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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
11

The Impact of Knowledge, Attitude, and Peer Influence on Adolescent Energy Drink Consumption

Ward, Alyson C. 01 December 2009 (has links)
Adolescents are labeled as sensitive to caffeine, though despite this predisposition, consumption is high among this population. Energy drinks are a current trend in soft-drink-like beverages and are marketed to 11-35 year olds. However, unlike soft drinks, energy drinks are not regulated by the Food and Drug Administration, and therefore do not have to limit their caffeine content. This cross-sectional, correlational study sought to identify the role that knowledge, attitudes, and peers play in adolescent energy drink consumption. Adolescents (n = 199), ages 18 to 21, at a university in the west were surveyed. Descriptive statistics revealed that 25% of the surveyed population reported consuming at least one energy drink in the last 30 days. Using binary logistic regression, it was determined that having seen warning labels on energy drink cans significantly reduced the odds that the participant would consume energy drinks (p < .01). Interestingly, having more negative attitudes toward caffeine increased the odds the individual would consume energy drinks (p < .01). Additionally, the more individuals disagreed that they drank energy drinks with friends, the more likely they were to drink energy drinks (p < .01). Being male significantly increased the odds that the individual would consume energy drinks (p < .01). Moreover, there was a significant interactive effect between having a negative attitude toward caffeine and the fewer friends they had that drank energy drinks, resulting in an increased odds the individual consumed energy drinks (p < .05). Hopefully, the results from this study will contribute to the current energy drink research.
12

The effect of Methylphenidate-OROS® on the narrative ability of children with ADHD

Rausch, Tessa L. January 2014 (has links)
Background: The growing number of children diagnosed with attention deficit hyperactivity disorder (ADHD) underscores the importance of the role speech language pathologists play in addressing the language difficulties experienced by this population, including difficulties in narrative production, especially due to the close correlation between narrative performance and academic, as well as social, achievement. Although stimulant medication is the primary method of treatment for children with ADHD and is known to successfully address the behavioural and academic difficulties experienced by this population, few studies have focused on the effect of this medication on language difficulties. The need for speech-language services in the ADHD population is well documented in the literature, but it is not fully understood whether stimulant medication should be regarded as a replacement for, or an essential adjunct to speech language pathology services. Objectives: The goal of the current study was to investigate the effect of Methylphenidate-OROS® (MPH-OROS®) on the narrative ability of children with ADHD, through the analysis of microstructure and macrostructure elements. Research has shown that children with ADHD experience difficulty in planning, organizing, and monitoring narratives. The current study was based on evidence suggesting that MPH may improve aspects of language production through its effect on the primary symptoms of ADHD. Methods: A multiple single-subject pretest-posttest design was employed to examine the effect of MPH-OROS® on the narrative ability of children with ADHD. Wordless picture books were used to elicit narrative production as these books display the narrative structure valued by story grammar analysis (Stein & Glenn, 1979) while minimising the need for language comprehension and auditory memory capacity (McCabe, Bliss, Barra, & Bennett, 2008). Narratives were obtained from 12 children with ADHD (between the ages of 7 and 13 years). The children were presented with the wordless picture books for preview prior to the production of story narratives. The narratives were recorded and orthographically transcribed. For microstructure, narratives were coded using the Systematic Analysis of Language Transcripts (SALT) (Miller & Iglasias, 2012) coding conventions. Number of words, type-token ratio, and mean length of utterance were determined. For macrostructure, the narratives were analyzed and coded according to the Narrative Scoring Scheme (NSS) (Miller, Andriacchi, DiVall-Rayan, & Lien, 2003) which includes introduction, character development, mental states, referencing, conflict resolution, cohesion, and conclusion as well as a composite score reflecting the child’s overall narrative ability. Results: The administration of MPH-OROS® had a significant effect on aspects of language macrostructure, namely conflict resolution and cohesion, as well as overall narrative ability, based on the NSS total score. Little effect was noted, however, in microstructure elements. The effect of stimulant medication differed between participants, with particular differences noted in measures of productivity. MPH-OROS® increased productivity in certain participants while decreasing productivity in the remaining participants. Conclusions: The positive effect of stimulant medication on the macrostructure elements conflict resolution and cohesion as well as overall narrative ability, in the absence of an improvement in microstructure linguistic elements, suggests that the language difficulties experienced by this population may be due to difficulties in executive functions as well as inattention, hyperactivity, and impulsivity, all of which may have a negative impact on early language acquisition. While stimulant medication improves behaviours of attention and concentration, it cannot fully compensate for the poor structural and pragmatic language abilities, and the accompanying cascading effects, associated with the primary symptoms of ADHD. Therefore, a combination of treatments is advocated so as to ensure that children with ADHD are successful in reaching their full potential. In addition, the results highlight the possibility that response to stimulant medication may differ between ADHD-presentations, based on the presence or absence of the hyperactive component of ADHD. / Dissertation (MCommunication Pathology)--University of Pretoria, 2014. / tm2015 / Speech-Language Pathology and Audiology / MCommunication Pathology / Unrestricted
13

