Attention Deficit and Disruptive Behavior Disorders: Includes two similar disorders: oppositional defiant disorder and CONDUCT DISORDERS. Symptoms occurring in children with these disorders include: defiance of authority figures, angry outbursts, and other antisocial behaviors.REM Sleep Behavior Disorder: A disorder characterized by episodes of vigorous and often violent motor activity during REM sleep (SLEEP, REM). The affected individual may inflict self injury or harm others, and is difficult to awaken from this condition. Episodes are usually followed by a vivid recollection of a dream that is consistent with the aggressive behavior. This condition primarily affects adult males. (From Adams et al., Principles of Neurology, 6th ed, p393)Attention Deficit Disorder with Hyperactivity: A behavior disorder originating in childhood in which the essential features are signs of developmentally inappropriate inattention, impulsivity, and hyperactivity. Although most individuals have symptoms of both inattention and hyperactivity-impulsivity, one or the other pattern may be predominant. The disorder is more frequent in males than females. Onset is in childhood. Symptoms often attenuate during late adolescence although a minority experience the full complement of symptoms into mid-adulthood. (From DSM-V)Conduct Disorder: A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated. These behaviors include aggressive conduct that causes or threatens physical harm to other people or animals, nonaggressive conduct that causes property loss or damage, deceitfulness or theft, and serious violations of rules. The onset is before age 18. (From DSM-IV, 1994)Child Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders in children.Aggression: Behavior which may be manifested by destructive and attacking action which is verbal or physical, by covert attitudes of hostility or by obstructionism.Antisocial Personality Disorder: A personality disorder whose essential feature is a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood. The individual must be at least age 18 and must have a history of some symptoms of CONDUCT DISORDER before age 15. (From DSM-IV, 1994)Diagnostic and Statistical Manual of Mental Disorders: Categorical classification of MENTAL DISORDERS based on criteria sets with defining features. It is produced by the American Psychiatric Association. (DSM-IV, page xxii)Child of Impaired Parents: Child with one or more parents afflicted by a physical or mental disorder.Child Behavior Disorders: Disturbances considered to be pathological based on age and stage appropriateness, e.g., conduct disturbances and anaclitic depression. This concept does not include psychoneuroses, psychoses, or personality disorders with fixed patterns.Attention: Focusing on certain aspects of current experience to the exclusion of others. It is the act of heeding or taking notice or concentrating.Parents: Persons functioning as natural, adoptive, or substitute parents. The heading includes the concept of parenthood as well as preparation for becoming a parent.Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function.Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time.Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.Psychiatric Status Rating Scales: Standardized procedures utilizing rating scales or interview schedules carried out by health personnel for evaluating the degree of mental illness.Methylphenidate: A central nervous system stimulant used most commonly in the treatment of ATTENTION DEFICIT DISORDER in children and for NARCOLEPSY. Its mechanisms appear to be similar to those of DEXTROAMPHETAMINE. The d-isomer of this drug is referred to as DEXMETHYLPHENIDATE HYDROCHLORIDE.Child Behavior: Any observable response or action of a child from 24 months through 12 years of age. For neonates or children younger than 24 months, INFANT BEHAVIOR is available.Parasomnias: Movements or behaviors associated with sleep, sleep stages, or partial arousals from sleep that may impair sleep maintenance. Parasomnias are generally divided into four groups: arousal disorders, sleep-wake transition disorders, parasomnias of REM sleep, and nonspecific parasomnias. (From Thorpy, Sleep Disorders Medicine, 1994, p191)Dreams: A series of thoughts, images, or emotions occurring during sleep which are dissociated from the usual stream of consciousness of the waking state.Behavior Therapy: The application of modern theories of learning and conditioning in the treatment of behavior disorders.Reinforcement, Social: The strengthening of a response with a social reward such as a nod of approval, a parent's love or attention.Aversive Therapy: A treatment that suppresses undesirable behavior by simultaneously exposing the subject to unpleasant consequences.Wandering Behavior: Moving oneself through space while confused or otherwise cognitively impaired. Patterns include akathisia, exhibiting neuroleptic-induced pacing and restlessness; exit seekers who are often newly admitted institution residents who try to open locked exit doors; self-stimulators who perform other activities such as turning doorknobs, in addition to continuous pacing; and modelers who shadow other pacers.Clonazepam: An anticonvulsant used for several types of seizures, including myotonic or atonic seizures, photosensitive epilepsy, and absence