Honing in on the Social Difficulties Associated with Sluggish Cognitive Tempo in Children: Withdrawal, Peer Ignoring, and Low Engagement

Total Page:16

File Type:pdf, Size:1020Kb

Honing in on the Social Difficulties Associated with Sluggish Cognitive Tempo in Children: Withdrawal, Peer Ignoring, and Low Engagement Journal of Clinical Child & Adolescent Psychology ISSN: 1537-4416 (Print) 1537-4424 (Online) Journal homepage: http://www.tandfonline.com/loi/hcap20 Honing in on the Social Difficulties Associated With Sluggish Cognitive Tempo in Children: Withdrawal, Peer Ignoring, and Low Engagement Stephen P. Becker, Annie A. Garner, Leanne Tamm, Tanya N. Antonini & Jeffery N. Epstein To cite this article: Stephen P. Becker, Annie A. Garner, Leanne Tamm, Tanya N. Antonini & Jeffery N. Epstein (2017): Honing in on the Social Difficulties Associated With Sluggish Cognitive Tempo in Children: Withdrawal, Peer Ignoring, and Low Engagement, Journal of Clinical Child & Adolescent Psychology, DOI: 10.1080/15374416.2017.1286595 To link to this article: http://dx.doi.org/10.1080/15374416.2017.1286595 Published online: 13 Mar 2017. Submit your article to this journal Article views: 55 View related articles View Crossmark data Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=hcap20 Download by: [University of Iowa Libraries] Date: 31 March 2017, At: 09:20 Journal of Clinical Child & Adolescent Psychology, 00(00), 1–10, 2017 Copyright © 2017 Society of Clinical Child & Adoloscent Psychology ISSN: 1537-4416 print/1537-4424 online DOI: 10.1080/15374416.2017.1286595 Honing in on the Social Difficulties Associated With Sluggish Cognitive Tempo in Children: Withdrawal, Peer Ignoring, and Low Engagement Stephen P. Becker Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine Annie A. Garner Department of Psychology, Saint Louis University Leanne Tamm Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine Tanya N. Antonini Department of Rehabilitation Psychology/Neuropsychology, TIRR Memorial Hermann and Department of Physical Medicine and Rehabilitation, Baylor College of Medicine Jeffery N. Epstein Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine Sluggish cognitive tempo (SCT) symptoms are associated with social difficulties in children, though findings are mixed and many studies have used global measures of social impair- ment. The present study tested the hypothesis that SCT would be uniquely associated with aspects of social functioning characterized by withdrawal and isolation, whereas attention deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms would be uniquely associated with aspects of social functioning characterized by inappropri- ate responding in social situations and active peer exclusion. Participants were 158 children (70% boys) between 7–12 years of age being evaluated for possible ADHD. Both parents and teachers completed measures of SCT, ADHD, ODD, and internalizing (anxiety/depres- sion) symptoms. Parents also completed ratings of social engagement and self-control. Teachers also completed measures assessing asociality and exclusion, as well as peer ignoring and dislike. In regression analyses controlling for demographic characteristics and other psychopathology symptoms, parent-reported SCT symptoms were significantly asso- ciated with lower social engagement (e.g., starting conversations, joining activities). Teacher-reported SCT symptoms were significantly associated with greater asociality/with- drawal and ratings of more frequent ignoring by peers, as well as greater exclusion. ODD symptoms and ADHD hyperactive-impulsive symptoms were more consistently associated with other aspects of social behavior, including peer exclusion, being disliked by peers, and poorer self-control during social situations. Findings provide the clearest evidence to date Correspondence should be addressed to Stephen P. Becker, Center for ADHD, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 10006, Cincinnati, OH 45229. E-mail: [email protected] 2 BECKER ET AL. that the social difficulties associated with SCT are primarily due to withdrawal, isolation, and low initiative in social situations. Social skills training interventions may be effective for children displaying elevated SCT symptomatology. Sluggish cognitive tempo (SCT) is characterized by beha- study found teacher-rated SCT to be associated with viors such as daydreaming, mental confusion and fogginess, poorer social skills, whereas parent-rated SCT was unas- behavioral slowness/hypoactivity, and drowsiness/sleepiness sociated with social skills after controlling for ADHD (Becker & Barkley, in press; Becker et al., 2016). Although symptoms (Bauermeister, Barkley, Bauermeister, SCT symptoms were once considered potentially useful for Martinez, & McBurnett, 2012). Other studies have identifying “purely” inattentive children with attention def- found the opposite. For example parent-rated SCT symp- icit/hyperactivity disorder (ADHD), SCT appears to be dis- toms were associated with poorer social skills beyond tinct from ADHD inattention (Barkley, 2014; Becker, ADHD