Aggressive behavior has been associated with numerous neurologic conditions including traumatic brain injury, mental retardation, developmental disorders, Huntington disease, and several dementias. Preclinical and human studies suggest that dysfunction of neural systems involving the brainstem, hypothalamus, amygdala, or prefrontal cortex can give rise to aggression. Several neurochemicals are felt to be relevant to modulation of aggression, including serotonin, dopamine, norepinephrine, GABA, acetylcholine, and androgens. Pharmacologic intervention studies have targeted these systems but have been limited by inconsistent definitions of aggression and a relative paucity of controlled trials. This article briefly reviews studies of neural systems and medication trials relevant to aggression and propose a clinical approach to treatment of patients manifesting aggressive behavior. Language: en
{"title":"Pharmacologic approach to aggression in neuropsychiatric disorders.","authors":"Ryan Jm","doi":"10.1053/SCNP.2000.9553","DOIUrl":"https://doi.org/10.1053/SCNP.2000.9553","url":null,"abstract":"Aggressive behavior has been associated with numerous neurologic conditions including traumatic brain injury, mental retardation, developmental disorders, Huntington disease, and several dementias. Preclinical and human studies suggest that dysfunction of neural systems involving the brainstem, hypothalamus, amygdala, or prefrontal cortex can give rise to aggression. Several neurochemicals are felt to be relevant to modulation of aggression, including serotonin, dopamine, norepinephrine, GABA, acetylcholine, and androgens. Pharmacologic intervention studies have targeted these systems but have been limited by inconsistent definitions of aggression and a relative paucity of controlled trials. This article briefly reviews studies of neural systems and medication trials relevant to aggression and propose a clinical approach to treatment of patients manifesting aggressive behavior. Language: en","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"5 1","pages":"238-249"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58314817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although the core features of autism do not change qualitatively, a gradual overall symptomatic improvement including an increase in adaptive skills is observed in most cases with age. Follow-up studies show that the diagnostic features, the differential diagnosis, and clinical problems of adult autistics differ substantially from that of autistic children. The differential diagnosis of older autistics include personality disorders, learning disabilities, and mood disorder. Depression, epilepsy, and behavioral problems such as aggression and agitation may be major clinical problems during adolescence. The early indicators of a better outcome include a higher level of IQ and language. Among the neuropsychological variables, measures of flexibility and cognitive shift are important as prognostic factors. Early behavioral and educational intervention may especially increase the adaptive skills of the patients and promote the in-family communication. The outcome studies of autism are particularly helpful in addressing the appropriate and most effective programs of remediation for adult autistics.
{"title":"Infantile autism: adult outcome.","authors":"B. Korkmaz","doi":"10.1053/SCNP.2000.6727","DOIUrl":"https://doi.org/10.1053/SCNP.2000.6727","url":null,"abstract":"Although the core features of autism do not change qualitatively, a gradual overall symptomatic improvement including an increase in adaptive skills is observed in most cases with age. Follow-up studies show that the diagnostic features, the differential diagnosis, and clinical problems of adult autistics differ substantially from that of autistic children. The differential diagnosis of older autistics include personality disorders, learning disabilities, and mood disorder. Depression, epilepsy, and behavioral problems such as aggression and agitation may be major clinical problems during adolescence. The early indicators of a better outcome include a higher level of IQ and language. Among the neuropsychological variables, measures of flexibility and cognitive shift are important as prognostic factors. Early behavioral and educational intervention may especially increase the adaptive skills of the patients and promote the in-family communication. The outcome studies of autism are particularly helpful in addressing the appropriate and most effective programs of remediation for adult autistics.","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"5 3 1","pages":"164-70"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58314552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adult outcomes of learning disability: An overview","authors":"B. Townes, P. Slade","doi":"10.1053/SCNP.2000.6725","DOIUrl":"https://doi.org/10.1053/SCNP.2000.6725","url":null,"abstract":"","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"15 1","pages":"156-156"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58314945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article reviews the current definitions of specific learning disability (LD). It describes the multiple causes among the specific learning disability (SLD) population, citing cognitive, neuroanatomical, cellular, and genetic research trends. Emphasis is placed on assessment components and processes, including typically used academic, cognitive, and neuropsychological measures and newly introduced dynamic or domain-based approaches. Researchers and practitioners now acknowledge that SLD represents a life-long condition, manifesting differently at each developmental stage. The impact of LD on adult adjustment and independence is described as the newest challenge in the field of LD research.
