Symptom endorsement differences on the Children's Depression Inventory with children and adolescents on an inpatient unit.

Responses to the Children's Depression Inventory (CDI; Kovacs, 1992), administered during intake, were collected from 521 children and adolescents (aged 7 to 17) at an inpatient crisis stabilization unit. Participants were grouped into 1 of 3 diagnostic groups: solely depressive, solely aggressive, or both depressive and aggressive. Self-report of symptoms for each diagnostic group, age and gender differences, and racial and ethnic differences in symptoms were examined in this study. There was a significant difference between the endorsement pattern of solely depressive and solely aggressive participants, whereas those categorized as both depressive and aggressive displayed an endorsement pattern similar to those who were solely aggressive. There was a significant gender difference in overall symptom report, with girls showing higher overall symptom levels than boys. This gender difference was significant for both the younger and the older age groups. These results held true even when gender was covaried out of the diagnostic group analyses and when diagnostic group was covaried out of the gender analyses. Symptom endorsement did not differ based on race and ethnicity. The primary contribution of this study centers around the findings from the item analyses of the CDI. These results are discussed in relation to the discriminant validity of the CDI and the need for additional research into comorbidity.

Antitumor activity of cryptophycins: effect of infusion time and combination studies.

INTRODUCTION/PURPOSE: Cryptophycins are a family of antitubulin antitumor agents. A synthetic cryptophycin derivative (LY355703, CRYPTO 52) is in early clinical evaluation. The effect of infusion time on the antitumor activity of four cryptophycins was assessed in rats bearing the 13762 mammary carcinoma and combination treatment regimens were assessed in nude mice bearing human tumor xenografts. METHODS: The cryptophycins were prepared in 2% PEG300/8% cremophor/90% normal saline and delivered by jugular vein catheter on days 7, 9 and 11 post tumor implant to 13762 tumor-bearing rats. The cryptophycins prepared in the same formulation were administered by intravenous bolus injection on an alternate day schedule for five doses to human tumor xenograft bearing nude mice. RESULTS: An infusion time of 2 h in the rats increased the tumor growth delay produced by CRYPTO 52 and CRYPTO 55, while increasing the infusion time to 6 h continued to increase the tumor growth delay for CRYPTO 292 and CRYPTO 296. Administering CRYPTO 292 at a higher dose two times was more effective than administering it at a lower dose three times. The tumor growth delays produced by the cryptophycins in the rat 13762 mammary carcinoma were greater than those with cisplatin, doxorubicin, 5-fluorouracil and 5 x 3 Gray and comparable with cyclophosphamide and gemcitabine. Combination studies were carried out in human tumor xenografts including the MX-1 breast carcinoma, the Calu-6 non-small cell lung carcinoma, the H82 small cell lung carcinoma and the SW-2 small cell lung carcinoma. CRYPTO 52 and CRYPTO 55 combined with doxorubicin, paclitaxel and 5-fluorouracil to form highly effective regimens against the human MX-1 breast carcinoma. CRYPTO 52 and CRYPTO 55 were also highly effective against the three lung carcinoma xenografts when combined with the antitumor platinum complexes, cisplatin, carboplatin or oxaliplatin. CONCLUSIONS: Cryptophycins represent a promising new class of antitumor agents that may be optimally administered by intravenous infusion and in combination with doxorubicin, paclitaxel and 5-fluorouracil.

Cryptophycin 52 and cryptophycin 55 in sequential and simultaneous combination treatment regimens in human tumor xenografts.

The antitumor activity of cryptophycin 52 (C52) and cryptophycin 55 (C55) in sequential and simultaneous combination treatment regimens in human tumor xenografts models was explored. The antitumor activity of C52 and C55 was compared alone and in sequential combination with gemcitabine or paclitaxel in four lung cancer models, H460 and Calu-6 NSCLC and SW2 and H82 small cell lung carcinoma. The combination of C52 followed by gemcitabine was additive in three tumors and greater-than-additive in the fourth. The combination of C55 followed by gemcitabine was additive in three tumors and less-than-additive in the fourth. The combination of C52 followed by paclitaxel was greater-than-additive in one tumor, additive in one tumor and less-than-additive in two tumors. The combination of C55 followed by paclitaxel was greater-than-additive in two tumors and less-than-additive in two tumors. The simultaneous combination of C52 or C55 with fractionated radiation therapy was assessed in the H460 NSCLC tumor. Both cryptophycins produced a tumor response that was additive along with radiation therapy. The HCT116 colon carcinoma was used to compare the antitumor activity of simultaneous or sequential combination of 5-fluorouracil or irinotecan with C52. C52 produced greater-than-additive tumor response when administered either simultaneously with or sequentially with 5-fluorouracil or iriniotecan. Finally, when administered to animals bearing intraperitoneal OVCAR-3 ovarian carcinoma, C52, docetaxel and paclitaxel resulted in mean survival times of 123, 80 and 85 days compared with 72 days in the untreated controls. In combination with carboplatin, C52, docetaxel and paclitaxel resulted in mean survival times of 140, 105 and 135 days. Cryptophycins have the potential to be useful chemotherapeutic agents in a wide variety of clinical combinations regimens.