seizures, although tolerance may develop. It is seldom effective in generalized tonic-clonic or partial seizures. The mechanism of action appears to involve the enhancement of GAMMA-AMINOBUTYRIC ACID receptor responses.Sleep-Wake Transition Disorders: Parasomnias characterized by behavioral abnormalities that occur during the transition between wakefulness and sleep (or between sleep and wakefulness).Polysomnography: Simultaneous and continuous monitoring of several parameters during sleep to study normal and abnormal sleep. The study includes monitoring of brain waves, to assess sleep stages, and other physiological variables such as breathing, eye movements, and blood oxygen levels which exhibit a disrupted pattern with sleep disturbances.Narcolepsy: A condition characterized by recurrent episodes of daytime somnolence and lapses in consciousness (microsomnias) that may be associated with automatic behaviors and AMNESIA. CATAPLEXY; SLEEP PARALYSIS, and hypnagogic HALLUCINATIONS frequently accompany narcolepsy. The pathophysiology of this disorder includes sleep-onset rapid eye movement (REM) sleep, which normally follows stage III or IV sleep. (From Neurology 1998 Feb;50(2 Suppl 1):S2-S7)Sleep, REM: A stage of sleep characterized by rapid movements of the eye and low voltage fast pattern EEG. It is usually associated with dreaming.Psychomotor Agitation: A feeling of restlessness associated with increased motor activity. This may occur as a manifestation of nervous system drug toxicity or other conditions.Central Nervous System Stimulants: A loosely defined group of drugs that tend to increase behavioral alertness, agitation, or excitation. They work by a variety of mechanisms, but usually not by direct excitation of neurons. The many drugs that have such actions as side effects to their main therapeutic use are not included here.Mood Disorders: Those disorders that have a disturbance in mood as their predominant feature.Anxiety Disorders: Persistent and disabling ANXIETY.Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence.Behavior, Animal: The observable response an animal makes to any situation.Frustration: The motivational and/or affective state resulting from being blocked, thwarted, disappointed or defeated.Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community.Olfaction Disorders: Loss of or impaired ability to smell. This may be caused by OLFACTORY NERVE DISEASES; PARANASAL SINUS DISEASES; viral RESPIRATORY TRACT INFECTIONS; CRANIOCEREBRAL TRAUMA; SMOKING; and other conditions.Lewy Body Disease: A neurodegenerative disease characterized by dementia, mild parkinsonism, and fluctuations in attention and alertness. The neuropsychiatric manifestations tend to precede the onset of bradykinesia, MUSCLE RIGIDITY, and other extrapyramidal signs. DELUSIONS and visual HALLUCINATIONS are relatively frequent in this condition. Histologic examination reveals LEWY BODIES in the CEREBRAL CORTEX and BRAIN STEM. SENILE PLAQUES and other pathologic features characteristic of ALZHEIMER DISEASE may also be present. (From Neurology 1997;48:376-380; Neurology 1996;47:1113-1124)Personality Assessment: The determination and evaluation of personality attributes by interviews, observations, tests, or scales. Articles concerning personality measurement are considered to be within scope of this term.Neuropsychological Tests: Tests designed to assess neurological function associated with certain behaviors. They are used in diagnosing brain dysfunction or damage and central nervous system disorders or injury.Multiple System Atrophy: A syndrome complex composed of three conditions which represent clinical variants of the same disease process: STRIATONIGRAL DEGENERATION; SHY-DRAGER SYNDROME; and the sporadic form of OLIVOPONTOCEREBELLAR ATROPHIES. Clinical features include autonomic, cerebellar, and basal ganglia dysfunction. Pathologic examination reveals atrophy of the basal ganglia, cerebellum, pons, and medulla, with prominent loss of autonomic neurons in the brain stem and spinal cord. (From Adams et al., Principles of Neurology, 6th ed, p1076; Baillieres Clin Neurol 1997 Apr;6(1):187-204; Med Clin North Am 1999 Mar;83(2):381-92)Token Economy: A practice whereby tokens representing money, toys, candy, etc., are given as secondary reinforcers contingent upon certain desired behaviors or performances.Parkinson Disease: A progressive, degenerative neurologic disease characterized by a TREMOR that is maximal at rest, retropulsion (i.e. a tendency to fall backwards), rigidity, stooped posture, slowness of voluntary movements, and a masklike facial expression. Pathologic features include loss of melanin containing neurons in the substantia nigra and other pigmented nuclei of the brainstem. LEWY BODIES are present in the substantia nigra and locus coeruleus but may also be found in a related condition (LEWY BODY DISEASE, DIFFUSE) characterized by dementia in combination with varying degrees of parkinsonism. (Adams et al., Principles of Neurology, 6th ed, p1059, pp1067-75)PropylaminesAromatherapy: The use of fragrances and essences from plants to affect or alter a person's mood or behavior and to facilitate physical, mental, and emotional well-being. The chemicals comprising essential oils in plants has a host of therapeutic properties and has been used historically in Africa, Asia, and