Eugene J. D'Angelo

Linkage analysis of attention deficit hyperactivity disorder

Results of behavioral genetic and molecular genetic studies have converged to suggest that both genes contribute to the development of ADHD. Although prior linkage studies have produced intriguing results, their results have been inconsistent, with no clear pattern of results emerging across studies. We genotyped 5,980 SNPs across the genome in 1,187 individuals from families with children diagnosed with ADHD. We then performed two nonparametric linkage analyses on ADHD families: (1) an affected sibling pair linkage analysis on 217 families with 601 siblings diagnosed with ADHD and (2) a variance components linkage analysis using the number of ADHD symptoms as the phenotype on 260 families with 1,100 phenotyped siblings. The affection status linkage analysis had a maximum LOD score of 1.85 on chromosome 8 at 54.2 cM. The maximum LOD score in the variance components linkage analysis was 0.8 on chromosome 8 at 93.4 cM. The absence of regions of significant or suggestive linkage in these data suggest that there are no genes of large effect contributing to the ADHD phenotype.

School functioning and disease severity in boys with hemophilia.

There have been few recent studies investigating the scholastic progress of children with hemophilia. The advent of PL94–142, which ensures an appropriate educational program based on a childs specific learning disabilities, and home Factor VIII therapy, which increases the hemophiliacs school attendance and sense of freedom and control, might have had a positive impact on the academic performance of these patients. We investigated past and current educational functioning of 26 boys with hemophilia, using both parental and teacher reports. Twenty-two of these children were administered reading and math achievement tests. Results indicate that school absenteeism is a continuing problem for these children, with the average hemophiliac missing 18 school days in an academic year (median = 11 school days missed); one child had missed 77% of the year. Although these boys had normal intelligence and made average grades in school, six of the 22 tested performed more than two grade levels below expectations in reading and 10 performed greater than two grade levels below expectations in math. School underachievement did not necessarily correlate with disease severity (as indicated by serum factor level), school absenteeism, or grade point average. Although eight parents indicated that their children had past or current school problems, and teachers reported that greater than 50% of the group received special tutoring or classes for learning disabled students, six out of 22 (27%) performed below expectations in either math or reading and yet had no current individual educational remediation plan. We recommend physicians collaborate with social workers, psychologists, educators, and other members of a multidisciplinary team to ensure this high-risk group of children receives anticipatory assessment of their educational progress and, whenever necessary, implementation of appropriate remedial services.

CULTURALLY SENSITIVE GUIDED IMAGERY FOR ALLOCENTRIC LATINOS: A PILOT STUDY

The Culturally Competent Relaxation Intervention (CCRI) was developed and assessed with 25 Latino adults. In contrast to traditional psychotherapeutic and relaxation interventions, which are highly influenced by individualistic/idiocentric (the tendency to define oneself in isolation from others) assumptions, the CCRI was designed according to an allocentric self-orientation (the tendency to define oneself in relationship with others), which is prevalent among Latinos. This pilot study found preliminary evidence suggesting that participants who were more allocentric had higher levels of treatment adherence and, contrary to what was expected, idiocentric levels were not inversely related with treatment adherence. In addition, as hypothesized, it was found that higher levels of treatment adherence were related to reductions of anxiety symptoms. These findings are consistent with the predictions of the cultural match theory, which proposes that patients adhere and benefit more from interventions that fit their own cultural characteristics. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Pediatric compliance and the roles of distinct treatment characteristics, treatment attitudes, and family stress : a preliminary report

Much research and clinical practice derives from the assumption that there is a set of psychological-social variables that commonly influence medical (non)compliance. This assumption may lead to overly general strategies for managing specific illnesses in children with chronic illness. With this concern in mind, a study was made of health provider ratings of compliance, treatment attitudes, and illness-related family stress for three pediatric cohorts (N = 75, ages 8 to 20 years): boys with hemophilia (n = 31), sickle cell disease (n = 22), or asthma (n = 22). Between-group differences were found on compliance and treatment attitudes (p < .05), with patients with sickle cell demonstrating greater treatment cooperation than their counterparts and boys with hemophilia expressing more positive outlooks on medical advice and about health outcomes (Newman-Keuls test, p < .05). Positive treatment attitudes were associated with specific compliance behaviors for boys with hemophilia (p < .045) but not for other groups.

