Thesis (Ph. D.)--University of North Texas, May, 2007. / Title from title page display. Includes bibliographical references.

Thesis (Ph. D.)--Florida State University, 2005. / Advisor: Dr. Janet Kistner, Florida State University, College of Arts and Sciences, Dept. of Psychology. Title and description from dissertation home page (viewed Sept. 21, 2005). Document formatted into pages; contains viii, 143 pages. Includes bibliographical references.

Thesis (D.Psych.) - University of Queensland, 2007. / Includes bibliography.

Text in Afrikaans / The focus of this qualitative study was the perceptions of parents regarding their toddlers' regressive behaviour. For the purposes of this study the term perceptions relates to both the impressions in a persons' consciousness as well as the result thereof. The researcher compiled a conceptual framework from the existing literature and then carried out the empirical study. A focus group of four parents' whose toddler or toddlers showed regressive behavior at the time of the study was compiled. A focusgroup discussion was held where the parents described their perceptions of their toddlers' regressive behaviour. The focus group discussion was recorded both by video camera as well as a digital recorder with the consent of all focus group participants, after which it was transcribed. Recurring themes were identified from the transcribed data and verified with literature. Qualitative data were obtained that answered the research question. / Social work / M.Diac.

Conduct Disorder (CD) is a repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate societal norms or rules are violated. It is one of the most common problems in South African schools, particularly in those that are poverty-stricken. The child who participated in the study lived in the shelter that was for homeless and disadvantaged children. He attended at Amasango School where the majority of children in the shelter attended. There were many conduct-disordered children in the shelter and the school, particularly in the school. They disrupted classes making in difficult for teachers to carry out their education activities. The aim of this study was to draw on the standard procedures of the CBT in order to design interventions that would be effective in reducing aggressive behaviour in an adolescent who had CD Adolescent-Type and who lived at the shelter. This case study evaluated the effectiveness of a multi-modal CBT programme in a 16 year-old Black male who had been displaying aggressive behaviour for about a year. The treatment consisted of 23 sessions and included teacher counseling, contingency management, self-control and self-instructional training. The treatment was evaluated qualitatively by means of interviews with the child and teacher and quantitatively by means of repeated applications of behaviour checklists completed by the teacher. The results showed a decrease in the client's aggressive behaviour and an increase in prosocial behaviour. The client ultimately ceased from all aggressive behaviour towards his peers and this outcome was sustained during his last two months in therapy.

Orientador: Rubens Nelson Amaral de Assis Reimão / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-07T02:15:32Z (GMT). No. of bitstreams: 1 Neves_SergioNolascoHoradas_M.pdf: 1751800 bytes, checksum: 9bfc14cfa73c38adebb4b448d4d3beed (MD5) Previous issue date: 2006 / Resumo: Esse estudo avalia a associação entre Transtorno do Déficit de Atenção e Hiperatividade (TDAH) e distúrbios do sono para caracterizar fatores clínicos e problemas associados. No primeiro artigo nós revisamos diversas pesquisas sobre alterações do sono em crianças com Transtorno do Déficit de Atenção e Hiperatividade (TDAH) com ou sem o tratamento com psicoestimulantes. No segundo artigo fizemos revisão de prontuários de 50 crianças e adolescentes com idade de 4 a 17 anos e consecutivo diagnóstico de TDAH sem diagnóstico de retardo mental ou transtornos invasivos do desenvolvimento. Resultados: estudos do sono têm sido realizados e anormalidades durante o sono como Síndrome das Pernas Inquietas (SPI), Movimentos Periódicos dos Membros Durante o Sono (MPMS), Distúrbios Respiratórios do Sono (DRS) podem ser responsáveis por muitos sintomas de TDAH. Crianças com distúrbios de sono nos primeiros meses de vida foram associados com desenvolvimento de sintomas de TDAH ainda na infância. Foram encontradas associações significativas entre alterações do sono e farmacoterapia (p<0,01), comorbidade (p<0,01) e maior aderência ao tratamento prescrito para sintomas de TDAH (p<0,05). Conclusões: avaliação de distúrbios do sono deve ser considerada antes de iniciar tratamento farmacológico para TDAH porque os critérios diagnósticos baseados no DSM-IV ou CID-10 não diferenciam entre crianças com ou sem distúrbios do sono. O conhecimento sobre os distúrbios do sono pode trazer uma nova oportunidade de tratamento para algumas crianças com TDAH. Serão necessárias novas pesquisas para clarear a relação entre distúrbios do sono e TDAH, ou os efeitos dos estimulantes no sono de crianças com TDAH. Descritores: Transtornos do Sono, Transtornos do Comportamento Infantil, Sono, Transtorno da Falta de Atenção com Hiperatividade, Literatura de Revisão / Abstract: This study examined the relationship between Attention Deficit Hyperactivity Disorder (ADHD) and sleeps disorders to chacterize clinical features and associated problems. In the first paper we review several researches about sleep disturbances in children with Attention-Deficit Hyperactivity Disorder (ADHD) with or without psychostimulant treatment. In the second paper we performed a record review for 50 consecutive children and adolescents aged 4 to 17 years with ADHD who do not have mental retardation or pervasive developmental disorders. Results: sleep studies have been performed and abnormalities during the sleep such Restless Legs Syndrome (RLS), Periodic Limbs Moviments in Sleep (PLMS), Sleep-Disorder Breathing (SDB) could be responsible for severe diurnal ADHD symptoms. Infants with sleep disorders were associated with development of ADHD in later childhood. Significant relationship were found between sleep disturbances and pharmacotherapy (p<0.01), comorbidity (p<0.01) and greatest adherence to treatment prescribed for symptoms of ADHD (p<0.05). Conclusions: evaluation of sleep disorders should be considered before starting drug treatment for ADHD because diagnostic criteria for ADHD based on DSM-IV or ICD-10 do not differentiate between children with or without sleep disorders. Assessment for sleep disorders may provide a new treatment opportunity for some ADHD children. Future researchs will need to clarify the relationship between sleep disorders and ADHD or the effects of stimulants on sleep de children with ADHD / Mestrado / Saude da Criança e do Adolescente / Mestre em Pediatria

