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Zhang W, Shen Y, Ou X, Wang H, Liu S. Sleep disordered breathing and neurobehavioral deficits in children and adolescents: a systematic review and meta-analysis. BMC Pediatr 2024; 24:70. [PMID: 38245707 PMCID: PMC10799548 DOI: 10.1186/s12887-023-04511-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 12/26/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Sleep disordered breathing (SDB) is broadly recognized to be associated with neurobehavioral deficits, which have significant impacts on developing-aged children and adolescents. Therefore, our study aimed to quantify the proportion of neurobehavioral impairments attributed to SDB in general children and adolescents by population attributable fraction (PAF). METHODS The study was registered at PROSPERO (ID: CRD42023388143). We collected two types of literature on the prevalence of SDB and the risk of SDB-related neurobehavioral deficits from ten electronic databases and registers, respectively. The pooled effect sizes (Pe, Pc, RR) by random-effects meta-analysis were separately substituted into Levin's formula and Miettinen's formula to calculate PAFs. RESULTS Three prevalence literature and 2 risk literature, all with moderate/high quality, were included in the quantitative analysis individually. The prevalence of SDB was 11% (95%CI 2%-20%) in children and adolescents (Pe), while the SDB prevalence was 25% (95%CI 7%-42%) in neurobehavioral patients (Pc). SDB diagnosis at baseline was probably associated with about threefold subsequent incidence of neurobehavioral deficits (pooled RR 3.24, 95%CI 1.25-8.41), after multi-adjustment for key confounders. Up to 19.8% or 17.3% of neurobehavioral consequences may be attributed to SDB from Levin's formula and Miettinen's formula, respectively. CONCLUSIONS A certain number of neurobehavioral consequences may be attributable to SDB. It is essential for clinicians to identify and treat SDB timely, as well as screen for SDB in patients with neurobehavioral impairments. More longitudinal studies of SDB and neurobehavioral deficits are needed in the future to further certify the association between them.
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Affiliation(s)
- Weiyu Zhang
- Department of Respiratory Medicine and Sleep Lab, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Yubin Shen
- Department of Respiratory Medicine and Sleep Lab, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Xiwen Ou
- Department of Respiratory Medicine and Sleep Lab, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Hongwei Wang
- Department of Respiratory Medicine and Sleep Lab, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Song Liu
- Department of Respiratory Medicine and Sleep Lab, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China.
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McKee LG, Yang Y, Highlander A, McCall M, Jones DJ. Conceptualizing the Role of Parent and Child Emotion Regulation in the Treatment of Early-Onset Behavior Disorders: Theory, Research, and Future Directions. Clin Child Fam Psychol Rev 2023; 26:272-301. [PMID: 36385585 DOI: 10.1007/s10567-022-00419-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 11/18/2022]
Abstract
Behavior disorders (BDs) are common and costly, making prevention and early-intervention a clinical and public health imperative. Behavioral Parent Training (BPT) is the standard of care for early-onset (3-8 years old) BDs, yet effect sizes vary and wane with time suggesting the role of underlying factors accounting for variability in outcomes. The literature on emotion regulation (ER), which has been proposed as one such underlying factor, is reviewed here, including a brief overview of ER, theory and research linking ER, externalizing symptoms, and/or BDs, and still largely preliminary work exploring the role of parent and child ER in BPT outcomes. Research to date provides clues regarding the interrelationship of ER, BDs, and BPT; yet, determining whether adaptations to BPT targeting ER are necessary or useful, for whom such adaptations would be most important, and how those adaptations would be implemented requires addressing mixed findings and methodological limitations. To guide such work, we propose a conceptual model elucidating how standard BPT may impact ER and processes linked to ER, which we believe will be useful in organizing and advancing both basic and applied research in future work.
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Affiliation(s)
- Laura G McKee
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Yexinyu Yang
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - April Highlander
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Madison McCall
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Deborah J Jones
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, 27599, USA.
