Journal of the American Academy of Child Psychiatry最新文献

During an investigation into the antecedents of schizophrenia that studied 12 offspring of chronic schizophrenic mothers, and their 12 controls, from birth, one subject was hospitalized at 19 and diagnosed schizophrenic. The early onset of social-affective and cognitive dysfunction clearly indicates that such children (and their families) need much earlier intervention than is usually provided. The prospective data also suggest that DSMIII schizotypal symptoms may identify some pre-schizophrenics in early adolescence and childhood. A standardized measure of thought disorder (the TDI), based on the WISC and Rorschach, could provide an additional quantitative confirmation.

This study compares 539 emotionally disturbed children with a history of abuse only, neglect, or no abuse or neglect who have been hospitalized at a children's psychiatric hospital. Neglected boys have lower verbal IQs and more impaired relatedness than abused boys or boys with no history of abuse or neglect. Abused boys and neglected boys have an increased frequency of conduct disorder diagnoses. Abused girls have an increase in conduct disorder diagnoses but the neglected girls do not. In contrast to the boys, verbal and performance IQ were lower for both abused and neglected girls.

The authors compared two approach methods for the diagnosis of attention deficit disorder with hyperactivity (ADDH) in a sample of 114 9-year-old children in the community. One method was the categorical approach using a structured interview of parents about their children (DISC-P) and the other was the dimensional approach using Achenbach's Child Behavior Checklist (CBCL) filled in by the parents. There were 14 children diagnosed as having ADDH by DISC-P. Of these, two were “diagnosed” by CBCL. The children diagnosed as ADDH by DISC-P differed on the Achenbach's Externalizing factors from the children who did not have any DSM-III diagnosis by DISC-P and from those who had other DSM-III diagnoses; and on the Achenbach's Internalizing Factors they only differed from the children with no diagnosis and not from children with other diagnoses. Finally it is concluded that it is unlikely that a single cut-off score on any rating scale will be an adequate substitute for a systemic evaluation using several data sources.

This paper describes a program of neurobehavioral research aimed at: (1) isolating core information processing impairments in childhood onset schizophrenia, and (2) identifying structures in the central nervous system which mediate those impairments. Children meeting DSM-III criteria for schizophrenia, mental age matched normals, and younger normals were administered a series of visual information processing tasks. The results of these studies suggest that controlled attentional processes, which normally develop during middle childhood, are impaired in schizophrenic children while more automatic modes of attending are relatively intact. Convergent evidence for this conclusion was provided by event related potentials recorded from 7 scalp loci while children were performing on one of the tasks used in the first project. The schizophrenic children produced a small contingent negative variation (CNV) which was slow to develop and resolve as well as diminished amplitudes for N1, P3, and slow wave components. This suggests that these children are impaired in their ability to regulate the mobilization and direction of attention and to discriminate target stimuli. Event-related potential components of the schizophrenic children tended to be most deviant at frontal leads, but midline and lateralized deficits were also seen at vertex and posterior recording sites. The relationship of these impairments in controlled attentional processes to the phenomenology of childhood onset schizophrenia is discussed.

This paper reports the results of a comparison of degrees of violence in adolescents psychiatrically hospitalized in the late 1960s and adolescents hospitalized 10 years later. The authors studied a random sample of 51 adolescents, including 26 boys and 25 girls in the late 1960s, and a random sample of 51 adolescents matched for sex and race 10 years later. Psychiatrically hospitalized girls in the 1970s were significantly more violent than psychiatrically hospitalized girls in the 1960s. The implications of these findings are discussed.