Effect of ferric ammonium citrate in feedlot diets with varying dried distillers' grains inclusion on ruminal hydrogen sulfide concentrations and steer growth.

Angus-cross steers ( = 128) were used to examine the effects of supplementing ferric ammonium citrate (FAC; 300 mg ferric Fe/kg DM) to diets of 20, 40, or 60% dried distillers' grains plus solubles (DDGS) on growth performance, liver mineral and ruminal hydrogen sulfide (HS) concentrations, and carcass traits of finishing steers. Steers were blocked by initial BW (436 ± 10.6 kg) into pens of 4 and randomly assigned to 1 of 6 treatments ( = 5 or 6 pens per treatment) including a 20, 40, or 60% DDGS inclusion diet with (+) or without (-) 300 mg Fe/kg DM from FAC. Liver biopsies (d -9/-10 and 96) and HS measures (d 0, 7, 14, 21, and 95) were determined from 1 steer/pen. Steers were harvested on d 102 and carcass data were collected. A treatment × month effect ( ≤ 0.006) was noted for ADG and G:F, in which the 20-FAC ADG and feed efficiency were greater ( ≤ 0.02) between d 0 to 28 but lesser ( ≤ 0.04) from d 29 to 56 than that of the 20+FAC steers. Final BW linearly decreased ( < 0.01) as DDGS inclusion increased. Final BW tended to be greater ( = 0.10) in the 60+FAC steers than in the 60-FAC steers, whereas final BW was not different ( ≥ 0.32) due to FAC supplementation in the 20 or 40% DDGS diets. A quadratic effect was noted for DMI ( = 0.02), where 60% DDGS decreased DMI. Within the 20% DDGS diet FAC+ improved DMI ( = 0.03) but had no effect within 40 or 60% DDGS inclusion. Ruminal HS concentrations were not affected ( ≥ 0.25) by FAC, but increasing DDGS linearly increased ( < 0.01) ruminal HS values. Liver Cu was decreased ( < 0.01) by FAC across all DDGS inclusions and tended to linearly decrease ( = 0.06) with increasing DDGS inclusion, whereas liver Fe, Mn, and Zn were not altered ( ≥ 0.11) by DDGS inclusion. Liver Zn concentrations tended to be ( = 0.08) or were ( = 0.03) decreased by FAC supplementation within 20 and 40% DDGS, respectively. Increasing the inclusion of DDGS linearly decreased ( = 0.04) HCW and quadratically affected marbling score where the 40% DDGS had the greatest ( = 0.02) marbling scores. Supplementation of FAC within 60% DDGS improved ( ≤ 0.03) HCW and LM area. Marbling scores were greater ( ≤ 0.04) in 20+FAC and 40+FAC compared with 20-FAC and 40-FAC, respectively. In conclusion, although ruminal HS concentrations were not affected by FAC under the conditions of this study, supplementing FAC to diets containing 60% DDGS improved HCW and LM area, suggesting that FAC may be beneficial when dietary S concentrations exceed 0.5%.

Impact of supplementing vitamin C for 56, 90, or 127 days on growth performance and carcass characteristics of steers fed a 0.31 or 0.59% sulfur diet.