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Mascherona I, Ferretti M, Soldini E, Biggiogero M, Maggioli C, Fontana PE. Essential oil therapy for the short-term treatment of behavioral and psychological symptoms of dementia: a monocentric randomized pilot study. Aging Clin Exp Res 2021; 33:2251-9. [PMID: 33184771 DOI: 10.1007/s40520-020-01754-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 10/30/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND The behavioral and psychological symptoms of dementia (BPSD) can be severely distressing for both patients and caregivers. AIMS This study assessed the efficacy of environmental diffusion essential oil therapy (EOT) combined with psychotropic drug therapy (group A) in BPSD management, compared with psychotropic drug therapy alone (group B). The stress responses of attending caregivers were also assessed. METHODS Thirty-two patients with dementia and BPSD were enrolled. The presence and severity of BPSD were assessed using the Italian version of the NPI-NH scale, which also measures the stress felt by professional caregivers. Global geriatric evaluations were performed to rule out acute diseases that could contribute to delirium and worsen patients' mental status. RESULTS Following treatment, the average NPI-NH value was significantly reduced in group A compared with group B (p < 0.001). Caregiver distress was also significantly reduced in group A (p < 0.01). DISCUSSION This pilot study showed that BPSD were better treated using EOT combined with standard pharmacological treatment, compared with standard pharmacological treatment alone. No adverse effects of EOT were observed. Reductions in caregiver distress could be due either to reductions in BPSD severity and frequency resulting in decreased caregiver burden, and/or the emotional benefit for caregivers of exposure to essential oils. CONCLUSIONS This study supports the combined use of EOT and psychotropic drugs in the treatment of BPSD. Essential oils may improve the wellbeing of both patients and caregivers, without adverse effects. Additionally, EOT is easy to administer by environmental diffusion.
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Marciano RC, Cardoso MGF, Vasconcelos MMA, Paula JJ, Oliveira EA, Lima EM. Depression, anxiety and quality of life impairment in parents of children with functional lower urinary tract dysfunction. J Pediatr Urol 2020; 16:838.e1-838.e7. [PMID: 33012646 DOI: 10.1016/j.jpurol.2020.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/20/2020] [Accepted: 09/14/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Lower urinary tract dysfunction (LUTD) is a common clinical condition in children, frequently associated with emotional issues both among the patients and their families. The objective of the present study was to measure depressive and anxious symptoms and quality of life (QoL) in parents of LUTD patients. METHODS This cross-sectional study applied Beck Depression and Anxiety Inventories and WHOQOL-Bref to 88 caregivers of children with LUTD followed at a tertiary care center. The prevalence of mental disorders in children and adolescents was assessed using the Child Behavior Check List (CBCL 6-18) answered by their caregivers. The association of clinical features and emotional aspects related to the caregivers' quality of life was evaluated through non-parametric correlation (Spearman) and multiple linear regression analysis. RESULTS Most of the caregivers were mothers (88%), with a mean age of 41.5 (SD 8.7 years), 67% of them married or in a stable union, and 38% had not completed elementary school. Considering 19 as the cutoff point for the Beck scale, 44% of the sample had a clinical score for depressive symptoms and 43% for anxious symptoms. According to the parents' report, 56% of children with LUTD had a clinical score for behavioral problems in CBCL. Parents' QoL was impaired, and the predictors of poor QoL were the age of the patients and presence of depressive/anxious symptoms in caregivers. Parents' depression/anxiety symptoms and poor QoL significantly correlated with behavioral problems in their children. The CBCL total problems score correlated both to depression (r = 0.38, p < 0.01) and to anxiety in parents (r = 0.49, p < 0.01) (Figure). CONCLUSIONS These findings indicate a possible emotional impact of LUTD in patients' caregivers. Our study suggests that an approach to the family of LUTD patients' may be an important therapeutic resource for an effective clinical control of this condition.
