Hyperactive behavior and minor physical anomalies

Evaluation of social cognition, autistic traits, and dysmorphology in comorbid specific learning disorder and attention-deficit/hyperactivity disorder

Research on areas such as social cognition, autistic traits, and minor physical anomalies in comorbid Specific Learning Disorder (SLD) and attention-deficit/hyperactivity disorder (ADHD) is limited. In this study, we compared these areas in children aged between 8 and 14 with comorbid SLD and ADHD and their typically developed peers. Emotion recognition and social cognition were evaluated by Faces Test, Reading the Mind in the Eyes Test, Comprehension Test, and Difficulties in Emotion Regulation Scale. Autism Spectrum Screening Questionnaire and Social Responsiveness Scale were used for screening of autism spectrum disorder in children. Furthermore, autistic traits in parents were measured by Autism-Spectrum Quotient. The MPAs of all the subjects were determined by pediatric geneticists. We detected that children with comorbid SLD and ADHD performed worse than controls in all social cognition tests and maternal AQ score had a strong correlation with the Faces Test, DERS, and SRS scores. Also, the total ASSQ score in the comorbid SLD and ADHD group was significantly higher than controls. Finally, MPAs were significantly more frequent in the comorbid SLD and ADHD group. Impairment in social cognition and evaluation of autistic traits and dysmorphology in children with comorbid SLD and ADHD may provide useful information on neurodevelopmental disorders.

The neuropsychology of conduct disorder

This article reviews evidence from neuropsychological tests that brain dysfunction is a correlate of conduct disorder. Most studies report consistent findings of differential neuropsychological deficits for antisocial samples in verbal and “executive” functions. Neuropsychological measures are related to some of the best indicators of poor outcome for children with conduct symptoms, such as early onset, stability across time, hyperactive symptoms, and aggressiveness. Neuropsychological tests statistically predict variance in antisocial behavior independently of appropriate control variables. This article argues that neuropsychological variables warrant further study as possible causal factors for conduct disorder and presents one developmental perspective on how neuropsychological problems might contribute risk for conduct disorder.

A novel scale including strabismus and 'cuspidal ear' for distinguishing schizophrenia patients from controls using minor physical anomalies

The present study explored minor physical anomaly items relevant to schizophrenia in order to establish a scale that can distinguish schizophrenia from controls using newly identified items along with items from the refined Waldrop scale. Seven items were significantly more frequent among schizophrenia patients (N=218) than controls (N=226). Among these seven items, two novel features, strabismus and 'cuspidal ear' showed markedly different prevalence rates between schizophrenia and control groups. A six-item scale, including the newly identified strabismus and cuspidal ear, was selected for most accurately discriminating patients with schizophrenia from controls. This scale correctly classified 59.6% of patients and 78.9% of control subjects. This new scale is procedurally more exacting and quantitative, and more relevant to schizophrenia than the original Waldrop scale. The validity of this scale should be sound since it was tested on a larger number of cohorts than used in previous research. Our scale can be used as a biomarker for predicting risk for future development of schizophrenia. The scale may also facilitate the identification of schizophrenia susceptibility genetic/environmental factors by stratifying etiologically heterogeneous patients according to physical abnormalities.

Normal values for morphological abnormalities in school children

Clinical morphology has proven to be a strong tool in the delineation of many syndromes and a helpful instrument in molecular studies. Numerous studies have been performed investigating the prevalence of minor anomalies in various disorders; all concluding that minor anomalies can well be utilized as indicators of altered embryonic differentiation. However, for adequate evaluation, normal values for phenotypic abnormalities are essential. So far, only few studies on the frequency of phenotypic abnormalities in the normal population have been done having one thing in common: all were performed in newborn infants. We studied morphological characteristics in a group of 1,007 school children, representative for the Dutch population, through a body surface examination using detailed definitions for all morphological findings. The region of study and distribution of children over various school types was chosen in such a way that it represented the general Dutch population. The median age of the studied children was 11 years (range 8-14 years), sex ratio (M:F) was 0.93. Nine hundred twenty-three children were of Caucasian descent, 84 others of mixed ethnic backgrounds. The reliability of the examinations was tested by independent scoring of 111 children by two observers, showing a kappa score of 0.85. Normal values for the morphological findings are presented together with their age-adjusted classification. These normal values provide a valuable source for validation of classifications of phenotypic abnormalities, especially those that are depending on frequency, that is, minor anomalies and common variants. Furthermore, they will allow a proper evaluation of patterns of phenotypic abnormalities found in patient groups with specific disorders.