India. Its greatest application is in the field of alternative medicine. (From Random House Unabridged Dictionary, 2d ed; from Dr. Atiba Vheir, Dove Center, Washington, D.C.)Parenting: Performing the role of a parent by care-giving, nurturance, and protection of the child by a natural or substitute parent. The parent supports the child by exercising authority and through consistent, empathic, appropriate behavior in response to the child's needs. PARENTING differs from CHILD REARING in that in child rearing the emphasis is on the act of training or bringing up the children and the interaction between the parent and child, while parenting emphasizes the responsibility and qualities of exemplary behavior of the parent.Social Behavior: Any behavior caused by or affecting another individual, usually of the same species.Substance-Related Disorders: Disorders related to substance abuse.Juvenile Delinquency: The antisocial acts of children or persons under age which are illegal or lawfully interpreted as constituting delinquency.Cataplexy: A condition characterized by transient weakness or paralysis of somatic musculature triggered by an emotional stimulus or physical exertion. Cataplexy is frequently associated with NARCOLEPSY. During a cataplectic attack, there is a marked reduction in muscle tone similar to the normal physiologic hypotonia that accompanies rapid eye movement sleep (SLEEP, REM). (From Adams et al., Principles of Neurology, 6th ed, p396)Education, Special: Education of the individual who markedly deviates intellectually, physically, socially, or emotionally from those considered to be normal, thus requiring special instruction.Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Temperament: Predisposition to react to one's environment in a certain way; usually refers to mood changes.Cognition Disorders: Disturbances in mental processes related to learning, thinking, reasoning, and judgment.Maternal Behavior: The behavior patterns associated with or characteristic of a mother.Socialization: The training or molding of an individual through various relationships, educational agencies, and social controls, which enables him to become a member of a particular society.Video Recording: The storing or preserving of video signals for television to be played back later via a transmitter or receiver. Recordings may be made on magnetic tape or discs (VIDEODISC RECORDING).Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.Acetogenins: Polyketides of up to a few dozen carbons in length, formed by chain extension of multiple PROPIONATES and oxygenated to form tetrahydrofuran and lactone rings along the length of the chain. They are found in ANNONACEAE and other PLANTS. Related compounds cyclize to MACROLIDES.Impulsive Behavior: An act performed without delay, reflection, voluntary direction or obvious control in response to a stimulus.Learning Disorders: Conditions characterized by a significant discrepancy between an individual's perceived level of intellect and their ability to acquire new language and other cognitive skills. These disorders may result from organic or psychological conditions. Relatively common subtypes include DYSLEXIA, DYSCALCULIA, and DYSGRAPHIA.Receptors, Dopamine D4: A subtype of dopamine D2 receptors that has high affinity for the antipsychotic CLOZAPINE.Feeding Behavior: Behavioral responses or sequences associated with eating including modes of feeding, rhythmic patterns of eating, and time intervals.Behavior Control: Manipulation of the behavior of persons or animals by biomedical, physical, psychological, or social means, including for nontherapeutic reasons.Brain: The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM.Psychological Techniques: Methods used in the diagnosis and treatment of behavioral, personality, and mental disorders.Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.Reaction Time: The time from the onset of a stimulus until a response is observed.Sleep Disorders: Conditions characterized by disturbances of usual sleep patterns or behaviors. Sleep disorders may be divided into three major categories: DYSSOMNIAS (i.e. disorders characterized by insomnia or hypersomnia), PARASOMNIAS (abnormal sleep behaviors), and sleep disorders secondary to medical or psychiatric disorders. (From Thorpy, Sleep Disorders Medicine, 1994, p187)Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Behavior: The observable response of a man or animal to a situation.Autonomic Nervous System Diseases: Diseases of the parasympathetic or sympathetic divisions of the AUTONOMIC NERVOUS SYSTEM; which has components located in the CENTRAL NERVOUS SYSTEM and PERIPHERAL NERVOUS SYSTEM. Autonomic dysfunction may be associated with HYPOTHALAMIC DISEASES; BRAIN STEM disorders; SPINAL CORD DISEASES; and PERIPHERAL NERVOUS SYSTEM DISEASES. Manifestations include impairments of vegetative functions including the maintenance of BLOOD PRESSURE; HEART RATE; pupil function; SWEATING; REPRODUCTIVE AND URINARY PHYSIOLOGY; and DIGESTION.Family Conflict: Struggle or disagreement between parents, parent and child or other members of a family.Irritable Mood: Abnormal or excessive excitability with easily triggered anger, annoyance, or impatience.Psychopathology: The study of significant causes and processes in the development of mental illness.Peer Group: Group composed