Nonhandicapped very-low-birth-weight infants at one year of age: developmental profile.

The developmental profile of 61 very-low-birth-weight infants without major cognitive, motor, or sensory deficits was compared with that of 28 term infants at 1 year chronologic age. The groups significantly differed in two ways on the Revised Gesell Developmental Schedules. First, very-low-birth-weight infants were more likely than term infants to have significant discrepancies between either their fine motor or language abilities and their early problem-solving skills as measured by the Adaptive scale of the Gesell. Second, across all fields of behavior (adaptive, gross motor, fine motor, language, and personal/social), very-low-birth-weight infants scored significantly below term infants. The very-low-birth-weight infant's motor performance significantly correlated with bronchopulmonary dysplasia, intracranial hemorrhage, and number of days spent in the hospital. Language performance significantly correlated with intracranial hemorrhage, birth weight, and sex. These findings underscore the limitations of global developmental scores to describe adequately the developmental performance of very-low-birth-weight infants. Instead, a comprehensive assessment of all fields of behavior is necessary to provide an accurate profile of this high-risk group.

Effects of quisqualic acid and glutamate on subsequent learning, emotionality, and seizure susceptibility in the immature and mature animal.

To compare the long-term behavioral effects of chronic administration of excitatory amino acids in the mature and immature brain quisqualic acid (QA) and glutamate (GLU) were administered intraventricularly by osmotic pumps over 7 days in 20- and 60-day-old rats. Both age groups received identical dosages of QA or GLU. At age 90 days, all animals were assessed for abnormalities of learning and memory using the Morris water maze, emotionality using the handling test, and seizure threshold using flurothyl inhalation. No significant differences were found in either the water maze or handling test. However, 60-day-old rats receiving QA or GLU had more spontaneous seizures than the 20-day-old rats. In both age groups histological damage following QA and GLU was limited to the ipsilateral hippocampus, was maximum at the site of the catheter tube, and was similar in the two age groups studied. The adverse effects of long-term effects of chronic exposure to excitatory amino acids are similar in the immature and mature brain.

Behavioral effects of continuous hippocampal stimulation in the developing rat.

There is controversy as to whether prolonged seizures are more detrimental to the immature than the mature brain. To evaluate this question continuous hippocampal stimulation was used to induce prolonged limbic seizures in 20-, 30- and 60-day-old rats. The long-term effects on learning and activity level were then studied at age 80 days using the Morris water maze, a test of spatial learning and memory, and the open field test, a test of an animal's reaction to a novel environment. Limbic status epilepticus in 60-day-old but not 20- and 30-day-old rats caused long-term impairment of learning in the Morris water maze. No differences were noted between the control and the experimental animals in the open field test. These results suggest that the age of seizure onset is an important determinant of long-term cognitive sequelae.

Effects of kindling on subsequent learning, memory, behavior, and seizure susceptibility.

To determine the long-term effects of seizures on the developing brain we kindled 20-, 40-, and 60-day-old rats to stage 5 seizures and then elicited an additional 15 seizures using the same kindling stimulation. At age 80 days, all animals that reached stage 5 kindling, and their respective age-matched controls, underwent behavioral testing using the Morris water maze, open field test, and handling test. Prior to euthanasia the animals had seizure threshold tested using flurothyl inhalation. No differences were noted in time to platform in the water maze or activity level in the open field test between the kindled rats and controls in any of the three age groups. Rats kindled at age 20 and 40 were more emotional than the controls in the handling test. In the flurothyl inhalation test, rats kindled at 40 and 60 days of age had a shorter latency to all seizures stages than the controls. These results demonstrate that while kindling results in no alteration of learning, memory, or activity level, it does result in altered emotionality and activity level in immature animals, as well as reduced seizure threshold in pubescent and mature rats. The animal model used appears to be an important variable in determining the long-term effects of seizures.

Cerebellar hemorrhage in the term neonate: developmental and neurologic outcome.

To elucidate the effects of cerebellar hemorrhage on the term neonate, neurodevelopmental assessments were conducted at a mean age of 32 months on six children. In addition to cerebellar hemorrhage, ventriculomegaly was present on each subject's initial computed tomographic scan. All were managed without surgical evacuation. Two patients required shunts for progressive ventriculomegaly. Five patients had follow-up computed tomography indicating mild atrophy of the superior anterior vermis of the cerebellum; however, none had abnormal ventricular size or abnormalities of the cerebrum. On detailed examination conducted between the ages of 18 and 48 months, five had hypotonia, truncal ataxia, and intention tremor; two had nystagmus. Only one patient walked independently. Intellectual performance of four patients was within the retarded range and two had mildly delayed development. Two patients had markedly disordered expressive language. These data suggest that term neonates surviving cerebellar hemorrhage have neurologic deficits related to the site of hemorrhage, and cognitive deficits related to more generalized cerebral insult.

