Specific Behavioral Problems Research Articles

Unrecognized Attention-Deficit Hyperactivity Disorder in Adults Presenting for Outpatient Psychotherapy

ABSTRACT Adult patients with significant childhood and current symptoms of attention-deficit hyperactivity disorder (ADHD), but whose ADHD had not been previously recognized, were evaluated by three clinical consultants working with diverse referral populations. These 60 adults shared common characteristics of physical and mental restlessness, impulsivity, disabling distractibility, low self-esteem, self-loathing, and a gnawing sense of underachievement. Specific learning or behavior problems were often present. These patients were chronically disaffected. The diagnosis of ADHD appeared to be missed because these individuals presented with atypical symptoms or had found ways to compensate for their deficits. Descriptive generalizations are offered concerning their coping strategies. These adults had sought previous psychiatric care for non-ADHD symptoms but had numerous unsuccessful treatment attempts. Most patients had been treated for mood or anxiety disorders. Traditional defense analysis had little beneficial effect and aggravated problems of self-esteem; modifications of the psychotherapeutic process are recommended. In open clinical trials without formal measures, the majority of such patients appeared to respond to low doses of antidepressants (i.e., desipramine 10-30 mg daily) and seemed to lose the therapeutic effect at higher antidepressant doses.

Differences and similarities between children, mothers, and teachers as informants on disruptive child behavior

Prevalence rates of disruptive child behaviors, based on structured psychiatric interviews, are presented for samples of clinic-referred prepubertal boys at two sites to investigate differences and similarities among reports of the behaviors from children, parents, and teachers. Children reported significantly less hyperactive/inattentive and oppositional behaviors than either parents or teachers. In contrast, children did not differ from parents or teachers in their report on the prevalence of more serious conduct problems. These results were well replicated across two sites, despite the fact that there were significant differences between the sites in the level of hyperactive/inattentive child behaviors and conduct problems. The ranking of parents' and teachers' reported prevalence of specific child behavior problems in each of the three domains of disruptive behavior was strikingly similar. With one exception, the concordance between the prevalence ranking based on the children's reports was lower than that based on adults' reports, Children's reports on their own behavior did not predict various child handicaps 1 year later as well as did adults' reports. The results are discussed in relation to the usefulness of certain child behaviors in symptom lists for diagnostic purposes; the reliability of children's reports on their own behavior; and the possible reasons why prevalence rankings, as perceived by adults, are so similar.

Influence of sensation seeking on general deviance and specific problem behaviors from adolescence to young adulthood.

Indicators of a Sensation Seeking latent construct were assessed during adolescence and used to predict changes in repeatedly gathered measures of a latent construct of General Deviance. A community sample of 595 male and female Ss was assessed 3 times over a 5-year period from late adolescence to young adulthood. Most Ss reported use of licit drugs, about one half had tried illicit drugs, and a substantial minority had engaged in other delinquent or criminal activities. The General Deviance construct was stable over time, although specific cross-effects were found. Sensation Seeking was moderately correlated with General Deviance at all 3 levels but did not predict directly the General Deviance construct over time; the effects of Sensation Seeking on later deviant behavior and attitudes were specific rather than general.

Influence of sensation seeking on general deviance and specific problem behaviors from adolescence to young adulthood.

Influence of sensation seeking on general deviance and specific problem behaviors from adolescence to young adulthood.