Adults living with stimulant abuse and bipolar disorder: Experiences of service users at treatment centres

van Zyl, Karina Marie January 2017 (has links)
The goal of the study was to explore how adults living with stimulant abuse and bipolar disorder experience treatment at treatment centres in the Gauteng Province. As the study was aimed at gaining an in-depth understanding of the lived experiences of service users in terms of treatment, a qualitative research approach was implemented. The research findings were aimed at adding knowledge to the field of social work, which could contribute to the development of treatment programmes and possible policy changes that could positively impact the recovery of individuals living with a dual-diagnosis, specifically the dual-diagnosis of bipolar disorder and stimulant abuse. A phenomenological research design was used as it allowed the researcher to discover and report on the details pertaining to the participants' experiences in terms of the treatment they received. The phenomenological research design also enabled the researcher to describe the commonalities and discords expressed by participants in relation to the phenomenon. The sampling process for the research study took place in three phases. In the first phase, purposive sampling was implemented to select three substance abuse treatment centres in the Gauteng Province, and more specifically the Tshwane Metropolitan Municipality. The second phase of sampling was also purposive sampling, where inclusion criteria were supplied to a social worker at each treatment centre who identified possible participants. During the third phase of sampling, possible participants were approached and informed of the study and ultimately four (N=4) individuals volunteered to participate in the study. Data was collected through the use of semi-structured one-on-one interviews which were guided by an interview schedule. Data gathered during the literature review and interviews were analysed through the process of thematic analysis and aimed at answering the research question "How do adults living with stimulant abuse and bipolar disorder experience services at treatment centres in the Gauteng Province?" The key findings indicate that admission to in-patient treatment programmes, for both stimulant abuse and psychiatric care, was prevalent among all participants, but re-occurring admissions to substance abuse treatment was more evident. Stimulants were primarily used as a means of coping with moods and emotions, as unstable mood patterns and emotions persisted regardless of the pharmacological treatment for bipolar disorder. The most helpful component of treatment which aided participants in managing their mood was counselling. When stimulants were not available and counselling was insufficient, other means of achieving psychological relieve were employed by participants, such as exercise, nicotine use, sweets and caffeine. The role of religion and spirituality in treatment is not clear, but all participants believe that religion and spirituality should be included in treatment. The need for education in terms of bipolar disorder, addictive behaviours, lifestyle changes and coping mechanisms were mentioned by most participants. In addition to education provided by professionals, participants expressed a need for sharing experiences with individuals that have managed to recover from bipolar disorder and/or stimulant abuse. When treatment plans and goals are set participants believe that they and their family should be included, a factor relevant to in-patient and reintegration services. With regards to in-patient treatment programmes, the psychosocial-cultural environment created within the physical environment was also mentioned as a component that needs to be considered. In order to deliver services that allow for the effective treatment and reintegration of individuals that abuse stimulants and are diagnosed with bipolar disorder the following recommendations are made: 1) Interventions, including prevention and early interventions, should be developed based on research findings focused on dual-diagnosis, to ensure that concurrent treatment and reintegration is achieved and sustained, thus promoting recovery, or the management, of both disorders. 2) Education in terms of stimulant addiction, cross-addiction, bipolar disorder, lifestyle changes, coping skills, as well as the interplay between these factors should be included in treatment programmes, however, education should be expanded to service providers and extended to family members too. 3) The role of religion and spirituality as part of dual-diagnosis treatment should be considered. 4) Treatment and support groups that focus on the specific dual-diagnosis of stimulant use and bipolar disorder, should be developed as part of in-patient treatment programmes, as well as supporting out-patient programmes, which could improve long-term recovery. 5) The physical and the psychosocial environments which are conducive to the recovery of dual-diagnosis patients should be established, as these environments could possibly be replicated, for example at home, and could ensure long-term recovery. 6) Service users and their families should be included in decisions regarding treatment planning and reintegration, as inclusion in this area of treatment could promote compliance to treatment. However, it should be stated that many of these recommendations are dependent on governing bodies, such as the Department of Social Development and the Department of Health, who are responsible for changing, developing and monitoring policies guiding treatment, which has a direct impact on the long-term recovery of individuals living with this dual-diagnosis. Future research studies that can contribute to understanding this phenomenon can focus on 1) Repeating the study within other private and government based treatment centres across South Africa in order to determine whether treatment needs differ or whether it presents the same results. 2) Comparing studies from different centres and areas of South Africa in order to establish treatment needs of individuals diagnosed with a dual-diagnosis. 3) Research should be done to determine the actual prevalence of the dual-diagnosis of stimulant abuse and bipolar disorder in South Africa, focused on admissions in both substance abuse treatment centres and psychiatric treatment facilities. 4) Treatment programmes developed from research findings should be implemented, and research should be conducted on the effectiveness of treatment. 5) Research on different combinations of dual-diagnosis is necessary to determine how treatment needs differ, as this will ensure the development of appropriate treatment. Individuals working at treatment centres (for both substance abuse and psychiatric disorders) should be aware of the needs of dual-diagnosis patients, and be educated on this phenomenon. 6) It is recommended that research should be done with the staff of psychiatric treatment centres, as well as staff at substance abuse treatment centres, to determine their views and knowledge in terms of dual-diagnosis. 7) Research focussed on the costs of not treating dual-diagnosis should be conducted. When the actual costs of non-treatment are established, government agencies and the private sector might be more prone to support treatment strategies. 8) Intervention strategies focused on families of dual-diagnosis patients should be implemented and the impact of these interventions on both patients and families should be researched. 9) More research in terms of this dual-diagnosis is necessary as this could allow for the development of effective treatment strategies that could lower relapse and readmission rates. / Mini Dissertation (MSW)--University of Pretoria, 2017. / Social Work and Criminology / MSW / Unrestricted
14