{"title":"Learning disabilities: diagnostic considerations from an educational perspective.","authors":"Betty L. Jones, Jane A. Eberle","doi":"10.1053/SCNP.2000.6726","DOIUrl":"https://doi.org/10.1053/SCNP.2000.6726","url":null,"abstract":"This article reviews the current definitions of specific learning disability (LD). It describes the multiple causes among the specific learning disability (SLD) population, citing cognitive, neuroanatomical, cellular, and genetic research trends. Emphasis is placed on assessment components and processes, including typically used academic, cognitive, and neuropsychological measures and newly introduced dynamic or domain-based approaches. Researchers and practitioners now acknowledge that SLD represents a life-long condition, manifesting differently at each developmental stage. The impact of LD on adult adjustment and independence is described as the newest challenge in the field of LD research.","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"5 3 1","pages":"157-63"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58314494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A selective survey of neurodevelopmental delay syndromes is presented and discussed from neural, cognitive, and behavioral perspectives to highlight their impact on adult neuromaturation, learning abilities, psychosocial expression, and psychiatric adjustment. Emphasis is placed on the discussion of major factors and issues that influence neurodevelopmental delays, dysfunctions, and selective clinical examples of how they are manifested in adult adjustment.
{"title":"Selected neurodevelopmental delay syndromes and their impact on adult neuromaturation and adjustment.","authors":"L. V. Majovski","doi":"10.1053/SCNP.2000.6728","DOIUrl":"https://doi.org/10.1053/SCNP.2000.6728","url":null,"abstract":"A selective survey of neurodevelopmental delay syndromes is presented and discussed from neural, cognitive, and behavioral perspectives to highlight their impact on adult neuromaturation, learning abilities, psychosocial expression, and psychiatric adjustment. Emphasis is placed on the discussion of major factors and issues that influence neurodevelopmental delays, dysfunctions, and selective clinical examples of how they are manifested in adult adjustment.","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"5 3 1","pages":"171-6"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58314638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prenatal alcohol exposure can cause a whole spectrum of central nervous system (CNS) sequelae that persist throughout the life span and manifest in a spectrum of effects from clinically indistinguishable to severely impairing. The greatest impact of alcohol as a teratogen is to the brain-the greatest need is for holistic treatment and management of the associated mental disorders. The interaction of this subtle brain damage with the complex psychosocial circumstances surrounding the birth of a child to a mother with alcohol problems can further compound development and result in costly and devastating social consequences. Research is urgently needed on the chronic neuropsychiatric sequelae of these subtle birth defects of the brain. Identification of these fetal alcohol spectrum disorders (FASD) in the psychiatric nomenclature is a necessary step to focus the attention and resources of the mental health field on this personally and socially significant problem.
{"title":"Neuropsychiatric implications and long-term consequences of fetal alcohol spectrum disorders.","authors":"A. Streissguth, K. O’Malley","doi":"10.1053/SCNP.2000.6729","DOIUrl":"https://doi.org/10.1053/SCNP.2000.6729","url":null,"abstract":"Prenatal alcohol exposure can cause a whole spectrum of central nervous system (CNS) sequelae that persist throughout the life span and manifest in a spectrum of effects from clinically indistinguishable to severely impairing. The greatest impact of alcohol as a teratogen is to the brain-the greatest need is for holistic treatment and management of the associated mental disorders. The interaction of this subtle brain damage with the complex psychosocial circumstances surrounding the birth of a child to a mother with alcohol problems can further compound development and result in costly and devastating social consequences. Research is urgently needed on the chronic neuropsychiatric sequelae of these subtle birth defects of the brain. Identification of these fetal alcohol spectrum disorders (FASD) in the psychiatric nomenclature is a necessary step to focus the attention and resources of the mental health field on this personally and socially significant problem.","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"5 3 1","pages":"177-90"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58314737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Attention-Deficit/Hyperactivity Disorder (ADHD) is a developmental disorder which begins in childhood. It is now recognized that ADHD persists into adolescence and adulthood in the majority of cases. Significant psychiatric comorbidity, particularly substance abuse, antisocial personality disorder, and mood and anxiety disorders occurs in adolescent and adult ADHD. Perhaps one fifth of childhood cases of ADHD may also have co-morbid learning disorder. Significant legal, academic, social, and occupational problems have been observed in adults with ADHD. The clinician faces a diagnostic and treatment challenge in trying to determine whether ADHD and learning disabilities (LDs) are present in the adult patient. Treatment and recommendations for accommodations in institutions of higher education and the workplace may rest on accurate discrimination between ADHD and LD.