and depressive symptoms, but teacher-rated SCT Marshall, & McBurnett, 2014). Indeed, bifactor modeling was unassociated with social skills when controlling for studies demonstrate that the SCT construct does not fall ADHD and depression (McBurnett et al., 2014). In a under the umbrella of either ADHD (Garner et al., 2014) longitudinal study of Spanish children, parent-reported or a general disruptive behavior factor (Lee, Burns, SCT symptoms, but not teacher-rated SCT symptoms, Beauchaine, & Becker, 2015). As such, research has turned predicted later social impairment (Bernad, Servera, toward investigating whether SCT uniquely predicts mean- Becker, & Burns, 2016). Fenollar Cortés and colleagues ingful external constructs after controlling for ADHD symp- (2014) examined separate inconsistent alertness (e.g., toms, which are clearly associated with a wide range of daydreams, loses train of thought) and slowness (e.g., functional impairments (Faraone et al., 2015). slow moving, seems drowsy) dimensions of SCT and Alargebodyofliteraturedemonstratesthatpeerrela- found that the inconsistent alertness factor was uniquely tionships are a potent determinant of concurrent and long- associated with parent-rated peer problems above and term adjustment, both in youth with and without ADHD beyond ADHD inattentive symptoms, whereas the SCT (Gardner & Gerdes, 2015;Parker,Rubin,Erath, slowness factor was not. Last, two studies reported that Wojslawowicz, & Buskirk, 2006). Several studies have SCT was either positively or unassociated with social sought to determine whether SCT is uniquely associated impairment when parent ratings were used but associated with social functioning. A recent meta-analysis demon- with less social impairment when teacher ratings were strated that SCT is bivariately correlated with social used (Belmar et al., 2015;Watabe,Owens,Evans,& impairment in children and adolescents (Becker et al., Brandt, 2014). In considering their findings, Watabe 2016). However, when examining individual studies and et al. (2014)hypothesizedthatSCTmaybelessnotice- various methodological factors, the story is less clear. able or viewed as less problematic to teachers who have a Many studies investigating SCT in relation to children’s large number of students in their classroom at any given social functioning have relied on broad measures of glo- time and are more readily drawn to disruptive behaviors bal social functioning. These studies have reported mixed as compared to the more passive behaviors of SCT findings, particularly when evaluating whether SCT (though, see Burns, Becker, Servera, Bernad, & García- remains associated with social impairment beyond Banda, 2017,forsomeevidenceincontrasttothis ADHD symptoms. A number of studies have shown hypothesis). Clearly, more research is needed to better parent- or teacher-reported SCT to remain associated understand the mixed findings across studies to date that with greater social difficulties and impairment beyond have evaluated SCT in relation to social functioning. ADHD (Becker, 2014;Becker&Langberg,2013; What might account for these discrepant findings? As Becker, Luebbe, Fite, Stoppelbein, & Greening, 2014; previously noted, the studies just reviewed relied on Burns, Servera, Carrillo, & Cardo, 2013;Khadka, broad, often single-item measures of social functioning/ Burns, & Becker, 2016;Lee,Burns,Snell,& impairment. Consequently, although a moderate-to-strong McBurnett, 2014), whereas others have not (Becker, bivariate correlation was found between SCT and social Luebbe, & Joyce, 2015;Belmar,Servera,Becker,& impairment in a recent SCT meta-analysis (Becker et al., Burns, 2015). Still others have found that whether SCT 2016), it was also noted that “future studies should remained associated with social impairment beyond increase the specificity used in examining various ADHD symptoms varied based on whether parent or domains of impairment” (p. 172). There is some indica- teachers were the informant. For instance, in a study of tion that SCT may be uniquely related to greater with- children from South Korea, SCT remained associated drawal and isolation. Two studies found that children with greater social impairment beyond ADHD when tea- diagnosed with ADHD Predominantly Inattentive Type cher ratings were
Recommended publications
  • Psychophysiology of Aggression