of associates of same species, approximately the same age, and usually of similar rank or social status.Case-Control Studies: Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.Autistic Disorder: A disorder beginning in childhood. It is marked by the presence of markedly abnormal or impaired development in social interaction and communication and a markedly restricted repertoire of activity and interest. Manifestations of the disorder vary greatly depending on the developmental level and chronological age of the individual. (DSM-V)Guadeloupe: The name of two islands of the West Indies, separated by a narrow channel. Their capital is Basse-Terre. They were discovered by Columbus in 1493, occupied by the French in 1635, held by the British at various times between 1759 and 1813, transferred to Sweden in 1813, and restored to France in 1816. Its status was changed from colony to a French overseas department in 1946. Columbus named it in honor of the monastery of Santa Maria de Guadalupe in Spain. (From Webster's New Geographical Dictionary, 1988, p470 & Room, Brewer's Dictionary of Names, 1992, p221)Psychometrics: Assessment of psychological variables by the application of mathematical procedures.Mother-Child Relations: Interaction between a mother and child.Psychological Tests: Standardized tests designed to measure abilities, as in intelligence, aptitude, and achievement tests, or to evaluate personality traits.
Adult attention deficit hyperactivity disorderAlejandro Rodriguez (psychiatrist): Alejandro Rodriguez (February 1918 – January 20, 2012) was a Venezuelan-American pediatrician and psychiatrist, known for his pioneering work in child psychiatry. He was the director of the division of child psychiatry at the Johns Hopkins University School of Medicine, and conducted pivotal studies on autism and other developmental disorders in children.Dog aggression: Dog aggression is a term used by dog owners and breeders to describe canine-to-canine antipathy. Aggression itself is usually defined by canine behaviorists as "the intent to do harm".History of psychopathy: Psychopathy, from psych (soul or mind) and pathy (suffering or disease), was coined by German psychiatrists in the 19th century and originally just meant what would today be called mental disorder, the study of which is still known as psychopathology. By the turn of the century 'psychopathic inferiority' referred to the type of mental disorder that might now be termed personality disorder, along with a wide variety of other conditions now otherwise classified.SchizophreniaGary H. Posner: Gary H. Posner (born c.Parent structure: In IUPAC nomenclature, a parent structure, parent compound, parent name or simply parent is the denotation for a compound consisting of an unbranched chain of skeletal atoms (not necessarily carbon), or consisting of an unsubstituted monocyclic or polycyclic ring system.Mental disorderComorbidity: In medicine, comorbidity is the presence of one or more additional disorders (or diseases) co-occurring with a primary disease or disorder; or the effect of such additional disorders or diseases. The additional disorder may also be a behavioral or mental disorder.MethylphenidateBenign neonatal sleep myoclonus: Benign neonatal sleep myoclonus (BNSM) is the occurrence of myoclonus (jerky movements) during sleep. It is not associated with seizures.Nightmare: A nightmare is an unpleasant dream that can cause a strong emotional response from the mind, typically fear but also despair, anxiety and great sadness. The dream may contain situations of discomfort, psychological or physical terror.Org 25435: Org 25435 is a synthetic drug developed by Organon International, which acts as a GABAA receptor positive allosteric modulator, and produces sedative effects. It has been researched for use as an intravenous anesthetic agent, with positive results in initial trials, although negative side effects like hypotension and tachycardia, as well as unpredictable pharmacokinetics at higher doses, have meant it has ultimately not been adopted for medical use.ClonazepamExploding head syndrome: Exploding head syndrome (EHS) is a condition in which a person hears loud noises (such as a bomb exploding, a gunshot, or a cymbal crash) or experiences an explosive feeling when falling asleep or waking up. These noises have a sudden onset, are typically brief in duration, and are often jarring for the sufferer.PolysomnographyNarcolepsyPsychomotor agitationBeta-Phenylmethamphetamine: β-Phenylmethamphetamine (N,α-dimethyl-β-phenyl-phenethylamine) is a potent and long lasting stimulant drug.Pharmazie 1973;28(10):677.Social anxiety disorderBipolar disorderGeometrical frustration: In condensed matter physics, the term geometrical frustration (or in short: frustrationThe psychological side of this problem is treated in a different article, frustration) refers to a phenomenon, where atoms tend to stick to non-trivial positions or where, on a regular crystal lattice, conflicting inter-atomic forces (each one favoring rather simple, but different structures) lead to quite complex structures. As a consequence of the frustration in the geometry or in the forces, a plenitude of distinct ground states may result at zero temperature, and usual thermal ordering may be suppressed at higher temperatures.Olfactory sulcus: The medial orbital