Early deviance and related risk factors in the children of narcotic addicts.

This descriptive study examines the self-reported behaviors of 285 male and female adolescent children (ages 12-17) of narcotic addicts participating in methadone maintenance programs. These children responded to an extensive 2.5-hour interview questionnaire focusing on current and past activities, including criminal activities prior to age 12. The findings revealed that early deviance, assessed by self-report measures of both severity and variety, is related to current adolescent drug and alcohol use, association with deviant peers, a negative view of home atmosphere, and psychological symptomatology. These results are contrasted with the retrospective reports of adolescent behavior obtained from adult male narcotic addicts in a prior study of vulnerability to addiction. The comparability of study results is discussed in the context of developmental risk factors, prevention and treatment strategies, and other considerations specifically related to the development of children of narcotic addicts.

The family experiences of narcotic addicts and their subsequent parenting practices.

This survey study of male and female narcotic addicts participating in methadone maintenance programs examined self-reported retrospective data on parental behavior experienced by addicts during their adolescent years. These findings were contrasted with the addicts' self-report of their current parenting practices with their own adolescent children. Results showed addicts as perceiving their mothers as significantly more functional in their parenting practices than their fathers on indices of parental involvement, attachment, and responsibility. Significant parenting differences between addicts and their parents were reported for the three indices mentioned, as well as for parent discipline and punitive actions, with the addicts rating their current parenting practices as more effective than those of their parents. Reported parenting practices were further analyzed in the context of how the ratings of parental functioning were related to problems of drug and alcohol abuse exhibited in the home. Findings are discussed in terms of the implications for prevention and treatment approaches for addicts and their children.

Rheoencephalographic and other studies of betahistine in humans. IV. Prolonged administration with improvement in arteriosclerotic dementia.

The effects of prolonged betahistine administration were studied in institutionalized geriatric patients with particularly severe and long-standing arteriosclerotic dementia. Thirty received betahistine hydrochloride (SERC) or placebo orally in fixed dosage for six months on a double-blind basis and were followed by ward behavioral and psychometric ratings. Six others received active medication and were additionally followed by intracranial rheoencephalography (IREG). Thirty patients successfully completed the two studies. No adverse effects ascribable to the drug were encountered. The results show that betahistine caused definite, strong, and highly significant cerebral and scalp arterial vasodilation and circulatory improvement and that these caused equally definite, strong, and highly significant global improvement in the patients' dementias. Bethahistine, thus, acts in humans as a potent and efficacious cerebral and peripheral microcirculatory and arterial vasodilator which can significantly improve cerebrovascular insufficiency and any associated dementia, no matter how severe either may be and despite the possible presence of large-vessel disease. These improvements sometimes were detected within two weeks or less, developed rapidly to maxima by about 90 days, and were sustained quite well there-after by continued therapy, They may, however, be drug dependent as they regressed in two patients following withdrawal. Various mechanisms whereby a microcirculatory vasodilator can cause arterial vasodilation are considered. The evidence apparently favors that prolonged microcirculatory vasodilatation can cause secondary passive arterial responses. The possibility that the IREG contains external carotid contamination is again examined. Significant discrepancies between the scalp and IREG effects of bethahistine indicate, however, that the response of any such component was negligible within experimental error and that the component, itself, must have comprised but a small percentage of the IREG. Since the circulatory responses detected by the IREG thus arose essentially completely from the effects of betahistine on the cerebral circulation alone, this appears to be the first direct demonstration that cerebral circulatory improvement can cause improvement in mental function in patients with even severe, longstanding, and apparently clinically irreversible arteriosclerotic dementia and that such improvements can be effected pharmacologically.

Effects of control techniques on therapeutic outcome in a controlled clinical trial.

Undertaken in the context of a controlled drug trial involving newly admitted psychiatric hospital patients, this study compared the effectiveness of a "Doctor's Choice" (DC) method of administering psychotropic drugs versus an experimentally determined treatment regimen employing random assignment and double-bline procedures. The 32-day drug trial sought to determine the comparative effectiveness of thioridazine-placebo, thioridazine-chlordiazepoxide, and thioridazine-imipramine, with the daily dosage of openly administered thioridazine ranging from 100 to 900 mg and dosages for chlordiazepoxide and imipramine, administered in a double-blind fashion, fixed at daily dosages of 30 and 75 mg, respectively. DC medication, consisting of a choice (by a research physician) of any of the three experimental medications determined on the basis of judged clinical need, was added as a fourth treatment category for present purposes. Criteria of effectiveness included standarized psychiatric rating scales and global measures of imporvement completed by research team members and ward physicians. Outcome results for the DC group compared to those for a single control group made up of individuals matched with DC patients on the basis of drug assignment indicated an essentially similar clinical effectiveness under both DC and control treatment conditions. Generalization of the finding was limited by the fact that the main treatment effect, attributable to thioridazine, overshadowed the more subtle action of the ancillary drugs.