William J. Burns

Cocaine use in pregnancy.

With the increasing use of cocaine in the United States, there has been growing concern regarding its effects on the fetuses and neonates of pregnant cocaine abusers. Twenty-three cocaine-using women enrolled in a comprehensive perinatal-addiction program were divided into two groups: those using cocaine only and those using cocaine plus narcotics. These two groups were compared with a group of women who had used narcotics in the past and were maintained on methadone during pregnancy, and with a group of drug-free women. All four groups were similar in maternal age, socioeconomic status, number of pregnancies, and cigarette, marijuana, and alcohol use. Their medical histories indicated that the cocaine-using women had a significantly higher rate of spontaneous abortion than the women in the other two groups. In the pregnancies under study, four cocaine-using women had onset of labor with abruptio placentae immediately after intravenous self-injection of cocaine. Neonatal gestational age, birth weight, length, and head circumference were not affected by cocaine use. However, the Brazelton Neonatal Behavioral Assessment Scale revealed that infants exposed to cocaine had significant depression of interactive behavior and a poor organizational response to environmental stimuli (state organization). These preliminary observations suggest that cocaine influences the outcome of pregnancy as well as the neurologic behavior of the newborn, but a full assessment will require a larger number of pregnancies and longer follow-up.

The early relationship of drug abusing mothers and their infants: an assessment at eight to twelve months of age.

Ten mother-infant dyads in which the mother abused drugs during pregnancy were compared to 10 matched drug-free dyads using a short form of the Parent-Child Early Relational Assessment to analyze videotaped mother-infant interactions. Interactions consisted of two five-minute segments: structured and unstructured play. Infants were 8-12 months of age. There was a consistent tendency for the drug abusing group mean scores to separate from the controls. Drug abusing dyads had significantly more (r = .71, Fishers Exact Probability) ratings below 3.0 in the unstructured play situation for items that measured enthusiasm, responsivity to infant cues, and infant happiness. These categories provide preliminary evidence for those characteristics which may be most problematic in the relationship between drug abusing mothers and their infants, especially in situations in which mother is responsible for providing structure.

Dyadic disturbances in cocaine-abusing mothers and their infants

A recently developed instrument for the quantification of mother-infant interaction, the Parent-Child Early Relationship Assessment (PCERA), was used to observe drug-abusing mothers and their infants. Compared to the standardization sample used in the development of the PCERA, these drug-abusing mothers (N = 5) showed a tendency toward rigidity and overcontrol in their parenting, a lack of enjoyment and pleasure in relating to their infants, and limited emotional involvement and responsivity in their interaction. An analysis of the dyadic behaviors showed an overall reduction in reciprocity, mutual enjoyment, and regulation of interaction between mother and infant.

NEUROCOGNITIVE DIFFERENTIAL DIAGNOSIS OF DEMENTING DISEASES: ALZHEIMER'S DEMENTIA, VASCULAR DEMENTIA, FRONTOTEMPORAL DEMENTIA, AND MAJOR DEPRESSIVE DISORDER

Similarities in presentation of Dementia of Alzheimers Type, Vascular Dementia, Frontotemporal Dementia, and Major Depressive Disorder, pose differential diagnosis challenges. The current study identifies specific neuropsychological patterns of scores for Dementia of Alzheimers Type, Vascular Dementia, Frontotemporal Dementia, and Major Depressive Disorder. Neuropsychological domains directly assessed in the study included: immediate memory, delayed memory, confrontational naming, verbal fluency, attention, concentration, and executive functioning. The results reveal specific neuropsychological comparative profiles for Dementia of Alzheimers Type, Vascular Dementia, Frontotemporal Dementia, and Major Depressive Disorder. The identification of these profiles will assist in the differential diagnosis of these disorders and aid in patient treatment.

Computerized Cognitive Training for Severely Emotionally Disturbed Children with ADHD.

An experiment was conducted to investigate the influence of Captains Log (a computerized cognitive-training system) on the behaviors and performance capabilities of 4 severely emotionally disturbed children with Attention Deficit Hyperactivity Disorder (ADHD), ages 7 to 11. Behavioral scales, spectral electroencephalograms, and intelligence and performance tests were assessed pre-and posttreatment. A behavioral point system and monitoring of progress on computer tasks were used throughout treatment to evaluate ongoing improvements. There were 64 training sessions administered over a 16-week period. Outcome of treatment was determined by computer advancement, changes in behavioral points, and pre-and postmeasures. Results support the expectation that children who were most successful in the training would demonstrate the highest levels of generalization of those skills that were the focus of treatnent.

