Journal of the American Academy of Child and Adolescent Psychiatry
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J Am Acad Child Adolesc Psychiatry · May 2009
Construct and differential item functioning in the assessment of prescription opioid use disorders among American adolescents.
To examine the psychometric properties of diagnostic criteria for prescription analgesic opioid use disorders (OUDs) and to identify background predictors of a latent continuum for OUD liability. ⋯ Study findings do not support the DSM-IV's current hierarchical distinction between abuse of and dependence on prescription opioids. Abuse symptoms in adolescents are not necessarily less severe than those of dependence. There is evidence of some differential item functioning in the assessment of OUDs.
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J Am Acad Child Adolesc Psychiatry · Feb 2009
Randomized Controlled Trial Multicenter StudyGuanfacine extended release in children and adolescents with attention-deficit/hyperactivity disorder: a placebo-controlled trial.
This study compared the efficacy of guanfacine extended release (GXR), a selective alpha(2A)-adrenoceptor agonist, with placebo in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). ⋯ : Guanfacine extended-release was effective in reducing symptoms of ADHD. Adverse events were mild to moderate, did not interfere with improvements in attention, and rarely led to discontinuation.
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J Am Acad Child Adolesc Psychiatry · Nov 2008
Cerebral dysfunctions of emotion-cognition interactions in adolescent-onset schizophrenia.
Schizophrenia is among the most severe of psychiatric disorders, leading to impairments of affective and cognitive abilities. These dysfunctions affect each other mutually. Adolescent-onset schizophrenia (AOS) constitutes a particularly severe form of the disorder. In this study, possible dysfunctions of the neural correlates underlying the interaction of negative emotion and working memory in AOS were investigated. ⋯ Our results provide new insights into the neural correlates underlying the mutual influence of affective and cognitive symptoms in AOS. During the n-back task, areas typically associated with working memory performance were found hypoactivated in patients relative to the control subjects, including the dorsolateral prefrontal and parietal cortex and the anterior cingulate. However, patients with AOS mainly demonstrated increased activation in key areas of emotion processing, such as the left orbitofrontal cortex and medial frontal areas, during negative emotion induction. A dysfunctional thalamocortical network during the interaction mainly included regions involved in the integration of converging information--either on the subcortical (thalamus) or on a higher-order cortical level (comprising the angular gyrus). These findings point to dysfunctional emotion-cognition interactions in AOS, which may explain its poor prognosis.
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J Am Acad Child Adolesc Psychiatry · Aug 2008
Multicenter StudyPediatric emergency department suicidal patients: two-site evaluation of suicide ideators, single attempters, and repeat attempters.
Reducing youth suicide and suicide attempts are national priorities. Suicidal youth emergency department (ED) patients are at high risk for repeat and fatal attempts, yet information is lacking to guide service delivery. In one of the largest clinical studies of youth ED patients presenting with suicidality, we examine ideators, single attempters, and repeat attempters with the aim of clarifying optimal strategies for ED management and risk assessment. ⋯ Pediatric ED patients presenting with suicidal ideation, single attempts, and repeat attempts fall along a continuum of increasing risk. Suicide attempt risk in males is associated with high levels of depression, but not with increased treatment rates, suggesting undertreatment in males, a group with particularly high risk for death by suicide. Treatment barriers must be addressed to achieve our national goal of reducing suicide/suicide attempts in youths.
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J Am Acad Child Adolesc Psychiatry · Feb 2008
ReviewChild psychiatry curricula in undergraduate medical education.
To review the literature describing the content and time allocated to undergraduate medical education curricula in child and adolescent psychiatry and make recommendations about child and adolescent psychiatry teaching goals and curricula content. ⋯ Medical schools should reconsider the relatively low priority given to teaching child and adolescent psychiatry to medical students. The child and adolescent psychiatry profession must identify clear learning goals for a longitudinal developmentally appropriate model of child and adolescent psychiatry education commencing at an undergraduate level in medical schools and continuing through residency and fellowships. There is a need to promote national and international standards for teaching in this area and to encourage stronger collaborations between teaching staff across different medical schools.