The objective was to examine differential timing of vitamin C (VC) supplementation during the finishing period (for the first 56, 90, or 127 d) on performance, VC, and glutathione (GSH) concentrations and carcass traits of steers receiving a 0.31 or 0.59% S diet. Angus steers (n = 42) were stratified to pens by initial BW (304 ± 13 kg) and GeneMax marbling score (4.3 ± 0.12), and pens were randomly assigned to 1 of 7 treatments (6 steers/pen and 1 pen/treatment), including a high-S (HS; 0.59% S) control (HS CON), HS CON + 10 g VC∙steer(-1)∙d(-1) for the first 56 d of the finishing period, HS CON + 10 g VC∙steer(-1)∙d(-1) for the first 90 d of the finishing period, HS CON + 10 g VC∙steer(-1)∙d(-1) for the entire 127-d finishing period (HS VC127), low-S (LS; 0.31% S) diet + 10 g VC∙steer(-1)∙d(-1) for the first 56 d of the finishing period (LS VC56), LS diet + 10 g VC∙steer(-1)∙d(-1) for the first 90 d of the finishing period, or LS diet + 10 g VC∙steer(-1)∙d(-1) for the entire 127-d finishing period. Jugular blood and ultrasound measures were taken from all steers before feeding on d 0, 56, 90, and 127, and liver biopsies and ruminal hydrogen sulfide measurements were collected on d 121 or 122. Steers (n = 40) were harvested on d 127, and carcass data were collected. Data were analyzed by ANOVA as a completely randomized design with the fixed effect of treatment. Because individual intake data were collected, steer was the experimental unit. Final BW and ADG were greater (P ≤ 0.03) and DMI tended (P = 0.09) to be greater in the LS steers compared to HS steers, but G:F did not differ (P = 0.41) by treatment. A treatment × time effect (P = 0.04) for DMI was noted, likely due to lesser DMI between d 91 and 127 for all treatments except the HS VC127 and LS VC56. Plasma VC concentrations of LS steers were less (P = 0.05) than the HS steers. Total (P = 0.06) and reduced (P = 0.03) plasma GSH were greater in HS steers supplemented with VC than the HS CON, but liver GSH were not different due to S or VC (P ≥ 0.13). The ratio of oxidized to reduced liver GSH was greater (P < 0.01) in HS CON than HS steers supplemented with VC. Marbling score, LM area, KPH, and quality grade were not different (P ≥ 0.19) due to diet, but LS steers had greater (P = 0.05) back fat than HS steers. In conclusion, steers fed a HS diet had poorer live performance and unexpectedly greater plasma ascorbate concentrations than the LS-fed steers. Interestingly, increasing days of VC supplementation across the HS diets increased GSH indices, suggesting that although HS diets may negatively affect antioxidant capacity of cattle, supplementing VC may help correct this.

Effects of duration of vitamin C supplementation during the finishing period on postmortem protein degradation, tenderness, and meat color of the longissimus muscle of calf-fed steers consuming a 0.31 or 0.59% sulfur diet.

High-S (HS) diets have been identified as a causative agent in the development of oxidative stress in cattle, which in postmortem muscle can negatively alter meat quality. Vitamin C (VC) is a potent antioxidant produced endogenously by cattle; however, exogenous supplementation of VC may be useful when HS diets are fed to cattle. The objective of this study was to examine the impact of duration of VC supplementation, for the first 56, 90, or 127 d, during the finishing period on meat color and tenderness of the longissimus thoracis (LT) collected from calf-fed steers consuming a 0.31 or 0.59% S diet. Angus steers ( n= 42) were stratified to pens by initial BW (304 ± 13 kg) and GeneMax marbling score (4.3 ± 0.12), and each pen was randomly assigned to 1 of 7 treatments (6 steers/pen, 1 pen/treatment), including HS (0.59% S, a combination of dried distillers grains plus solubles and sodium sulfate) control (HS CON), HS CON + 10 g VC·steer·(-1)d(-1) for the first 56 d (HS VC56), 90 d (HS VC90), or 127 d (HS VC127), low S (LS; 0.31% S) + 10 g VC·steer·(-1)d(-1) for the first 56 d (LS VC56), 90 d (LS VC90), or 127 d (LS VC127). Steers were harvested (n = 40) and, after a 24-h chill, rib sections (LT) were collected. pH was determined on each rib section before division into 3 sections for determination of 1) 7-d retail display and color and Warner-Bratzler shear force (WBSF), 2) 14-d WBSF determination, and 3) protein degradation and collagen content (2 d postmortem). Data were analyzed by ANOVA as a completely randomized design, with the fixed effect of treatment. Individual feed intake was recorded, and steer was the experimental unit. The HS steers had a greater and lesser percent of the 80- and 76-kDa subunits of calpain-1 (P ≤ 0.05), respectively, and tended to have less (P = 0.08) troponin T degradation (d2), and more (P = 0.02) collagen than LS steers. Increasing days of VC supplementation decreased (P = 0.05) the percentage of the 80 kDa subunit of calpain-1 in HS steers but actually increased it in LS steers (P= 0.003). Supplementing VC, regardless of dietary S, did not affect meat collagen, WBSF, or color (P ≥ 0.12). a* and b* values were greater (P ≤ 0.05) in the LS treatments compared to the HS treatments. Increasing the days of VC supplementation to steers fed a HS diet appears to alleviate the negative effects of the HS diet on calpain-1 but has no effect on muscle tenderness or meat color.

Changing perceptions of illness in the early course of psychosis: psychological pathways to self-determination and self-management of treatment.

