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Query: UMLS:C0025362 (mental retardation)
15,878 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Measurement methods from behavioral psychology were used to assess antiepileptic drug behavioral side effects in 5 individuals with mental retardation. When the suspected antiepileptic drug was altered, an 81% reduction of maladaptive behaviors occurred. Quality of life outcomes included successful community placement and termination of an aversive intervention procedure. Three cases demonstrated antiepileptic drug exacerbation of disruptive vocalizations, agitation, self-injurious behavior, and property destruction; 2 demonstrated improved aggression, but illustrated a common clinical problem. When seizure control must be maintained and a suspected antiepileptic drug cannot be reduced before a second antiepileptic drug with potential psychotropic properties is initiated, it was not possible to absolutely conclude that the first antiepileptic drug was responsible for the behavior problem. Overall, these measurement methods were instrumental in the systematic clinical evaluation of antiepileptic drug behavioral side effects in individuals unable to verbally communicate the presence of these side effects.
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PMID:Antiepileptic drug behavioral side effects in individuals with mental retardation and the use of behavioral measurement techniques. 856 87

Platelet 3H-imipramine (3H-IMI) binding and platelet sulfotransferase (ST) activity, taken as markers of the serotonin (5-HT) and sulfated neurotransmitters (tyramine, dopamine, serotonin, noradrenaline), respectively, were evaluated in 14 severely aggressive subjects institutionalized since childhood for mental retardation and in an equal number of healthy controls. The results showed the presence of a lower number of 3H-IMI binding sites and a higher ST activity in the patients as compared with controls. These data provide supporting evidence for the hypothesis of an abnormality of the 5-HT system and suggest possible dysfunctions of dopamine and sulfated amines in aggressive behavior, at least as reflected by platelet markers.
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PMID:Platelet abnormalities in aggressive subjects with mental deficiency. 882 Jan 76

The nature of social competence of 55 children with mental retardation was explored. Four social-cognitive processes (encoding, cue interpretation, strategy generation, and evaluation of consequences) and their link to social behavior were investigated. During a structured interview, the children responded to videotaped vignettes of social conflict situations involving peer group entry and peer provocation. Although the children were consistently accurate in interpreting hostile intentions, they exhibited difficulty in accurately interpreting benign intentions. Children generated different strategies for the peer entry and peer provocation conflicts. Children who experienced social-cognitive processing difficulties were more likely to display extreme patterns of behavior. Aggressive children frequently misinterpreted benign intention cues and generated aggressive strategies, whereas those who engaged in sensitive/isolated behavior frequently generated avoidant or appeal to authority strategies. Results suggest that assessment and intervention practices in the area of social competence need to address social-cognitive processes.
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PMID:Assessment of social-cognitive processes in children with mental retardation. 885 97

Genes for Prader Willi syndrome/Angelman syndrome are homologous to genes for fragile X syndrome. Genetic imprinting and expanded trinucleotide repeats cause mental retardation, autism and aggression.
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PMID:Genes for Prader Willi syndrome/Angelman syndrome and fragile X syndrome are homologous, with genetic imprinting and unstable trinucleotide repeats causing mental retardation, autism and aggression. 891 Aug 78

Professional staff in four state facilities for individuals with mental retardation were surveyed to determine their perceptions, knowledge and opinions regarding the use of psychotropic medication. A large majority of the 377 respondents indicated that the physicians in their facilities were primarily responsible for medication-related decisions. Under ideal conditions, however, all professional staff and parents were seen as having a greater influence in the decision-making process. Aggression, delusions and hallucinations, self-injury, other psychiatric disorders, and anxiety were rated as disorders most likely to result in medication therapy. Behaviour modification was viewed as a suitable alternative to drug treatment for acting out and aggression. The professionals indicated that behavioural observation was the most influential assessment technique in current usage, followed by global impressions and informal diaries. Over 80% of the respondents perceived their preservice and inservice training on issues related to the use of psychotropic medication to treat behaviour problems as inadequate, with 96% of them desiring continuing education. These findings were compared to data from similar studies of populations with other disabilities, and suggestions for modifications in the current decision-making processes related to the use of psychotropic medication in institutionalized individuals with mental retardation are discussed.
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PMID:Professionals' perceptions of psychotropic medication in residential facilities for individuals with mental retardation. 893 51

Two interrelated cross-sectional studies were conducted to expand earlier findings about correlates of outwardly directed aggressive behavior in children with mental retardation. In Study 1 we compared children with mental retardation, 27 with and 23 without aggression. Aggression was best predicted by concurrent self-injurious behavior (SIB). In Study 2 we examined the likelihood that aggression was predicted by concurrent SIB and other nondestructive maladaptive behaviors in an archival cohort of 701 children younger than 21 with IQs below 70. Self-injurious behavior significantly predicted outwardly directed aggression for all children regardless of age. Additional predictors besides SIB showed only minimal improvements in model R2 values. Results were discussed in light of recent research proposing a common basis for aggression and SIB.
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PMID:Characteristics of children and adolescents with mental retardation and frequent outwardly directed aggressive behavior. 893 99

