Pubmed du 28/10/09

jeudi 29 octobre 2009

1. Aman MG, McDougle CJ, Scahill L, Handen B, Arnold LE, Johnson C, Stigler KA, Bearss K, Butter E, Swiezy NB, Sukhodolsky DD, Ramadan Y, Pozdol SL, Nikolov R, Lecavalier L, Kohn AE, Koenig K, Hollway JA, Korzekwa P, Gavaletz A, Mulick JA, Hall KL, Dziura J, Ritz L, Trollinger S, Yu S, Vitiello B, Wagner A, the Research Units on Pediatric Psychopharmacology Autism Network. Medication and Parent Training in Children With Pervasive Developmental Disorders and Serious Behavior Problems : Results From a Randomized Clinical Trial. J Am Acad Child Adolesc Psychiatry ;2009 (Oct 23)

OBJECTIVE :: Many children with pervasive developmental disorders (PDDs) have serious, functionally impairing behavioral problems. We tested whether combined treatment (COMB) with risperidone and parent training (PT) in behavior management is superior to medication alone (MED) in improving severe behavioral problems in children with PDDs. METHOD :: This 24-week, three-site, randomized, parallel-groups clinical trial enrolled 124 children, aged 4 through 13 years, with PDDs, accompanied by frequent tantrums, self-injury, and aggression. The children were randomized 3:2 to COMB (n = 75) or MED (n = 49). The participants received risperidone monotherapy from 0.5 to 3.5 mg/day (with switch to aripiprazole if risperidone was ineffective). Parents in the COMB group (n = 75 ; 60.5%) received a mean of 10.9 PT sessions. The primary measure of compliance was the Home Situations Questionnaire (HSQ) score. RESULTS :: Primary : intent-to-treat random effects regression showed that COMB was superior to MED on HSQ (p =.006) [effect size at week 24 (d) = 0.34]. The HSQ score declined from 4.31 (+/-1.67) to 1.23 (+/-1.36) for COMB compared with 4.16 (+/-1.47) to 1.68 (+/-1.36) for MED. Secondary : groups did not differ on Clinical Global Impressions-Improvement scores at endpoint ; compared with MED, COMB showed significant reductions on Aberrant Behavior Checklist Irritability (d = 0.48 ; p =.01), Stereotypic Behavior (d = 0.23 ; p =.04), and Hyperactivity/Noncompliance subscales (d = 0.55 ; p =.04). Final risperidone mean dose for MED was 2.26 mg/day (0.071 mg/kg), compared with 1.98 mg/day for COMB (0.066 mg/kg) (p =.04). CONCLUSIONS :: Medication plus PT resulted in greater reduction of serious maladaptive behavior than MED in children with PDDs, with a lower risperidone dose.Clinical trial registration information-RUPP PI PDD : Drug and Behavioral Therapy for Children With Pervasive Developmental Disorders. URL : Unique identifier : NCT00080145.

2. Giunco CT, de Oliveira AB, Carvalho-Salles AB, Souza DS, Silva AE, da Rocha SS, Fett-Conte AC. Association between APOE polymorphisms and predisposition for autism. Psychiatr Genet ;2009 (Dec) ;19(6):338.

3. Hsu WS, Ho MH. Ritual behaviours of children with autism spectrum disorders in Taiwan*. J Intellect Dev Disabil ;2009 (Oct 28)

Background Ritual behaviour, while often considered as nonpurposeful or problematic, can also be regarded as functional behaviour for individuals with autism spectrum disorders (ASD). This study investigated the types and characteristics of ritual behaviour in children with ASD in a Taiwan context. Methods Sixty-four primary school teachers, who taught 71 students with ASD, were surveyed. In addition, observations with five children with ASD were conducted, and their parents were interviewed. Two control groups of students with intellectual disability and children without a disability were included in the study. Results Ritual behaviour occurred in the majority of children with ASD, and across all levels of ability. Prevalence was much higher in the ASD group as compared to the two control groups. These behaviours could be categorised into seven types, and ritual behaviour was strongly associated with sensory sensitivity. Conclusions Although ritual behaviours were diverse in nature and were common among children with ASD in Taiwan, their frequency may be associated with cultural context.

4. Samson AC, Hegenloh M. Stimulus Characteristics Affect Humor Processing in Individuals with Asperger Syndrome. J Autism Dev Disord ;2009 (Oct 27)

The present paper aims to investigate whether individuals with Asperger syndrome (AS) show global humor processing deficits or whether humor comprehension and appreciation depends on stimulus characteristics. Non-verbal visual puns, semantic and Theory of Mind cartoons were rated on comprehension, funniness and the punchlines were explained. AS individuals did not differ to the control group in humor appreciation of visual puns. However, they had difficulty understanding and appreciating Theory of Mind cartoons and provided mentalistic explanations less frequently than controls suggesting that humor processing is strongly related to the cognitive requirements that the stimuli pose on the perceiver. Furthermore, AS individuals referred in all conditions more frequently to non-joke relevant details. Therefore, humor processing is also influenced by their detail-oriented processing style.


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