Undergraduate Prescription Stimulant Misuse: The Impact of Academic Strain, Social Norms, and Gender

Norman, Lauren 01 January 2015 (has links)
This study investigates the misuse of prescription stimulants among undergraduates for a variety of different purposes, including: academic, other instrumental, and recreational. This research is important as existing literature as well as national level surveillance data indicates a substantial increase in this type of prescription drug misuse, especially among young adults aged 18-25. Drawing from several theoretical frameworks, this research focuses on how academic strain, social norms, and gender influence prescription stimulant misuse among undergraduates. Roughly 900 quantitative surveys were collected that specifically address undergraduate prescription stimulant misuse. The results indicate that college students are at an increased likelihood of misusing prescription stimulants if they experienced academic impediments and/or grade strain during the past academic year. Additionally, the findings show that undergraduates who have accepting attitudes of prescription stimulant misuse and who have peers that misuse prescription stimulants are also at an increased likelihood of misusing prescription stimulants. Furthermore, males were at an increased likelihood of prescription stimulant misuse for academic purposes if they had experienced grade strain during the past academic year in comparison to their female counterparts. Female undergraduates, on the other hand, were four times more likely than male undergraduates to obtain prescription stimulants from their close friends for free.
15

Re-evaluating cyclosporine A as a hair growth-promoting agent in human scalp hair follicles

Hawkshaw, N.J., Haslam, I.S., Ansell, David, Shamalak, A., Paus, R. 07 May 2020 (has links)
no / Cyclosporine A (CsA) has long been recognized as a potent hair growth stimulator in both humans and rodent. The induction of a dose-dependent hypertrichosis is one of the most frequent adverse effects of long-term CsA therapy (Lutz, 1994). However, it is unclear how this immunosuppressant induces hypertrichosis in patients or stimulates hair growth in human scalp skin transplanted on nude mice (Gilhar et al., 1988; Gilhar et al., 1991).
16