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Affiliation(s)
- Renata C Marciano
- Department of Psychiatry, School of Medicine, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maíra Gloria F Cardoso
- Department of Psychology, School of Medicine, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Monica M A Vasconcelos
- Division of Pediatric Nephrourology, School of Medicine, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Jonas J Paula
- Division of Pediatric Nephrourology, School of Medicine, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Eduardo A Oliveira
- Division of Pediatric Nephrourology, School of Medicine, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Eleonora M Lima
- Division of Pediatric Nephrourology, School of Medicine, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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Baker BL, Blacher J. Brief Report: Behavior Disorders and Social Skills in Adolescents with Autism Spectrum Disorder: Does IQ Matter? J Autism Dev Disord 2020; 50:2226-33. [PMID: 30888552 DOI: 10.1007/s10803-019-03954-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Disruptive behavior disorders and social skills were assessed in 187 youth aged 13 years, with typical cognitive development (TD n = 98), intellectual disability (ID n = 37), autism spectrum disorder (ASD, IQ > = 85, n = 26), or Autism Spectrum Disorder with ID (ASD/ID; IQ < 85, n = 26). The primary question was whether youth with ASD and co-morbid ID had greater associated adjustment problems than youth with ASD-only. Youth with ASD, with or without ID, had significantly higher behavior problems and lower social skills than their TD peers. However, youth with ASD and co-morbid ID did not differ from youth with ASD-only on any variable assessed, including behavior problems, behavior disorders, social acceptance, social skills, and student teacher relationships.
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Blacher J, Baker BL. Collateral Effects of Youth Disruptive Behavior Disorders on Mothers' Psychological Distress: Adolescents with Autism Spectrum Disorder, Intellectual Disability, or Typical Development. J Autism Dev Disord 2019; 49:2810-2821. [PMID: 29071563 DOI: 10.1007/s10803-017-3347-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Disruptive behavior disorders were assessed in 160 youth aged 13 years, with Autism Spectrum Disorder (ASD, n = 48), intellectual disability (ID, n = 28), or typical development (TD, n = 84). Mothers' reported collateral effects on their psychological adjustment were related to both youth disability status and clinical level behavior disorders. More youth with ASD or ID had clinical level behavior disorders than their TD peers, and their mothers reported significantly higher personal stress and psychological symptoms, as well as lower positive impact of the youth on the family. The youth's clinical level behavior disorders accounted for these differences more than the diagnostic status. Mothers high in dispositional optimism reported the lowest stress and psychological symptoms in relationship to youth behavior challenges.
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Affiliation(s)
- Jan Blacher
- Graduate School of Education, University of California, UCR, Sproul Hall, Riverside, CA, 92521, USA.
| | - Bruce L Baker
- Department of Psychology, University of California, Los Angeles (UCLA), Franz Hall, Los Angeles, CA, 90095, USA
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Frey AJ, Kuklinski MR, Bills K, Small JW, Forness SR, Walker HM, Feil EG, Seeley JR. Comprehensive Cost Analysis of First Step Next for Preschoolers with Disruptive Behavior Disorder: Using Real-World Intervention Data to Estimate Costs at Scale. Prev Sci 2019; 20:1219-1232. [PMID: 31313053 DOI: 10.1007/s11121-019-01035-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
While the long-term societal costs for youth with disruptive behavior disorders are well documented, there is a dearth of information about the comprehensive costs of implementing even the most well-regarded early intervention programs, and the costs of scaling effective interventions are even less well understood. This study estimated the costs of delivering and disseminating First Step Next (FSN), an established tier two school-based early intervention, in preschool and kindergarten settings, including the training and ongoing technical assistance that support sustained, high-quality implementation. Using the Ingredients Method, we estimated (a) the per student costs of implementation, (b) the incremental cost of offering FSN to an additional student, and (c) the cost to disseminate FSN to 40 preschool and kindergarten students, including a sensitivity analysis to examine potential areas of cost savings. The per child cost to implement the FSN intervention with 29 triads in two cohorts was $4330. The incremental cost per additional student was only $2970, highlighting efficiencies gained once intervention infrastructure had been established. The cost of disseminating the intervention to a single cohort of 40 students was $170,106, or $4253 per student. The range in sensitivity analysis was $3141-$7829 per student, with variability in personnel wages having the greatest impact on cost estimates. This research expands on existing literature by providing a more comprehensive understanding of the cost of effective disruptive behavior interventions based on real-world implementation data, using these data to estimate dissemination costs, and showing how dissemination costs are particularly sensitive to personnel wages.
