OPPOSITIONAL DEFIANT DISORDER A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Oppositional Defiant Disorder: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84139-X 1. Oppositional Defiant Disorder-Popular works. I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on oppositional defiant disorder. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.
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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.
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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health
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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON OPPOSITIONAL DEFIANT DISORDER ........................................................ 3 Overview........................................................................................................................................ 3 Federally Funded Research on Oppositional Defiant Disorder...................................................... 3 The National Library of Medicine: PubMed ................................................................................ 17 CHAPTER 2. DISSERTATIONS ON OPPOSITIONAL DEFIANT DISORDER .......................................... 25 Overview...................................................................................................................................... 25 Dissertations on Oppositional Defiant Disorder ......................................................................... 25 Keeping Current .......................................................................................................................... 26 CHAPTER 3. PATENTS ON OPPOSITIONAL DEFIANT DISORDER ..................................................... 27 Overview...................................................................................................................................... 27 Patents on Oppositional Defiant Disorder................................................................................... 27 Patent Applications on Oppositional Defiant Disorder............................................................... 29 Keeping Current .......................................................................................................................... 31 CHAPTER 4. BOOKS ON OPPOSITIONAL DEFIANT DISORDER......................................................... 33 Overview...................................................................................................................................... 33 Book Summaries: Online Booksellers........................................................................................... 33 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 37 Overview...................................................................................................................................... 37 NIH Guidelines............................................................................................................................ 37 NIH Databases............................................................................................................................. 39 Other Commercial Databases....................................................................................................... 41 APPENDIX B. PATIENT RESOURCES ................................................................................................. 43 Overview...................................................................................................................................... 43 Patient Guideline Sources............................................................................................................ 43 Finding Associations.................................................................................................................... 45 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 47 Overview...................................................................................................................................... 47 Preparation................................................................................................................................... 47 Finding a Local Medical Library.................................................................................................. 47 Medical Libraries in the U.S. and Canada ................................................................................... 47 ONLINE GLOSSARIES.................................................................................................................. 53 Online Dictionary Directories ..................................................................................................... 53 OPPOSITIONAL DEFIANT DISORDER DICTIONARY ....................................................... 55 INDEX ................................................................................................................................................ 71
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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with oppositional defiant disorder is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about oppositional defiant disorder, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to oppositional defiant disorder, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on oppositional defiant disorder. Abundant guidance is given on how to obtain free-ofcharge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to oppositional defiant disorder, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on oppositional defiant disorder. The Editors