Treatment early in the course of psychosis can improve prognostic outcomes, facilitate adaptive functioning, and reduce familial and societal burden. However, little is known about the pathway of first episode psychosis (FEP) from the perspective of highly adherent adolescents and young adults. This study sought to understand the pathways in youth self-determination and self-management of treatment by investigating youth and parents' changing perceptions of illness in the early course of psychosis. Twenty-eight (n = 28) interviews were conducted using a semistructured interview guide on 12 adolescents following their FEP hospitalization and 16 parents. Standardized self-report forms and hospital inpatient records were used to collect and confirm demographic and clinical data. On average, three years had passed from initial hospitalization (age 16.2 years, SD = 1.2) to time of interview (age 19.3 years, SD = 2.3), thus allowing for a range of experiences across the early period of illness. Highly adherent adolescents experienced identifiable temporal phases of early psychosis, comprised of emergent and specific themes. Parents described a parallel pathway toward supporting their child's self-determination and self-management of treatments, with some distinct experiential differences. Five dominant themes that emerged across time were symptom recognition, awareness of change, negative appraisals, positive appraisals, and treatment self-management. Examining how these themes evolve over the early course of psychosis can help guide interventions that are compatible with the parent and adolescent's perceptions of illness at that point in time, and can therefore work in concert with the family's existing efforts to understand and manage their emerging condition and progress toward recovery.

High-sulfur in beef cattle diets: a review.

While many cattle feeding areas in the United States have long dealt with high sulfate water, increased feeding of ethanol coproducts such as distillers grains with solubles to beef cattle has led to a corresponding increase in dietary sulfur. As a result, sulfur metabolism in the ruminant has been the focus of many research studies over the past 10 yr, and advances in our knowledge have been made. Excessive sulfur in cattle diets may have implications on trace mineral absorption, dry matter intake, and overall cattle growth. This review will focus on what we have learned about the metabolism of sulfur in the ruminant, including ruminal sulfate reducing bacteria, the role of ruminally available sulfur, factors affecting the production of hydrogen sulfide in the rumen, and the potential mechanisms behind sulfur toxicity in cattle. Additionally, this review will discuss potential strategies to minimize risk of sulfur toxicity when cattle are fed high-sulfur diets, including dietary and management strategies. Further research related to high-sulfur diets including implications for carcass characteristics, meat quality, and animal health will also be discussed. As ethanol production processes continue to change, the nutrient profile of the resulting coproducts will as well. Often removal of one nutrient such as oil will result in the concentration of other nutrients such as sulfur. Therefore, it seems even more likely that a better understanding of sulfur metabolism in the ruminant will be important to beef cattle feeding in the future.

Feeding ferric ammonium citrate to decrease the risk of sulfur toxicity: effects on trace mineral absorption and status of beef steers.

The objective of this study was to determine the effects of adding ferric ammonium citrate (FAC; 300 mg ferric Fe/kg DM) to a 0.51% S diet on diet digestibility, mineral balance, and 56-d performance of steers fed a high concentrate diet. Angus-crossbred steers (n = 18) were randomly assigned to 1 of 3 treatments: 1) control diet (0.21% S; CON), 2) CON + sodium sulfate (0.51% S; high S [HS]), and 3) the HS diet + 300 mg of ferric Fe from FAC/kg DM (0.51% S; HS+Fe). This study included 2 phases, 1) a metabolism trial (d -1 to 20) and 2) a 56-d feedlot trial (d 22 to 79). In phase 1, 2 groups of 9 steers (370 ± 9.5 kg) were adapted to diet (10 d) and metabolism stalls (5 d), and following the adaptation period, a 5-d total collection of feces and urine was conducted. Feed offered and refused was recorded daily, and diet digestibility and retention of Cu, Fe, Mn, and Zn was determined. In phase 2, steers (384 ± 11.9 kg) were individually fed their respective diet in feedlot pens for 56 d and ADG was determined. From each steer, jugular blood and a liver biopsy were collected on d -1, 41, and 72 and d -1 and 72, respectively, for mineral content. Ruminal hydrogen sulfide concentrations (n = 18) were determined on d -1, 9, 23, 31, 41, 51, 61, and 72. In phase 1, DMI (P = 0.02), fecal output (P = 0.06), and intake of Cu, Mn, and Zn (P ≤ 0.04) were less in steers consuming the high S diets than CON, but DM and OM digestibility and urine excretion of minerals were not different (P ≥ 0.12) due to treatment. As a percent of intake, urinary excretion of Cu tended (P = 0.07) to be greater in the HS steers than the CON and HS+Fe steers, which did not differ (P = 0.74). In phase 2, BW, ADG, and G:F were not different (P ≥ 0.29) due to treatment, but DMI was lesser (P < 0.01) in the HS+Fe steers than CON and HS steers, which did not differ (P = 0.13). Ruminal hydrogen sulfide concentrations were greater (P < 0.01) in the steers fed high S diets than CON but were not different (P = 0.86) among the high S diets. Plasma Cu, Fe, and Zn concentrations were not different (P ≥ 0.27) due to treatment on all days. Final liver Cu concentrations were lesser (P < 0.01) in the steers fed high S diets compared with the CON, while liver Fe, Mn, and Zn concentrations did not differ (P ≥ 0.28) among treatments. In conclusion, adding Fe to a high S diet did not affect DM or OM digestibility or trace mineral absorption and status of steers relative to the HS diet alone.

