Prevalence and assessment of attention-deficit/hyperactivity disorder in primary care settings.

Research literature relating to the prevalence of attention-deficit/hyperactivity disorder (ADHD) and co-occurring conditions in children from primary care settings and the general population is reviewed as the basis of the American Academy of Pediatrics clinical practice guideline for the assessment and diagnosis of ADHD. Epidemiologic studies revealed prevalence rates generally ranging from 4% to 12% in the general population of 6 to 12 year olds. Similar or slightly lower rates of ADHD were revealed in pediatric primary care settings. Other behavioral, emotional, and learning problems significantly co-occurred with ADHD. Also reviewed were rating scales and medical tests that could be employed in evaluating ADHD. The utility of using both parent- and teacher-completed rating scales that specifically assess symptoms of ADHD in the diagnostic process was supported. Recommendations were made regarding the assessment of children with suspected ADHD in the pediatric primary care setting.

Effects of stimulant medication treatment on mothers' and children's attributions for the behavior of children with attention deficit hyperactivity disorder.

Participants were 55 children with attention deficit hyperactivity disorder (ADHD) who were receiving ongoing treatment with stimulant medications and their mothers, and 31 children with ADHD who were beginning stimulant medication and their mothers. Mothers and children offered attributions for child behaviors that occurred when the child was medicated and not medicated. Mothers rated child compliance and prosocial behavior as more global and stable when the child was medicated and rated noncompliance, ADHD symptoms, and oppositional behavior as more externally caused, less global and stable, but more controllable by the child when the child was medicated. Children rated both their compliance and noncompliance as more controllable in the medicated condition. On a forced-choice measure, both mothers and children selected ability, effort, and task attributions for compliance more in the not-medicated condition, and pill-taking attributions more in the medicated condition. This was reversed for noncompliance, which was attributed more to effort, task, or ability in the medicated condition and more to not taking a pill in the not-medicated condition. The potential risks and benefits for parent-child interactions and children's self-perceptions of these medication-related differences in attributions are discussed.

Why do episodes of panic stop?

Episodes of panic are self-limiting--they all come to an end. However, it has not been explained how and why they end. Neither the cognitive nor the biological theory of panic deals with this phenomenon. As a first step toward an understanding of what stops a panic, we collected evidence about the self-limiting nature of these episodes. A semistructured interview was developed and conducted with 25 participants who had received a diagnosis of panic disorder. Participants reported a variety of triggers of panic, signs that a panic was ending, and strategies used to terminate panic episodes. A substantial proportion of participants indicated that there was a refractory period following panic episodes. The theoretical and therapeutic significance of this self-limiting feature of panic episodes is considered, as is the probable occurrence of a postpanic refractory period.

Assessing parent attributions for child behavior using open-ended questions.

Assessed parent attributions for child behavior using open-ended questions. Sixty-one parents of children with attention deficit hyperactivity disorder (ADHD) and 49 parents of nonproblem children participated. An open-ended, thought-listing question asked following child behavior indicated that parents spontaneously offer causal attributions for their children's behavior. Responses to a second open-ended question asking specifically for attributions for the child behavior indicated that both groups of parents attributed prosocial (PRO) child behaviors more than problem behaviors to internal, controllable, and stable causes or to the external situation and attributed problem behaviors most often to uncontrollable and unstable causes within the child or to factors within the parent. Compared with parents of nonproblem children, parents of children with ADHD were less likely to see themselves as the cause of child behavior and were more likely to mention medication. Analyses indicated that, although attributions elicited by rating scales were related to attributions provided in an open-ended format, each method provided unique information.

Radiation measurements in a labyrinth penetration at a high-energy proton accelerator.

The efficient design of access penetrations at high-energy proton accelerators is desirable for both economic and personnel protection reasons. This paper reports on a series of measurements made in a personnel access labyrinth which viewed an A1 target bombarded by 400-GeV protons from the Fermilab Tevatron. Measurements of absorbed dose in the labyrinth using tissue-equivalent ion chambers were consistent with theoretical predictions of both the relative attenuation through the penetration and the absolute magnitude near the target. The multisphere technique was used to determine the neutron energy spectrum in one section of the labyrinth. A recombination chamber was used to measure the quality factor of the radiation field in two sections of the labyrinth. Good agreement with the quality factor deduced from the multisphere result was obtained at the same measurement location.

When patients 'can't' take the pill.

Most side effects of oral contraceptives can be attributed to an excess or a deficiency of estrogen or progestin. Knowledge of the relative amounts of estrogen and progestin in the available preparations permits a rational adjustment of dosage if side effects occur. With this information, nearly every woman who wants to use birth control pills can.