1
From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. DISORDER
STUDIES ON OPPOSITIONAL DEFIANT
Overview In this chapter, we will show you how to locate peer-reviewed references and studies on oppositional defiant disorder.
Federally Funded Research on Oppositional Defiant Disorder The U.S. Government supports a variety of research studies relating to oppositional defiant disorder. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to oppositional defiant disorder. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore oppositional defiant disorder. The following is typical of the type of information found when searching the CRISP database for oppositional defiant disorder: •
Project Title: A PROSPECTIVE STUDY OF THE DEVELOPMENT OF ADHD AND ODD Principal Investigator & Institution: Harvey, Elizabeth A.; Psychology; University of Massachusetts Amherst 408 Goodell Building Amherst, Ma 01003
2
Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
4
Oppositional Defiant Disorder
Timing: Fiscal Year 2002; Project Start 15-JUL-2000; Project End 30-JUN-2005 Summary: This proposal focuses on the early development of attentiondeficit/hyperactivity disorder (ADHD) and comorbid oppositional defiant disorder (ODD). Although these disorders are typically diagnosed in elementary school age children, associated symptoms are thought to appear frequently by the preschool years. By the time ADHD children are diagnosed and treated, the comorbid problems and interaction patterns that may have caused them are likely firmly entrenched and resistant to treatment. Early interventions that target children at risk for developing ADHD could have the potential to prevent the development of comorbid problems among ADHD children and may limit the symptom severity and degree of impairment among children with ADHD. Early identification of these children is critical to early intervention. Therefore, the proposed project seeks to identify factors that predict the development of pure ADHD and comorbid ADHD/ODD among preschool children with externalizing problems. This prospective study will follow 180 three-year-old children with externalizing problems and 70 non-problem comparison children. Diagnostic and family assessments will be conducted yearly from age three to age six. The following specific aims will be addressed: a) to determine the extent to which preschoolers with externalizing problem are later diagnosed with ADHD, b) to evaluate the utility of early hyperactivity/impulsivity in predicting later ADHD diagnoses, c) to examine whether the chronicity and biological markers of early hyperactive/impulsive symptoms and neuropsychological functioning predict later ADHD and whether they predict ADHD beyond early hyperactivity/impulsivity, d) to evaluate the utility of early hostility/defiance in predicting later ODD among ADHD children, e) to examine whether parental discipline, family stress (including parent psychopathology, marital discord, negative life events, SES, and single parenthood), and family history of antisocial behavior predict later ODD among ADHD children and whether they predict ODD beyond what would be predicted from early hostility/impulsivity, f) to examine whether parental discipline mediates the effects of family stress on the development of ODD among ADHD children, g) to evaluate whether family stress interacts with early hyperactivity/impulsivity and hostility/defiance in predicting parental discipline and later ODD, and h) To examine whether early hostility/defiance and hyperactivity/impulsivity interact with parenting in predicting later ODD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ADOLESCENT PSYCHOPATHOLOGY AND ALCOHOL USE DISORDERS Principal Investigator & Institution: Clark, Duncan B.; Associate Professor; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2001; Project Start 01-SEP-1999; Project End 31-AUG-2004 Summary: This Independent Scientist Award (K02) is proposed for the applicant to acquire necessary skills to apply the developmental psychopathology conceptual framework and innovative statistical techniques for categorical longitudinal data to creating a model for the relationships among alcohol use disorders (AUD) and other mental disorders in adolescence. Based on empirical findings to date, the specific hypotheses focus on antisocial disorders (i.e., conduct disorder, oppositional defiant disorder) and negative affect disorders (i.e., mood and anxiety disorders) as possible predictors, consequences, or moderators of the structure, course and consequences of adolescent AUD. The applicant, trained as a child clinical psychologist and adult psychiatrist, is the Scientific Director of the NIAAA-funded Pittsburgh Adolescent Alcohol Research Center (PAARC). The career development plan focuses on the
Studies
5