High dietary sulfur decreases the retention of copper, manganese, and zinc in steers.

To examine the effects of dietary S on diet digestibility and apparent mineral absorption and retention, 16 steers [8 ruminally fistulated (368 ± 12 kg BW) and 8 unmodified (388 ± 10 kg BW)] were paired within modification status and BW, and within each of the 2 consecutive 28-d periods, 4 pairs of steers were randomly assigned to either a low-S (0.24%) or high-S (0.68%) pelleted diet. Bromegrass hay was fed at 5 or 7% of the diet, during periods 1 and 2, respectively. Sodium sulfate was used to increase the S content of the high-S diet. The low-S steers were fed the amount of feed their high-S counterpart consumed the previous day, while the high-S steers received 110% of the previous day's intake. Steers were adapted to individual metabolism stalls for 4 d (d -3 to 0 of period), acclimated to diet for 7 d (d 1 to 7 of period), and after high-S steers were consuming ad libitum intake for 7 d (d 14 of period), total urine and feces were collected for 5 d. Feed intake and orts were recorded daily. Dry matter and OM digestibility were determined. Jugular blood was collected before and after each collection period on d 14 and 20, and liver biopsies were collected on d 0 and 27. Macromineral (Ca, K, Mg, and Na) and micromineral (Cu, Mn, and Zn) concentrations were determined for pellets and hay, orts, feces, urine, and plasma and liver samples from each steer via inductively coupled plasma spectrometry. Dry matter intake, DM and OM digestibility, and urine volume were not affected (P ≥ 0.11) by dietary treatment, but fecal output was greater (P = 0.02) in the low-S steers than the high-S steers. A high-S diet decreased plasma Cu (P = 0.04) and liver Zn (P = 0.03) compared to low-S steers. No differences (P ≥ 0.20) were noted among urinary excretion of Cu, Mn, and Zn. Sodium absorption was greater (P < 0.01) and Cu, Mn, and Zn retention was lesser (P ≤ 0.01) in the high-S steers than the low-S steers. Apparent absorption of Ca, K, and Mg was not affected (P ≥ 0.18) by dietary treatment, while absorption of Cu, Mn, and Zn in the high-S treatment was lesser (P ≤ 0.06). In conclusion, consumption of a high-S diet for 28 d had limited effects on Ca, K, Mg, and Na absorption and retention, but decreased Cu, Mn, and Zn retention, which may limit growth and production of cattle consuming a high-S diet long-term.

Effect of varying concentrations of vitamin C on performance, blood metabolites, and carcass characteristics of steers consuming a common high-sulfur (0.55% S) diet.

