Italian standardization of the Apples Cancellation Test.

Hemispatial neglect due to right parieto-temporo-frontal lesions has a negative impact on the success of rehabilitation, resulting in poor functional gain. Recent research has shown that different types of neglect can impact in a different way on rehabilitation outcomes. The availability of a sensitive test, useful for distinguishing egocentric and allocentric forms of neglect, may be clinically important as all current clinical instruments fail to distinguish between these forms of disturbance, yet they differentially predict outcome. The Apples Test is a new instrument useful to evaluate both egocentric and allocentric forms of neglect. In order to establish Italian norms for this diagnostic instrument the test was administered to a sample of 412 healthy people of both genders (201 M and 211 F), aged from 20 to 80 years enrolled from 14 different rehabilitation centers in Italy. Based on the data, we established pathological performance cut-offs for the accuracy score (total omission errors), the asymmetry score for egocentric neglect (omission error difference), the asymmetry score for allocentric neglect (commission error difference) and execution time. The usefulness of the Apples Test for diagnostic purposes is illustrated by presenting three patients with different forms of neglect (egocentric, allocentric and mixed neglect).

Assessing the need for challenging behaviour services in an English health district.

The aim of the present study was to assess the health care needs for people with learning difficulties who display challenging behaviour in a newly established health district. Ninety-eight clients were studied, using Disability Assessment Schedule (DAS), Aberrant Behaviour Checklist (ABC) and The Psychopathology Inventory for Mentally Retarded Adults (PIMRA). The results showed that a large proportion of them were mobile, continent and able to feed themselves. Almost half had no problems in communication but less than half were sociable. On the whole, they did not have adequate skills. A large proportion of them did not present severe challenging behaviour and did not suffer from psychiatric illnesses, apart from inappropriate adjustment disorder. Correlation coefficients showed that there were relationships between challenging behaviours and some of clients' disabilities and inappropriate adjustment disorder.

A preliminary study on the prevalence of challenging behaviours.

The purpose of this study was to estimate the prevalence of challenging behaviour among subjects with learning disabilities in an English health district. Subjects' disabilities included incontinence, lack of communication skills, and need of assistance with domestic activities, feeding, washing, and dressing. Some also had physical impairments. The most common behaviours were hyperactivity and irritability and the most common psychiatric disorders included severe anxiety, affective disorder, and adjustment disorder.

A randomised controlled out-patient trial of cognitive-behavioural treatment for children and adolescents with depression: 9-month follow-up.

Nine-month outcome data of a randomized controlled out-patient trial of cognitive-behavioural treatment (CBT) for children and adolescents with depression are presented. CBT was compared with a non-focussed intervention (NFI) in 56 subjects. At 9 months after thr termination of the trial, 21 children (37.5%) fulfilled criteria for a psychiatric disorder (DSM-III-R), out of whom 15 (26.8%) had a depressive illness. However, 25 subjects (45%) reported depressive symptoms of significant severity to suggest a depressive episode during the previous 9-month period. Both treatment groups maintained a significant improvement on all psychosocial measures since the post-treatment assessment. No significant treatment effect was established. Low self-esteem at the time of referral, predicted presence of psychiatric disorder, and child-reported scores of depressive symptoms and low self-esteem at follow-up. The research and clinical implications for the treatment of depressive disorders in young life are discussed.