gyrus presents a well-marked antero-posterior sulcus, the olfactory sulcus, for the olfactory tract.Dennis Walsh: Dennis Walsh (12 June 1933 – 1 June 2005) was an English astronomer, born into a poor family in Manchester. He was best known for his discovery in 1979 of the first example of a gravitational lens which he made while studying quasars found in the Jodrell Bank 966MHz survey.Repeatable Battery for the Assessment of Neuropsychological Status: The Repeatable Battery for the Assessment of Neuropsychological Status is a neuropsychological assessment initially introduced in 1998. It consists of ten subtests which give five scores, one for each of the five domains tested (immediate memory, visuospatial/constructional, language, attention, delayed memory).Gregor Wenning: Gregor K. Wenning (* born 21st March1964 in Horstmar, Westfalia) is a German Neurologist best known for his clinical and scientific work in Parkinson's disease and atypical Parkinsonian disorders, particularly multiple system atrophy (MSA).Causes of Parkinson's disease: Parkinson's disease (PD) is a degenerative disorder of the central nervous system. Most people with PD have idiopathic Parkinson's disease (having no specific known cause).Lithium diisopropylamideAromatherapy: Aromatherapy uses plant materials and aromatic plant oils, including essential oils, and other aromatic compounds for the purpose of altering one's mood, cognitive, psychological or physical well-being.Genetics of social behavior: The genetics of social behavior is an area of research that attempts to address the question of the role that genes play in modulating the neural circuits in the brain which influence social behavior. Model genetic species, such as D.Substance-related disorderTexas Juvenile Justice Department: The Texas Juvenile Justice Department (TJJD) is a state agency in Texas, headquartered in the Braker H Complex in Austin.CataplexySpecial education in the United Kingdom: 'Special Educational Needs' is an umbrella term for an aspect of UK school education focusing on students primarily with learning difficulties and/or disability. In school documents, it is abbreviated to 'SEN' / 'SEND' – these abbreviations are also used in Commonwealth countries such as Australia and Singapore.Closed-ended question: A closed-ended question is a question format that limits respondents with a list of answer choices from which they must choose to answer the question.Dillman D.Hyperthymic temperament: Hyperthymic temperament, or hyperthymia, from Greek hyper ("over", meaning here excessive) + θυμός ("spirited"), is a proposed personality type characterized by an excessively positive disposition similar to, but more stable than, the hypomania of bipolar disorder.Postoperative cognitive dysfunction: Postoperative cognitive dysfunction (POCD) is a short-term decline in cognitive function (especially in memory and executive functions) that may last from a few days to a few weeks after surgery. In rare cases, this disorder may persist for several months after major surgery.Professional DiscJerry L. McLaughlin: Jerry L. McLaughlin is a researcher who has conducted research for 28 years studying plants looking for molecules that fight cancer at Purdue University's School of Pharmacy.Barratt WaughLearning Disability Coalition: The Learning Disability Coalition is a group of fourteen organisations which campaigns to secure better funding for social care for people with learning disabilities in England.Coalition was formed in May 2007.Child life specialist: Child Life}}QRISK: QRISK2 (the most recent version of QRISK) is a prediction algorithm for cardiovascular disease (CVD) that uses traditional risk factors (age, systolic blood pressure, smoking status and ratio of total serum cholesterol to high-density lipoprotein cholesterol) together with body mass index, ethnicity, measures of deprivation, family history, chronic kidney disease, rheumatoid arthritis, atrial fibrillation, diabetes mellitus, and antihypertensive treatment.Developmental psychopathology: Developmental psychopathology is the study of the development of psychological disorders, such as psychopathy, autism, schizophrenia and depression, with a lifecourse perspective.Cicchetti, D.Nested case-control study: A nested case control (NCC) study is a variation of a case-control study in which only a subset of controls from the cohort are compared to the incident cases. In a case-cohort study, all incident cases in the cohort are compared to a random subset of participants who do not develop the disease of interest.Focus on Autism and Other Developmental Disabilities: Focus on Autism and Other Developmental Disabilities is a peer-reviewed academic journal covering the field of special education. The editors-in-chief are Alisa K.Invasion of Guadeloupe (1794): The Invasion of Guadeloupe was a British attempt in 1794 to take and hold the island of Guadeloupe in the West Indies during the French Revolutionary Wars. The British had negotiated with the French planters, Ignace-Joseph-Philippe de Perpignan and Louis de Curt, who wished to gain British protection, as the French Constitutional Assembly was passing a law abolishing slavery.David Budescu: David Budescu is a psychologist and academic. He is the Anne Anastasi Professor of Psychometrics and Quantitative Psychology at Fordham University.