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Affiliation(s)
- Andy J Frey
- Kent School of Social Work, University of Louisville, Patterson Hall, Louisville, KY, 40292, USA.
| | - Margaret R Kuklinski
- Social Development Research Group, School of Social Work, University of Washington, Box #358734, 9725 Third Ave. NE, Suite 401, Seattle, WA, 981115, USA
| | - Kiersten Bills
- Kent School of Social Work, University of Louisville, Patterson Hall, Louisville, KY, 40292, USA
| | - Jason W Small
- Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR, 97403-1983, USA
| | - Steven R Forness
- University of California, 11901 Sunset Blvd., Apt. #216, Los Angeles, CA, 90049, USA
| | - Hill M Walker
- Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR, 97403-1983, USA.,College of Education, University of Oregon, Eugene, OR, 97403, USA
| | - Edward G Feil
- Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR, 97403-1983, USA
| | - John R Seeley
- Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR, 97403-1983, USA.,College of Education, University of Oregon, Eugene, OR, 97403, USA
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Scheper FY, Majdandžić M, van de Ven PM, Jansen LMC, Doreleijers TAH, Schuengel C, de Vries ALC. Temperament Traits and Psychopathology in Young Clinically Referred Children Compared to a General Population Sample. Child Psychiatry Hum Dev 2017; 48:841-850. [PMID: 28097446 PMCID: PMC5680369 DOI: 10.1007/s10578-016-0708-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Evidence from general population studies shows the contribution of various temperament traits to the development of child psychopathology. Little is known about which traits are associated with internalizing and externalizing problems in young clinically referred children. The current study assessed temperament and internalizing and externalizing problems in 216 referred children (M = 4.35 years, SD 0.89, 81% boys). A comparison was made with an age and gender matched general population sample. Referred children showed less effortful control than general population children. Less effortful control and more negative affectivity were associated with more internalizing and externalizing problems across groups. Surgency, and specifically temperamental impulsivity, was more strongly associated with externalizing problems in referred children compared to general population. Less soothability, less inhibitory control and more frustration predicted (sub)clinical levels of comborbid internalizing and externalizing problems in referred children. The results can be used in diagnostic and treatment procedures in early childhood.
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Affiliation(s)
- Frederike Y Scheper
- Department of Child and Adolescent Psychiatry, VU University medical centre, Amsterdam, The Netherlands.
| | - Mirjana Majdandžić
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter M van de Ven
- Department of Epidemiology and Biostatistics, VU University medical centre, Amsterdam, The Netherlands
| | - Lucres M C Jansen
- Department of Child and Adolescent Psychiatry, VU University medical centre, Amsterdam, The Netherlands
| | - Theo A H Doreleijers
- Department of Child and Adolescent Psychiatry, VU University medical centre, Amsterdam, The Netherlands
| | - Carlo Schuengel
- Section of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annelou L C de Vries
- Department of Child and Adolescent Psychiatry, VU University medical centre, Amsterdam, The Netherlands
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Eickmann SH, Emond AM, Lima M. Evaluation of child development: beyond the neuromotor aspect. J Pediatr (Rio J) 2016; 92:S71-83. [PMID: 27012923 DOI: 10.1016/j.jped.2016.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 01/12/2016] [Accepted: 01/14/2016] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To review the epidemiology and update the scientific knowledge on the problems of development and behavior in childhood, and the recommendations for the role of the pediatrician in identifying and managing delays and disturbances in child development and mental health. SOURCES A search for relevant literature was performed in the PubMed and Scopus databases and publications of the National Scientific Council on the Developing Child. SUMMARY OF THE FINDINGS With the decline in the incidence of communicable diseases in children, problems with development, behavior, and emotional regulation are increasingly becoming a part of the work of pediatricians, yet many are not trained and feel uncomfortable about this extension of their role. The available screening tools for child development and behavior are reviewed, and a 'school readiness' checklist is presented, together with recommendations on how the pediatrician can incorporate developmental surveillance into routine practice, aware of the need for children to acquire social, emotional, and cognitive skills so that they can develop their full potential. CONCLUSIONS The pediatrician's role in the future will include both physical and mental health, recognizing that social development, resilience, and emotional maturity are as important as physical growth and neuromotor skills in a child's life course.