The objective of this study was to examine the effects of vitamin C (VC) supplementation for an average of 102 d before harvest on finishing performance and blood metabolites of steers receiving a 40% dry distillers grains plus solubles diet (0.55% S). Yearling, Angus-cross steers (n = 140) were blocked by initial BW (432 ± 25.5 kg), stratified within blocks by intramuscular fat (3.6% ± 0.30%) determined by ultrasonography, and assigned to treatments (5 steers/pen, 7 pens/treatment). Treatments included 1) no VC control (CON), 2) 5 g VC • steer(-1) • d(-1) (5VC), 3) 10 g VC • steer(-1) • d(-1) (10VC), and 4) 20 g VC • steer(-1) • d(-1) (20VC). Jugular blood was collected from 2 steers/pen before feeding at the beginning and end of the 102-d study, and steers were harvested by block on 3 separate dates (d 91, 105, and 112). Sulfur intake linearly decreased (P = 0.01) as VC inclusion increased (59.2, 57.7, 57.0, and 54.8 ± 0.79 g S • steer(-1) • d(-1) for CON, 5 VC, 10 VC, and 20 VC, respectively). The CON cattle had greater (P < 0.01) DMI than the VC-supplemented cattle. Inclusion of VC did not influence ADG or final BW, resulting in a tendency for a linear increase (P = 0.08) in G:F as VC inclusion increased (0.150, 0.152, 0.158, and 0.160 ± 0.004 for CON, 5 VC, 10 VC, and 20 VC, respectively). Ending (2 d before harvest) plasma ascorbate showed a quadratic effect (P < 0.05) because of lesser concentrations exhibited by 5 VC cattle (1,186 µg/L) compared with the CON (1,454 µg/L), 10 VC (1,304 µg/L), and 20 VC (1,436 µg/L; SEM ± 64.8) cattle. Ending plasma insulin concentrations of CON cattle tended (P = 0.07) to be less than the VC-supplemented cattle. Plasma glucose and NEFA concentrations were not affected (P ≥ 0.23) by VC inclusion. Hot carcass weight, 12th-rib back fat, marbling, and quality grade were not affected (P ≥ 0.27) by VC inclusion. Increasing VC inclusion linearly increased (P = 0.02) rib eye area (84.9, 86.5, 88.7, and 89.1 cm(2) ± 1.17 for CON, 5 VC, 10 VC, and 20 VC, respectively), corresponding to a linear decrease (P = 0.02) in yield grade with increasing inclusions of VC. A tendency (P = 0.06) for a quadratic effect on KPH was observed, in which values generally increased from CON (2.27%) to 5 VC (2.37%) to and 10 VC (2.39%), then decreased in 20 VC (2.20%). In conclusion, VC supplementation to a high-S diet for an average of 102 d before harvest has limited effects on blood metabolites but increased rib eye area and tended to increase feed efficiency of yearling steers.

Supplemental vitamin C improves marbling in feedlot cattle consuming high sulfur diets.

The objective of this study was to examine the effects of supplemental rumen-protected vitamin C (VC) on live and carcass-based performance, and antioxidant capacity of cattle consuming varying concentrations of dietary S. Angus-cross steers (n = 120) were blocked by initial BW (341 ± 11 kg) and assigned equally to 1 of 6 treatments, evaluating 3 concentrations of dietary S [0.22%, 0.34%, and 0.55%, for low S (LS), medium S (MS), and high S (HS), respectively] and 2 concentrations of supplemental VC (0 or 10 g • steer(-1) • d(-1)). Steers receiving VC-supplemented diets consumed an average of 10.3 g of supplemental VC • steer(-1) • d(-1) and increasing dietary S linearly increased (P < 0.01) grams of S consumed. Increasing dietary S decreased (P < 0.01) DMI, final BW, and ADG, and linearly increased (P < 0.05) rumen hydrogen sulfide and blood sulfhemoglobin concentrations. The inclusion of VC, regardless of S treatment, tended to increase (P = 0.08) plasma VC concentrations, specifically within the medium and high S diets (P = 0.04). Plasma total antioxidant capacity (d 90) linearly decreased (P = 0.003) and total liver glutathione (GSH; d 143) tended to decrease (P = 0.08) due to increased S intake. Within the high S treatment, addition of VC decreased (P = 0.04) the ratio of oxidized-to-reduced GSH compared with HS alone. Increased dietary S and VC decreased (P < 0.05) plasma Cu concentrations, whereas VC increased (P = 0.01) plasma Fe concentrations. Linear decreases (P < 0.02) in marbling score, backfat thickness (BF), yield grade, and HCW were observed as dietary S increased; however, the addition of VC to the HS diet increased (P < 0.01) BF, marbling scores, and percentage of cattle grading Choice compared with HS without VC. In conclusion, supplementation of VC to cattle receiving the high S diet improved marbling scores; although the exact mechanism for this improvement is unknown, it may be related to greater circulating VC available for lipid metabolism in these cattle.

Mineral concentrations of plasma and liver after injection with a trace mineral complex differ among Angus and Simmental cattle.