Rôle du CSF1R dans les maladies neurodégénératives

Pons, Vincent 12 February 2021 (has links)
La maladie d'Alzheimer (MA) est la maladie neurodégénérative la plus fréquente dans le monde, son incidence augmente au cours des années dû à un vieillissement de la population et à manque de thérapies efficaces. L'étiologie de la maladie est associée à une altération de la mémoire et du comportement ainsi qu'à l'accumulation de la bêta-amyloïde (Aβ) dans le parenchyme et les vaisseaux sanguin du cerveau. Ces dépôts aberrants sont la conséquence d'une altération de l'élimination du peptide. Depuis quelques années des évidences venant des expériences menées en laboratoire montrent que l'injection de certaines molécules ont des effets bénéfiques sur la MA, tant au niveau cognitif que sur la présence d'Aβ. Une de ces molécules est le macrophage-colony stimulating factor (m-CSF) et son récepteur (CSF1R). Cette voie de signalisation a fait l'objet de plusieurs études dans le contexte de la MA or l'implication de son récepteur dans le processus pathologique est peu connu. Les études incluses dans cette thèse de doctorat avaient pour but de mieux comprendre le rôle du CSF1R sur la prolifération et la survie microgliale dans un contexte non-pathologique ainsi que dans un modèle animal de la MA. Plusieurs études indiquent que ce récepteur est primordial pour la survie, l'activation et la prolifération microgliale. Nous avons utilisé une approche du style « perte de fonction » pour étudier le CSF1R. Grâce à un modèle de souris knock-out (KO) inductible, nous avons spécifiquement aboli la transcription du récepteur dans les microglies. Dans un premier temps nous avons comparé les fonctions du CSF1R dans deux modèles. Le premier étant purement prolifératif avec pas ou peu d'inflammation. Le second un modèle inflammatoire. Nous avons observé que les microglies dans le premier modèle étaient capables de proliférer et donc survivaient au KO. Dans le second modèle, les cellules microgliale perdaient leur capacité proliférative mais survivaient. Nous avons pu déduire que le CSF1R au stade adulte n'a vraisemblablement qu'un effet accessoire sur la prolifération et il ne semble pas être impliquer dans la survie microgliale. En utilisant la même approche, nous avons supprimé comme précédemment le CSF1R dans un modèle de souris Alzheimer APP[indice swe/PS1]. Dans cette étude nous montrons là aussi que non seulement le CSF1R n'a pas de rôle sur la survie et la prolifération des microglies, mais en plus on observe une diminution des symptômes associés à la MA. À savoir une diminution du déclin cognitif ainsi que de la charge amyloïde. Ensembles ces données nous montre de nouvelles informations sur CSF1R. Son rôle n'est pas aussi primordial dans certaines fonctions microgliale à l'âge adulte. / Alzheimer's disease (AD) is the most frequent neurodegenerative disease in the world, its incidence increases every year due to the aging of the population and a lack of therapies. AD etiology is associated with an alteration of cognitive functions and aberrant accumulation of amyloid-beta (Aβ) in the parenchyma and blood vessels in the brain. Aβ deposits are due to an impairment of phagocytosis. For many years, experimental evidence shown that injections of different molecules could have beneficial effects on AD course, either cognition or amyloid load. One of these molecules is macrophage-colony stimulating factor (m-CSF) and its receptor (CSF1R). This signaling pathway was extensively studied in AD context, but it remains largely unknown. Studies which are included in thesis, aimed to better understand the role of CSF1R on microglia proliferation and survival in both healthy and AD context. Many studies mentioned that CSF1R has a crucial impact on these functions. We used a "loss of function" approach to study this receptor. We used an inducible knock-out (KO) mice model, where microglia are specifically deleted of CSF1R. In the first time we compared CSF1R function in two models. The first model is a pure proliferative model without or barely without inflammation, the second is a model with a robust inflammatory response. We observed in the first model that microglia were still able to proliferate and survived to the KO, whereas in the second model, microglia were unable to proliferate but they also survived. We deducted that CSF1R at adult stage, has an accessory role on proliferation and has no major impact on microglia survival. Using the same approach, we have deleted the receptor in a mouse model of AD, namely APP[subscript swe/PS1]. Likewise, in this study we have shown that CSF1R was not required for proliferation and survival, moreover we observed an improvement of cognition and a reducing level of amyloid. Altogether, these data provide a new insight on CSF1R functions, its role is not as primordial for microglia as we though.
17