Obesidade sindrômica é definida como a obesidade ocorrendo em conjunto com várias características clínicas distintas, associadas a retardo mental. A forma sindrômica mais freqüente é a síndrome de Prader-Willi (PWS) caracterizada por hipotonia, dificuldade de sucção no período neonatal, atraso do desenvolvimento neuropsicomotor (DNPM), hiperfagia, obesidade, baixa estatura na adolescência, mãos e pés pequenos, hipogonadismo, dificuldade de aprendizado e distúrbios de comportamento. Estudamos 141 pacientes com obesidade e/ou hiperfagia, atraso no desenvolvimento neuropsicomotor e/ou dificuldades de aprendizado e distúrbios de comportamento, pela técnica de MLPA (multiplex ligation-dependent probe amplification) assim como 19 pacientes que apresentavam além de atraso do DNPM e/ou dificuldade de aprendizado, distúrbios de comportamento, obesidade e/ou hiperfagia, outro sinal ao exame físico que sugerisse alteração cromossômica, pela técnica de SNP-array (The GeneChip 174; Mapping 100K Set, Affymetrix), com o objetivo de identificar genes e/ou segmentos cromossômicos envolvidos com obesidade sindrômica. Essas técnicas detectam deleções e/ ou duplicações do genoma, seja analisando regiões específicas, como a de MLPA, seja cobrindo praticamente o genoma inteiro (SNP-array). Dez pacientes apresentaram alterações cromossômicas: duas deleções 1p36, uma deleção 2p25.3, uma deleção 3p26.3 e duplicação 11q22.3, uma deleção 6(q16.1-q21), duas deleções 12(q15q21.1) (irmãs gêmeas), uma deleção X(p22.13p22.12), uma duplicação 14q11.2 e uma duplicação X(q26.3). Dentre as alterações encontradas estão duas síndromes relacionadas com obesidade já descritas, a monossomia 1p36 e a monossomia 6q16, que são diagnósticos diferencias da PWS. Nos segmentos alterados foram localizados vários genes relacionados a obesidade: DRD2, MCHR2, PLCH2, PRKCZ, RAB21, RAB2B, RAB39, TPO e SIM1. Onze genitores foram analisados por MLPA, SNP-Array e/ou cariótipo e rearranjos cromossômicos não foram identificados. Na presença dos cromossomos parentais normais o risco de recorrência é considerado desprezível. O diagnóstico de pacientes com obesidade sindrômica é um desafio, pois há sobreposição de fenótipos impossibilitando até agora o diagnóstico diferencial, a não ser o da síndrome de Prader-Willi clinicamente reconhecível, pelo menos, em sua segunda fase. O emprego de técnicas que detectam variações no número de cópias do genoma humano amplia a possibilidade de reconhecimento de novas síndromes e a descrição do espectro da variabilidade fenotípica de síndromes conhecidas. Estas síndromes são uma potencial fonte de esclarecimento das causas das formas comuns de obesidade. / Syndromic obesity is defined as obesity occurring in association with several distinct clinical features and mental retardation (MR). Prader-Willi syndrome (PWS) is the most frequent syndromic form of obesity and is characterized by hypotonia, poor sucking in the neonatal period, developmental delay, hyperphagia, obesity, short stature in adolescence, small hands and feet, hypogonadism, learning disabilities and behavior disturbances. Herein, we studied 141 patients with obesity and/or hyperphagia, psychomotor developmental delay and/or learning disabilities and behavior disturbances with the technique of MLPA (multiplex ligation-dependent probe amplification), and 19 patients by SNP-array technique (\"The GeneChip 174; Mapping 100K Set, Affymetrix) to identify copy number variations. By using both techniques we detected deletions or duplications of the genome in ten patients: two deletions at 1p36, two deletions at 12q15q21.1 (twins), a deletion of chromosomes 2p25.3, 6q16.1-q21, and Xp22.13p22.12, a duplication of chromosomes 14q11.2 and Xq26.3, and an unbalanced translocation between chromosomes 3p26.3 and 11q22.3. Monosomy 1p36 and monosomy 6q16 are well-known syndromes and had already been related with obesity. Both syndromes are considered as differential diagnosis of PWS. Several genes related to obesity are mapped in the altered chromosome segments: DRD2, MCHR2, PLCH2, PRKCZ, RAB21, RAB2B, RAB39, TPO and SIM1. Eleven parents were studied by MLPA, SNP array, and / or karyotype analyses, and chromosomal rearrangements were not identified. Therefore, we consider these rearrangements to be causative of the patients´ phenotype. The diagnosis of patients with syndromic obesity is a challenge due to the overlapping of the phenotypes, except for Prader-Willi syndrome that is a clinically recognizable syndrome, mainly in its second phase. The use of techniques that detect copy number variations of the human genome will increase the recognition of new syndromes and also the description of the spectrum of phenotypic variability of known syndromes. These syndromes are a potential source for the understanding of the etiology of the common forms of obesity.