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Affiliation(s)
- Sophie Helena Eickmann
- Post-graduation in Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil.
| | - Alan Martin Emond
- Centre for Child and Adolescent Health, University of Bristol, Bristol, United Kingdom
| | - Marilia Lima
- Post-graduation in Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil
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Shelleby EC, Kolko DJ. Predictors, Moderators, and Treatment Parameters of Community and Clinic-Based Treatment for Child Disruptive Behavior Disorders. J Child Fam Stud 2015; 24:734-748. [PMID: 25750506 PMCID: PMC4349495 DOI: 10.1007/s10826-013-9884-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This study examines predictors, moderators, and treatment parameters associated with two key child outcomes in a recent clinical trial comparing the effects of a modular treatment that was applied by study clinicians in the community (COMM) or a clinic (CLINIC) for children with oppositional defiant disorder (ODD) or conduct disorder (CD). Based on a literature review, moderator and predictor variables across child, parent, and family domains were examined in relation to changes in parental ratings of the severity of externalizing behavior problems or the number of ODD and CD symptoms endorsed on psychiatric interview at pretreatment, posttreatment, and 36-month posttreatment follow-up. In addition, associations between parameters of treatment (e.g., hours of child, parent, and parent-child treatment received, treatment completion, referral for additional services at discharge) and child outcomes were explored. Path models identified few moderators (e.g., level of child impairment, attention deficit hyperactivity disorder diagnosis, level of family conflict) and several predictors (child trauma history, family income, parental employment, parental depression) of treatment response. Treatment response was also related to a few treatment parameters (e.g., hours of child and parent treatment received, treatment completion, referral for additional services at discharge). We discuss the implications of these findings for maximizing the benefits of modular treatment by optimizing or personalizing intervention approaches for children with behavior disorders.
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Affiliation(s)
- Elizabeth C. Shelleby
- Department of Psychology, University of Pittsburgh, 4425 Sennott Square, 210 S. Bouquet St., Pittsburgh, PA 15260, USA
| | - David J. Kolko
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Ferreira AR, Martins S, Ribeiro O, Fernandes L. Validity and reliability of the European portuguese version of neuropsychiatric inventory in an institutionalized sample. J Clin Med Res 2014; 7:21-8. [PMID: 25368697 PMCID: PMC4217749 DOI: 10.14740/jocmr1959w] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2014] [Indexed: 11/11/2022] Open
Abstract
Background Neuropsychiatric symptoms are very common in dementia and have been associated with patient and caregiver distress, increased risk of institutionalization and higher costs of care. In this context, the neuropsychiatric inventory (NPI) is the most widely used comprehensive tool designed to measure neuropsychiatric Symptoms in geriatric patients with dementia. The aim of this study was to present the validity and reliability of the European Portuguese version of NPI. Methods A cross-sectional study was carried out with a convenience sample of institutionalized patients (≥ 50 years old) in three nursing homes in Portugal. All patients were also assessed with mini-mental state examination (MMSE) (cognition), geriatric depression scale (GDS) (depression) and adults and older adults functional assessment inventory (IAFAI) (functionality). NPI was administered to a formal caregiver, usually from the clinical staff. Inter-rater and test-retest reliability were assessed in a subsample of 25 randomly selected subjects. Results The sample included 166 elderly, with a mean age of 80.9 (standard deviation: 10.2) years. Three out of the NPI behavioral items had negative correlations with MMSE: delusions (rs = -0.177, P = 0.024), disinhibition (rs = -0.174, P = 0.026) and aberrant motor activity (rs = -0.182, P = 0.020). The NPI subsection of depression/dysphoria correlated positively with GDS total score (rs = 0.166, P = 0.038). NPI showed good internal consistency (overall α = 0.766; frequency α = 0.737; severity α = 0.734). The inter-rater reliability was excellent (intraclass correlation coefficient (ICC): 1.00, 95% confidence interval (CI) 1.00 - 1.00), as well as test-retest reliability (ICC: 0.91, 95% CI 0.80 - 0.96). Conclusion The results found for convergent validity, inter-rater and test-retest reliability, showed that this version appears to be a valid and reliable instrument for evaluation of neuropsychiatric symptoms in institutionalized elderly.
