Objective To describe adolescent outcomes of childhood attention deficit-/ hyperactivity disorder (ADHD) in a diverse community sample. Method ADHD screening of a school district sample of 1,615 students ages 5 to 11 years was followed by a case-control study 8 years later. High risk youths meeting full (n=94) and subthreshold (n=75) DSM-IV ADHD criteria were matched with demographically similar low risk peers (n=163). Outcomes domains included symptoms; functional impairment; quality of life; substance use; educational outcomes; and juvenile justice involvement. Results 44% of youths with childhood ADHD had not experienced remission. Compared to unaffected peers, adolescents with childhood ADHD were more likely to display oppositional defiant disorder (OR=12.9; 95% CI 5.6-30.0), anxiety/depression (OR=10.3; 95% CI 2.7-39.3), significant functional impairment (OR=3.4; 95% CI 1.7-6.9), reduced quality of life (OR=2.5, 95% CI 1.3-4.7), and to have been involved with juvenile justice (OR=3.1; 95% CI 1.0-9.1). Subthreshold ADHD, but not full ADHD, increased the risk of grade retention, whereas both conditions increased the risk of graduation failure. Oppositional defiant disorder (ODD), but not childhood ADHD, increased the risk of cannabis and alcohol use. None of the adolescent outcomes of childhood ADHD were moderated by gender, race or poverty. Conclusions ADHD heralds persistence of ADHD and comorbid symptoms into adolescence, as well as significant risks for functional impairment and juvenile justice involvement. Subthreshold ADHD symptoms typically do not qualify affected students for special educational interventions, yet increase the risk for adverse educational outcomes. Findings stress the importance of early ADHD recognition, especially its comorbid presentation with ODD, for prevention and intervention strategies.
Objective-To describe adolescent outcomes of childhood attention deficit-/ hyperactivity disorder (ADHD) in a diverse community sample.Method-ADHD screening of a school district sample of 1,615 students ages 5 to 11 years was followed by a case-control study 8 years later. High risk youths meeting full (n=94) and subthreshold (n=75) DSM-IV ADHD criteria were matched with demographically similar low risk peers (n=163). Outcomes domains included symptoms; functional impairment; quality of life; substance use; educational outcomes; and juvenile justice involvement.Results-44% of youths with childhood ADHD had not experienced remission. Compared to unaffected peers, adolescents with childhood ADHD were more likely to display oppositional defiant disorder (OR=12.9; 95% CI 5.6-30.0), anxiety/depression (OR=10.3; 95% CI 2.7-39.3), significant functional impairment (OR=3.4; 95% CI 1.7-6.9), reduced quality of life (OR=2.5, 95% CI 1.3-4.7), and to have been involved with juvenile justice (OR=3.1; 95% CI 1.0-9.1). Subthreshold ADHD, but not full ADHD, increased the risk of grade retention, whereas both conditions increased the risk of graduation failure. Oppositional defiant disorder (ODD), but not childhood ADHD, increased the risk of cannabis and alcohol use. None of the adolescent outcomes of childhood ADHD were moderated by gender, race or poverty.Conclusions-ADHD heralds persistence of ADHD and comorbid symptoms into adolescence, as well as significant risks for functional impairment and juvenile justice involvement. Subthreshold ADHD symptoms typically do not qualify affected students for special educational interventions,
This study evaluated the psychometric properties of the ADHD Stigma Questionnaire (ASQ) among a community sample of 301 adolescents ages 11-19 years at high (n = 192) and low risk (n = 109) for attention deficit hyperactivity disorder (ADHD). Study subjects were drawn from a cohort study assessing ADHD detection and service use. The 26-item ASQ demonstrated good internal consistency. Confirmatory factor analysis using random parceling supported a three factor structure with highly correlated subscales of Disclosure Concerns, Negative Self Image, and Concern with Public Attitudes, and a Schmid-Leiman analysis supported an overall stigma factor. Test-retest stability was assessed after two-weeks (n = 45) and found to be adequate for all three subscales. Construct validity was supported by relationships with related constructs, including clinical maladjustment, depression, self-esteem and emotional symptoms and the absence of a relationship with school maladjustment. Findings indicate that the ASQ has acceptable psychometric properties in a large community sample of adolescents, some of whom met DSM-IV criteria for ADHD.
Attention‐Deficit/Hyperactivity Disorder (ADHD) is one of the most frequently diagnosed psychiatric disorders in childhood and adolescence. It is associated with high levels of stigma, which may lead to treatment barriers, self‐fulfilling prophecies, and social rejection. This study established the reliability of the ADHD Stigma Questionnaire (ASQ) when applied to teachers by evaluating its internal consistency and confirmed the previously reported factor structure. In addition, the study examined the extent to which holding a special education certification and having years of teaching experience impact teachers' perceptions of ADHD stigma. Results indicated that teachers holding special education certification endorsed higher ratings, which indicated high stigma perceptions, on the Overall Stigma score, as well as the three subscales, Disclosure Concerns, Negative Self‐Image, and Concern with Public Attitudes; however, years of teaching experience was not related to stigma scores. Implications for teacher training practices are discussed. © 2010 Wiley Periodicals, Inc.
