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Although responses are sometimes easy to predict, at other times responding seems highly variable, unpredictable, or even random. The inability to predict is generally attributed to ignorance of controlling variables, but this article is a review of research showing that the highest levels of behavioral variability may result from identifiable reinforcers contingent on such variability. That is, variability is an operant. Discriminative stimuli and reinforcers control it, resulting in low or high variability, depending on the contingencies. Schedule-of-reinforcement effects are orderly, and choosing to vary or repeat is lawfully governed by relative reinforcement frequencies. The operant nature of variability has important implications. For example, learning, exploring, creating, and problem solving may partly depend on it. Abnormal levels of variability, including those found in psychopathologies such as autism, depression, and attention deficit hyperactivity disorder, may be modified through reinforcement. Operant variability may also help to explain some of the unique attributes of voluntary action.
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PMID:Operant variability: evidence, functions, and theory. 1261 72

The sequencing of chromosome 21 and the use of models of Down's syndrome in mice have allowed us to relate genes and sets of genes to the neuropathogenesis of this syndrome, and to better understand its phenotype. Research in prenatal screening and diagnosis aims to find methods to identify fetuses with Down's syndrome, and reduce or eliminate the need for amniocentesis. Other areas of active research and clinical interest include the association of Down's syndrome with coeliac disease and Alzheimer's disease, and improved median age of death. Medical management of the syndrome requires an organised approach of assessment, monitoring, prevention, and vigilance. Improvements in quality of life of individuals with Down's syndrome have resulted from improvements in medical care, identification and treatment of psychiatric disorders (such as depression, disruptive behaviour disorders, and autism), and early educational interventions with support in typical educational settings. Approaches and outcomes differ throughout the world.
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PMID:Down's syndrome. 1285 16

We assessed depression, anxiety, and relevant cognitions in persons with mental retardation by administering modified versions of the Reynolds Child Depression Scale, the Beck Anxiety Inventory, the Automatic Thoughts Questionnaire, and the Cognitions Checklist to 46 persons with borderline to moderate mental retardation. Consistent with research with other groups, self-reports of depression and anxiety were highly correlated (r = .74) in these individuals, and cognitions were strong predictors of negative affect. Subscales measuring cognitions related to depression and anxiety were also highly related, limiting the "cognitive-specificity" hypothesis. Hierarchical multiple regression analyses offered mixed support for cognitive-specificity. We discuss the implications of these findings for the cognitive and affective assessment of persons with intellectual limitations.
J Autism Dev Disord 2003 Feb
PMID:Depression, anxiety, and relevant cognitions in persons with mental retardation. 1270 81

Australian research in psychiatric genetics covers molecular genetic studies of depression, anxiety, alcohol dependence, Alzheimer's disease, bipolar disorder, schizophrenia, autism, and attention deficit hyperactivity disorder. For each disorder, a variety of clinical cohorts have been recruited including affected sib pair families, trios, case/controls, and twins from a large population-based twin registry. These studies are taking place both independently and in collaboration with international groups. Microarray studies now complement DNA investigations, while animal models are in development. An Australian government genome facility provides a high throughput genotyping and mutation detection service to the Australian scientific community, enhancing the contribution of Australian psychiatric genetics groups to gene discovery.
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PMID:Psychiatric genetics in Australia. 1296 Jul 44

The concept of DAMP (deficits in attention, motor control, and perception) has been in clinical use in Scandinavia for about 20 years. DAMP is diagnosed on the basis of concomitant attention deficit/hyperactivity disorder and developmental coordination disorder in children who do not have severe learning disability or cerebral palsy. In clinically severe form it affects about 1.5% of the general population of school age children; another few per cent are affected by more moderate variants. Boys are overrepresented; girls are currently probably underdiagnosed. There are many comorbid problems/overlapping conditions, including conduct disorder, depression/anxiety, and academic failure. There is a strong link with autism spectrum disorders in severe DAMP. Familial factors and pre- and perinatal risk factors account for much of the variance. Psychosocial risk factors appear to increase the risk of marked psychiatric abnormality in DAMP. Outcome in early adult age was psychosocially poor in one study in almost 60% of unmedicated cases. There are effective interventions available for many of the problems encountered in DAMP.
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PMID:Deficits in attention, motor control, and perception: a brief review. 1450 Mar 12