acquisition of a thorough foundation in statistical modeling techniques and related methodological issues, including the implications of sampling strategies, missing data imputation, model selection, and controversies concerning causal inference from observational data. The applicant will learn statistical methods based on regression for modeling time-dependent relationships among continuous and categorical variables. The focus on methods for categorical variables is relevant to longitudinal research involving symptom and diagnostic categories. Relevant statistical techniques include methods for observed variables, including proportional hazards and random regression modeling and methods for latent variables, including latent class analysis, latent transition analysis, and growth mixture modeling with latent trajectory classes. Bayesian approaches to model selection and causal inference will also be considered. These methods will be specifically applied to examining the relationships among AUD, antisocial disorders, and negative affect disorders using longitudinal data from PAARC (n=1000 adolescents). Methods for evaluating the extent and the influence of sampling bias will assessed through comparison of the model generated using PAARC data with models generated with other data sets, including studies using high-risk and community sampling approaches. The integration of the concepts of developmental psychopathology with innovative longitudinal statistical modeling methods will contribute to the applicant's long-term career goal to advance research on adolescent AUD by clarifying the importance of psychopathology in determining the structure, course and consequences of adolescent alcohol abuse and dependence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SYNDROME
BIOMARKERS
FOR
PSYCHOSIS
IN
VELOCARDIOFACIAL
Principal Investigator & Institution: Kates, Wendy R.; Psychiatry and Behavioral Scis; Upstate Medical University Research Administration Syracuse, Ny 13210 Timing: Fiscal Year 2003; Project Start 19-FEB-2002; Project End 31-JAN-2007 Summary: (provided by applicant): Velocardiofacial syndrome (VCFS), caused by a microdeletion on chromosome 22q1 1.2, is associated with multiple congenital anomalies, neurocognitive deficits, and a neuropsychiatric phenotype duringchildhood that affects up to 65 percent of patients, and includes ADHD, oppositional defiant disorder and anxiety. Although up to 30 percent of adults with this syndrome develop schizophrenia (SZ) or bipolar disorder (BPD), currently we do not understand the relation between childhood psychiatric disorders in VCFS and the deterioration in adaptive/psychosocial functioning or mood regulation that may signal the eventual onset of SZ or BPD in late adolescence or early adulthood. We hypothesize that a subset of VCFS-affected subjects with child psychiatric disorders will demonstrate deficits on markers of biological vulnerability (i.e., neuroanatomic anomalies, and impairments in eye tracking, sustained attention and memory) that have been associated with SZ and/or BPD in the general population. We predict that this subset of children and youth will demonstrate, during a three year period, a deterioration in adaptive/psychosocial function or mood regulation that may signal the eventual onset of SZ or BPD in adulthood. We anticipate that this project will provide the first phase of data for a clinically based longitudinal study in which children with VCFS will be followed into adulthood to determine the eventual psychiatric outcome of each patient. Accordingly, the aims described in this application are designed 1) to increase our understanding of the natural history of child psychiatric disorders in VCFS; 2) to assess whether putative biomarkers for psychosis emerge and co-occur in a subset of psychiatrically-disordered children with VCFS; and 3) to explore the extent to which the presence of biomarkers in
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Oppositional Defiant Disorder
VCFS-affected children contribute to deterioration in adaptive/psychosocial functioning or mood regulation over time. To address these aims, children and youth will be assessed across multiple domains, including neuropsychological function, sustained attention, eye-tracking performance, brain morphology and clinical symptomatology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BRAIN DYSFUNCTION AND ALCOHOLISM Principal Investigator & Institution: Begleiter, Henri; Professor; Psychiatry; Suny Downstate Medical Center 450 Clarkson Ave New York, Ny 11203 Timing: Fiscal Year 2003; Project Start 01-AUG-1979; Project End 28-FEB-2008 Summary: (provided by applicant): For the past three decades, our laboratory as well as several others, have repeatedly observed significantly lower amplitudes of the visual P3(00) component of the Event-related potential (ERP) in both abstinent alcoholics and offspring of alcoholics. More recently we have identified a number of additional neurophysiological anomalies in both abstinent alcoholics and their offspring. This set of deficient neuroelectric features is not the result of excessive alcohol intake but appears to be related to family history of alcoholism. We have recently proposed that these anomalies may be indicative of increased central nervous system (CNS) disinhibition. While this disinhibition is manifested subclinically at the neurophysiological level, it is also present at the behavioral level in such conditions as attention deficit disorder with hyperactivity, conduct disorder, oppositional defiant disorder, antisocial personality disorder, etc. A critical issue, which remains to be examined, is the functional significance of this putative disinhibition. We have proposed that this underlying neural disinhibition is involved in a predisposition to develop alcohol dependence. It is now