Restricted and repetitive behavior (RRB) is a group of heterogeneous maladaptive behaviors. RRB is one of the key diagnostic features of autism spectrum disorders (ASDs) and also commonly observed in Prader–Willi syndrome (PWS). In this study, we assessed RRB using the Repetitive Behavior Scale-Revised (RBS-R) in two ASD samples (University of Illinois at Chicago [UIC] and University of Florida [UF]) and one PWS sample. We compared the RBS-R item endorsements across three ASD cohorts (UIC, UF and an ASD sample from Lam, The Repetitive Behavior Scale-Revised: independent validation and the effect of subject variables, PhD thesis, 2004), and a PWS sample. We also compared the mean RBS-R subscale/sum scores across the UIC, UF and PWS samples; across the combined ASD (UIC + UF), PWS-deletion and PWS-disomy groups; and across the combined ASD sample, PWS subgroup with a Social Communication Questionnaire (SCQ) score ≥15, and PWS subgroup with a SCQ score <15. Despite the highly heterogeneous nature, the three ASD samples (UIC, UF and Lam’s) showed a similar pattern of the RBS-R endorsements, and the mean RBS-R scores were not different between the UIC and UF samples. However, higher RRB was noted in the ASD sample compared with the PWS sample, as well as in the PWS subgroup with a SCQ score ≥15 compared with the PWS subgroup with a SCQ score <15. Study limitations include a small sample size, a wide age range of our participants, and not controlling for potential covariates. A future replication study using a larger sample and further investigation into the genetic bases of overlapping ASD and RRB phenomenology are needed, given the higher RRB in the PWS subgroup with a SCQ score ≥15.
Abstract. Anthrax, caused by the environmental bacterium Bacillus anthracis, is an important zoonosis nearly worldwide. In Central Asia, anthrax represents a major veterinary and public health concern. In the Republic of Kyrgyzstan, ongoing anthrax outbreaks have been reported in humans associated with handling infected livestock and contaminated animal by-products such as meat or hides. The current anthrax situation has prompted calls for improved insights into the epidemiology, ecology, and spatial distribution of the disease in Kyrgyzstan to better inform control and surveillance. Disease control for both humans and livestock relies on annual livestock vaccination ahead of outbreaks. Toward this, we used a historic database of livestock anthrax reported from 1932 to 2006 mapped at high resolution to develop an ecological niche model-based prediction of B. anthracis across Kyrgyzstan and identified spatial clusters of livestock anthrax using a cluster morphology statistic. We also defined the seasonality of outbreaks in livestock. Cattle were the most frequently reported across the time period, with the greatest number of cases in late summer months. Our niche models defined four areas as suitable to support pathogen persistence, the plateaus near Talas and Bishkek, the valleys of western Kyrgyzstan along the Fergana Valley, and the low-lying areas along the shore of Lake Isyk-Kul. These areas should be considered "at risk" for livestock anthrax and subsequent human cases. Areas defined by the niche models can be used to prioritize anthrax surveillance and inform efforts to target livestock vaccination campaigns.
The effect of a test diet of conventional North American foods on breath 13CO2 abundance was determined in 4 healthy males. Subjects consumed a diet containing 41.9% energy as fat and a polyunsaturated:saturated fatty acid ratio of 0.217 for 5 days at a level equal to estimated requirements for total energy. One subject underwent four 5-day feeding periods. Over the feeding period mean change in subjects' body weight was -0.165 +/- 0.64% (means +/- SEM) of initial body weight. On day 5 breath samples were collected hourly from 0745 to 1645 h and analyzed for 13CO2 enrichment relative to the pre-breakfast fasted state (level at 0745 h). Breakfast and lunch were consumed at 0820 and 1300 h respectively. Mean enrichment peaked at 1445 h at 0.00311 atom % excess above fasting level for all subjects and 0.00243 atom % excess for the four repeated trials on one subject. Between subject variation (SEM) in 13CO2 enrichment (0.000618 atom %) was significantly greater than within subject variation (0.000308 atom %). These results indicate that ingestion of normal meals during the breath test period increases breath 13CO2 abundance due to a shift in substrate oxidation. The small within subject variation in repeated 13CO2 enrichment profiles indicates the reliability of 13C breath tests using controlled diets. It is concluded that for tests conducted under identical conditions, an initial background 13CO2 abundance profile determined once for each subject, can be subtracted from the subsequent enrichment profile generated by a labeled test substrate.
Objective This study examines whether elementary school-aged children can report behaviors relevant to assessing symptoms of attention-deficit/hyperactivity disorder (ADHD). Methods Interviews were conducted with 120 children ages 6 to 12 and their parents across three waves as part of a longitudinal cohort study of ADHD detection and service use. Child self-reports obtained through the Dimensions of Temperament Scale-Revised-Child (DOTS-R-C) were correlated with parent reported ADHD symptoms, which were assessed through DSM-IV-based instrument ratings obtained concurrently and five years later. Results The DOTS-R-C subscales Activity Level and Task Orientation demonstrate adequate internal consistency after eliminating items requiring reverse scoring. Children’s self-reports of Task Orientation Problems correlate with their parents’ concurrent reports of inattention, r(117) = .23, p<.05, and with parents’ Wave 3 reports of inattention, r(118) = .25, p< .01 as well as hyperactivity, r(118) = .25, p<.01. Children’s self-reports of Activity Level correlate with their parents’ concurrent reports of hyperactivity, r(117) = .21, p<.05, as well as Wave 3 reports of hyperactivity/impulsivity, r(118) = .37, p<.001 and inattention, r(118) = .23, p<.05. Conclusions Findings suggest that children may be capable of producing meaningful self-reports of activity level and task orientation. We propose that the development of child-friendly self-report instruments targeting ADHD symptoms is merited in order to facilitate the collection of child input during ADHD assessments.
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