RESUMEN
OBJECTIVES: The diagnosis of a specific developmental disorder of reading, writing and arithmetic can be made based upon individually applied standardized methods for testing scholastic achievement and IQ. To make the choice of suitable methods easier for the administrator of the test, a critical survey of German-language methods for assessing skills in reading, writing and arithmetic is presented. METHODS: Test intention and psychometric properties for scholastic achievement are summarized. The methods are assessed with regard to their utility in the diagnosis of congenital alexia and dyscalculia. Supplementary suggestions for clinical assessment are given. RESULTS: In summary, beyond the primary school area there is a lack of current standardized methods that meet the current standards of quality. Particularly the assessment of arithmetic skills above those of the 4th grade level require resorting to methods of dubious curricular validity. Coverage is once again better for the upper elementary and middle school levels. CONCLUSIONS: There is a need for new constructions, respectively a need to update published scholastic achievement tests.
Asunto(s)
Evaluación Educacional , Matemática , Pruebas Psicológicas/normas , Lectura , Escritura , Adolescente , Agrafia/diagnóstico , Niño , Dislexia/diagnóstico , Alemania , Humanos , Discapacidades para el Aprendizaje/diagnóstico , PsicometríaRESUMEN
OBJECTIVE: The aim of the study was to investigate the long-term course of obsessive-compulsive disorder (OCD) with onset in childhood or adolescence. This presentation focuses on the social adjustment of the former patients in adulthood. METHODS: Fifty-five out of 116 patients with childhood OCD classified according to DSM-IV criteria were interviewed personally using structured interviews. Mean age at onset of OCD was 12.5 years, and mean follow-up time was 11.2 years. RESULTS: Despite the evident burden of mental disorder at the time of the follow-up, 76% led their own lives without being overly dependent upon their parents. 84% had no problems that impaired either school or their occupation. 73% were rated as maintaining satisfying social contacts, but only 54% were in a relationship at follow-up. CONCLUSIONS: In agreement with other studies we found an association between the level of psychosocial adjustment and the course of obsessive-compulsive symptoms. Summing up, social adjustment and psychosexual functioning seem to be more impaired than occupational functioning. The relatively good adjustment of our sample indicates that most patients have found a way of managing their lives, albeit still suffering from mental disorders.
Asunto(s)
Adaptación Psicológica , Relaciones Interpersonales , Trastorno Obsesivo Compulsivo/psicología , Autoimagen , Ajuste Social , Adolescente , Adulto , Factores de Edad , Niño , Femenino , Estudios de Seguimiento , Humanos , Entrevista Psicológica , Masculino , Trastorno Obsesivo Compulsivo/diagnóstico , Muestreo , Factores SocioeconómicosRESUMEN
BACKGROUND: The German version of the Conners Adult ADHD Rating Scales (CAARS) has proven to show very high model fit in confirmative factor analyses with the established factors inattention/memory problems, hyperactivity/restlessness, impulsivity/emotional lability, and problems with self-concept in both large healthy control and ADHD patient samples. This study now presents data on the psychometric properties of the German CAARS-self-report (CAARS-S) and observer-report (CAARS-O) questionnaires. METHODS: CAARS-S/O and questions on sociodemographic variables were filled out by 466 patients with ADHD, 847 healthy control subjects that already participated in two prior studies, and a total of 896 observer data sets were available. Cronbach's-alpha was calculated to obtain internal reliability coefficients. Pearson correlations were performed to assess test-retest reliability, and concurrent, criterion, and discriminant validity. Receiver Operating Characteristics (ROC-analyses) were used to establish sensitivity and specificity for all subscales. RESULTS: Coefficient alphas ranged from .74 to .95, and test-retest reliability from .85 to .92 for the CAARS-S, and from .65 to .85 for the CAARS-O. All CAARS subscales, except problems with self-concept correlated significantly with the Barrett Impulsiveness Scale (BIS), but not with the Wender Utah Rating Scale (WURS). Criterion validity was established with ADHD subtype and diagnosis based on DSM-IV criteria. Sensitivity and specificity were high for all four subscales. CONCLUSION: The reported results confirm our previous study and show that the German CAARS-S/O do indeed represent a reliable and cross-culturally valid measure of current ADHD symptoms in adults.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Escalas de Valoración Psiquiátrica , Adulto , Trastorno por Déficit de Atención con Hiperactividad/psicología , Estudios Transversales , Autoevaluación Diagnóstica , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadAsunto(s)
Trastornos Disociativos/psicología , Adolescente , Niño , Preescolar , Comorbilidad , Trastornos de Conversión/diagnóstico , Trastornos de Conversión/psicología , Trastornos Disociativos/diagnóstico , Femenino , Estudios de Seguimiento , Humanos , Masculino , Desarrollo de la Personalidad , Escalas de Valoración PsiquiátricaRESUMEN
