eighteen college student subjects were presented with a series of intermixed high and low pitched tones and instructed to attend to tones of one pitch and to ignore tones of the other pitch. The majority of the attended and ignored tones served as prepulses for an eyeblink-eliciting burst of white noise presented at lead intervals of 60, 120, 240 and 2000 ms following prepulse onset. Results indicate that both attended and ignored prepulses produce significant startle eyeblink modification: significant blink inhibition at the 60, 120 and 240 ms short lead intervals, and blink facilitation at the 2000 ms long lead interval. In addition, compared with the ignored prepulse, the attended prepulse produced significantly greater blink inhibition at the 120 ms lead interval as well as significantly greater blink facilitation at the 2000 ms lead interval. These results suggest that both short and long lead interval startle eyeblink modification measures may be useful tools for future investigations of the early and later stages of attentional processing.

Attention and schizophrenia: Impaired modulation of the startle reflex.

The startle reflex (SR) elicited by abrupt stimuli can be modified by attention to nonstartling stimuli that shortly precede the startle-eliciting stimulus. The present study of 15 recent-onset, relatively asymptomatic schizophrenic outpatients and 14 demographically matched normal control subjects demonstrated that attentional modulation of SR is impaired in schizophrenic patients. Specifically, the control group exhibited greater startle eye-blink modification following to-be-attended prestimuli than following to-be-ignored prestimuli, whereas the patients failed to show the attentional modulation effect. These results suggest traitlike attentional deficits in schizophrenia because the patients were relatively asymptomatic. The measurement of attentional modulation of SR may provide a nonverbal, reflexive, state-independent marker of the vulnerability to schizophrenia.

Therapeutic Interventions to Prevent Delinquency in Hyperactive Boys

Abstract Results of two prospective longitudinal studies of predelinquent hyperactive boys are presented. The first was a study of 80 Caucasian hyperactive boys treated with stimulant medication and the second a study of 50 Caucasian hyperactive boys treated with multimodality treatment (MMT). The two groups were well matched on before-treatment variables. Official teenage arrest and institutional rates were found to be significantly lower in the multimodality treated group. These findings demonstrate the importance of long-term evaluations in treatment studies of chronic handicapping childhood disorders and suggest that MMT in childhood is a cost-effective treatment approach for delinquency prevention in hyperactive boys.

On the clinical and cognitive meaning of impaired sensorimotor gating in schizophrenia.

Schizophrenia patients have been shown to have a defective sensorimotor gating process as indexed by impaired prepulse inhibition of the startle eyeblink reflex. Moreover, we have previously reported that schizophrenia patients have dysfunctional attentional modulation of prepulse inhibition. The present experiment combined our previous sample of 14 schizophrenia outpatients and 12 demographically matched control subjects with a new sample of 10 outpatients and 6 control subjects. All participants performed a tone-length judgement task that involved attending to one pitch of tone (the attended prepulse) and ignoring another pitch of tone (the ignored prepulse). During this task the acoustic startle eyeblink reflex was electromyographically recorded from the orbicularis oculi muscle. The results replicated the finding of impaired attentional modulation of prepulse inhibition in the new sample of schizophrenia outpatients compared to demographically matched control subjects. Specifically, the new control group exhibited greater startle modification during the attended prepulse, whereas the new patient group failed to show this differential effect. In addition, impaired prepulse inhibition following the attended prepulse was significantly correlated with heightened delusions, conceptual disorganization, and suspiciousness as measured with the expanded Brief Psychiatric Rating Scale. These correlations were significant with prepulse inhibition to the attended prepulse but not with prepulse inhibition to the ignored prepulse. Impaired prepulse inhibition was not correlated with negative symptoms. All in all, the results support the hypothesis that impaired attentional modulation of startle prepulse inhibition reflects basic neurocognitive processes related to thought disorder in schizophrenia.

Modification of the Startle Reflex in a Community Sample: Do One or Two Dimensions of Psychopathy Underlie Emotional Processing?