    CHAPTER 5 Psychophysiology of Aggression SUSAN BRANJE and HANS M. KOOT Brief Introduction In this chapter we review psychophysiological studies of the development and main- tenance of aggression in childhood and adolescence. As aggression is likely to be a function of a complex interplay between individual and social factors, this review is concerned with the role of psychophysiological or neurobiological systems in aggressive behavior of children and adolescents, as well as with the interactions of these systems with social factors. The autonomic nervous system (ANS) and the hypothalamic–pituitary–adrenal (HPA) axis both play important roles in the regulation of stress and decision making, and these stress-regulating mechanisms are thought to be important in understanding individual differences in aggressive behavior (Van Goozen, Fairchild, Snoek, & Harold, 2007). Therefore, we focus on the roles of the ANS and the HPA axis in particular. Main Issues Although a large body of literature has addressed psychophysiological correlates of aggressive behavior, the results of these studies are at times quite inconsistent. Contributing to this inconsistency in findings is the heterogeneity in studies in terms of methodological and theoretical issues. We pay attention to a number of these issues, which include the heterogeneity in behavioral constructs and the roles of sex and age. 84 Book_Malti.indb 84 5/10/2018 3:24:42 PM Psychophysiology of Aggression 85 Different Forms of Antisocial and Aggressive Behavior Regarding heterogeneity in behavioral constructs, many studies focus on antisocial behavior more generally and do not distinguish aggressive behaviors from other antisocial or externalizing behaviors. Although externalizing behaviors are often significantly and strongly correlated, failing to distinguish them might obscure research findings and interpretations.
    [Show full text]
  • Leveraging Insights and Approaches from Social and Affective Neuroscience to Promote Adaptive Aging: a Workshop
    Leveraging Insights and Approaches from Social and Affective Neuroscience to Promote Adaptive Aging: A Workshop National Academies of Sciences, Engineering, and Medicine Division of Behavioral and Social Sciences and Education in collaboration with the National Institute on Aging November 18-19, 2019 Keck Center of the National Academies 500 Fifth Street NW, Washington, DC 20001 Final April 10, 2020 This meeting summary was prepared by Bethany Stokes, Rose Li and Associates, Inc., under contract to the National Institute on Aging (NIA). The views expressed in this document reflect both individual and collective opinions of the meeting participants and not necessarily those of the NIA. Review of earlier versions of this meeting summary by the following individuals is gratefully acknowledged: Kelly Beazley, Natalie Ebner, Derek Isaacowitz, Janice Kiecolt-Glaser, Anne Krendl, Rose Maria Li, Beatriz Luna, Mara Mather, Ulrich Mayr, Meghan Meyer, Judith Moskowitz, Lisbeth Nielsen, Marc Schulz, Rebecca Spencer, Luke Stoeckel, Ann Thompson, Nancy Tuvesson. Leveraging Insights from Social and Affective Neuroscience November 18-19, 2019 Table of Contents Acronym Definitions ............................................................................................................. iii Meeting Summary ................................................................................................................. 1 Introduction ..................................................................................................................................1
    [Show full text]
  • Social Neuroscience and Psychopathology: Identifying the Relationship Between Neural Function, Social Cognition, and Social Beha
    Hooker, C.I. (2014). Social Neuroscience and Psychopathology, Chapter to appear in Social Neuroscience: Mind, Brain, and Society Social Neuroscience and Psychopathology: Identifying the relationship between neural function, social cognition, and social behavior Christine I. Hooker, Ph.D. ***************************** Learning Goals: 1. Identify main categories of social and emotional processing and primary neural regions supporting each process. 2. Identify main methodological challenges of research on the neural basis of social behavior in psychopathology and strategies for addressing these challenges. 3. Identify how research in the three social processes discussed in detail – social learning, self-regulation, and theory of mind – inform our understanding of psychopathology. Summary Points: 1. Several psychiatric disorders, such as schizophrenia and autism, are characterized by social functioning deficits, but there are few interventions that effectively address social problems. 2. Treatment development is hindered by research challenges that limit knowledge about the neural systems that support social behavior, how those neural systems and associated social behaviors are compromised in psychopathology, and how the social environment influences neural function, social behavior, and symptoms of psychopathology. 3. These research challenges can be addressed by tailoring experimental design to optimize sensitivity of both neural and social measures as well as reduce confounds associated with psychopathology. 4. Investigations on the neural mechanisms of social learning, self-regulation, and Theory of Mind provide examples of methodological approaches that can inform our understanding of psychopathology. 5. High-levels of neuroticism, which is a vulnerability for anxiety disorders, is related to hypersensitivity of the amygdala during social fear learning. 6. High-levels of social anhedonia, which is a vulnerability for schizophrenia- spectrum disorders, is related to reduced lateral prefrontal cortex (LPFC) activity 1 Hooker, C.I.