Animal psychodietetics

ABSTRACTAt present, behaviour and diet are linked in psychodietetics which, in turn, correlates to food quality and animal wellbeing, as well as to specific behavioural problems. Several studies indicate that food should be ascribed diverse effects, such as nutritional, pharmacological, toxic and extranutritional. Some of these actions affect behaviour. Particular attention was recently devoted to relationships linking flavours, pheromones and behaviour, as well as to neurological pathologies associated with nutrition and depending on diet disorders.Many studies are at present being conducted on the relationship between nutrition, neurotransmitter synthesis and neurohormonal system activity, with relative behavioural changes. In particular, data were collected on the relationship between nutrition and aggressiveness, nutrition and psychoses, nutrition and dyskinesiae, nutrition and alimentary behaviour (control of food intake) in carnivorous domestic animals. Recently, studies on the relationship between nutrition and nervous system growth and early life behaviour were carried out, focusing on domestic carnivores. Pets' nutrition involves a broader significance than was given by traditional dietetics, including the man‐animal relationship. From this new viewpoint, many ‘parallel pathologies’ affecting the pets and their owners (obesity, hyperkinesia, aggressiveness, etc) are better interpreted.

Preschool Behavior Problems and Subsequent Risk of Injury

The hospital records of 951 children from a previously established birth cohort for which behavioral and extensive background information was available were checked for 3 years following the fifth birthday of the youngest child. The aim was to determine whether children with certain specific behavior disorders had a higher rate of injury than those without. Although the predicted relationships between overactive behavior, decreased concentration, and injury rate were not found, the hypothesis of an increased risk of injury for boys and for children with discipline problems was confirmed. Also, the association between male sex and injury remained after controlling for the behavior variables related to injury. In general, some support was found for the suggestion of increased risk of injury among children who have specific behavior problems, although, contrary to widespread belief, this relationship accounts for only a small percentage of the injuries found in the cohort. Moreover, the relationship is modified by maternal characteristics and by the sex of the child. Unexpectedly, encopresis and marked fears were found to be risk factors for injury, although these effects were relatively small.

Prevalence of behaviour problems in Ajmer school children.

In a questionnaire survey of 10,000 primary school children, parents and teachers reported behaviour problems in 38% of 6199 children on whom complete information was made available. Categorization of 3572 behaviour problems according to a modified APA-DSM II classification showed aggressive reactions to be the commonest (22.7%). This was followed by disorders of sleep (17.1%), unsocial aggressive reactions (15.5%), aggressive-regressive reactions (13.5%), regressive reactions (10.7%), school grade problems (8.7%) and others. Significant influence of sex, age and socio-economic class was noted on the overall prevalence, and prevalence of specific behaviour problems. A general lack of awareness among the parents about the childhood behavioural problems was noticeable from the pattern of utilization of the pediatric outpatient services in the study area. There is a need to educate parents on behaviour of children and the significance of behavioural deviations.

Family Caregiver Appraisals of Patient Behavioral Disturbance in Senile Dementia

In the present study, 44 primary family caregivers of elderly patients with dementia were interviewed concerning the prevalence of 31 specific behavioral problems in the home setting, the subjective stressfulness of each problem, and caregivers' perceived self-efficacy in managing each problem. Results indicate that, although self-care deficits and disorientation are extremely common, they are of less concern to caregivers than a number of prevalent and highly stressful behavioral problems such as agitation, hallucinations, and dangerous or embarrassing behaviors. These specific behavioral problems deserve greater attention in the management of dementia patients who live in community settings.

The Nature and Correlates of Psychological/Emotional Functioning among a Sample of Detained Youths

This study explores the relationships between a sample of detained juveniles' specific problems and their psychological orientations. It was proposed that for youths who are in trouble with the law, specific behavioral difficulties (e.g., substance abuse) would be associated with the youths' psychological orientation to a deviant lifestyle. Analysis of a sample of 145 status offender and juvenile delinquent cases revealed a significant positive association among “antisocial” orientation and physical abuse, illicit drug use, repeated placements in secure detention, and self-derogation. These relationships held when controlling for the effects of gender, age, and ethnicity. These results support the view that specific behavior problems are related to a valuation of a deviant lifestyle. The implications of these results for service providers are discussed.

