Non-small-cell lung cancer with multiple paraneoplastic syndromes.

We describe the case of a patient with multiple paraneoplastic syndromes, six in total, associated with a non-small-cell cancer of the lung. In this single patient we found hypertrophic pulmonary osteoarthropathy, hyperkeratosis of palms and soles, erythema annulare centrifugum, syndrome of inappropriate secretion of antidiuretic hormone (SIADH), and ectopic andrenocorticotrophic hormone (ACTH) and calcitonin production.

A developmental investigation of inattentiveness and hyperactivity.

The development of inattentiveness and hyperactivity in middle childhood was investigated using a prospective longitudinal approach. Endogenous and exogenous predictors measured in infancy and in early and middle childhood were examined independently and in combination. In early childhood, quality of caregiving more powerfully predicted distractibility, an early precursor of hyperactivity, than did early biological or temperament factors. Caregiving and contextual factors together with early distractibility significantly predicted hyperactivity in middle childhood. While environmental variables also predicted hyperactivity in later elementary years, these factors did not improve the prediction beyond the influence of hyperactivity in early elementary years. The findings support a developmental view of the origins and course of hyperactivity in childhood, that is, that the emergence and persistence of AD/HD symptoms depend on developmental history along with current circumstances.

The transition to young adulthood: generational boundary dissolution and female identity development.

This research explored links between differential qualities of family connectedness and young adult females' development of an independent identity. Identity development involves exploration of possible roles and choices in particular domains such as occupation, dating, and friendship, followed by commitment to a set of values and behaviors in one of these areas. In this study, women who reported that their parents encouraged autonomy while still maintaining closeness also reported more exploration in their friendship and dating relationships. In contrast, reports of parent-child boundary dissolution, characterized by role-reversal, enmeshment, and overinvolvement, were related to less exploration, particularly in dating relationships. Mother-daughter boundary dissolution, specifically, was linked to women's tendency to base their commitments to a career and relationships with others on parental values and expectations without ever exploring alternative choices. Father-daughter boundary dissolution was related to lower exploration as well as lower commitment to values and beliefs in any area. These findings lend support to theoretical and clinical impressions that intergenerational boundary violations hinder the development of an independent identity.

Treatment of attentional and hyperactivity problems in children with sympathomimetic drugs: a comprehensive review.

Issues concerning sympathomimetic drug treatment of children with attentional problems and hyperactivity are considered in light of cumulative and current research. These issues concern the atypical or "paradoxical" drug response of such children, predictability of drug response from neurological or biochemical assessments, and, especially, long-term outcome or effectiveness of sympathomimetic medication. Short-term drug effects on behavior and performance are well documented. However, follow-up studies that exist presently suggest little long-term impact of sympathomimetic drugs on school achievement, peer relationships, or behavior problems in adolescence. Questions remain concerning development of tolerance in children, ways to define subgroups of disordered children who may respond uniquely to stimulants, the efficacy of medication in combination with other treatments, and possible long-term negative consequences of medication.

Breaking the cycle of abuse.

The aim of this study was to identify variables that distinguish mothers who broke the cycle of abuse from mothers who were abused as children and who also abused their own children. Based on maternal interviews and questionnaires completed over a 64-month period, measures of mothers' past and current relationship experiences, stressful life events, and personality characteristics were obtained. Abused mothers who were able to break the abusive cycle were significantly more likely to have received emotional support from a nonabusive adult during childhood, participated in therapy during any period of their lives, and to have had a nonabusive and more stable, emotionally supportive, and satisfying relationship with a mate. Abused mothers who reenacted their maltreatment with their own children experienced significantly more life stress and were more anxious, dependent, immature, and depressed.

The early caregiver-child relationship and attention-deficit disorder with hyperactivity in kindergarten: a prospective study.

Newborn status, ratings of temperament, and heretofore neglected experiential (parenting) antecedents of hyperactivity were evaluated in a prospective, longitudinal investigation. The experiential variables were derived from a developmental theory of arousal modulation in the early years. Patterns of maternal intrusive care, seductive behavior, and overstimulation were assessed at 6 months, 2 years, and 3 1/2 years, respectively. 2 of these 3 variables significantly predicted hyperactivity in kindergarten at age 5 or 6, as determined by clinically validated ratings made by teachers. Of the 38 early child variables, which included neonatal behavioral assessments and ratings of activity level by parents and observers on many occasions during the first 2 1/2 years, only the motor maturity factor from 2 composited Brazelton exams yielded a significant relation. In addition, a measure of distractibility at 42 months was predictive of hyperactivity. Although other child measures may prove to be more powerful than those we tested, it will remain the case that prospective data are a critical arbiter of etiological factors in hyperactivity. Such data have important implications for both diagnosis and treatment.

Generational boundary dissolution between mothers and their preschool children: a relationship systems approach.

A particular perspective on relationship systems served as the basis for this research. Postulates within this perspective include qualitative aspects of relationships are stable over time, and there are lawful relations among relationships within the same system. Previously, a concept of seductive mother-toddler relationships was initially validated. From the theory surrounding this concept, later forms of this pattern were conceived, and a hypothesis concerning complementary mother-daughter relationships was formulated. In the present research we showed first that the pattern of "seductiveness" was stable, though transformed, from 24 to 42 months. Second, the same mothers were not found to be seductive with male or female siblings. Third, mothers who showed the seductive pattern (almost always with boys) were, as predicted, hostile toward their daughters in a particular way ("derision"). 2 other scales used at 42 months ("nonresponsive intimacy" and "generational boundaries") were elevated for target mother-male dyads and not for mother-daughter pairs. In fact, mothers who were seductive with sons were rated significantly lower on the intimacy scale when seen with daughters than were control mothers. It is suggested that maternal relationships across siblings are coherent, however distinct, and that these connections derive from the totality of the mother's relationship history.