    [Show full text]
  • Adenomatous Polyposis Coli Heterozygous Knockout Mice Display Hypoactivity and Age-Dependent Working Memory Deficits
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by PubMed Central ORIGINAL RESEARCH ARTICLE published: 21 December 2011 BEHAVIORAL NEUROSCIENCE doi: 10.3389/fnbeh.2011.00085 Adenomatous polyposis coli heterozygous knockout mice display hypoactivity and age-dependent working memory deficits Hisatsugu Koshimizu1,2, Yasuyuki Fukui 3, Keizo Takao 2,4, Koji Ohira 1,2, Koichi Tanda 3,5, Kazuo Nakanishi 3, Keiko Toyama 1,2, Masanobu Oshima 6, Makoto Mark Taketo 7 and Tsuyoshi Miyakawa 1,2,4* 1 Division of Systems Medical Science, Institute for Comprehensive Medical Science, Fujita Health University, Toyoake, Japan 2 Core Research for Evolutional Science and Technology (CREST), Japan Science and Technology Agency, Kawaguchi, Japan 3 Genetic Engineering and Functional Genomics Group, Frontier Technology Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan 4 Section of Behavior Patterns, Center for Genetic Analysis of Behavior, National Institute for Physiological Sciences, Okazaki, Japan 5 Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan 6 Division of Genetics, Cancer Research Institute, Kanazawa University, Kanazawa, Japan 7 Department of Pharmacology, Graduate School of Medicine, Kyoto University, Kyoto, Japan Edited by: A tumor suppressor gene, Adenomatous polyposis coli (Apc), is expressed in the nervous Jeff Dalley, University of system from embryonic to adulthood stages, and transmits the Wnt signaling pathway in Cambridge, UK which schizophrenia susceptibility genes, including T-cell factor 4 (TCF4) and calcineurin Reviewed by: (CN), are involved. However, the functions of Apc in the nervous system are largely Jeff Dalley, University of Cambridge, UK unknown. In this study, as the first evaluation of Apc function in the nervous system, Adam C.
    [Show full text]
  • Utility for Candidate Gene Studies in Human Attention-Deficit Hyperactivity
    Journal of Neuroscience Methods 166 (2007) 294–305 Rodent models: Utility for candidate gene studies in human attention-deficit hyperactivity disorder (ADHD) Jonathan Mill a,b,∗ a Centre for Addiction and Mental Health, Toronto, Canada b Toronto Western Research Institute, Toronto, Canada Received 6 September 2006; received in revised form 30 November 2006; accepted 30 November 2006 Abstract Attention-deficit hyperactivity disorder (ADHD) is a common neurobehavioral disorder defined by symptoms of developmentally inappropriate inattention, impulsivity and hyperactivity. Behavioral genetic studies provide overwhelming evidence for a significant genetic role in the patho- genesis of the disorder. Rodent models have proven extremely useful in helping understand more about the genetic basis of ADHD in humans. A number of well-characterized rodent models have been proposed, consisting of inbred strains, selected lines, genetic knockouts, and transgenic animals, which have been used to inform candidate gene studies in ADHD. In addition to providing information about the dysregulation of known candidate genes, rodents are excellent tools for the identification of novel ADHD candidate genes. While not yet widely used to identify genes for ADHD-like behaviors in rodents, quantitative trait loci (QTL) mapping approaches using recombinant inbred strains, heterogeneous stock mice, and chemically mutated animals have the potential to revolutionize our understanding of the genetic basis of ADHD. © 2006 Elsevier B.V. All rights reserved. Keywords: Attention-deficit hyperactivity disorder (ADHD); Genetics; Animal model; Quantitative trait loci (QTL); Rodents; Behavior; Candidate gene 1. Introduction is likely that susceptibility is mediated by the effect of numer- ous genes of small effect, interacting both epistatically and with Attention-deficit hyperactivity disorder (ADHD) is a com- the environment.