well established that clinicians consider craving an important contributor to the development and maintenance of alcoholism and have postulated that it is responsible for relapse. We hypothesize that the neuroelectric features that are related to CNS disinhibition may provide insights into the neurobiology of craving. To fully understand craving we must identify the brain mechanisms that lead to this overwhelming urge to drink.In the proposed project we plan to further investigate our findings of electrophysiological disinhibition in alcoholics by examining the underlying neural oscillations and their synchrony during ERP tasks, as well as during the resting condition. Characteristics of these oscillations appear to be aberrant in abstinent alcoholics and a goal of the proposed project is to identify these anomalies. We hypothesize that the spatial-temporal dynamics of these neural oscillations reflect an imbalance between excitation and inhibition in alcoholics. There is evidence in the literature that electrophysiological measures may be better indices of relapse in alcoholics than any clinical measures. We propose to identify brain oscillations that are predictive of relapse and explore the role of neurophysiological features of CNS disinhibition in predicting relapse in alcoholic patients Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: CHILD PSYCHOPATHOLOGY, ADVERSITY & DEVELOPING DRUG ABUSE Principal Investigator & Institution: Molnar, Beth; Maternal and Child Health; Harvard University (Sch of Public Hlth) Public Health Campus Boston, Ma 02460 Timing: Fiscal Year 2003; Project Start 06-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): Comorbidity of addictive and mental disorders has been shown to be pervasive, with more than half (54%) of those aged 15-54 in the
Studies
7
National Comorbidity Survey who had one diagnosable disorder having at least one cooccurring disorder. Less is known about comorbidity in youth or the degree to which it is affected by environmental factors. This proposal describes a two-year, multi-level investigation of the roles that mental disorders and adverse family, school, and community environments play in increasing risk of children and adolescents' misuse of alcohol and other drugs. The primary objective is to identify preventable antecedents of youth substance use disorders, using a developmental psychopathology approach. These investigations will be accomplished through secondary analyses of a multi-level study of 3000 youth and their communities, gathered by the Project on Human Development in Chicago Neighborhoods (PHDCN) from 1995-2001. Comorbidity between mental and addictive disorders among the youth will be described; additionally, the developmental risk processes that gave rise to the disorders themselves on the pathway to subsequent substance problems will be investigated. This proposal is being submitted by a new investigator, trained in social/psychiatric epidemiology. Youth, 9-18 years of age at baseline, and a caregiver were interviewed at home three times. Community characteristics were measured in 1995 and 2001 from independent samples and from videotapes of subjects' neighborhoods. Multilevel statistical methods will be used including discrete time survival analysis, hierarchical linear modeling, and individual growth modeling. This sample is uniquely suited to address the proposed aims, given (1) the longitudinal nature of the study; (2) the ability to compare neighborhoods and schools using an ecological framework and measurement of contextual features; and (3) comprehensive assessments of individual mental health and substance use behaviors. The use of existing data sets represents an opportunity to address these questions in a cost-effective manner. In his 1999 report on mental health, former U.S. Surgeon General Satcher asserted that little is known about the role of mental disorders in increasing the risk of misuse of alcohol and other drugs by youth. By addressing this research silence in a scientifically sound, multi-level study design, the products of the proposed research will be important contributions toward improving the planning and efficacy of health promotion and substance abuse prevention programs at the individual and local community level. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CONSEQUENCES OF PRENATAL COCAINE EXPOSURE IN ADOLESCENCE Principal Investigator & Institution: Delaney-Black, Virginia; Professor; Pediatrics; Wayne State University 656 W. Kirby Detroit, Mi 48202 Timing: Fiscal Year 2003; Project Start 05-JUN-2003; Project End 31-MAY-2007 Summary: (provided by applicant): Our previous studies demonstrated that prenatal cocaine exposure is associated with substantial problems in school-age children. After controlling for covariates, we identified relationships between prenatal cocaine exposure and growth deficits, poor expressive language, increased problem behaviors and lower achievement, all in the absence of IQ deficits. Problems in boys and girls with prenatal cocaine exposure included exposure-level dependent poor behavioral control. Boys with heavy exposure had poor conduct, hyperactivity and central processing problems. Girls with heavy exposure had deficits in achievement that were likely related to behavior problems. These early school age abnormalities, especially under-controlled behavior, raise serious concerns about the risks faced by these children in adolescence. Using one of the oldest, well-studied cohorts of prospectively identified children exposed prenatally to varying levels of cocaine, the proposed research will evaluate adolescent behaviors, early initiation of substance use and attention problems in this cohort. We