Convergent and discriminant validity of the borderline syndrome index

The convergent and discriminant validity of the Borderline Syndrome Index was examined by using a multitrait-multimethod matrix 80 subjects with DSM-III—R diagnoses of Borderline Personality Disorder completed three self-report measures, namely, the Borderline Syndrome Index, the MMPI Schizophrenia subscale, and the Beck Depression Inventory. A semistructured interview was blindly conducted with each subject, and symptom ratings were made on the Diagnostic Interview for Borderlines, New Haven Schizophrenia Index, and Hamilton Rating Scale for Depression. High convergent validity was found on the Borderline Index and the Diagnostic Interview for Borderlines. While fulfilling most of the criteria for discriminant validity, the Borderline Syndrome Index scores were also significantly correlated with depression scores on the Beck and Hamilton measures of depression.

Early auditory processing evoked potentials (N100) show a continuum of blunting from clinical high risk to psychosis in a pediatric sample

BACKGROUND The N100 is a negative deflection in the surface EEG approximately 100 ms after an auditory signal. It has been shown to be reduced in individuals with schizophrenia and those at clinical high risk (CHR). N100 blunting may index neural network dysfunction underlying psychotic symptoms. This phenomenon has received little attention in pediatric populations. METHOD This cross-sectional study compared the N100 response measured via the average EEG response at the left medial frontal position FC1 to 150 sinusoidal tones in participants ages 5 to 17 years with a CHR syndrome (n=29), a psychotic disorder (n=22), or healthy controls (n=17). RESULTS Linear regression analyses that considered potential covariates (age, gender, handedness, family mental health history, medication usage) revealed decreasing N100 amplitude with increasing severity of psychotic symptomatology from healthy to CHR to psychotic level. CONCLUSIONS Longitudinal assessment of the N100 in CHR children who do and do not develop psychosis will inform whether it predicts transition to psychosis and if its response to treatment predicts symptom change.

Developmentally Informed Evaluation of Depression: Evidence-Based Instruments

This article has two primary aims: (1) to describe how to incorporate evidence-based assessment procedures into diagnostic practice and (2) to present a review of the more commonly used interview methods and clinical measures of depression among preschoolers, school-age children, and adolescents.

Overlapping 16p13.11 deletion and gain of copies variations associated with childhood onset psychosis include genes with mechanistic implications for autism associated pathways: Two case reports.

Copy number variability at 16p13.11 has been associated with intellectual disability, autism, schizophrenia, epilepsy, and attention‐deficit hyperactivity disorder. Adolescent/adult‐ onset psychosis has been reported in a subset of these cases. Here, we report on two children with CNVs in 16p13.11 that developed psychosis before the age of 7. The genotype and neuropsychiatric abnormalities of these patients highlight several overlapping genes that have possible mechanistic relevance to pathways previously implicated in Autism Spectrum Disorders, including the mTOR signaling and the ubiquitin‐proteasome cascades. A careful screening of the 16p13.11 region is warranted in patients with childhood onset psychosis.

A content analyses of guided imagery scripts: a strategy for the development of cultural adaptations

This paper proposes a first step in deciding whether it is necessary to develop a cultural adaptation by comparing the cultural characteristics of an intervention with the same characteristics of a specific group. Larger cultural differences suggest a greater need to conduct a cultural adaptation. This recommendation stems from the cultural match theory (CMT) which, explains that therapeutic outcomes increase as interventions are more similar to the cultural characteristics of specific treatment groups. However, the CMT has rarely been tested, partly because strategies to effectively measure the cultural characteristics of an intervention are still lacking. This article addresses this gap by assessing two dimensions of the self-orientation relevant to cultural adaptations, namely, idiocentrism--the tendency to define oneself in isolation from others--and allocentrism--the tendency to define oneself in relationship to others--through a content analysis of guided imagery scripts. Two independent evaluators analyzed 123 guided imagery scripts (published during 1989-2008) using 6 theoretically derived categories to analyze idiocentrism versus allocentrism. Results indicated that idiocentric elements were 1.5 to 52.3 times more frequently used than were allocentric ones. The implications of these findings for the development of culturally adapted interventions are discussed.

Suicidal behaviors in children and adolescents with psychotic disorders

Suicide is the leading cause of premature death in individuals with psychotic disorders. Risk for onset of suicidal behaviors tends to begin in adolescence, remaining high into young adulthood. The present study aims to evaluate the interplay of early onset psychosis and suicide risk by examining suicidal behaviors (ideation, planning, and attempts) in children and adolescents with psychotic disorders (PD) compared to typically developing peers (TD). Twenty five youths were recruited and were diagnostically evaluated for psychosis. We found that the PD children exhibited significantly higher levels of suicidal behaviors than TD children, even when parsed into individual at-risk behaviors.