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Affiliation(s)
- Ana Rita Ferreira
- Faculty of Medicine, University of Porto, Al. Hernani Monteiro, 4200-319 Porto, Portugal
| | - Sonia Martins
- Research and Education Unit on Aging (UNIFAI), University of Porto, Rua Jorge de Viterbo Ferreira, no. 228, 4050-313 Porto, Portugal
| | - Orquidea Ribeiro
- Department of Health Information and Decision Sciences (CIDES) and CINTESIS, Faculty of Medicine, University of Porto, Al. Hernani Monteiro, 4200-319 Porto, Portugal
| | - Lia Fernandes
- UNIFAI/CINTESIS Research Unit, Faculty of Medicine, University of Porto. Clinic of Psychiatry and Mental Health, CHSJ, Porto, Al. Hernani Monteiro, 4200-319 Porto, Portugal
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FAYYAZI A, SALARI E, KHAJEH A, GAJARPOUR A. A comparison of risperidone and buspirone for treatment of behavior disorders in children with phenylketonuria. Iran J Child Neurol 2014; 8:33-8. [PMID: 25657768 PMCID: PMC4307366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Revised: 03/13/2014] [Accepted: 04/19/2014] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Many patients with late-diagnosed phenylketonuria (PKU) suffer from severe behavior problems. This study compares the effects of buspirone and risperidone on reducing behavior disorders in these patients. MATERIALS & METHODS In this crossover clinical trial study, patients with severe behavior disorders after medical examination were randomly divided into two groups of two 8-week crossover treatments with risperidone or buspirone. Patient behavioral disorders before and after treatment by each drug was rated by parents on the Nisonger Child Behavior Rating Form (NCBRF), and after treatment by each drug, were assessed by a physician through clinical global impression (CGI). RESULTS Thirteen patients were able to complete the therapy period with these two medications. The most common psychiatric diagnoses were intellectual disability accompanied by pervasive developmental disorder NOS, and intellectual disability accompanied by autistic disorder. Risperidone was significantly effective in reducing the NCBRF subscales of hyperactivity disruptive/stereotypic, and conduct problems. Treatment by buspirone only significantly decreased the severity of hyperactivity, but other behavior aspects showed no significant differences. Assessment of the severity of behavior disorder after treatment by risperidone and buspirone showed significant differences in reducing hyperactivity and masochistic/stereotype. CONCLUSION Although buspirone is effective in controlling hyperactivity in patients with PKU, it has no preference over risperidone. Therefore, it is recommended as an alternative to risperidone.
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Affiliation(s)
- Afshin FAYYAZI
- Department of Pediatric Neurology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Elham SALARI
- Child & Adolescent Psychiatrist, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali KHAJEH
- Department of Pediatric Neurology, Zahedan University of Medical Sciences, Zahedan, Iran
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Medeiros K, Curby TW, Bernstein A, Rojahn J, Schroeder SR. The progression of severe behavior disorder in young children with intellectual and developmental disabilities. Res Dev Disabil 2013; 34:3639-3647. [PMID: 24012587 PMCID: PMC4453924 DOI: 10.1016/j.ridd.2013.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 08/05/2013] [Accepted: 08/05/2013] [Indexed: 06/02/2023]
Abstract
Behavior disorders, such as self-injurious, stereotypic, and aggressive behavior are common among individuals with intellectual or developmental disabilities. While we have learned much about those behaviors over the past few decades, longitudinal research that looks at developmental trajectory has been rare. This study was designed to examine the trajectory of these three forms of severe behavior disorders over a one year time period. The behaviors were measured on two dimensions: frequency of occurrence and severity. Participants were 160 infants and toddlers at risk for developmental delays in Lima, Peru. Using structural equation modeling, we found that the frequency of self-injury and stereotypic behavior and the severity of aggressive behavior remained stable over the 12-month period. Uni-directional structural models fit the data best for self-injurious and aggressive behavior (with frequency being a leading indicator of future severity of self-injury and severity being a leading indicator of future frequency for aggression). For stereotypic behavior, a cross-lagged autoregressive model fit the data best, with both dimensions of frequency and severity involved as leading indicators of each other. These models did not vary significantly across diagnostic groups, suggesting that toddlers exhibiting behavior disorders may be assisted with interventions that target the specific frequencies or severities of behaviors, regardless of diagnostic category.
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