    [Show full text]
  • Attention-Deficit/Hyperactivity Disorder Predominantly Inattentive
    brain sciences Review Attention-Deficit/Hyperactivity Disorder Predominantly Inattentive Subtype/Presentation: Research Progress and Translational Studies Ike C. de la Peña 1,* , Michael C. Pan 2,3, Chau Giang Thai 1 and Tamara Alisso 1 1 Department of Pharmaceutical and Administrative Sciences, Loma Linda University School of Pharmacy, Loma Linda, CA 92350, USA; [email protected] (C.G.T.); [email protected] (T.A.) 2 Department of Psychology, Korea University, Seoul 02841, Korea; [email protected] 3 Division of Social Sciences, University of the Philippines Visayas Tacloban College, Tacloban 6500, Philippines * Correspondence: [email protected]; Tel.: +1-909-651-5995; Fax: +1-909-558-0446 Received: 23 April 2020; Accepted: 9 May 2020; Published: 14 May 2020 Abstract: Research on the predominantly inattentive attention-deficit/hyperactivity disorder (ADHD-PI) subtype/presentation is important given its high prevalence, but paradoxically it is under-recognized and undertreated. The temporal stability of the inattention symptom could impact the high worldwide prevalence of ADHD-PI. Some evidence suggests differences in the nature of attentional deficit in ADHD-PI vs. that in other subtypes. Impairments in neuropsychological, neurocognitive, and social functioning are also evident in ADHD-PI, which could be specific to the subtype (e.g., processing speed, social perception, and skills), or differ from others in severity. Neuroimaging studies have also revealed ADHD-PI-specific neuropathological abnormalities and those that are shared with other subtypes. ADHD-PI is highly comorbid with learning and internalizing (e.g., anxiety and depression) disorders. There is no solid evidence for ADHD-PI-specific genetic etiologies and differential responses of subtypes to ADHD medications.
    [Show full text]
  • A PET Study on D2-Receptor Binding
    doi:10.1093/brain/awl163 Brain (2006), 129, 2017–2028 Support for dopaminergic hypoactivity in restless legs syndrome: a PET study on D2-receptor binding Simon Cˇ ervenka,1 Sven E. Pa˚lhagen,2 Robert A. Comley,4 Georgios Panagiotidis,3 Zsolt Csele´nyi,1 Julian C. Matthews,4,5 Robert Y. Lai,6 Christer Halldin1 and Lars Farde1 1Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Karolinska University Hospital Solna, 2Department of Neurology, 3Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska University Hospital Huddinge, Stockholm, Sweden, 4Translational Medicine and Genetics, GlaxoSmithKline, Cambridge, 5The University of Manchester, Wolfson Molecular Imaging Centre, Manchester and 6Neurology Discovery Medicine, GlaxoSmithKline, Harlow, UK Correspondence to: Simon Cˇ ervenka, Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Karolinska University Hospital Solna, Building R5, SE-171 76 Stockholm, Sweden E-mail: [email protected] Clinical observations support a central role of the dopamine system in restless legs syndrome (RLS) but previous imaging studies of striatal dopamine D2-receptors have yielded inconclusive results. Extrastriatal dopaminergic function has hitherto not been investigated. Sixteen RLS patients naı¨ve to dopaminergic drugs and sixteen matched control subjects were examined with PET. [11C]Raclopride and [11C]FLB 457 were used to estimate D2-receptor availability in striatum and extrastriatal regions, respectively. Examinations were performed both in the morning (starting between 10:00 and 12:00 h) and evening (starting at 18:00 h). Measures were taken to monitor and control for head movement during data acquisition. In the striatum, patients had significantly higher [11C]raclopride binding potential (BP) values than controls.
