ABSTRACT
This cross-sectional, case control study examines the association between child sexual abuse and interpersonal and intrapersonal outcomes among 54 adolescents, examining specific clinical measures (depression, anxiety, dissociation, and posttraumatic stress disorder, attachment patterns, self-esteem, self-disclosure, and family environment characteristics). The research results point to a correlation between sexual abuse and higher levels of the clinical measures. In addition, a correlation was found between sexual abuse and level of avoidant attachment, self-esteem, and family environment characteristics. Stepwise hierarchical regressions were conducted to examine how adolescent attributes predicted depression, anxiety, and dissociation beyond the prediction based on sexual abuse. A combination of self-esteem, anxiety attachment, and family cohesiveness made sexual abuse insignificant when predicting levels of depression, anxiety, and dissociation. This study contributes to characterizing the emotional, personal, and family attributes of adolescents who experienced sexual abuse. It also raises questions about the clinical outcomes usually associated with sexual abuse.
Subject(s)
Interpersonal Relations , Self Concept , Stress Disorders, Post-Traumatic/psychology , Adolescent , Anxiety/psychology , Case-Control Studies , Child Abuse, Sexual/psychology , Cross-Sectional Studies , Depression/psychology , Family , Female , Humans , Male , Object AttachmentABSTRACT
OBJECTIVE: This open-label study assessed the long-term effectiveness and tolerability of reboxetine maintenance treatment in children with attention-deficit/hyperactivity disorder (ADHD). METHODS: Six children aged 9-13 (mean +/- standard deviation, SD, 10.7 +/- 1.6) years, diagnosed with ADHD and successfully treated with reboxetine for 6 weeks were enrolled in a long-term (18-36 months) follow-up study. Assessments included rater-administered scales (ADHD Rating Scale; Clinical Global Impressions Scale) and a parent-administered scale (the Abbreviated Conners' Rating Scale). The safety and tolerability were evaluated by documenting spontaneous self-reported adverse effects as well as by vital signs, electrocardiogram, body weight, and routine blood screen. Reboxetine was maintained at a dose of 4 mg/day. RESULTS: The children were followed up to 36 months (mean +/- SD, 24 +/- 6.6; range, 18-36). The significant decrease in ADHD symptoms achieved in the short-term phase (first 6 weeks) was maintained throughout the study. No new onset adverse effects was detected during this follow-up period. No suicidal attempt or ideation was noted. CONCLUSIONS: The results suggest the long-term effectiveness and safety of reboxetine maintenance treatment in children with ADHD. Future large-scale, long-term, placebo/comparator-controlled studies should assess the benefit/risk ratio of reboxetine in ADHD children.
Subject(s)
Adrenergic Uptake Inhibitors/therapeutic use , Attention Deficit Disorder with Hyperactivity/drug therapy , Morpholines/therapeutic use , Adolescent , Adrenergic Uptake Inhibitors/adverse effects , Body Weight/drug effects , Child , Electrocardiography , Female , Follow-Up Studies , Humans , Male , Morpholines/adverse effects , Parents , Psychiatric Status Rating Scales , Reboxetine , Severity of Illness Index , Suicide/psychologyABSTRACT
The aim of the present study was to assess vesicular monoamine transporter (VMAT2) density in attention deficit/hyperactivity disorder (ADHD), a disorder involving monoaminergic dysregulation. It was hypothesized that the hypoactivity of monoaminergic neurotransmission related to ADHD could be associated with an under-expression of VMAT2. We assessed high affinity [3H]dihydrotetrabenazine [TBZOH] binding to platelet VMAT2 in untreated male ADHD children and adolescents (n=11) as compared to age-matched controls (n=14), as well as the correlation between VMAT2 density and the severity of ADHD symptoms as measured by the clinician-administered DSM-IV ADHD Scale (DAS) and the parent-administered Abbreviated Conners' Rating Scale (ACPRS). The [3H]TBZOH binding capacity (Bmax) was significantly lower (17%) in the ADHD group as compared to the controls. There was no difference between the two groups in the affinity (Kd value) of [3H]TBZOH to its binding site. An inverse correlation was found between the ADHD symptom scales and the Bmax values. It remains unclear whether the under-expression of platelet VMAT2 in ADHD children is reflective of a parallel change in the brain, and whether it is primary or an epiphenomenon of ADHD.