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Oppositional Defiant Disorder
hypothesize that prenatal cocaine exposure will be associated with 1) higher levels of externalizing types of behavior; 2) earlier initiation of substance use; and 3) more problems with attention and impulsivity. We also hypothesize that the effects of prenatal cocaine exposure will be related to level of exposure, and moderated by gender. The hypotheses will be tested by evaluating approximately 500 adolescents and their primary caregivers who were previously evaluated at birth and at 6 to 7 years old. Starting in Year 1, these subjects will be recruited to participate at ages 13 to 14. The well-validated outcome measures will include DSM-IV diagnoses for disruptive behavior disorders, substance abuse/dependency, a health profile, behavior reports, and various specific laboratory tasks. Hypotheses will be evaluated with modelspecified control variables, namely various potential confounders (e.g., prenatal and current alcohol exposure, other substance exposures, maternal comorbidities), mediators (e.g., birth weight, gestational age, child violence exposure), moderators (e.g., child gender, self-concept, custody status), and covariates (e.g., socioeconomic status, parity). Hierarchical linear and structural equation modeling will be the primary methods of data analysis. The proposed research will provide data critical to understanding the impact of prenatal cocaine exposure in adolescence, and to shape future studies of problem behaviors in late adolescence and early adulthood. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CULTURAL RESILIENCE OF RURAL AND REMOTE OJIBWE FAMILIES Principal Investigator & Institution: Whitbeck, Leslie B.; Professor of Sociology; Sociology; University of Nebraska Lincoln 14Th and R Sts Lincoln, Ne 68588 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2007 Summary: (provided by applicant): This application responds to announcement PA-00082, Research on Mental Disorders in Rural and Frontier Populations. It seeks five years of funding for a longitudinal diagnostic study of 350 Ojibwe children aged ten through twelve years (4th - 6th grades) and their parents who live on two rural American Indian reservations in northern Minnesota and Wisconsin and three more remote, less economically developed Canadian reserves. This application draws from more than six years of work with Ojibwe Bands in the upper Midwest through NIDA funded basic (DA 13580) and prevention (DA 10049) research programs. The purpose of the proposed research is to identify precursors of mental disorder and problematic externalizing and internalizing symptoms and to evaluate specific cultural risks and protective factors identified in previous research. A promising model will be investigated that proposes that cultural protective factors (e.g., traditional practices, traditional spirituality, and Ojibwe identity) operate over and above other resiliency factors for Ojibwe children. In addition, specific cultural risks (e.g., discrimination and negative life events associated with reservation life) function to increase risk to this population even when other risk factors are considered. Risks and protective factors will be evaluated in terms of remote location (e.g., the Canadian reserves) vs. the more assimilated and economically; developed U.S. reservations. Using computer assisted personal interviewing, the children will be screened (DISC 4.0) for Conduct Disorder, Oppositional Defiant Disorder, Attention Deficit Hyperactivity Disorder, Substance Abuse Disorder, Major Depression, and Generalized Anxiety Disorder. Both child and parent reports will be used for both diagnostic and symptom reports. Parents will be screened for mental disorder (Substance Abuse Disorder, Antisocial Personality Disorder, Major Depression, and Generalized Anxiety Disorder) at year 1. In addition, to examining a model of cultural risk and protective factors, we will also investigate formal and informal help
Studies
9
seeking among Ojibwe people in rural and remote communities. This application is extremely cost effective in that if funded it will extend an ongoing NIDA funded longitudinal diagnostic study (DA 13580) of 450 Ojibwe families for a total of 800 American Indian and First Nation families on six reservations and three remote Canadian reserves. It will allow more sophisticated investigation of cultural effects by increasing both the size and diversity of the sample and add new dimensions (e.g. variance in traditional knowledge and service utilization) to the study. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DISRUPTIVE DISORDERS & STD/HIV RISK IN ADOLESCENT DYADS Principal Investigator & Institution: Aalsma, Matthew; Medicine; Indiana Univ-Purdue Univ at Indianapolis 620 Union Drive, Room 618 Indianapolis, in 462025167 Timing: Fiscal Year 2002; Project Start 17-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): The overall objective of this research request for a Mentored Research Scientist Development Award is to gain expertise in the area of adolescent problem behavior and risk for infection with sexually transmitted diseases (STD) and human immunodeficiency virus (HIV). Specifically, health risk behaviors in adolescent romantic/sexual dyads where the female member of the dyad is engaging in disruptive behaviors will be explored during the career development period. The importance of this career development program is highlighted by epidemiological studies of STD and HIV infection, where adolescents with disruptive disorders are overrepresented. Additionally, romantic partnerships are integral to the sexual relationships that are implicitly associated with adverse health outcomes (infection with STD/HIV). Romantic partnerships provide unique types of social influence and controls. Hence, romantic/sexual dyads specific to this population are an important public health focus for research. The specific aims of this career development proposal are 1) to assess the role of dyad specific risk behavior when dyad members exhibit behaviorally concordant or discordant risk and protective behavior; 2) to assess the dyad specific risk behavior when the female member has a disruptive disorder; and 3) to understand the key tools that are needed in the creation of an intervention research program focused on dyadic and contextual influences with this population. Aim 1 will be explored through analyses of data obtained from the Add Health database. Aim 2 will be assessed via a pilot study of romantic/sexual dyads where the female member is diagnosed with conduct disorder, oppositional defiant disorder, or is involved in delinquent or criminal activity within the community setting. Aim 3 will be developed in conjunction with mentorship from nationally recognized experts in the field of adolescent sexuality and the results from research studies conducted in this career development program. This research request will provide the basis for an R21 STD/HIV intervention research application for adolescent females with disruptive disorders. Additionally, this career award will fill an important research gap and provide critical scientific data for planning future intervention trials. The career development plan and supervised research experiences will provide the candidate with the necessary research skills for a career as an independent research investigator. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: PATTERNS
EARLY
DISRUPTIVE
DISORDER:
TWO
DEVELOPMENTAL
Principal Investigator & Institution: Thomas, Jean M.; Children's Research Institute Washington, D.C., Dc 20010
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Oppositional Defiant Disorder
Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2006 Summary: (provided by applicant): The applicant is a child and adolescent psychiatrist with primary appointments at Children's National Medical Center (CNMC) and at The George Washington University School of Medicine (GWUSM). Dr. Thomas has extensive clinical experience in toddler psychiatry. This award will allow her to obtain the training and mentoring to become an independent clinical investigator focusing on disruptive disorders in toddlers. The educational plan includes didactic courses covering the principles and practice of clinical research, statistics, bioinfomatics, research design, and early childhood methodology. The goal of the present proposal is to examine the comorbidity between disruptive and other disorders in early childhood. The principal investigator will focus on two types of comorbidity: disruptive disorders with affective dysregulation, and disruptive disorders with neurodevelopmental difficulties (cognitive, language, motor, and neurobehavioral). The aim of this proposal is to take a first step in distinguishing these two developmental patterns of disruptive behavior with cross-sectional data. First, the PI plans to explore patterns of symptoms to verify that patients can be reliably classified into two forms of disruptive disorders: Affective/Disruptive and Neurodevelopmental/Disruptive. Second, she will test the association between these two groups of toddlers and healthy controls with characteristics of the parent and the parent-child relationship. Data from this study will inform a prospective cohort study that will examine developmental pathways to, and etiology of, early disruptive disorders, and guide strategies for intervention and prevention. These studies are important because children with early disruptive difficulties are at increased risk for continuing extemalizing difficulties, for internalizing and academic difficulties, and for adult psychopathology. This study will be conducted at the Pediatric Clinical Research Center (PCRC) at CNMC, affiliated with the Georgetown University Clinical Research Center (GCRC), and requires heavy use of the three PCRC observation rooms, and the PCRC Biostatistics/Bioinfomatics and Behavioral Phenotyping/Instrument Cores. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DISORDERS
ETIOLOGICAL
VARIATIONS
IN
DISRUPTIVE
BEHAVIOR