(1/275) Nursing home characteristics and the development of pressure sores and disruptive behaviour.
OBJECTIVE: To determine how nursing home characteristics affect pressure sores and disruptive behaviour. METHOD: Residents (n = 5518, aged > or =60 years) were selected from 70 nursing homes in the National Health Care chain. Homes were classified as high- or low-risk based on incidence tertiles of pressure sores or disruptive behaviour (1989-90). Point-prevalence and cumulative incidence of pressure sores and disruptive behaviour were examined along with other functional and service variables. RESULTS: The overall incidence of pressure sores was 11.4% and the relative risk was 4.3 times greater in high- than low-risk homes; for disruptive behaviour, the incidence was 27% and the relative risk was 7.1 times greater in the high-risk group. At baseline, fewer subjects in homes with a high risk of pressure sores were white or in restraints, but more had received physician visits monthly and had had problems with transfers and eating. High-risk homes also had fewer beds and used less non-licensed nursing staff time. At follow-up (1987-90), 52% of homes in the low-risk group and 35% of those in the high-risk group had maintained their risk status; low-risk homes were more likely to have rehabilitation and maintenance activities. Having multiple clinical risk factors was associated with more pressure sores in high- (but not low-) risk homes, suggesting a care-burden threshold. By logistic regression, the best predictor of pressure sores was a home's prior (1987-88) incidence status. Interestingly, 67% of homes with a high risk of pressure sores were also high-risk for disruptive behaviour, while only 27% of homes with a low risk of pressure sores were high-risk for disruptive behaviour. A threshold effect was also observed between multiple risk factors and behaviour. More homes with a high risk of disruptive behaviour (68%) remained at risk over 4 years, and the best predictor of outcome was a home's previous morbidity level. CONCLUSION: Nursing-home characteristics may have a greater impact than clinical factors on pressure sores and disruptive behaviour in long-stay, institutionalized elders. (+info)
(2/275) An evaluation of the properties of attention as reinforcement for destructive and appropriate behavior.
The analogue functional analysis described by Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994) identifies broad classes of variables (e.g., positive reinforcement) that maintain destructive behavior (Fisher, Ninness, Piazza, & Owen-DeSchryver, 1996). However, it is likely that some types of stimuli may be more effective reinforcers than others. In the current investigation, we identified 2 participants whose destructive behavior was maintained by attention. We used concurrent schedules of reinforcement to evaluate how different types of attention affected both destructive and appropriate behavior. We showed that for 1 participant praise was not an effective reinforcer when verbal reprimands were available; however, praise was an effective reinforcer when verbal reprimands were unavailable. For the 2nd participant, we identified a type of attention that effectively competed with verbal reprimands as reinforcement. We then used the information obtained from the assessments to develop effective treatments to reduce destructive behavior and increase an alternative communicative response. (+info)
(3/275) A descriptive analysis of social consequences following problem behavior.