Hair whorl patterns on the bovine forehead may be related to breeding soundness measures

The objective of this study was to determine if there is an association between facial hair whorl patterns on the bovine forehead and sperm morphology. Breeding soundness exams were conducted on 219 yearling bulls at three Colorado State University facilities. There were 150 Angus bulls and the remaining bulls were of several different breeds. Hair whorl patterns on the forehead were classified as round or nonround epicenters. Angus bulls with round epicenters had a higher percentage of morphologically normal spermatozoa compared to nonround epicenters (P < 0.05). Hair whorls on Angus bulls were sorted into two extreme groups of round spirals, with rotation or long lines that were longer than the width of the eyes. Bulls with round spirals had a greater percentage of normal spermatozoa compared to bulls with long lines (P < 0.05). Hair whorl pattern on Angus bulls also had an effect on the percentage of bulls that had the minimum threshold value of 70% normal spermatozoa. Eighty percent of Angus bulls with round epicenters had > 70% or more normal spermatozoa compared to 59% with a nonround epicenter (P < 0.01). Fifty percent of Angus bulls with long lines failed because they had < 70% normal spermatozoa. There were no significant differences in the remaining non-Angus bulls. Hair whorl patterns may be useful for making early culling decisions.

Minor physical anomalies: modifiers of environmental risks for psychiatric impairment?

OBJECTIVE

To test the hypothesis that minor physical anomalies (MPAs) modify an adolescent's vulnerability to environmental risk factors for psychopathology.

METHOD

One hundred eighteen unreferred male adolescents who had been evaluated as 7-year-olds received a comprehensive neuropsychiatric evaluation. The evaluation included standardized assessments of environmental risk factors for psychiatric impairment, neurological signs, IQ, MPAs, and psychiatric impairment. The relationship between psychiatric status and environmental risk was examined as a function of the MPA profile.

RESULTS

There was a significant interaction between MPAs and environmental risk in predicting psychiatric status. Environmental risk was more predictive of psychiatric impairment at age 17 in subjects with high scores on the MPA scale than in subjects with low scores on the scale. This relationship was particularly apparent in subjects with conduct disorder. MPAs also exhibited relationships with two childhood factors, neurological soft signs and Verbal IQ, that had been shown to predict adolescent psychopathology in prior reports on this cohort.

CONCLUSIONS

MPAs may contribute to psychiatric impairment by influencing an individual's vulnerability to environmental risk factors for psychopathology. These suggestive findings are consistent with an emerging body of literature examining the role of biopsychosocial interactions in psychiatric disorders.

NIMH collaborative multisite multimodal treatment study of children with ADHD: I. Background and rationale

OBJECTIVE

The National Institute of Mental Health's recently initiated 5-year, multisite, multimodal treatment study of children with attention-deficit hyperactivity disorder (MTA) is the first major clinical trial in its history focused on a childhood mental disorder. This article reviews the major scientific and clinical bases for initiating the MTA.

METHOD

A selective review of the literature is presented in the service of describing the estimated prevalence of ADHD among children and adolescents, its core clinical features, evidence concerning psychopharmacological and psychosocial treatment effects, and related research issues and trends leading to the development of the MTA.

RESULTS

Despite decades of treatment research and clinical practice, there is an insufficient basis for answering the following manifold question: under what circumstances and with what child characteristics (comorbid conditions, gender, family history, home environment, age, nutritional/metabolic status, etc.) do which treatments or combinations of treatment (stimulants, behavior therapy, parent training, school-based intervention) have what impacts (improvement, stasis, deterioration) on what domains of child functioning (cognitive, academic, behavioral, neurophysiological, neuropsychological, peer relations, family relations), for how long (short versus long term), to what extent (effect sizes, normal versus pathological range), and why (processes underlying change)?

CONCLUSIONS

The important scientific, clinical, and public health issues nested within this manifold question provide both the impetus and scaffolding for the MTA.

Minor physical anomalies and recidivistic adult violent criminal behavior

Minor physical anomalies (MPA) result from disruptions of gestation, and may be used as signs of central nervous system defects in development. Utilizing a Danish birth cohort, we tested the hypothesis that MPA predict adolescent and adult recidivistic violent criminal behavior. The number of MPA was measured at 11 to 13 years of age and police records of criminal behavior were ascertained at 20 to 22 years of age. Recidivistic violent offenders evidenced an elevated level of MPA compared with subjects with one violent offense or subjects with no violent offenses.

A prospective study of psychosocial background factors associated with congenital malformations

Women's life situation and experiences during pregnancy were prospectively studied in relationship to the development of congenital malformations (CMs) in their offspring, within samples of 84 offspring of pregnant index women with a history of nonorganic psychosis and 100 offspring of pregnant control women. Within both samples, offspring CMs were related to more problematic maternal life situations during pregnancy, the common denominator in these problems across samples being difficulties associated with the husband. Little relationship was found between CMs and the woman's own attitude toward the pregnancy or her mental condition during pregnancy. In both groups, total life situational problems and distress were more strongly related to the development of very minor CMs (termed "variants") than to the major, classical CMs.