Differential Diagnoses Based on the Task-Related Behavior of Learning Disabled and Low-Achieving Adolescents

Observations of 18 learning disabled (LD) and 18 low-achieving adolescents were compared to identify differences which may lead to differential labeling and placement. Multiple measures were used, including observations of task-related behaviors and teacher ratings of specific low-frequency problem behaviors. Observational results indicated that LD and low-achieving populations differed in total on-task behavior with the low-achieving groups demonstrating higher percentages of on-task behavior. Also, the LD group engaged in more passive off-task behavior. Teacher ratings of specific problem behaviors showed no group differences, although some LD students tended to demonstrate disturbed peer relationships. Noted behavioral differences were interpreted as leading to application of the learning disabilities label.

The Behavior Objective Checklist: Reliability and Validity with Child Psychiatric Patients

The present study assesses the reliability and validity of the Behavior Objective Checklist (BOC) with child psychiatric patients. The BOC is a 137-item problem behavior checklist in which each item addresses a specific measurable problem behavior for consideration as an IEP short-term objective. The 27 participants were psychiatric day- or inpatients who attend preschool to sixth grade self-contained behavioral disorder classrooms in a residential program. Four certified teachers of the behaviorally disordered and four paraprofessionals also participated in the study. A percent agreement analysis indicated an average test-retest reliability of 87% and an average interrater reliability of 77%. A Pearson Product Moment Correlation was used to determine concurrent validity and yielded a correlation of .69 with another behavior problem checklist.

The specificity of childhood problem behavior for adolescent and young adult maladjustment

A longitudinal sample of 1130 low peer choice grade school children were followed through record sources into young adulthood. Specific childhood problem behavior clusters were examined in relationship to delinquency, adult criminality, and mental health treatment contact. Childhood aggression, in the context of peer rejection, was related significantly to delinquency for males, an antisocial diagnosis for both sexes, and differentiated subjects in the judicial system from those in the mental health system. A childhood "neurological" scale differentiated subjects with a schizophrenic spectrum diagnosis from other subjects with mental health treatment.

A COMPARISON OF FAMILY ADAPTATIONS TO HAVING A CHILD WITH CYSTIC FIBROSIS

The effect of Cystic Fibrosis (CF) on the structure and social climate of the family was examined with self‐report scales and independent observations of family functioning. Families in which the child with CF was not the firstborn were found to be functioning more healthily than those in which the child was the firstborn. This was found on 7 of 10 family environment scales, a family hierarchy test, and on all three of the family system scales used by the independent observers (power, cohesion and closeness). Significant correlations between specific family variables and problem behaviors and social competencies were also found.

A Developmental View of Children's Behavioral Tolerance

The purpose of this study was to assess children's tolerance of specific problem behaviors and to determine if differences in grade levels existed. The Children's Tolerance Scale (CTS) was completed by 469 third to sixth graders. A one-way multivariate analysis of variance yielded significant grade level differences (p < .001), with older children generally the most tolerant. The more outer-directed behaviors (Negative Aggressive and Poor Peer Cooperation) were rated as most disturbing. Implications for mainstreaming behaviorally disordered students and future research are discussed.

Behavioral and Cognitive Impairments in Children with Epilepsy: The Long-term Effects of Anticonvulsant Therapy

Findings from a study of 312 children with complicated epilepsy, all of whom attended a special hospital school, have shown significant associations between long-term anticonvulsant therapy, particularly with phenytoin and phenobarbitone, and cognitive deterioration. Associations were found between specific behavioral problems and focal (particularly left temporal) cerebral dysfunction. There was no association between medication and overall behavioral deviance, which occurred in 67% of the sample. Underlying influences, especially brain damage and dysfunction, are of greater importance in the causation of behavioral disturbances.