    [Show full text]
  • 7Th World Congress on ADHD: from Child to Adult Disorder
    ADHD Atten Def Hyp Disord (2019) 11(Suppl 1):S1–S89 https://doi.org/10.1007/s12402-019-00295-7 ABSTRACTS Ó Springer-Verlag GmbH Austria, part of Springer Nature 2019 7th World Congress on ADHD: From Child to Adult Disorder 25th–28th April, Lisbon Portugal Editors: Manfred Gerlach, Wu¨rzburg Peter Riederer, Wu¨rzburg Andreas Warnke, Wu¨rzburg Luis Rohde, Porto Alegre 123 S2 ABSTRACTS Introduction Dear Colleagues and Friends, We are pleased to have received more than 180 poster abstracts as well as more than 100 poster abstracts from young scientists and clinicians (\ 35 years) who applied for our Young Scientists’ Award. Of all abstracts submitted by our young colleagues, the Scientific Programme Committee has selected the best eight. The authors have been invited to give a presentation as part of our two Young Scientist Award Sessions and to receive a prize money in the amount of 500 Euros. With this approach, we intend to highlight the importance of original scientific contributions, especially from our young colleagues. In this volume, the abstracts of our two Young Scientist Award Sessions come first, followed by regular poster abstracts. These have been organized by topics: Aetiology, Autism Spectrum Disorders, Co-morbidity, Diagnosis, Electrophysiology, Epidemiology, Experimental Models, Genetics, Neuroimaging, Non-pharmacological Treatment, Pathophysiology, Pharmacological Treatment, Quality of Life/Caregiver Burden, Substance Use Disorders and Miscellaneous. Submitted abstracts have not been modified in any way. Please, do not just read the selected poster abstracts, we also encourage you to actively discuss and share your ideas with our young colleagues. Finally, we would like thank all our speakers, contributors and sponsors of our 7th World Congress on ADHD: from Childhood to Adult Disease, and welcome you to join—what we are sure will be—a very enjoyable and highly informative event.
    [Show full text]
  • 2003 New Orleans, UNITED STATES
    INTERNATIONAL BEHAVIOURAL AND NEURAL GENETICS SOCIETY 6th Annual Meeting November 5-7, 2003 Hyatt Regency New Orleans Convention Hotel New Orleans, Louisiana USA Program Sponsored by National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, USA National Institute of Mental Health, National Institutes of Health, USA National Institute on Aging, National Institutes of Health, USA National Institute of Child Health and Human Development, National Institutes of Health, USA Wednesday, November 5th 6:00-9:00pm Registration Poydras AB – 2nd fl RCC 7:00-10:00pm Reception – hors d’oeuvres and cash bar Poydras AB – 2nd fl RCC Thursday, November 6th 7:00-7:45am Thursday Speakers’ Presentation Preparation Loyola AB – Lower Level RCC (please bring your PPT presentation to be loaded on our computer) 7:00-8:30am Continental Breakfast RCC Foyer - Lower Level 8:15-8:30am Opening Remarks Loyola AB – Lower Level RCC 8:30-10:30am Symposium Session I Loyola AB – Lower Level RCC Genetic influences on anxiety related behaviors: From mouse to monkey to man Chairs & Organizers: Christina Barr & Tim Newman DICBR/LCS Animal Center, National Institute on Alcohol Abuse and Alcoholism, NIH, Dickerson, Maryland, USA Identifying genes that influence complex behaviors has become an increasingly important aspect of understanding the spectrum of etiological factors involved in the pathogenesis of neuropsychiatric disease. Both human and animal studies support a role for genes in the incidence of anxiety. While various anxiety-related traits are asserted to be under the influence of genes, gene association studies are often difficult to replicate. Of use to neurobehavioral genetics research is the use of animal models and the identification and definition of appropriate intermediate phenotypes.