Principal Investigator & Institution: Friedman, Melanie C.; Psychology; University of Denver Box 101562 Denver, Co 80208 Timing: Fiscal Year 2001; Project Start 01-AUG-2001 Summary: The overall goal of the proposed research is to investigate the individual etiology of Attention-Deficit/Hyperactivity Disorder (ADHD) and the shared etiologies of ADHD with other disruptive behavior disorders, namely Conduct Disorder (CD), and Oppositional Defiant Disorder (ODD). In addition the proposed research seeks to investigate how these etiologies may differ as a function of age, intelligence (IQ), socioeconomic status (SES), and gender. Twin pairs of children in which at least one twin shows elevated levels of ADHD symptomatology will be included in the study. Parent reports of ADHD, CD, and ODD symptomatology will be obtained as well as estimates of IQ and SES. Univariate and bivariate behavioral genetic analyses will be employed to estimate the genetic, shared environmental, and non-shared environmental contributions to the etiology of ADHD, its overlap with CD and ODD, as well as to test whether these etiologies vary as a function of age, IQ, SES, and gender. Specific knowledge of the etiology of disruptive behavior disorders as a function of age, gender, IQ, and SES is important for understanding how these disorders develop and can potentially be relevant to their prevention and treatment. Moreover, a thorough
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behavioral genetics analysis of the phenotypes of the disruptive behavior disorders can greatly aid future molecular genetics analyses. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HIGH FIELD MRI OF STIMULANTS IN ADOLESCENTS AT RISK Principal Investigator & Institution: Anderson, Carl M.; Mc Lean Hospital (Belmont, Ma) Belmont, Ma 02478 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 29-SEP-2004 Summary: (provided by applicant): This application is in response to (PAR-02-058) Imaging - Science Track Award for Research Transition (I/START) for the study of neurobehavioral and neurobiological factors that may contribute to the initiation of substance use disorders (SUD). The first objective is to obtain preliminary fMRI measurements at 4T of individual functional differences in stimulant response coupled with objective behavioral measures of hyperactivity and structural MRI in a subgroup of male adolescents at risk for SUD, thus, replicating published findings at 1.5 T. The second is to develop preliminary data for an application targeting both male and female adolescents with conduct disorder (CD) under the auspices of a NIDA sponsored Mentored Research Scientist Development Award. Conduct disorder with behavioral hyperactivity (BH) and impulsivity is a known precursor to SUD, particularly with a positive family history of SUD. Behavioral hyperactivity, and its individual variation, is often cited as a critical link between CD and progression to SUD. We have measured, using optical tracking of movement, individual variations in BH, and have reported correlated blood flow abnormalities in dopamine transporter (DAT) rich subregions of the basal ganglia and cerebellum that were reduced, dose-dependently, by methylphenidate (MPH). Hyperactivity and stimulant response-rate appear to mirror disproportionate blood flow among DAT-rich subregions of the basal ganglia-cerebellar system. We hypothesize, those functional and/or structural defects in the basal gangliacerebellar system link BH with risk for SUD. To test functional and structural hypotheses about BH, responsiveness to MPH and volumes of DAT-rich subregions, we will examine, using phased-array MRI at 4T, four groups (n=10 each) of adolescent males (14-17 yrs). Two cohorts with (DSM-IV+) ADHD and comorbid oppositional defiant disorder ODD, having a first degree relative with SUD (SUD+), will be carefully screened with optical tracking for either presence (BH+/ SUD+) or absence of hyperactivity (BH-/SUD+) prior to scanning pro- and post-MPH, and compared with matched, (DSM-IV-) comparison groups, with (BH-/SUD+) and without (BH-/SUD-) a family history of SUD. Thus, imaging BH+/BH- individuals with ADHD/ODD will allow a prospective focus on antecedent neurobehavioral and neurobiological factors, in a population at high risk for SUD, without the confounds of developed CD or prior substance abuse on brain development. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HOME BASED TREATMENT FOR DRUG USE IN EARLY ADOLESCENTS Principal Investigator & Institution: Bukstein, Oscar G.; Associate Professor; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 30-JUN-2006 Summary: (provided by applicant): Disruptive behavior disorders (DBDs), which include Attention-Deficit/Hyperactivity Disorder, Oppositional Defiant Disorder, and Conduct Disorder, are among the most robust risk factors for the development of the
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early onset type of substance abuse and dependence. However, manualized treatments that target early substance use and abuse, as well as the symptoms and impairments of the DBDs collectively, remain to be developed. The current Development/Exploratory (R21) research proposal seeks to develop a home-based behavioral intervention or Home Based Therapy (HBT) for early adolescents that halts the progressive development of the early onset substance abuse that is often associated with the DBDs. The proposal is composed of two study phases. Preliminary treatment development and standardization activities will occur in Phase I of the protocol in pilot work with 12 adolescents and their families. In Phase II, 36 patients with a DBD and sub-diagnostic use or abuse of one or more substances will be randomly assigned to treatment using either standard treatment for DBDs in this age group or the newly developed intervention. Treatment outcomes for the 24 patients assigned