Treatment regimens including the multitargeted antifolate LY231514 in human tumor xenografts.

The scheduling of antifolate antitumor agents, including the new multitargeted autofolate LY231514 (MTA), with 5-fluorouracil was explored in the human MX-1 breast carcinoma and human H460 and Calu-6 non-small cell lung carcinoma xenografts to assess antitumor activity and toxicity (body weight loss). Administration of the antifolate (methotrexate, MTA, or LY309887) 6 h prior to administration of 5-fluorouracil resulted in additive growth delay of the MX-1 tumor when the antifolate was methotrexate or LY309887 and greater-than-additive tumor growth delay (TGD) when the antifolate was MTA. In the H460 tumor, the most effective regimens were a 14-day course of MTA or LY309887 along with 5-fluorouracil administered on the final 5 days. In addition, the simultaneous combination of MTA administered daily for 5 days for 2 weeks with administration of gemcitabine resulted in greater-than-additive H460 TGD. MTA was additive with fractionated radiation therapy in the H460 tumor when the drug was administered prior to each radiation fraction. MTA administered along with paclitaxel produced greater-than-additive H460 TGD and additive responses along with vinorelbine and carboplatin. In the Calu-6 non-small cell lung carcinoma xenograft, MTA administered in combination with cisplatin or oxaliplatin was highly effective, whereas MTA administered in combination with cyclophosphamide, gemcitabine, or doxorubicin produced additive responses. Administration of MTA along with paclitaxel or doxorubicin resulted in additive MX-1 TGD. Thus, MTA appears to be especially effective in combination therapies including 5-fluorouracil or an antitumor platinum complex.

Body image, psychological functioning, and parental feedback regarding physical appearance.

OBJECTIVE: To investigate the role of parental appearance-related commentary, body image, and psychological functioning in females and males. METHOD: Retrospective reports of teasing and appearance-based feedback were assessed, along with current levels of body image and overall psychological functioning. RESULTS: Women and men did not differ in their reports of comments received from mothers, however, women received significantly more appearance-related messages from fathers. Correlational analyses demonstrated significant relationships between feedback and body satisfaction for women, but not for men. Regression analyses indicated that fathers' and mothers' teasing about weight were predictive of daughters' body image. For both males and females, psychological functioning was significantly predicted from the combination of mothers' and fathers' feedback regarding appearance. DISCUSSION: The findings further support an emerging theoretical model of appearance-related commentary as a factor in body image disturbance and overall psychological functioning.

Clinically referred children and adolescents: fathers, family constellations, and other demographic factors.

Investigated the likelihood that clinically referred youth have contact with their biological father. Family demographics such as family constellation, race/ethnicity, and socioeconomic status were also explored. Based on 356 consecutive therapy and assessment referrals to an outpatient clinic, slightly less than half (42.4%) of the children and adolescents referred due to psychological problems and more than half (67.8%) of the youth referred due to learning difficulties lived with both their biological mother and biological father. For those who did not live with both of their biological parents, 40.0% and 56.0%, respectively, had regular face-to-face contact with both biological parents. These figures suggest that, although the percentages of intact families are somewhat lower in treatment samples than in the general population or in a sample referred for learning difficulties, close to half of clinically referred youth continue to live with both of their biological parents. Future directions for the inclusion of fathers in clinical research are discussed.

Accuracy of informants: do parents think that mother knows best?

A total of 200 mothers and fathers provided their opinions as to the accuracy of mothers, fathers, teachers, children's peers, and children themselves as informants of children's emotional/behavioral problems. The results showed that mothers and fathers had very similar patterns of perceptions of accuracy, although fathers' ratings showed less differentiation between informants than did mothers' ratings. Patterns were very similar for reports on children and adolescents. Overall, mothers were perceived to be more accurate in reporting internalizing problems; mothers and teachers (and fathers to a lesser extent) were perceived to be more accurate in reporting externalizing problems; mothers, fathers, and teachers were seen as more accurate in reporting children's adaptive behaviors, and mothers, fathers, and children were seen as more accurate in reporting family problems. The results are discussed in the context of multiple informants of children's and adolescents' emotional/behavioral problems.