To examine the effects of cattle breed on the clearance rate of an injectable mineral product, 10 Angus and 10 Simmental steers were blocked by breed and initial BW (332 ± 33 kg) and injected with either Multimin 90 (MM) or sterilized saline (CON) at a dose of 1 mL/45 kg BW. Multimin 90 contains 15 mg Cu/mL (as Cu disodium EDTA), 60 mg Zn/mL (as Zn disodium EDTA), 10 mg Mn/mL (as Mn disodium EDTA), and 5 mg Se/mL (as sodium selenite). Steers received a corn-silage-based diet, and inorganic sources of Cu, Zn, Mn, and Se were supplemented at NRC recommended amounts. Jugular blood was collected immediately before injection and at 8 and 10 h post-injection and on days 1, 8, and 15 post-injection. Liver biopsies were collected 3 d before injection and on days 1, 8, and 15 post-injection. Liver and plasma mineral concentration and glutathione peroxidase (GSH-Px) activity data were analyzed as repeated measures. Plasma concentrations of Zn, Mn, and Se were greater (P = 0.01) and Cu tended to be greater (P = 0.12) post-injection in MM steers compared with the CON steers. Regardless of treatment, Simmental cattle had lower plasma concentrations of Cu, Zn, and Se (P ≤ 0.05) when compared with Angus cattle. Erythrocyte GSH-Px activity was greater (P = 0.01) in MM steers compared with CON steers. Liver concentrations of Cu, Zn, and Se were greater (P = 0.05) in MM steers compared with CON steers post-injection. Liver Mn concentrations tended to be greater (P = 0.06) in MM steers compared with CON steers in the days post-injection. Interestingly, Simmental cattle exhibited greater (P = 0.01) liver Mn concentrations in the days after injection compared with Angus cattle (7.0 and 6.0 mg Mn/kg for Simmental and Angus cattle, respectively), regardless of treatment. It is unclear if this breed difference is biologically relevant; however, these data may suggest that differences in liver excretion of Mn exist between the two breeds. Overall, use of an injectable trace mineral increased liver concentrations of Cu and Se through the 15-d sampling period, suggesting that this injectable mineral is an adequate way to improve Cu and Se status of cattle through at least 15 d.

Use of atypical antipsychotic medications in adolescent psychiatric inpatients: a comparison with inpatients who did not receive antipsychotic medications during their stay.

The use of atypical antipsychotic medications has been reported to be increased in adolescent psychiatric outpatients and to include many patients with non-psychotic disorders. This study examined the correlates of antipsychotic usage in adolescent inpatients and compared their characteristics with a sample of adolescent inpatients who did not receive antipsychotics during their hospitalisation. A total of 159 consenting consecutive patients treated with atypical antipsychotic medications were compared with 150 patients who were admitted during the same time period and not treated with antipsychotics. The samples were compared for demographic factors, clinical diagnoses, clinical symptoms at admission and other medications received during their inpatient stay. Sex and ethnicity did not differ significantly as a function of antipsychotic mediation status. Significantly few patients with an admission diagnosis of major depression received antipsychotic medications and more patients with admission diagnosis of bipolar and/or conduct disorder were treated with antipsychotic medications. Clinical symptom differences and additional medications received were consistent with the differences in admission diagnoses. Despite the fact that significantly fewer patients with major depression received antipsychotic medications, 47% of the patients who did receive antipsychotic medications in this study had an admission diagnosis of major depression. There are several differences between these inpatient data and previous studies of outpatient claims databases, the majority of adolescent inpatient cases treated with antipsychotic medications had admission diagnoses consistent with both adult indications and previous research with adolescent patients. These data suggest an urgent need to study the safety and efficacy of atypical antipsychotic medications on aspects of depression in adolescents.

The relationship of the Rorschach Schizophrenia Index to psychotic features in a child psychiatric sample.

In this study we investigated the reliability and validity of the Rorschach Schizophrenia Index (SCZI) from Exner's (1978, 1993) Comprehensive System for a sample of 413 child psychiatric inpatients by examining relationships with the Personality Inventory for Children-Revised (PIC-R) and chart diagnoses. Interscorer reliability and internal consistency were acceptable. Multivariate analyses of variance results revealed significantly different PIC-R profiles for those with and without elevated SCZI scores, with significant differences emerging on the PIC-R Psychosis (PSY) scale and 2 cognitive triad scales (Intellectual Screening and Development), which have been reported to be more frequently elevated in PIC-R profiles of children with psychotic disorders. Significant differences were found across SCZI groups for the PSY scale, Reality Distortion scale, reality testing critical items and chart diagnoses of psychotic disorder. Implications for clinical interpretation of the SCZI with children and issues for further research with this population are discussed.