Risperidone, in conjunction with behavioral interventions, was used to reduce aggression and assault, self-injury, and property destruction in 33 institutionalized adults with mental retardation. Target behavior frequencies, global assessments by staff, wages earned by patients, and the institution's costs for assault-related injury to staff and lost work time were evaluated before and after initiation of risperidone treatment. Risperidone (1-8 mg/day) was associated with a 50 percent or greater reduction in at least one target behavior frequency in 61 percent of patients. After 6 months of treatment, 85 percent of patients were rated "improved" and 15 percent were rated "unchanged." Treated patients' wage earnings increased by 37 percent. The number of staff work days lost because of assault by treated patients decreased from 444 during the 6 months before initiation of risperidone to 29 during the 6 months after initiation. Sedation, pseudoparkinsonism, possible akathisia, and weight gain were noted in 9-12 percent of patients. No patients were withdrawn from risperidone because of intolerable side effects or lack of efficacy. The results of this evaluation suggest that risperidone is effective and well tolerated in this population.
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PMID:Clinical and economic aspects of risperidone treatment in adults with mental retardation and behavioral disturbance. 899 95

A 7-yr.-old Bangladeshi boy with autistic disorder, unspecified mental retardation, asthma, pica, and generalized tonic seizures, presented for hyperactivity, aggression, and disruptive behaviors. He had a history of an elevated blood lead level. He was being treated with haloperidol and valproic acid. He was assessed in an unstimulated state for the occurrence of adventitious movements. He exhibited hand flapping, jumping, running, and spinning as well as other motor and phonic stereotypes typical of autistic disorder. Although the presence of subjective distress and a sensation of inner restlessness could not be ascertained given his cognitive impairments, the objective picture of constant leg movement and inability to sit still was consistent with akathisia. The hyperkinesias may be due to autistic disorder, multiple comorbid conditions, and medications. Further studies with large populations of medicated and unmedicated children with autistic disorder are needed to characterize further the associated movement disorders which may result from neurological disorders and pharmacological treatments.
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PMID:Hyperkinesias in a prepubertal boy with autistic disorder treated with haloperidol and valproic acid. 912 23

The role of expressive communicative ability and level of mental illness symptoms in predicting aggressive behavior was explored in 67 adults with mental retardation. Overall rates of aggression were low with dangerous aggression more the exception than the rule. However, a subset of aggressive behaviors appeared to exist as a continuing risk for injury to others. Both expressive communicative ability and level of mental illness symptoms were strong predictors of aggressive behavior. In combination, high mental health symptoms and low expressive communicative ability were associated with the greatest prevalence of aggression.
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PMID:Expressive communicative ability, symptoms of mental illness and aggressive behavior. 916 85

Several drugs are apparently effective in treating pathologic anger and aggression. Because many of the studies on aggressive populations allowed the use of concomitant medications, it is unclear whether the efficacy of each drug in a particular population is dependent on the presence of other medications, such as antipsychotic agents. Finally, one needs to be circumspect in inferring efficacy of a particular drug in aggressive patients with neuropsychiatric conditions other than the ones in which some efficacy has been established. Lithium appears to be an effective treatment of aggression among nonepileptic prison inmates, mentally retarded and handicapped patients, and among conduct-disordered children with explosive behavior. Certainly, lithium would be the treatment of choice in bipolar patients with excessive irritability and anger outbursts, and it has been shown to be effective in this population. Anticonvulsant medications are the treatment of choice for patients with outbursts of rage and abnormal EEG findings. The efficacy of these drugs in patients without a seizure disorder, however, remains to be established, with the exception perhaps of valproate and carbamazepine. In fact, dyphenylhydantoin did not appear to be effective in treating aggressive behavior in children with temper tantrums and was found to be effective in only a prison population. There is some evidence for the efficacy of carbamazepine and valproate in treating pathologic aggression in patients with dementia, organic brain syndrome, psychosis, and personality disorders. As Yudofsky et al point out in their review of the literature, although traditional antipsychotic drugs have been used widely to treat aggression, there is little evidence for their effectiveness in treating aggression beyond their sedative effect in agitated patients or their antiaggressive effect among patients whose aggression is related to active psychosis. Antipsychotic agents appear to be effective in treating psychotic aggressive patients, conduct-disordered children, and mentally retarded patients, with only modest effects in the management of pathologic aggression in patients with dementia. Furthermore, at least in one study, these drugs were found to be associated with increased aggressiveness in mentally retarded subjects. On the other hand, atypical antipsychotic agents (i.e., clozapine, risperidone, and olanzapine) may be more effective than traditional antipsychotic drugs in aggressive and violent populations, as they have shown efficacy in patients with dementia, brain injury, mental retardation, and personality disorders. Similarly, benzodiazepines can reduce agitation and irritability in elderly and demented populations, but they also can induce behavioral disinhibition. Therefore, one should be careful in using this class of drugs in patients with pathologic aggression. Beta-blockers appear to be effective in many different neuropsychiatric conditions. These drugs seem effective in reducing violent and assaultive behavior in patients with dementia, brain injury, schizophrenia, mental retardation, and organic brain syndrome. As pointed out by Campbell et al in their review of the literature, however, systematic research is lacking, and little is known about the efficacy and safety of beta-blockers in children and adolescents with pathologic aggression. Although widely used in the management of pathologic aggression, the use of this class of drugs has been limited partially by marked hypotension and bradycardia, which are side effects common at the higher doses. The usefulness of the antihypertensive drug clonidine in the treatment of pathologic aggression has not been assessed adequately, and only marginal benefits were observed with this drug in irritable autistic and conduct disorder children. Psychostimulants seem to be effective in reducing aggressiveness in brain-injured patients as well as in violent adolescents with oppositional or conduct disorders, particu
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PMID:Psychopharmacologic treatment of pathologic aggression. 919 23


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