A model of the association between adolescents’ perception of the quality of parent/adolescent attachment and adolescent aggression was examined, with social cognition and self-esteem as mediators. A total of 68 sixth graders, their parents, and their language arts teachers participated. Adolescents completed measures of attachment with mother and with father, self-esteem, social cognition, and aggressive tendencies. Mothers, fathers, and teachers each completed measures of adolescent aggressive and prosocial behavior. Evidence was obtained for social cognition and self-esteem both as mediators between adolescents’ perceived quality of mother/adolescent attachment and adolescent selfreport of aggression. Controlling for mother/adolescent and father/adolescent attachment and adolescent self-esteem, adolescent higher social cognition was associated with adolescent lower self-report of aggression. Controlling mother/adolescent and father/adolescent attachment and adolescent social cognition, adolescent higher self-esteem was associated with father-reported lower adolescent aggression and father-reported higher adolescent prosocial behavior. Implications for further research are discussed.

A single-source, principal-axis factor analysis of medical chart ratings of primary and secondary symptoms in 135 hyperkinetic/minimal brain dysfunction (MBD) boys resulted in two relatively independent symptom dimensions: Aggression, accounting for 44.6% of the factor variance, and Hyperactivity, accounting for 23.4%. Correlations between factor scores on these dimensions and descriptors from parent and teacher rating scales provided evidence for concurrent validity. The pattern of additional correlations between the Aggression and Hyperactivity factors and several demographic, psychometric, parenting, and treatment measures suggest the utility and necessity of considering both of these symptom dimensions in clinical research on the hyperkinetic/MBD syndrome. The use of the two symptom factors to form and study more homogeneous subgroups is also advised as a result of this multistage multivariate investigation.

This study examined the contributions of childhood symptom dimensions and aspects of methylphenidate (MPH) treatment to the prediction of young adult outcomes in boys who were referred to a child psychiatry outpatient clinic. They were diagnosed with hyperkinetic reaction of childhood/minimal brain dysfunction, and given MPH for an average of 30 months. Including significant effects and statistical trends, childhood Inattention-Over-activity was uniquely associated with fewer than 10% of adult outcomes such as schizotypic features, impairment on the Global Assessment Scale (GAS), and unemployment. Childhood aggression was uniquely associated with 38% of adult outcomes such as lifetime diagnoses of major depression, drug abuse disorder, and antisocial personality disorder; MMPI PD, PA, and SC scores; and six additional measures of adult impairment and life circumstances-extending external validation of the two-factor model to young adulthood. For 20 young adult outcomes (63%), aspects of childhood treatment with MPH had no lasting effects. For one adult outcome (3%), a lasting negative effect of childhood drug treatment was found; better initial response to medication was associated with not graduating from high school. For 11 young adult outcomes (34%), however, aspects of childhood MPH treatment had positive effects that lasted long after treatment was discontinued. Higher dosage was associated with fewer diagnoses of alcoholism or suicide attempts. Better response to medication was associated with lower MMPI D scores and better social functioning. Longer medication duration was associated with fewer schizotypic features, lower MMPI MA scores, higher WAIS Performance and Full Scale IQs, and better WRAT Reading and Arithmetic performance.

School-based mental health (SBMH) programs and services have grown progressively in the United States in the past two decades, related in part to increased recognition of their advantages and heightened federal support. However, SBMH is an emerging field, with many issues needing attention. This introductory article provides a context for the special issue by highlighting the importance of increased conceptual clarity about SBMH, enhanced mental health-education systems integration, and advancement of the SBMH research base. Key elements for success of SBMH programs and services are discussed, as underscored recently by the report of the New Freedom Commission on Mental Health (2003) and other important initiatives. These elements include (a) school-family-community agency partnerships, (b) commitment to a full continuum of mental health education, mental health promotion, assessment, problem prevention, early intervention, and treatment, and (c) services for all youth, including those in general and special education. A synopsis of the articles in the special issue is provided, emphasizing their conceptual and empirical contributions to delivery and sustainability of effective mental health practices in schools.

Preliminary validity of DSM-IV ADHD was examined in a sample of 6-to 12-year-old boys with behavior problems. Problem identification, extent of impairment, cognitive/attentional, family context, and behavioral symptom differences were examined among 28 boys with ADHD, inattentive type; 9 with ADHD, hyperactive-impulsive type; 59 with ADHD, combined type; and 18 with no ADHD diagnosis. Some evidence for validity of ADHD was suggested, especially for the inattentive and combined subtypes, and on measures of impairment, mother-, father-, and teacher-rated disruptive symptoms, and observed playroom behavior. Few differences were obtained on measures of family context and age-corrected indices of cognitive/attentional functioning. Supplementary analyses of the boys with ADHD, combined type, subgrouped on the presence or absence of oppositional and conduct disorders, highlight the role of such diagnostic comorbidity in some of the dysfunctions attributed to ADHD. ecades of debate have surrounded a condition referred to in the 1968 nomenclature of the American Psychiatric Association (DSM-II) as the hyperkinetic reaction of childhood. With publication of the DSM-III in 1980, an explicitly descriptive approach was taken toward diagnosis, and specific numbers of diagnostic descriptors were required for each of three symptom types (inattention, impulsivity, and hyperactivity). Signs of developmentally inappropriate inattention and impulsivity were conceptualized as the essential features of the disorder, which was renamed attention deficit disorder. Two subtypes of attention deficit disorder were proposed, one with and one without hyperactivity. In the DSM-III-R developmentally inappropriate degrees of inattention, impulsivity, and hyperactivity defined a unitary condition (attention-deficit hyperactivity disorder), with ADHD individuals displaying disturbance in the three symptom areas to varying degrees.Revisions included in the recently published DSM-IV were preceded by reviews of the empirical literature and extensive field trials. Diagnostic criteria were selected on the basis of their test-retest reliability, and of their correlation with clinicians' diagnoses and with indicators of social and academic impairment (Lahey et al., 1994a). In the DSM-IV a persistent pattern of inattention and/or hyperactivity-impulsivity is the essential feature of attention-deficit/hyperactivity disorder (ADHD), and three subtypes of ADHD are distinguished: predominantly inattentive ; predominantly hyperactive-impulsive; and combined (both inattentive and hyperactive-impulsive). For the inattentive type, the presence of any six of nine inattentive symptoms for at least 6 months is required for diagnosis. For the hyperactive-impulsive type, six symptoms of hyperactivity and three symptoms of impulsivity are described, and the diagnostic criterion is the presence of any six of the nine symptoms for at least 6 months. For the combined type, the symptom criteria for both inattention and hyperactivity-impulsivity must be met. Additional crit...