Recent research on psychopathy has begun to explore two dimensions that possibly underlie psychopathy–one related more to emotional and interpersonal traits, and another related more to antisocial behaviors. A community sample of adults was assessed for psychopathy using Hares (1991) Psychopathy Checklist-Revised (PCL-R). Eyeblinks elicited by startle probes were recorded while participants viewed pictures of emotionally-laden stimuli. Consistent with previous research, participants scoring high on PCL-R Factor 2 (“antisocial”) showed no affective modification of startle if they also scored high on PCL-R Factor 1 (“emotional detachment”). When the factor scores were analyzed together as continuous variables in a regression analysis, however, affective modification of startle was negatively related to Factor 1 but positively related to Factor 2. The results thus provide further support for a two-factor model of psychopathy.Emotion

Attentional modulation of short- and long-lead-interval modification of the acoustic startle eyeblink response: comparing auditory and visual prestimuli.

Studies in our laboratory have shown that modification of startle by lead stimuli with short- and long-lead-intervals is modulated by stimulus significance. The significant stimulus in a tone duration judgement task generates enhanced short-lead-interval startle inhibition as well as pronounced long-lead-interval startle facilitation. The present study was designed to compare tones with simple visual stimuli as lead stimuli in a counterbalanced within-subjects design (Experiment I) or between-subjects design (Experiment II). The results show that auditory compared to visual lead stimuli generate more short-lead-interval inhibition but comparable amounts of long-lead-interval startle facilitation, which was significantly enhanced on to-be-attended trials independent of sensory modality. The attentional manipulation did not yield short-lead-interval effects in Experiment I, but previously reported attention effects were replicated in Experiment II. The results suggest early modality effects on startle modification, reflected by the differing levels of inhibition. Late effects of both modality and attention, however, seem to reflect a sensory modality independent process in startle modification.

Prepulse Facilitation and Prepulse Inhibition in Schizophrenia Patients and Their Unaffected Siblings

BACKGROUND Deficits in schizophrenia patients and their first-degree relatives have been reported in prepulse inhibition (PPI), a phenomenon that measures an early stage of information processing (sensorimotor gating). It is less clear whether these information processing deficits extend to prepulse facilitation (PPF), which measures a later stage of generalized alerting or orienting. METHODS This study examined three separate issues: first, whether schizophrenia patients have deficits in PPI and PPF; second, whether the siblings of patients show deficits in these processes; and third, whether prepulse duration influences the degree of the deficits. These issues were examined in 76 schizophrenia patients, 36 of their siblings, and 41 normal control subjects. RESULTS Patients and siblings did not differ from control subjects in PPI, perhaps due to the use of different procedural parameters compared with other laboratories that have consistently found PPI deficits in schizophrenia patients. Patients and their siblings produced significantly less PPF than control subjects. For both PPI and PPF, prepulse duration was not a significant factor. CONCLUSIONS These results imply that PPF deficits reveal a generalized alerting or orienting deficit that is present in both schizophrenia patients and their siblings, suggesting that this deficit may be tapping an endophenotypic vulnerability factor.

Automatic and controlled attentional processes in startle eyeblink modification: effects of habituation of the prepulse.

The effect of prehabituation of the prepulse on startle eyeblink modification was studied in two experiments. In Experiment 1, college student participants were either prehabituated or nonhabituated to a tone that served as a prepulse in a startle modification passive attention paradigm. Neither short lead interval (60 and 120 ms) prepulse inhibition (PPI) nor long lead interval (2,000 ms) prepulse facilitation (PPF) was affected by the prehabituation procedure. In Experiment 2, participants were presented with an active attention paradigm in which one of two tone prepulses was attended while the other was ignored. One group was prehabituated to the prepulses and the other was not. Unlike the results with the passive paradigm in Experiment 1, prehabituation did significantly diminish attentional modulation of PPI and PPF. These results are consistent with the hypothesis that passive PPI and PPF are primarily automatic processes, whereas attentional modulation involves controlled cognitive processing.