{"title":"Attention-deficit/hyperactivity disorder and learning disabilities in adults.","authors":"Barbara S. McCann, Peter Roy-Byrne","doi":"10.1053/SCNP.2000.6730","DOIUrl":"https://doi.org/10.1053/SCNP.2000.6730","url":null,"abstract":"Attention-Deficit/Hyperactivity Disorder (ADHD) is a developmental disorder which begins in childhood. It is now recognized that ADHD persists into adolescence and adulthood in the majority of cases. Significant psychiatric comorbidity, particularly substance abuse, antisocial personality disorder, and mood and anxiety disorders occurs in adolescent and adult ADHD. Perhaps one fifth of childhood cases of ADHD may also have co-morbid learning disorder. Significant legal, academic, social, and occupational problems have been observed in adults with ADHD. The clinician faces a diagnostic and treatment challenge in trying to determine whether ADHD and learning disabilities (LDs) are present in the adult patient. Treatment and recommendations for accommodations in institutions of higher education and the workplace may rest on accurate discrimination between ADHD and LD.","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"5 3 1","pages":"191-7"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58314747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There are few empirical studies of the adult outcomes of nonverbal learning disability (NLD). An overwhelming majority of NLD studies has been devoted to the nature of academic difficulties of school children, whereas the few follow-up studies have tended to be limited to college-age young adults. Herein, it is argued that the problems of adults with NLD do not fall solely in academic areas, and that early academic remediation programs might do well to include intervention in emotional and social skills enhancement.
{"title":"Nonverbal learning disability: adult outcomes.","authors":"A. Dugbartey","doi":"10.1053/SCNP.2000.6732","DOIUrl":"https://doi.org/10.1053/SCNP.2000.6732","url":null,"abstract":"There are few empirical studies of the adult outcomes of nonverbal learning disability (NLD). An overwhelming majority of NLD studies has been devoted to the nature of academic difficulties of school children, whereas the few follow-up studies have tended to be limited to college-age young adults. Herein, it is argued that the problems of adults with NLD do not fall solely in academic areas, and that early academic remediation programs might do well to include intervention in emotional and social skills enhancement.","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"5 3 1","pages":"198-204"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58314756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although it is currently generally accepted that, in most cases, verbal learning disability (VLD) can persist into adulthood, adult outcomes of learning disability are still under much discussion. The adult outcomes of two types of VLD (dyslexia and dysgraphia) will be the focus of this article. The defining characteristics of VLD and what constitutes these types of VLD are provided in detail elsewhere in this issue (see Jones and Eberling). This article will focus on the current epidemiology, possible causative factors, neurocognitive profiles, and neurological correlates of such disability. In addition, adult outcomes will be discussed for both those who succeed despite the disability and those who continue to struggle with the issues of VLD into adulthood. Specifically, factors that seem to contribute to success or struggle, and suggested treatments for VLD, will be discussed.
{"title":"Adult outcomes of verbal learning disability.","authors":"P. Sánchez, D. Coppel","doi":"10.1053/SCNP.2000.6733","DOIUrl":"https://doi.org/10.1053/SCNP.2000.6733","url":null,"abstract":"Although it is currently generally accepted that, in most cases, verbal learning disability (VLD) can persist into adulthood, adult outcomes of learning disability are still under much discussion. The adult outcomes of two types of VLD (dyslexia and dysgraphia) will be the focus of this article. The defining characteristics of VLD and what constitutes these types of VLD are provided in detail elsewhere in this issue (see Jones and Eberling). This article will focus on the current epidemiology, possible causative factors, neurocognitive profiles, and neurological correlates of such disability. In addition, adult outcomes will be discussed for both those who succeed despite the disability and those who continue to struggle with the issues of VLD into adulthood. Specifically, factors that seem to contribute to success or struggle, and suggested treatments for VLD, will be discussed.","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"5 3 1","pages":"205-9"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58314765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adult outcome of verbal learning disability: an optimistic note.","authors":"B. Townes","doi":"10.1053/SCNP.2000.6735","DOIUrl":"https://doi.org/10.1053/SCNP.2000.6735","url":null,"abstract":"","PeriodicalId":79723,"journal":{"name":"Seminars in clinical neuropsychiatry","volume":"12 1","pages":"210-1"},"PeriodicalIF":0.0,"publicationDate":"2000-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58314811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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