Role of Sensation Seeking in Sensitivity to d-amphetamine Reinforcement

Patrick, Mollie E. 01 January 2014 (has links)
Psychomotor stimulant abuse is a significant public health problem. While many individuals experiment with stimulants, there is marked variability in individuals' behavioral and subjective response to these drugs and these differences may be associated with their risk for abuse. One characteristic shown to be associated with drug abuse is sensation seeking, defined as the seeking of novel sensations and experiences and the willingness to take risks for the sake of such experiences. While observational studies have shown that individuals with elevated sensation seeking are more likely to report stimulant use and abuse, less clear is whether subjective and behavioral response to acute stimulant administration may vary as a function of sensation seeking status. We recently completed an outpatient laboratory study in which 37 healthy adults received repeated opportunities to sample and choose between d-amphetamine (d-AMPH; 5, 10, 20 mg/70kg) or placebo. That study provided an opportunity to examine associations between sensation seeking and d-AMPH choice and subjective response under rigorous double-blind experimental conditions. The Zuckerman Sensation Seeking Scale V was administered at intake, providing a Total sensation seeking score as well as four subscales (i.e., Experience Seeking, Disinhibition, Thrill and Adventure Seeking, Boredom Susceptibility). We hypothesized that elevated sensation seeking at intake would be associated with increased preference for d-AMPH over placebo in subsequent choice sessions, as well as greater positive d-AMPH subjective effects. Among males, increased baseline sensation seeking was associated with increased d-AMPH choice and positive subjective effects at the 5 and 10 mg/70 kg doses. Among females we found no significant associations between sensation seeking and d-AMPH choice or subjective effects. Finally, when the association between sensation seeking and other baseline characteristics was examined, there was a significant positive association with lifetime drug use as well as impulsivity. Taken together, our data suggest that elevated sensation seeking in males may be associated with increased sensitivity to d-AMPH reinforcement and positive subjective effects, suggesting increased vulnerability for stimulant use and abuse.
18

Efeito da suplementação na ração de Drosophila Melanogaster (Meigem, 1830) com o fungo Pleurotus Citrinopileatus (singer, 1942) e Lentinus Sajor-Caju (fr.) Fr. e a sua relação com a reprodução de moscas das frutas.