Developmental psychopathologists have criticized categorical classification systems for their inability to account for within-group heterogeneity in biological, etiological. developmental, and cultural influences on behavior. Dichotomizing continuous scores of symptom severity is also inadvisable statistically. Perhaps because of a resulting wariness of categorizing, few explorations into the ontological status of traits or disorders as dimensional versus discrete have been conducted. It is argued here that the limitations of categorizing have little to do with the ontological status of traits and that developmental psychopathologists should be concerned with identifying discrete behavioral syndromes. Common taxometric methods for resolving discrete traits are described, and questions of concern to developmental psychopathologists are outlined that can be addressed through taxometrics studies. These include (a) identifying children who are at risk for future psychopathology, (b) identifying discrete subtypes within current diagnostic classes, (c) locating sensitive periods in the development of discrete pathological traits, (d) discovering moderators of treatment outcome, and (e) elucidating mechanisms of equifinality and multifinality. Although most behavioral traits probably are distributed continuously, identifying those that are discrete will advance the science of developmental psychopathology. Disorders for which taxometric analyses might be applied include anxiety, attention deficit hyperactivity disorder, autism spectrum disorders, conduct problems, depression, and schizophrenia.
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PMID:Taxometrics and developmental psychopathology. 1458 30

A review of the literature revealed that there was no adequate assessment instrument available that screens comprehensively for anxiety and depression in persons with mental retardation. The purpose of this research was to develop the Anxiety, Depression, and Mood Scale (ADAMS), an instrument intended to fill this gap. We developed a preliminary rating scale that included 55 symptom items. We examined the factor structure of these items by an exploratory factor analysis of behavior ratings on 265 individuals. A five-factor solution emerged that was both statistically sound and clinically meaningful. These factors were labeled "Manic/Hyperactive Behavior," "Depressed Mood," "Social Avoidance," "General Anxiety" and "Compulsive Behavior." We validated this solution by conducting a confirmatory factor analysis on ratings of 268 additional individuals. Model fit was acceptable. Internal consistency of the subscales and retest reliability for both the total scale and the subscales was high. Interrater reliability was satisfactory. The validity of the ADAMS was assessed with a clinical sample of 129 individuals with mental retardation who were seen in a psychiatric clinic; this provided additional support for the subscales. The ADAMS appears to be a psychometrically sound instrument for screening anxiety, depression and mood disorders among individuals with mental retardation.
J Autism Dev Disord 2003 Dec
PMID:Reliability and validity of an assessment instrument for anxiety, depression, and mood among individuals with mental retardation. 1471 31

Co-morbid conditions frequently occur in childhood epilepsy and may significantly affect epilepsy and its treatment. Similarly, epilepsy and antiepileptic drugs (AEDs) may affect these associated conditions. Co-morbidities that have a significant association with childhood epilepsy include attention-deficit/hyperactivity disorder, autism, developmental disabilities, accidental injury, migraine, and depression/anxiety. Understanding the interrelationships among co-morbidities, epilepsy, and their treatments is essential to optimal management of pediatric patients. Treatment should be individualized with consideration for specific co-morbidities and concomitant medications. Key treatment goals are to achieve seizure control and optimal physical and cognitive function using the simplest possible AED regimen. The clinician should consider whether an antiepileptic treatment can be chosen that also ameliorates the co-morbid condition. Newer AEDs, such as lamotrigine, topiramate, gabapentin, oxcarbazepine, and tiagabine, may benefit children with epilepsy and some co-morbid disorders.
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PMID:Understanding co-morbidities affecting children with epilepsy. 1500 60

This study aimed to determine if relatives of children with autism and less severe pervasive developmental disorders (PDDs) have higher rates of various components of the broad autistic phenotype. Psychiatric and medical disorders were investigated. Parents of children with PDDs were selected from an epidemiological survey and compared with parents of control children with non-autistic developmental problems. Rates of abnormalities and disorders were compared in relatives of 79 cases and 61 controls. Medical and autoimmune disorders in both groups were endorsed by few relatives. Specific developmental disorders were commoner in parents of controls. Depression and anxiety were significantly more prevalent in mothers of children with PDDs. Significantly more PDD children had at least one first-degree relative with anxiety and one second-degree relative with OCD. PDDs were commoner in first-degree relatives. The implications of the findings for the definition of the broad phenotype of autism are discussed.
Autism 2004 Mar
PMID:The broad autism phenotype: findings from an epidemiological survey. 1507 May 45

In this paper evidence is presented that Michelangelo met the criteria for Asperger's disorder, or high-functioning autism. The evidence relates to his single-minded work routine, unusual lifestyle, limited interests, poor social and communication skills, and issues of life control. Depression and various medical conditions, including gout, renal colic and renal stones, did not stop his obsessive working habits.
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PMID:Did Michelangelo (1475-1564) have high-functioning autism? 1525 44


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