As práticas educativas parentais são consideradas determinantes primários no desenvolvimento de comportamentos socialmente competentes, problemas de comportamento e comportamentos relacionados à saúde na infância. Na adolescência, a influência parental sobre esses comportamentos tem literatura divergente, visto que diversos autores acreditam que a influência parental continua central, enquanto outros defendem a idéia de que a principal determinação vem do grupo de pares. Diante desse contexto, o objetivo geral dessa pesquisa foi o de relacionar as práticas educativas maternas e paternas aos comportamentos de proteção e risco à saúde na adolescência, bem como as variáveis de competência social (CS), problemas de comportamento (PC) e dificuldades com os pares, avaliando o grau de predição das práticas parentais sobre os comportamentos do adolescente. Para atingir tais objetivos, participaram deste estudo 485 adolescentes, divididos em três faixas etárias (11 a 13 anos, 14 e 15 anos, 16 e 17 anos). Todos responderam ao Inventário de Estilos Parentais materno e paterno, Inventário de auto-relato para jovens (YSR) e questionário de estilo de vida (HBSC). Os dados foram analisados através estatística descritiva, análises de correlação, de inferência estatística e análises multivariadas. Os principais resultados foram: 1) práticas educativas maternas e paternas não variaram em função do sexo dos adolescentes, porém foram diferentes entre as três faixas etárias (considerando p &#8804; 0,05); 2) não houve diferença quanto à CS entre meninos e meninas, porém estas alcançaram maiores PC; 3) CS se relacionou às práticas positivas maternas (PPM) entre os mais jovens, e às PPM e às práticas positivas paternas (PPP) entre os mais velhos; 4) a partir da categorização dos índices de estilo parental em famílias com estilo parental de risco, intermediária e de proteção, observou-se que aquelas consideradas de proteção tiveram filhos com escores mais positivos de CS e menores escores nas escalas de PC, sendo que as famílias intermediárias tiveram seus filhos mais próximos das famílias de proteção na CS e mais próximo das famílias de risco nas escalas de PC nas três faixas etárias; 5) em relação aos comportamentos de proteção, os adolescentes mais jovens relataram maior freqüência desses, enquanto que os mais velhos alcançaram maiores escores nos comportamentos de risco; 6) as correlações entre estilo parental e comportamentos de proteção e risco foram significativos nas três faixas etárias, porém decaíram com o aumento da idade; 7) a partir da categorização de estilo parental, observouse que entre os adolescentes mais jovens, os de famílias de proteção tiveram filhos com escores significativamente melhores nos comportamentos de saúde e de risco; o que se manteve nas outras faixas etária, porém, em geral, não de forma significativa.; 8) os modelos de análise multivariada (modelo de regressões múltiplas e modelagem de equações estruturais) indicaram que as práticas parentais são preditoras de CS e PC nas três faixas etárias. Diante desses resultados, a pesquisa indica que a influência parental na adolescência ocorre de forma distinta em função da idade, sendo direta na fase inicial e esvanece gradualmente com o aumento da idade, porém ainda mostrando-se significativa, em especial no que concerne às práticas parentais negativas e aos comportamentos de risco. / The parental educational practices are considered primary determining in the development of socially competent behaviors, behavioral problems and behavior related to childhood health. At adolescence, the parental influence over those behaviors has divergent literature, given that several authors believe that the parental influence continues central, while others defend the idea that the main determination comes from the pair groups. In that context, the overall objective of this research was to relate the maternal and paternal educational practices to the behaviors of protection and risk to the health at adolescence, as well as the social competence (SC) variables, behavioral problems (BP) and difficulties with the pairs, evaluating the degree of prediction of the parental practices over the adolescent\'s behaviors. In order to achieve such objectives, 485 teenagers participated in this study, divided into three age groups (11 to 13; 14 and 15; 16 and 17 year-olds). They all answered the Maternal and Paternal Parental Style Inventory; the Young Self Relate (YSR) and the questionnaire of lifestyle (QLS). The data have been analyzed through descriptive statistics, correlation analysis, of statistics inferring and multi varied analysis. The main results were: 1) maternal and paternal practices did not vary according to the adolescents\' gender, on the other hand, were different according to the age groups (considering p &#8804; 0,05); 2) there was no difference in SC between boys and girls, however these reached higher PC; 3) SC related to the Maternal Positive Practices (MPP) among the youngest, and to the Paternal Positive Practices (PPP) among the oldest; 4) with the categorization of the families\' parental style as risky, intermediate and protective, it has been observed that those considered protective had children with the highest SC scores and lower BP scores, being that the intermediate families had their children closer to the protective families\' SC scores and closer to the risky families in the BP scores for all three age groups; 5) concerning the protective behaviors, the youngest teenagers stated more frequency of those, while the oldest reached higher risky behavior scores; 6) the correlations between parental style and risk and protection behaviors were significant at all three age groups, however, decreased at higher ages; 7) from the categorization of parental style, it has been observed that among the younger teenagers, the ones from the protective families had kids with significantly higher scores at health and risk behaviors; which was maintained at the other age groups, although in general, not significantly; 8) the models with multi varied analysis ( multiple regression model and structural equations modeling) indicated that the parental practices are predictor of SC and BP at the three age groups. With those results, the research indicates that the parental influence in adolescents occurs in different ways according to the age, being more direct in the initial phase and vanishing gradually as age increases, although still significant, especially concerning the negative parental practices and the risk behaviors.