Neurodevelopmental status of low birth weight infants with bronchopulmonary dysplasia requiring prolonged oxygen supplementation.

Fifty infants weighing 1,500 g or less at birth with a diagnosis of bronchopulmonary dysplasia (BPD) were followed to a mean age of 25 months to determine their clinical course and short-term neurodevelopmental outcome after discharge from the Neonatal Intensive Care Unit, and to identify possible predictive factors for outcome. Because study participation was voluntary, the subjects may not have represented the total population of BPD survivors. Occurrences of abnormalities were high: 11 hearing impaired, 10 legally blind, 14 cerebral palsy, and 23 abnormal development scores. Twenty-one subjects had feeding problems and weight was below the fifth percentile in 26. Home-oxygen therapy was required by 50 per cent of the subjects. Although severity of illness, duration of oxygen therapy and feeding problems were greater among those sent home on oxygen, their neurodevelopmental status did not differ from that of infants breathing room air by discharge. Factors associated with neurodevelopmental outcome were intracranial hemorrhage, pulmonary air leak, and length of hospital stay.

Comparisons of parent and adolescent perspectives on deviance.

This study investigated hospitalized adolescents (57 girls; 46 boys; mean age = 14 years, 8 months) and their fathers and mothers to ascertain the degree of correspondence (by gender of parent and child) on ratings of total symptoms and of internalizing and externalizing psychopathology. Parents (especially mothers) reported higher levels of symptom severity than their offspring; girls' ratings were more severe than boys'. Whereas interparent correspondence was essentially the same in ratings of daughters, mother-son convergence was generally higher than father-son correspondence. Boys and their parents did not differentiate internalizing from externalizing disorders; girls and parents were better able to discriminate between these types of psychopathology.

Internal-external control, interpersonal trust, and the motive to avoid success in college women.

The Internal-External Control scale, Interpersonal Trust scale, and an assessment of the Motive To Avoid Success were administered to 86 undergraduate women. As expected, external and low trust scores covaried with comparatively high levels of achievement-related anxiety. The results were interpreted in terms of possible repression tendencies of internal subjects and the defensive properties inherent in the external and low trust belief systems.

Psychosis or temporal lobotomy: SPECT findings in a paraplegic patient with chronic mental illness.

OBJECTIVE: To ascertain if single proton emission computerized tomography (SPECT) imaging involving a patient with a history of head trauma, paraplegia, and chronic mental illness, would provide useful information regarding diagnosis and treatment. METHOD: A case report. RESULTS: SPECT data indicated a convexity of the temporal lobe; it was significantly crumpled inward in the location of the traumatic blow suffered 18 years earlier. The center of hypoperfusion suggested a complete disruption of connections between the temporal lobe and Broca's area, and a practically ablated left temporal area. CONCLUSION: The patient was reclassified with an organic psychosis and as an individual who might benefit more from medications to treat temporal lobe irritability rather than antipsychotic medications. Despite these findings and recommendations, psychiatric personnel discharged the patient without implementation. He is currently in critical condition following a suicide attempt.

Effect size estimates in chemical aversion treatments of alcoholism.

This study found that aggregate studies on alcohol aversion therapy tended to support a moderate level of treatment impact that may have noteworthy practical import. Emetics appear to generate fairly consistent findings; a paralysis-inducing chemical may produce variable results.

The Therapist Evaluation Inventory: evidence for an unidimensional scale.

The internal structure of the Therapist Evaluation Inventory (TEI) was investigated with data gathered from therapy sessions conducted by 16 individual psychotherapists with 292 psychiatrically disturbed adolescent inpatients. A principal components analysis (Varimax rotation) indicated a single dimension that accounted for 70.39% of scale variance. The findings did not corroborate a factor structure consistent with the a priori scales of the TEI.

Cognitive imbalance and antisocial personality characteristics.

A cognitive imbalance, in which intellectual functioning is elevated in the performance area in comparison to verbal IQ, has been posited as an antecedent condition in relation to antisocial behaviors. The current investigation was based on the notion of a developmental arrest in which verbal, analytical, controlling brain processes (analogous to verbal IQ) fail to develop commensurately with the more impulsive actions mediated by the motor areas of the cerebral cortex (analogous to performance IQ). The simple verbal IQ performance IQ discrepancy index used in prior studies was reformulated as a causal theoretical model consisting of shared and unique performance IQ variance. The participants were 325 adults including 141 prison inmates. They were administered the Wechsler Adult Intelligence Scale-Revised (WAIS-R) and the Psychopathic Deviate (Pd) and Mania (Ma) scales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). These were the manifest (measured) variables in the model tested by means of structural equation modeling procedures. Several statistical indices suggested an excellent model-data congruence.