Bolson, Sibele Marques 02 August 2016 (has links)
Submitted by Francine Silva (francine.silva@unipampa.edu.br) on 2017-01-10T12:36:56Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) DISSERTAÇAO_SIBELE_BOLSON.pdf: 739236 bytes, checksum: 62e3dc921b3fd26e06e396f1afe89cf3 (MD5) / Made available in DSpace on 2017-01-10T12:36:56Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) DISSERTAÇAO_SIBELE_BOLSON.pdf: 739236 bytes, checksum: 62e3dc921b3fd26e06e396f1afe89cf3 (MD5) Previous issue date: 2016-08-02 / Effects of supplementation in the diet of Drosophila melanogaster (MEIGEM, 1830) with the fungus Pleurotus Citrinopileatus (SINGER, 1942) and Lentinus sajor-cashew (Fr.) Fr. and its relationship with the reproduction of fruit flies. The mushrooms of genus Pleurotus are widely used as food, rich in protein and antioxidants when added to animal feed increases its nutritional value. The fungi of this genus are noted for easily grow in a wide variety of substrates which facilitates cultivation and increases its biotechnological use. The species of fly, Drosophila melanogaster (Meigen, 1830) is a reference in biological and genetic studies, especially because it is easy to maintain in the laboratory and mainly have similar metabolic reactions to mammals. In nature uses as food yeasts that colonize fruits, flowers and fungi putrefying stage. This study aims to identify the effect of Pleurotus Citrinopileatus and Lentinus sajor-caju in Drosophila melanogaster body. First fungi were grown on rice straw, the fruiting bodies were weighed into 0,5-1,0-1,5-2,0-2,5-3,0 (g) were homogenized ration composed of flour maize (Klein et al, 1999) and supplied as feed for D. melanogaster, they were kept in chamber at 25 ° C ± 1. The counting larvae and pupae every twenty-four hours and the final number of flies. How to analyze the possible genotypic changes made to DNA extraction and PCR, these data were analyzed with the NTSYS 2.1 program. The results were tested for analysis of variance with the aid of Statistix8 program. It was observed that the mycelium of P. citrinopileatus stimulated reproduction in D. melanogaster, accelerating the reproductive cycle and the number of individuals compared with control and other species L. sajor-caju. The concentration of 1.5g of mycelium in the substrate was best expressed this feature and the one that showed genotypic change. The experiment suggests that the use of mycelium of P. citrinopileatus added to feed for D. melanogaster grown in the laboratory, it can be used as a reproductive stimulant for this organism, but its effect on genetic changes should be better investigated. / Efeito da suplementação na ração de Drosophila melanogaster (MEIGEM, 1830) com o fungo Pleurotus citrinopileatus (SINGER, 1942) e Lentinus sajor-caju (Fr.) Fr. e a sua relação com a reprodução de moscas das frutas. Os cogumelos do gênero Pleurotus são muito utilizados na alimentação humana, ricos em proteínas e antioxidantes, quando agregados a alimentação animal eleva o seu valor nutritivo. Os fungos deste gênero destacam-se por crescerem facilmente em uma ampla variedade de substratos o que facilita o seu cultivo e amplia o seu uso biotecnológico. A espécie de mosca, Drosophila melanogaster (MEIGEN, 1830) é referência em estudos biológicos e genéticos, destacando-se pela fácil manutenção em laboratório e principalmente por possuírem reações metabólicas similares a dos mamíferos. Na natureza essa espécie utiliza como alimentação leveduras que colonizam frutos, flores e fungos em estágio de putrefação. O presente trabalho objetiva identificar o efeito de Pleurotus citrinopileatus e Lentinus sajor-caju no organismo de Drosophila melanogaster. Primeiramente os fungos foram cultivados em palha de arroz, as frutificações foram pesadas em 0,5-1,0-1,5-2,0-2,5-3,0(g) que foram homogeneizadas a ração composta de farinha de milho (Klein et Al, 1999) e fornecida como alimento para D. melanogaster, estas foram mantidas em BOD a 25ºC ± 1. A contagem de larvas e pupas foi realizada a cada vinte quatro horas e o numero final de moscas foi quantificado no fim do tratamento. Como analise das possíveis alterações genotípicas fez-se a extração do DNA e PCR, esses dados foram analisados com o programa NTSYS 2.1. Os resultados foram testados quanto à análise de variância com o auxilio do programa Statistix8. Foi observado que o micélio de P. citrinopileatus estimulou a reprodução em D. melanogaster, acelerando o ciclo reprodutivo e o número de indivíduos quando comparado com o controle e com a outra espécie L. sajor-caju. A concentração de 1,5g de micélio no substrato foi a que melhor expressou essa característica e a única que demonstrou alteração genotípica. O experimento sugere que o uso do micélio de P. citrinopileatus agregado a ração para D. melanogaster cultivadas em laboratório, pode ser utilizado como estimulante reprodutivo para este organismo, porém seu efeito em alterações genéticas deve ser melhor investigado.
19