M.A. / ADD is a term used to describe a group of individuals who have certain common problems. Most have learning difficulties that may interfere with school and social activities. Many are hyperactive and/or easily distracted with short spans of attention. The exact causes of ADD are not known, but there is widespread acceptance that the disorder is often inherited. ADD is presently managed, but not cured. Effective management requires understanding. It is essential that all those involved develop a commonsense understanding of the associated problems. The aim of this study is to describe the behaviour of ADD children and their parents in order to establish whether similarities exist between the two. This will assist in understanding this complex disorder. The literature review served as a theoretical basis for the research. It also aided in the design of additional questionnaires which were used to gather demographic information on the children and parents involved. The objectives of the study were firstly to describe the behaviour of ADD children using the Behaviour Rating Scale for Hyper-children (BRASH). By analyzing data gathered from this instrument, high scores in the areas of intensity, persistence, sensitivity, perceptiveness, energy and extroversion, were identified. Secondly, the Assessment Scale for Hyperpersons (ASH) was administered in order to collect data concerning the behaviour of parents involved. Areas that received high scores included: intensity, perceptiveness, sensitivity, energy and extroversion. The next objective was to establish possible similarities in the behaviour of ADD children and their parents. The behaviour patterns were compared, and similarities identified. Both groups scored highest in the areas of intensity, perceptiveness, sensitivity, energy and extroversion. The results emphasize ADD as a family issue, rather than an individual one.