An Overview of the “Project Future” Report “Child Psychiatry: A Plan for the Coming Decades“

The objective of this Clinical Update is to review the principles, structures, processes, and outcomes of community systems of care as they pertain to the delivery of behavioral health care to children and adolescentsA search of the literature on this topic from 2002 was initially conducted in 2016 and repeated in 2019 and 2021, yielding 1,604 English-language citations. These citations were supplemented by references suggested by topic experts and identified through Web searches, increasing the yield to 1,684 total citations, of which 1,184 were unduplicated. After sequential review by Update authors at title/abstract and then full-text levels, the citations were winnowed to 156 based on relevance to the topic.The systems of care approach, arising in the 1980s, expanded child and adolescent behavioral health care from the core services of psychotherapy, medication management, inpatient psychiatric services, and residential treatment to include home- and community-based treatment and support services; promotion, prevention, and early intervention programs; and specialized services for very young children and youth and young adults of transition age. These services and supports are delivered by a large multidisciplinary workforce and are governed by key principles, including a biopsychosocial case conceptualization; family-driven, youth-guided, strengths-based, and trauma-informed care. Services in the least restrictive setting; continuity of care across transitions; a public health framework for service delivery; promotion of wellness and resilience; and elimination of health disparities. Challenges to systems of care implementation include funding availability, workforce shortages, deficiencies in cross-systems collaboration, and variability in insurance coverage. Although controlled studies have failed to provide convincing evidence of favorable outcomes from the whole systems of care approach, uncontrolled research has demonstrated increased access to care, positive clinical and functional outcomes, improved family functioning, and reductions in costs, particularly when research is focused on specific behavioral health problems, specific interventions such as Wraparound care, or highly specified groups of youth.Health professionals who are educated in the systems of care approach can improve access to and quality of behavioral health care for children and adolescents with behavioral health needs.

The Family and the Autistic Child: A Behavioral Perspective

In the past 20 years our understanding of infantile autism has shifted to focus upon biological rather than environmental factors and has drawn extensively upon behavioral technology to treat specific behavior problems. The role of parents as therapists in this treatment has found empirical support. Nevertheless, it is important for the therapist to go beyond teaching parents behavioral skills and to recognize that such training occurs within a family context. Unless there is sensitivity to the impact of behavioral interventions upon family functioning such training may prove disruptive rather than helpful to the family as a whole.

Problem behaviours encountered by families living with a schizophrenic member.

Attention is focused on the problem behaviours encountered by relatives of schizophrenic patients. Seventy families, members of the "Friends of Schizophrenics" association completed a questionnaire aimed at eliciting specific problem behaviours from the perspective of the relative. By far, the most frequent problems were concerned with the 'negative' symptoms of schizophrenia while the problems found most difficult to manage included those to do with insight compliance and 'positive' symptoms.

Using Multidimensional Scaling and Unfolding to Explore Teacher Perceptual Biases for Selected Special Education Referral Categories

Multidimensional scaling (POLYCON) and unfolding (PREFMAP) algorithms developed by Young (24) and Carroll (3), respectively, were used to explore teacher perceptions of special education labels (e.g., emotional disturbance) in terms of a reference set of 28 student behaviors (e.g., withdrawn, short attention span) across two context variables: student gender and student ethnicity. The resulting two-dimensional scaling solution revealed teacher perceptual distinctions between student acting-out and passive behaviors, and between student intellectual impairment and specific behavior problems. In addition, scaling analyses also suggested teacher perceptual biases that required both males and minority (i.e., black) students to behave more extremely before being seen by teachers as having either learning or emotional problems.

Behavior problems of children as perceived by teachers, mental health professionals, and children

The objective of this study was to examine current teacher and mental health professional ratings regarding the relative seriousness of 50 specific children's behavior problems and to compare the results to those found by Wickman (1928). Wickman's questionnaire and procedures were replicated to insure comparability. A second objective was to extend Wickman's work so that children's ratings of their own behavior problems may be ascertained. An increase in the similarity between teachers' and mental health professionals' judgements concerning the seriousness of specific children's behavior problems was found. These findings were attributable to a more pragmatic approach taken by mental health professionals. A very high agreement on the seriousness of specific behavior problem ratings was demonstrated by children and teachers. This similarity may be the result of proximity of effects.