Diagnosis of manic episodes in adolescent inpatients: structured diagnostic procedures compared to clinical chart diagnoses.

This study examined the accuracy of clinical chart diagnoses of manic episodes in adolescent psychiatric patients, as well as treatment selection and patient outcome. A consecutive sample of 120 consenting adolescent patients was assessed at admission, discharge, and 30 and 120 days post-discharge. Clinical chart diagnoses were compared to research-quality diagnoses involving structured interview, chart review, and consensus. Agreement statistics were computed, and the symptom and treatment differences were compared between patients for whom there was and was not diagnostic agreement. Clinical diagnoses of manic episodes were more common than research diagnoses, and the rate of agreement between diagnoses was low (kappa = 0.15). Patients diagnosed as experiencing a manic episode by the clinical chart, but not via the research procedure, had reduced severity scores on elation and activity, and higher scores on depression. These patients also had more severe scores on depressive symptoms at follow-up. Manic episodes were diagnosed more frequently by clinicians relative to research-quality procedures. Patients who were diagnosed as experiencing manic episodes by the clinician, but not the research procedure, appeared to have depression and hostility, but not elation. The depression in these patients may not be adequately treated, and there are potential clinical implications of over-diagnosis of manic episodes in adolescents.

Development of an Infrequency-Psychopathology scale for the MMPI-A: the Fp-A Scale.

This article describes the development and initial validation of the Infrequency-Psychopathology scale, Fp-A, for the MMPI-A (Butcher et al., 1992). The scale parallels the Infrequency-Psychopathology scale, F(p), that has been developed for the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). Results demonstrated that the 40-item Fp-A scale is superior to the F scale at discriminating between faking-bad and accurate reports of psychopathology, although the improvement over F was modest, particularly when compared to the improvement found for the F(p) scale. The difference seemed to reflect the superiority of the MMPI-A F scale to the MMPI-2 F scale. Even so, the findings suggest that the identification of overreporting on the MMPI-A could potentially be enhanced by using Fp-A as an adjunct to the F scale.

A new perspective on gender orientation measurement with the MMPI-2: development of the Masculine-Feminine Pathology Scale.

A new scale of gender orientation for the MMPI-2 (Minnesota Multiphasic Personality Inventory-II; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) called the Masculine-Feminine Pathology Scale, or Mfp, was developed as an alternative to the available Mf, GM, and GF scales. It differs from previous scales in its emphasis on symptomatic correlates of gender. Items were included in the new scale if they (a) discriminated between male and female psychiatric patients and (b) were likely to be indicators of psychopathology. Statistical analyses suggested an acceptably reliable but factorially complex scale. When used to predict clinician ratings of global psychopathology, the scale demonstrated incremental validity over both the existing gender-related scales and the traditional clinical scales. Scores at the "feminine" end of the Mfp scale seem to reflect distress characterized by high levels of anxiety. Scores at the "masculine" end of the Mfp scale suggest a more composed interpersonal presentation, which may reflect an amoral attitude. It is suggested that the new scale may prove superior to the existing gender role scales as a supplement to other clinical scales. Avenues for future research with the Mfp scale are discussed.

Predictors of medication compliance after hospital discharge in adolescent psychiatric patients.

Failure in medication compliance in adult psychiatric patients is often found to be due to side effects or associated with unawareness of illness. Little research has been conducted on medication compliance in adolescent psychiatric patients. In this study, 97 adolescent psychiatric patients, including 46 with substance abuse, were followed up an average of 14 months after their discharge from inpatient psychiatric care. Compliance with prescribed medications was examined and the association between several potential predictors and compliance was examined. The overall rate of medication compliance was only 38% at 14-month follow-up, whereas the rate of patients stopping their medications because of side effects was only 23%. Significant predictors of compliance failures were general noncompliance with the discharge plan, followed by postdischarge substance abuse. Side effects did not contribute any additional variance when these factors were considered. These data suggest that medication compliance may be adversely impacted by general tendencies toward noncompliance with treatment, which may be mediated by several possible factors. Interventions to increase awareness of the need for psychotropic medications as well as careful monitoring for substance abuse relapse in this population are suggested.