Abstract Attention deficit hyperactivity disorder (ADHD) and disruptive behavior disorder (DBD) are two very common and co-occurring psychiatric disorders among children and adolescents. They are among the leading reasons for clinical referrals to child and adolescent mental health facilities worldwide and have many unfavorable consequences with a high cost to society. In this thesis, the potential early risk factors associated with ADHD and/or DBD were examined, the current well-being of the adolescent with ADHD and/or DBD was evaluated and the later education and the psychiatric morbidity of the adolescent were researched. The study population in this thesis is based on a subsample of the Northern Finland Birth Cohort 1986 (NFBC 1986) containing 457 study subjects, of which 91 (19.9%) were diagnosed with ADHD, 44 (9.6%) with DBD, 72 (15.6%) with comorbid ADHD and DBD and 250 (54.7%) with neither of these disorders. Confirmatory factor analysis, Kaplan-Meier survival analysis, Kruskal-Wallis one-way analysis of variance and several regression analyses were carried out in the study. This thesis contains four original publications. The results in the first publication indicated that there are different risk factors in childhood associating with different behavioral problems in adolescence. The differences between behavioral problems were also visible in the results of the second publication, where those adolescents who were diagnosed with both ADHD and DBD had more severe conduct disorder symptoms and had increased risks for many psychiatric disorders. The results from the third publication suggested that those adolescents who were diagnosed with both ADHD and DBD fared worse in school at the end of ninth grade and were later less likely to achieve higher than basic education. Finally, the fourth publication showed that the adolescents diagnosed with DBD (both with and without ADHD) seemed to have an increased risk for admittance to the psychiatric inpatient hospital. This thesis underlines the differences between children and adolescents diagnosed with ADHD and/or DBD and emphasizes the role of comorbidity between these disorders as an indicator of poorer outcomes later in life. / Tiivistelmä Tarkkaavaisuus- ja ylivilkkaushäiriö (attention deficit hyperactivity disorder, ADHD) sekä käytös- ja uhmakkuushäiriöt (disruptive behavior disorder, DBD) ovat hyvin yleisiä – ja usein yhtä aikaa ilmeneviä – lasten ja nuorten psyykkisiä häiriöitä. Nämä häiriöt ovat hyvin usein syynä lasten ja nuorten psykiatristen terveyspalveluiden käyttöön. Niillä on myös todettu olevan useita epätoivottuja seurauksia, joiden hoitaminen puolestaan nostaa yhteiskunnan kuluja. Tämä väitöskirjatyö tutkii mahdollisia varhaisia riskitekijöitä, jotka assosioituivat ADHD- ja/tai DBD-häiriöiden kanssa, arvioi näillä häiriöillä diagnosoitujen nuorten sen hetkistä hyvinvointia ja tutkii näiden nuorten kouluttautumista sekä muuta psykiatrista sairastavuutta. Tutkimusaineisto koostuu Pohjois-Suomen syntymäkohortti 1986 (Northern Finland Birth Cohort 1986, NFBC 1986) -aineiston osaotoksesta, johon kuuluu 457 henkilöä. Osaotoksesta 91:llä (19,9 %) oli diagnosoitu ADHD, 44:llä (9,6 %) DBD ja 72:lla (15,6 %) komorbidi ADHD ja DBD. 250 henkilöllä (54,7 %) osaotoksesta ei ollut diagnosoitu kumpaakaan diagnoosia. Aineiston analysoinnissa käytettiin konfirmatorista faktorianalyysiä, Kaplan-Meierin elossaolomenetelmää, Kruskal-Wallisin yksisuuntaista varianssianalyysiä ja useita regressioanalyysejä. Tämä väitöskirja koostuu neljästä osajulkaisusta. Ensimmäisen osajulkaisun tulokset osoittivat, että eri riskitekijät lapsuudessa assosioituivat eri käytösongelmiin nuoruudessa. Eri käytösongelmien eroavaisuudet olivat myös nähtävillä toisessa osajulkaisussa: niillä nuorilla, joilla oli diagnosoitu komorbidi ADHD ja DBD, todettiin olevan vakavampia käytöshäiriöiden oireita sekä kohonnut riski useisiin muihin psykiatrisiin sairauksiin. Kolmannen osajulkaisun tulokset viittasivat näiden nuorien, jotka oli diagnosoitu komorbidillä ADHD:lla ja DBD:llä, pärjäävän huonommin koulussa ja valmistuvan muita todennäköisemmin vain peruskoulusta. Lopuksi neljännessä osajulkaisussa todettiin, että DBD diagnoosin nuorena saaneilla (riippumatta ADHD diagnoosista) näytti olevan kohonnut riski psykiatriseen osastohoitoon joutumiselle. Tämä väitöskirjatyö alleviivaa tarkkaavaisuus- ja ylivilkkaushäiriöllä sekä käytös- ja uhmakkuushäiriöillä diagnosoitujen lasten ja nuorten eroavaisuuksia ja korostaa kyseisten häiriöiden komorbidin ilmenemisen roolia huonon lopputuloksen ennustetekijänä myöhemmin nuoren elämässä.