    [Show full text]
  • Treatment-Resistant Attention-Deficit Hyperactivity Disorder: Clinical
    Review Treatment-resistant Attention-deficit Hyperactivity Disorder: Clinical Significance, Concept, and Management Mu‑Hong Chen, M.D., Ph.D.1,2, Kai‑Lin Huang, M.D.1,2, Ju‑Wei Hsu, M.D.1,2,*, Shih‑Jen Tsai, M.D.1,2,* 1Department of Psychiatry, Taipei Veterans General Hospital, 2Division of Psychiatry, School of Medicine, National Yang‑Ming University, Taipei, Taiwan Abstract Background: Attention-deficit hyperactivity disorder (ADHD) is the most commonly diagnosed neurodevelopmental disorder known to cause impairment across the lifespan. ADHD was ranked as approximately the 50th leading cause of global years lived with disability for children, coming in ahead of diabetes, meningitis, and intellectual disability. About 20%–40% of patients with ADHD would not achieve the treatment response and symptomatic remission, increasing future risks of substance abuse, suicidal behavior, and premature mortality. However, there is no standard consensus for defining treatment resistance in ADHD.Method: In this systematic review, we intend to focus on treatment-resistant ADHD in the aspects of disease definition, psychopathology, pathophysiology, and treatment. Results: We suggest that the more ideal strategy of defining treatment resistance should consider the improvement of ADHD symptoms and the global functioning simultaneously. Psychiatric comorbidities (i.e. destructive behavior disorders and mood disorders), physical comorbidities (i.e. epilepsy), and psychosocial adversities (i.e. parental psychopathology and poor family functioning) should be the first to be assessed in the evaluation of treatment response or resistance. The optimal medication adjustment or the combination of medications and psychotherapy may be the potential therapeutic strategy for treatment-resistant ADHD. Conclusion: Further studies would be necessary to elucidate the underlying mechanisms of treatment-resistant ADHD and to research the novel treatment strategies for ADHD.
    [Show full text]
  • Sluggish Cognitive Tempo: Current Knowledge and Future Directions
    Research RESEARCH BRIEFS Sluggish Cognitive Tempo: Current Knowledge and Future Directions by Lisa Jacobson, PhD, NCSP Do you find yourself saying, “Come on! Hurry up!” multiple times each day? Maybe she is your daughter or he is a student in your classroom. She is the last one to com- plete her work, turn in that test, or even get her things together to go home. Even when he is paying attention, he just seems to need longer than anyone else to get the job done. Neither child is particularly hyperactive. Could this be ADHD? Something else? in interest in better characterizing the be- almost sixty percent of those with SCT The something else might be sluggish havioral characteristics of sluggish cogni- also met criteria for diagnosis of ADHD cognitive tempo (SCT). A growing body of tive tempo and determining whether and and close to forty percent of those meet- evidence suggests that SCT is a distinct be- to what degree symptoms are distinct from ing the diagnostic symptom threshold for havioral pattern, or phenotype, that is both ADHD and other childhood disorders. ADHD also had SCT. Other studies have overlapping and yet distinct from ADHD similarly found that approximately thirty and other childhood disorders. Identified Measuring SCT symptoms to sixty percent of youth with ADHD inat- during field trials for the fourth edition of SCT symptoms are usually measured with tentive type show high levels of SCT.These the Diagnostic and Statistical Manual of behavior rating scales, typically completed numbers suggest that a large proportion Mental Disorders (DSM-IV), SCT is char- by parents or teachers.
    [Show full text]
  • The Neuropsychology of Self-Reflection in Psychiatric Illness
    Journal of Psychiatric Research 54 (2014) 55e63 Contents lists available at ScienceDirect Journal of Psychiatric Research journal homepage: www.elsevier.com/locate/psychires Review The neuropsychology of self-reflection in psychiatric illness Carissa L. Philippi*, Michael Koenigs* Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Boulevard, Madison, WI 53719, USA article info abstract Article history: The development of robust neuropsychological measures of social and affective functiondwhich link Received 12 November 2013 critical dimensions of mental health to their underlying neural circuitrydcould be a key step in achieving Received in revised form a more pathophysiologically-based approach to psychiatric medicine. In this article, we summarize 10 February 2014 research indicating that self-reflection (the inward attention to personal thoughts, memories, feelings, Accepted 7 March 2014 and actions) may be a useful model for developing such a paradigm, as there is evidence that self- reflection is (1) measurable with self-report scales and performance-based tests, (2) linked to the ac- Keywords: tivity of a specific neural circuit, and (3) dimensionally related to mental health and various forms of Self-reflection Psychiatric illness psychopathology. Ó Depression 2014 Elsevier Ltd. All rights reserved. Anxiety Psychopathy Autism Neuropsychology Rest-state functional neuroimaging Medial prefrontal cortex Default mode network 1. Introduction and/or function. Neuropsychology offers a promising approach in this regard. For certain cognitive functions, extensive neuropsy- A major goal in psychiatric medicine is to develop a system of chological batteries of performance-based tests have long been diagnosis and treatment that is pathophysiologically-based (Insel established. For example, in the domain of memory, there are et al., 2010).
    [Show full text]