Code type-specific tables for interpretation of MMPI-2 Harris and Lingoes subscales: consideration of gender and code type definition.

Normative tables for various MMPI-2 code types, which may be used to enhance the interpretation of the Harris and Lingoes subscales, were developed. It was found that scores on the subscales covaried significantly as a function of code type. Gender and code type definition strategy were considered as moderators of the relationship between code type and subscale scores, but neither accounted for a large enough proportion of variance to justify consideration in the tables.

Validity of the Childhood Trauma Questionnaire in an adolescent psychiatric population.

OBJECTIVE: To present initial findings on the validity of a recently developed maltreatment inventory, the Childhood Trauma Questionnaire (CTQ), in a sample of adolescent psychiatric patients. METHOD: Three hundred ninety-eight male and female adolescents (aged 12 to 17 years) admitted to the inpatient service of a private psychiatric hospital were given the CTQ as part of a larger test battery. Structured interviews were also conducted with the primary therapists of 190 of the patients to obtain ratings of abuse and neglect based on all available data, including clinical interviews with patients and their relatives and information from referring clinicians and agencies. RESULTS: Principal-components analysis of the CTQ items yielded five rotated factors-emotional abuse, emotional neglect, sexual abuse, physical abuse, and physical neglect-closely replicating the factor structure in an earlier study of adult patients. The internal consistency of the CTQ factors was extremely high both in the entire sample and in every subgroup examined. When CTQ factor scores were compared with therapists' ratings in a series of logistic regression analyses, relationships between the two sets of variables were highly specific, supporting the convergent and discriminant validity of the CTQ. Finally, when therapists' ratings were used as the validity criterion, the CTQ exhibited good sensitivity for all forms of maltreatment, and satisfactory or better levels of specificity. CONCLUSIONS: These initial findings suggest that the CTQ is a sensitive and valid screening questionnaire for childhood trauma in an adolescent psychiatric inpatient setting.

Learning and memory in adolescent psychiatric inpatients with major depression: a normative study of the California Verbal Learning Test.

Depressed adults have deficits in memory functions, especially on demanding tasks, but few studies of depressed adolescents have been published. In order to examine the extent of memory impairment and its diagnostic specificity, adolescent inpatients with DSM-III-R diagnoses of Major Depression (n = 56), Conduct Disorder (n = 42), or mixed Depression and Conduct Disorder (n = 22) were tested on the California Verbal Learning Test (CVLT) and compared to each other, to CVLT norms, and to previously published CVLT norms for adults with Major Depression. Adolescents with Major Depression performed below normative standards on all aspects of the CVLT, but did not have a specific profile of memory impairments that was different from the two comparison samples. Relative to norms for adult patients with Major Depression, adolescent females under performed across all CVLT measures, but males did not differ from adults Depression in adolescence is not associated with specific memory impairments, but adolescent females with depression may have more severe deficits than depressed adults.

CPR knowledge, self-efficacy, and anticipated anxiety as functions of infant/child CPR training.

STUDY OBJECTIVE: To determine the effect of infant/child CPR training on CPR knowledge, self-efficacy, and anticipated anxiety among parents of healthy infants/children. PARTICIPANTS: Parents (n = 36) undergoing a 4-hour training program in infant/child CPR at a tertiary-care hospital located in a suburb of a large metropolitan region and a control group of parents (n = 47) without CPR training were enrolled in the study. DESIGN: Two parallel forms developed specifically to assess the impact of infant/child CPR training on CPR knowledge, self-efficacy, and anticipated anxiety were independently evaluated for their psychometric characteristics before being administered to the parents with and without CPR training. The CPR-trained parents were requested to complete one form immediately before and the other 1 month after CPR training, and the control group completed the two forms over a 1-month interval. Estimates of the likelihood of infant/child CPR situations were also rated by the parents at the same times. Demographic data were obtained during administration of the second form. RESULTS: Self-efficacy had increased significantly and anticipated anxiety about CPR had decreased significantly 1 month after CPR training among CPR-trained parents, compared with controls. We found no significant changes in the CPR-trained parents' CPR knowledge or estimates of the likelihood of experiencing CPR situations over the 1-month interval on comparison with data from the controls. CONCLUSION: Community-based infant/child CPR training programs affect parents on a variety of levels but may not effect changes in CPR knowledge.