Research on different subtypes of attention deficit hyperactivity disorder (ADHD) yielded inconsistent results regarding the nature of cognitive deficits. Whereas some studies report significant differences between subtypes, others fail to report these differences. In fact, the majority of studies in the field of ADHD does not differentiate between subtypes at all. The present study adopted the cognitive task of negating valence to compare the DSM-defined ADHD combined subtype (ADHD-C; n = 25), the inattentive subtype (ADHD-I; n = 25) and the control group (n = 30). As a main result, children with ADHD-C showed significant impairments compared to children with ADHD-I and the control group on conscious responses-driven by executive function, as well as on unconscious associative tasks. Medical treatment with stimulants positively influenced cognitive performance, although to a different extent for subgroups. The results are discussed in the context of current theories of ADHD and imply indications for further research in this field.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Estimulantes del Sistema Nervioso Central/uso terapéutico , Trastornos del Conocimiento/tratamiento farmacológico , Conducta Impulsiva/tratamiento farmacológico , Desempeño Psicomotor/efectos de los fármacos , Inconsciente en Psicología , Adolescente , Aprendizaje por Asociación/efectos de los fármacos , Trastorno por Déficit de Atención con Hiperactividad/complicaciones , Niño , Trastornos del Conocimiento/complicaciones , Trastornos del Conocimiento/psicología , Función Ejecutiva/efectos de los fármacos , Humanos , Conducta Impulsiva/complicaciones , MasculinoRESUMEN
Evidence-based treatments for attention-deficit hyperactivity disorder (ADHD) in children include primarily medication (stimulants and atomoxetine) and psychosocial interventions (parent training and behavioural classroom interventions). Results of treatment studies suggest that ADHD without significant coexisting disorders can be treated effectively by pharmacotherapy and expert counselling, while additional behaviour therapy demonstrates no significant improvement. Incremental benefits of combined pharmacological and behavioural interventions emerge if a comorbid condition is present. Behaviour therapy alone may be useful for treating less pronounced ADHD symptoms. Therapeutic strategies also account for the specific treatment of comorbid disorders and the need for support by youth welfare services.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/terapia , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Trastorno por Déficit de Atención con Hiperactividad/psicología , Terapia Conductista , Estimulantes del Sistema Nervioso Central/efectos adversos , Estimulantes del Sistema Nervioso Central/uso terapéutico , Terapia Combinada , Conflicto Psicológico , Educación , Humanos , Discapacidades para el Aprendizaje/diagnóstico , Discapacidades para el Aprendizaje/psicología , Discapacidades para el Aprendizaje/terapia , Grupo de Atención al Paciente , Guías de Práctica Clínica como Asunto , Medio Social , SocializaciónRESUMEN
The aim of this prospective longitudinal study was to examine the course of adolescent anorexia nervosa and obsessive-compulsive disorder (OCD) (fulfilling DSM-III-R criteria) to compare psychiatric comorbidity and personality disorders of both groups. Because anorexia nervosa patients are mainly female, we compared them only with female OCD patients. Ten years after discharge the whole sample (32 female patients; 100%) of a group of 39 (32 female; 7 male) anorexia nervosa patients could be reexamined personally. 25 (61%) female patients of a group of 116 patients (41 female; 75 male) with obsessive-compulsive disorder were also reexamined. The anorexia nervosa patients were interviewed using the Structured Interview for Anorexia and Bulimia nervosa (SIAB [39]) to assess eating disorder symptomatology. To examine comorbid psychiatric disorders we used the Composite International Diagnostic Interview, WHO [44] and SCID-II [45] for personality disorders. One fourth of the patients with anorexia nervosa (AN) and 20% of the patients with obsessive-compulsive disorder had a personality disorder according to DSM-III-R. Most of them were "Cluster C"-personality disorders (AN: 28%; OCD: 20%). In the group of the female OCD patients 8% schizoid, 4% schizotype and 12% paranoid personality disorders were observed. The most prevalent psychiatric disorders were anxiety (AN: 28%; OCD: 20%) and affective disorders (AN: 16%; OCD: 16%). Our results support the view that in the course of anorexia nervosa and in obsessive-compulsive disorder there is a high prevalence of psychiatric comorbidity and "Cluster C"-personality disorders according to DSM-III-R. These results might confirm a model of a high vulnerability of the serotonergic neurotransmitter system in patients with anorexia nervosa or OCD.
Asunto(s)
Anorexia Nerviosa/complicaciones , Trastornos Mentales/complicaciones , Trastorno Obsesivo Compulsivo/complicaciones , Trastornos de la Personalidad/complicaciones , Adolescente , Adulto , Anorexia Nerviosa/epidemiología , Comorbilidad , Femenino , Humanos , Estudios Longitudinales , Masculino , Trastornos Mentales/epidemiología , Trastorno Obsesivo Compulsivo/epidemiología , Trastornos de la Personalidad/epidemiología , Estudios Prospectivos , Escalas de Valoración PsiquiátricaRESUMEN
The aim of the catch-up follow-up study is to describe the long-term outcome of obsessive-compulsive disorder (OCD) with onset in childhood and adolescence. The psychiatric morbidity in adulthood including personality disorders was assessed and predictors in childhood for the course of obsessive-compulsive symptoms were examined. The total study group consisted of the entire patient population treated for OCD at our departments for child and adolescent psychiatry between 1980 and 1991. We reassessed 55 patients personally by way of structured interviews. The mean age of onset of OCD was 12.5 years and the mean follow-up time was 11.2 years. At the follow-up investigation 71% of the patients met the criteria for some form of psychiatric disorder, while 36% were still suffering from OCD. Of the patients with a present diagnosis of OCD 70% had at least one further clinical disorder (especially anxiety and affective disorders). The most frequent personality disorders diagnosed were obsessive-compulsive (25.5%), avoidant (21.8%), and paranoid (12.7%) personality disorders. In-patient treatment, terminating treatment against advice and tics in childhood or adolescence significantly correlated with more severe OC symptoms in adulthood.