Family demographics of clinically referred children: what we know and what we need to know.

Published empirical studies were reviewed to establish family demographics of clinically referred children and adolescents. Data on parental marital status were collected from studies of referred and nonreferred children and adolescents in six empirical journals. Data on family socioeconomic status (SES) and child race or ethnicity were also collected. Based on 86 studies that presented parental marital status, 56.4% of clinically referred children and adolescents live with both their biological mother and biological father. Family SES data were difficult to summarize because of the different methods of presenting this information. When considering race and ethnicity, 86% of the children and adolescents in the clinical samples were Caucasian American. Of the studies that were originally reviewed, 80.4% did not include parental marital status and 36.7% did not include SES, race, or ethnicity of the participants. There were no significant differences between journals in the rates of inclusion of family demographic data. In addition to revealing family demographic information about children and adolescents who participate in clinical research, these data highlight the lack of consistency in the presentation of family demographic data in published research. Suggestions are provided to help researchers collect and present meaningful family demographic data in clinical and nonclinical research with children and adolescents.

Fathers' and mothers' participation in research.

This study investigated the participation rates of fathers, as compared to mothers, in research related to parent and older adolescent psychological symptoms, drinking behavior, and perceived competence. Fathers and mothers did not differ in their rates of participation in the research (59% and 65%, respectively). Additionally, few differences were found between participating and nonparticipating parents. Implications for fathers' and mothers' involvement in research on the family are discussed.

Adolescents', parents', and teachers' distress over adolescents' behavior.

This study evaluated adolescents', parents', and teachers' self-reported distress and wishes to change adolescents' emotional/behavioral problems in a sample of clinically referred adolescents. Parents reported being bothered more than adolescents or teachers by adolescents' internalizing behavior. Both parents and teachers rated adolescents' externalizing behavior as more bothersome than did adolescents. Adolescents were significantly less likely to want to change their behavior than were parents or teachers. In addition, adolescents were significantly more likely to want to change their internalizing problems than their externalizing problems. For all three informants, being bothered by adolescents' behaviors was strongly associated with a desire to change the behaviors. Clinical implications of these findings are discussed.

The role of fathers in child and adolescent psychopathology: make room for daddy.

This review summarizes research concerning the relation between paternal factors and child and adolescent psychopathology. When compared with mothers, fathers continue to be dramatically underrepresented in developmental research on psychopathology. However, findings from studies of children of clinically referred fathers and nonreferred samples of children and their fathers indicate that there is substantial association between paternal characteristics and child and adolescent psychopathology. Findings from studies of fathers of clinically referred children are stronger for fathers' effects on children's externalizing than internalizing problems. In most cases the degree of risk associated with paternal psychopathology is comparable to that associated with maternal psychopathology. Evidence indicates that the presence of paternal psychopathology is a sufficient but not necessary condition for child or adolescent psychopathology.

Where's poppa? The relative lack of attention to the role of fathers in child and adolescent psychopathology.

Compared with mothers, fathers are dramatically underrepresented in clinical child and adolescent research. The author reviewed empirical and theoretical clinical child and adolescent literature to ascertain the reasons for this underrepresentation. Four somewhat interrelated factors are discussed: practical issues in participant recruitment, differential base rates of paternal vs. maternal psychopathology, theory-driven research based on sexist theories, and research assumptions based on outdated societal norms. Suggestions for future research are discussed, including parallel investigations of paternal characteristics whenever maternal characteristics are investigated, assessment of both similarities and differences in the role of fathers and mothers in child and adolescent psychopathology, and investigation of parenting factors for both fathers and mothers (e.g., time spent in actual caretaking, career vs. family orientation) in relation to child and adolescent psychopathology.

Correlates of internalizing and externalizing behavior problems: perceived competence, causal attributions, and parental symptoms.

Young adolescents in the clinical range on internalizing, externalizing, and both internalizing and externalizing behavior problems, as well as youth in the normal range on both types of problems, were identified separately using adolescents' self-reports and mothers' reports of behavior problems. In comparisons of groups identified on the basis of either type of informant, differences among the four groups were found in adolescents' self-perceptions of competence and in their fathers' psychological symptoms. Specifically, normals reported a more positive sense of their social acceptance and their behavioral conduct than all clinical groups, and fathers of adolescents in the clinical range on both internalizing and externalizing problems tended to report more psychological symptoms than the fathers of the normal group. Differences were found in mothers' psychological symptoms only when mothers' reports of adolescents' behavior problems were used to identify the groups. No consistent differences among the groups were found on adolescents' causal attributions for success and failure.