The social consequences delivered for problem behavior during functional analyses are presumed to represent common sources of reinforcement; however, the extent to which these consequences actually follow problem behavior in natural settings remains unclear. The purpose of this study was to determine whether access to attention, escape, or tangible items is frequently observed as a consequence of problem behavior under naturalistic conditions. Twenty-seven adults who lived in a state residential facility and who exhibited self-injurious behavior, aggression, or disruption participated. Observers recorded the occurrence of problem behavior by participants as well as a variety of consequences delivered by caregivers. Results indicated that attention was the most common consequence for problem behavior and that aggression was more likely to produce social consequences than were other forms of problem behavior. (+info)
(4/275) Child psychiatric symptoms and psychosocial impairment: relationship and prognostic significance.
BACKGROUND: Relatively little is known about the relationships between psychiatric symptoms, diagnosis and psychosocial impairment. AIMS: To examine these contemporaneous relationships and prognostic significance in a large general population sample. METHOD: Symptoms of major depression, conduct and oppositional defiant disorders were assessed by interview in two waves of the Virginia Twin Study of Adolescent behavioural Development (2800 children aged 8-16 years). RESULTS: Many children below the DSM-III-R diagnostic threshold, especially for depression, had symptom-related impairment, whereas many children reaching the symptom threshold for conduct and oppositional defiant disorders were little impaired. Impairment score was linearly related to symptom count, with no evidence of any additional impairment at the diagnostic threshold. For depression, only symptoms predicted later symptoms and diagnosis. For conduct and oppositional defiant disorders, impairment was additionally predictive of later symptoms and diagnosis. CONCLUSIONS: Impairment, in addition to symptoms, is important for both nosology and prognosis. (+info)
(5/275) Unintentional injury in preschool boys with and without early onset of disruptive behavior.
OBJECTIVE: To determine subsequent risk of unintentional injury among preschool boys diagnosed with ODD, boys with comorbid ODD and ADHD, and boys matched demographically to the clinical sample; to test predictive validity of a measure of injury proneness; and to examine factors that might predict injury beyond clinic status. METHODS: Seventy-nine consecutive clinic-referred preschool-age boys and 76 demographically matched boys without disruptive behavior participated in a 2-year prospective longitudinal design. Time 1 assessment included clinical diagnosis, parent-reported injury proneness, attachment, and verbal abilities. Injury history was measured 1 and 2 years later. RESULTS: Clinic-referred children had more injuries than the comparison group. Children with comorbid ODD and ADHD had approximately the same injury rate as those with ODD but not ADHD. Parent-reported injury proneness was unrelated to subsequent injuries. Neither attachment nor verbal ability predicted injury significantly beyond clinic status. CONCLUSIONS: Children with early disruptive behavior are at increased risk of unintentional injury and therefore should be considered prime candidates for injury prevention campaigns. (+info)
(6/275) The influence of activity choice on problem behaviors maintained by escape versus attention.
This study assessed whether the function of an individual's problem behavior was related to the effectiveness of an intervention involving choice among tasks. Analogue functional analyses were conducted with 7 students with various diagnoses to determine whether problem behaviors were maintained by escape or attention. Following identification of the function of each student's problem behavior, reversal designs were used to assess the effectiveness of an intervention that allowed the students to choose their own instructional tasks. Results showed that students who displayed escape-maintained problem behavior showed substantial reductions in such behavior when they were provided with opportunities to choose among tasks. On the other hand, students who displayed attention-maintained problem behavior did not show any effects as a result of the choice intervention. These findings are discussed in terms of the effective use of behavior management programs involving choice and the reduction of problem behavior. (+info)
(7/275) Developmental trajectories of childhood disruptive behaviors and adolescent delinquency: a six-site, cross-national study.
This study used data from 6 sites and 3 countries to examine the developmental course of physical aggression in childhood and to analyze its linkage to violent and nonviolent offending outcomes in adolescence. The results indicate that among boys there is continuity in problem behavior from childhood to adolescence and that such continuity is especially acute when early problem behavior takes the form of physical aggression. Chronic physical aggression during the elementary school years specifically increases the risk for continued physical violence as well as other nonviolent forms of delinquency during adolescence. However, this conclusion is reserved primarily for boys, because the results indicate no clear linkage between childhood physical aggression and adolescent offending among female samples despite notable similarities across male and female samples in the developmental course of physical aggression in childhood. (+info)
(8/275) An evaluation of a brief functional analysis format within a vocational setting.
We conducted and compared both brief and extended functional analyses of disruptive behaviors for 3 individuals with developmental disabilities who attended a vocational training program. Results demonstrated that the brief assessment identified the function of 2 of the 3 participants' disruptive behavior compared to the extended assessment. (+info)
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