Computer-Assisted Cognitive Training for ADHD: A Case Study

A computer-assisted cognitive training program was used to treat a 13-year-old Caucasian male with attention deficit hyperactivity disorder. The subject was administered a cognitive training computer program, Captains Log, for 35 sessions. Pre/post differences on the Conners Parent Rating Scale revealed a decrease on all subscales. The scores on the Conners Teacher Rating Scale were less conclusive. Electrophysiological testing on the A620 EEG/Neurofeedback revealed a reduction in EMG, theta, and beta wave amplitudes. However, the theta/beta ratio increased. A 7-month follow-up revealed that most of the acquired gains were maintained, but at a slightly lower level.

Parenting Dysfunction in Chemically Dependent Women

The destructive impact of chemical abuse by a parent on other members of the family has been well documented in the literature1,2. Because the number of infants born to chemically abusing mothers is on the increase, there is a genuine concern about the quality of parenting by these mothers. It is reasonable to assume that the ignorance, naivety or irresponsibility that was involved in their use of drugs during pregnancy would carry over into their parenting. We know how important the mother’s role is in the socioemotional development of her infant. In the early dyadic interaction of mother and infant, when the early bases of development are laid, the mother’s initiation of and response to her baby affect the likelihood of the occurance of specific infant behaviors. Newborn infants need to be carefully trained in how to interact socially. It is by first coacting with their mothers and fathers that they learn to initiate social interaction by themselves.

Phencyclidine: effects on the fetus and neonate

As phencyclidine hydrochloride (PCP) has become one of the more frequently abused drugs in the United States, there has been increasing interest in its effect on the fetus and neonate of the pregnant abuser. Two groups of women enrolled in a comprehensive perinatal addiction program were studied: 7 women abused PCP prior to and during pregnancy, and these women were compared to a group of 27 drug-free women. No differences between the two groups were seen in maternal age, gravidity, gestational age or Apgar scores. At birth, there was no difference in birth weight, length, or head circumference between the two groups of neonates. The most characteristic features of the PCP-exposed infants were the sudden outbursts of agitation and rapid changes in level of consciousness, similar to responses described in adults intoxicated with PCP. Scores on the Brazelton Neonatal Behavioral Assessment Scale revealed a significant increase in lability of states and poor consolability in PCP-exposed infants. 3-month scores on the Bayley Scales of Infant Development revealed no significant difference between the two groups of infants.

Differences in young children's IQs on the Wechsler preschool and primary scale of intelligence-revised as a function of stratification variables.

The normative sample (N = 1700) of the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R), stratified on age, gender, ethnicity, geographic region, education, and occupation of childrens parents, served as the database with which to examine the associations of demographic characteristics with Verbal Intelligence Quotients (VIQs), Performance Intelligence Quotients (PIQs), and Full Scale Intelligence Quotients (FSIQs) among young children. A 3-way multivariate analysis of variance (MANOVA) and follow-up analyses of variance (ANOVAs) found significant effects of parent education and ethnicity, but not childs gender, on IQ. A separate 2-way MANOVA and follow-up ANOVAs found significant interaction effects between region and ethnicity on IQ. Parent education showed the largest association with all 3 IQs, whereas gender and age showed the least. The meaning of the hierarchy of the stratification variable associations with IQ is discussed.

Relationship between the Millon Clinical Multiaxial Inventory-II and coolidge axis II inventory in chronically mentally ill older adults: A pilot study

The purpose of this study was to investigate the relationship between two self-report measures of personality disorders in older chronically mentally ill inpatients. A random sample of 30 chronically mentally ill (DSM-III-R schizophrenia, schizoaffective disorder, recurrent major depression) inpatients aged 55 and older completed the Millon Clinical Multiaxial Inventory-II (MCMI-II) and the Coolidge Axis II Inventory (CATI). The personality inventories were concurrently administered in counterbalanced fashion to assess concurrent validity of the CATI and MCMI in this older adult group. Data were submitted for correlational analysis. Median concurrent validity (raw score sums) between the CATI and MCMI-II for the 13 personality disorder scales was moderate (r = .55). Individual scale correlations ranged from -.13 for schizoid disorder to .88 for borderline disorder. Individual scale correlations were somewhat lower than previously reported values, but were above .54 for 7 of 13 disorders. Findings provide preliminary support for use of the CATI and MCMI with chronically mentally ill elders. Suggestions for future research are offered.