Seven-year outcome of the Vermont Intervention Program for Low-Birthweight Infants.

We compared 24 low-birthweight subjects of an experimental intervention (LBWE), 32 no-treatment controls (LBWC), and 37 normal birthweight (NBW) subjects. The intervention involved 7 hospital sessions and 4 home sessions in which a nurse helped mothers adapt to their LBW babies. At age 7, LBWE scored significantly higher than LBWC on the Kaufman Mental Processing Composite (p less than .001), Sequential (p = .02), and Simultaneous (p = .001) Scales, after statistical adjustments for socioeconomic status. LBWE did not differ from NBW (F less than 1). These results bear out a divergence between the LBWE and LBWC that first became statistically significant at age 3. The findings suggest that the intervention prevented cognitive lags among LBW children, and that long-term follow-ups are needed to evaluate the developmental effects of efforts to overcome major biological and environmental risks.

Adolescents' subjective distress over their emotional/behavioral problems.

This study analyzed the relations among 151 7th- and 8th-grade adolescents' self-evaluations of the occurrence of their behavior, their own subjective distress over their behavior, their perceptions of their personal competence, their perceptions of their mothers' and fathers' distress over these behaviors, and their parents' reports of the occurrence of adolescent behaviors. As hypothesized, adolescents' self-reports of occurrence of their behaviors were significantly but moderately correlated with their subjective distress about these behaviors, and adolescents made a distinction between the occurrence of a behavior and their distress about it. Externalizing behaviors were rated by adolescents as more distressing to mothers and to fathers than to adolescents themselves, and conversely, internalizing behaviors were rated as more distressing to self than to parents. Ratings of subjective distress were significantly related to self-perceptions of behavioral conduct and self-worth, whereas parents' ratings of the occurrence of behavior were not related to these self-perceptions.

Epidemiological comparisons of Puerto Rican and U.S. mainland children: parent, teacher, and self-reports.

U.S. mainland and Puerto Rican nonreferred samples were compared via the Child Behavior Checklist (ages 4 to 16), Teacher's Report Form (ages 6 to 16), and Youth Self-Report (ages 12 to 16). Problem scores were significantly higher in parent and teacher ratings of Puerto Rican than mainland subjects, but were significantly lower in self-ratings by Puerto Rican adolescents. Adolescents in both cultures reported significantly more problems than their parents or teachers did. Most of the significant cross-cultural differences in parent, teacher, and self-ratings of competencies showed more favorable scores for the mainland subjects. High referral rates, a high prevalence of DSM diagnoses, and low scores on the Children's Global Assessment Scale are consistent with the high problem rates reported by Puerto Rican parents and teachers but not with the lower rates reported by adolescents. Different clinical cutoffs may be needed for all assessments in the mainland versus Puerto Rico.

Problems and competencies reported by parents of Australian and American children.

We compared problems and competencies reported for 2600 randomly selected nonreferred children in Sydney and the U.S.A. Sydney children scored significantly higher on 82 problem items, with a mean total problem score of 31.6 versus 20.1 for the U.S.A. Nevertheless, item scores correlated 0.92 between countries, most differences between competence scores were small, and patterns were similar for sex, age, socioeconomic status, and internalizing versus externalizing problems. Although higher clinical cutoffs may be needed in Sydney, the similarity of patterns in scores permits calibration of the Child Behavior Checklist between Sydney and the U.S.A. Sex differences found in seven cultures were summarized.

Risk factors for emotional/behavioral problems in young adolescents: a prospective analysis of adolescent and parental stress and symptoms.

Stressful events in the lives of 309 10- to 15-year-olds and stressful events and psychological symptoms reported by their parents were examined in a 9-month study. Ss' self-reported emotional/behavioral problems were predicted by their reports of stressful events and their fathers' reports of psychological symptoms in cross-sectional analyses. Analyses at follow-up after controlling for initial reports of emotional/behavioral problems and prospective analyses predicting from first assessment to follow-up yielded significant effects for Ss' self-reported stressful events. Mothers' reports of children's problems were predicted by mothers' psychological symptoms in cross-sectional analyses and at follow-up after controlling for initial emotional/behavioral problems. Only prior levels of maternal reports of emotional/behavioral problems predicted mothers' reports of their children's problems 9 months later.

Perceptions of control at school among students in special education programs.

Data are reported on special and regular education students' perceptions of control at school and the importance to the students of having such control. For both special and regular education populations, comparisons were made between students enrolled in experimental and nonexperimental programs. Findings indicate comparability among the four groups with regard to areas in which control is valued. Perceptions of control at school for those in the standard special education group were lower than the ratings of regular education students and lower than those given by special education students in the experimental program.