Heterogeneity in hyperkinetic disorder

Coghill, David Rockwell January 2010 (has links)
It is increasingly recognised that the broadly defined behavioural phenotype of attention deficit – hyperactivity disorder (ADHD) is a heterogeneous condition and that this heterogeneity is seen across all levels of analysis from the genetic and environmental causes to the associated neuropsychological deficits, the clinical presentation and response to treatment. This work investigated whether the more restrictive and clinically homogeneous hyperkinetic disorder (HKD) phenotype is associated with reduced neuropsychological heterogeneity compared with the broader ADHD phenotype. Using a well known, broad based battery of neuropsychological tasks from the Cambridge Neuropsychological Test Automated Battery (CANTAB) and a computerised Go/NoGo task in a large well described group of boys with rigorously diagnosed HKD who were stimulant medication naïve at baseline, it was demonstrated that the neuropsychological heterogeneity in the HKD boys was very similar to that seen previously in children with ADHD. Interestingly, and contrary to popular opinion, the strongest associations were with more simple recognition memory tasks with a low executive demand. Although there were significant associations between HKD and deficits on a range of tasks with high executive demands these were less strong. Could this neuropsychological heterogeneity be a function of different developmental issues or comorbidity? With respect to development there was evidence that boys with HKD lagged behind the healthy boys with respect to the development of their neuropsychological performance. However the pattern of development was similar with the performance of the HKD boys paralleling that of the healthy boys, suggesting that the neuropsychological heterogeneity seen in HKD is not accounted for by developmental issues. With respect to the relationship between neuropsychological functioning and comorbidity, the impact of comorbid oppositional defiant disorder (ODD) and conductdisorder (CD), it was found that all three clinical groups (pure HKD, HKD + ODD and HKD + CD) demonstrated deficits on several tasks compared with the healthy boys. Compared with healthy boys each of the three clinical groups was associated with at least one unique neuropsychological deficit. This suggests that comorbidity between HKD and both ODD and CD may contribute to the neuropsychological heterogeneity in the HKD boys. Is there an association between clinical and neuropsychological responses to the treatment of HKD with the stimulant drug methylphenidate (MPH)? Detailed analyses were conducted to investigate heterogeneity of clinical and neuropsychological response in these boys to MPH. As predicted in previous studies there is evidence for clinical heterogeneity in response with between 68 and 78% of boys with HKD responding to MPH treatment at either one or both of the doses. The precise proportion responding was dependent on the scale and definition of response used. Clinical response was not predicted by age but was predicted to a degree by severity of symptoms at baseline and it was generally true that better response was predicted by lower (better) scores at baseline. Baseline performance on a component reflecting recognition memory performance at baseline predicted clinical response to the lower (0.3 mg/kg/dose), but not the higher (0.6, mg/kg/dose) dose of MPH with poorer baseline neuropsychological performance predicting a better clinical response. Whilst there was improvement on some neuropsychological measures following administration of MPH there was little association between clinical and neuropsychological responses to medication. Clinical response was only associated with neuropsychological response on a single measure from a single task (Go/NoGo Block 2 Errors to Distractors), a task that did not itself discriminate between the HKD boys and healthy Controls at baseline.
20

Attention Deficit-Hyperactivity Disorder and Undifferentiated-Attention Deficit Disorder: Differences in Cognitive and Affective Characteristics and Responses to Stimulant Medication

Campbell, Richard Alan 01 May 1991 (has links)
The cognitive and affective characteristics and responses to stimulant medication of children who were diagnosed as having attention deficit-hyperactivity disorder (AD-HD) or undifferentiated-attention deficit disorder (UADD) were investigated using a pretest-posttest experimental design. Nineteen AD-HD and 17 UADD children were compared using unpaired t-tests, prior to initiation of stimulant medication, on measures of intellectual functioning, impulsivity, problem behavior, and self-reported depression and self-esteem. Children from both the AD-HD (n = 12) and UADD (n = 12) groups were then compared before and after a 3-month trial of stimulant medication on measures of impulsivity, problem behavior, and self-reported depression and self-esteem using repeated measures analyses of variance. No significant differences were found between groups in cognitive ability, impulsivity, depression, self-esteem, anxiety, peer relationships, or social withdrawal. AD-HD children were found to exhibit more hyperactive, aggressive, and delinquent problem behavior. Significant improvement was found in both groups in self-reported depression and self-esteem following a trial of stimulant medication. A trial of stimulant medication was found to reduce hyperactive problem behavior in AD-HD children. Stimulant medication had a beneficial effect on peer relationships and aggressive problem behavior in UADD children but did not produce similar positive effects in AD-HD children. These results are discussed as in relationship to the issue of whether AD-HD and UADD are separate syndromes and to the previous literature regarding attention deficit disorder with hyperactivity (ADD/H) and attention deficit disorder without hyperactivity (ADD/WO). Ramifications regarding appropriate treatment are also discussed.

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