to receive the study intervention will then be compared to outcomes for the 12 patients assigned to receive standard treatment. The intervention includes three major components: (1) parent training in skills which have been shown to reduce oppositional behavior and conduct problems, including parent-adolescent communication skills, parent discipline practices and increased monitoring of adolescent behaviors; (2) home-based interventions with the adolescent designed to improve a range of skills typically deficient among teens with conduct, ADHD, and substance abuse problems (e.g., organizational skills, communication skills, problem-solving skills, relapse prevention, etc.); and (3) parentteenager negotiation training in family-based sessions to improve communication and problem-solving skills between parents and adolescent. These components will be administered through weekly sessions over 12 weeks with 3 monthly booster sessions over 12 subsequent weeks. These interventions are expected to improve not only substance abuse outcomes, but a range of impairments and symptoms associated with the DBDs and high risk for the early onset type of substance use disorder. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INTERGENERATIONAL INFLUENCE OF SUBSTANCE USE ON CHILDREN Principal Investigator & Institution: Hill, Karl G.; None; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2001; Project Start 29-SEP-2000; Project End 30-JUN-2005 Summary: (adapted from Investigator's abstract): This proposal seeks five years of support to collect and analyze data on the children of the Seattle Social Development Project (SSDP) panel. The proposed study will collect data from this third generation and their parents to examine the effects of current and past parental and grandparental substance use on child development. We have recently received a separate grant to follow up the full SSDP panel at ages 24 and 27 (P.I., J. David Hawkins), and have entered the field period of the age 24 interview. The two companion studies have complementary but separate aims. The SSDP panel study has focused on understanding childhood and adolescent risk and protective factors predictive of substance abuse, violence, and related health and behavior problems. The multiethnic urban of 808 males and females, constituted in 1985 when subjects entered the fifth grade in 18 elementary schools serving high crime neighborhoods, ahs been tracked and interviewed over an eleven-year period through 1996 when subjects were 21 years old. Extensive data are also available on these subjects' parents. Panel members are now having children of their own. The proposed study will obtain archival data for the oldest children of SSDP panel members from birth to three years of age, from birth certificates, Medicaid records for measures of prenatal, birth and postpartum maternal and child health, and social
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system involvement. The study will collect interview and observational data on cognitive, affective, academic and social development of these children from birth to early adolescence, and assessments of parenting practices and parent-child relationship quality. Data collection in the third generation will include self-reports of substance use initiation, and delinquent and other conduct problems, and a diagnostic assessment at age 6 of conduct disorder, oppositional defiant disorder, and attention deficit/hyperactive disorder. The proposed study will examine the effects of present and past parental and grandparental substance use on these child outcomes, and will examine hypothesized mechanisms producing these effects. Measurement and analyses are guided by the investigators' social development model, which organizes empirical findings on risk and protective factors into a causal theory. The study will provide vital information on the effects and mechanisms of past and current parental substance abuse and parenting practices on children for use in designing preventive interventions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MAINTENANCE TREATMENTS FOR CONDUCT DISORDERED CHILDREN Principal Investigator & Institution: Eyberg, Sheila M.; Professor; Clinical & Health Psychology; University of Florida Gainesville, Fl 32611 Timing: Fiscal Year 2003; Project Start 01-DEC-1999; Project End 30-NOV-2004 Summary: Conduct-disordered behavior in preschool-age children represents the single most important behavioral risk factor for later antisocial behavior and can be reliably identified in children as young as 3 years. Early intervention may be critical. Without treatment, conduct-disordered behavior is highly persistent and worsens with time. Evidence indicates that the short-term effects of interventions at preschool age are highly effective, may be more effective than treatments when children are older, and may prevent many of the associated academic and peer difficulties that require multiple interventions only a few years later. Evidence of the long-term effects of treatment (beyond 1 year), however, are limited. The few studies that exist suggest that beyond the first follow-up year, as many as 50 percent of treated children may return to pretreatment levels. Lack of information about the course of child and family functioning after treatment hinders our understanding of factors associated with treatment failure, and studies of psychosocial maintenance treatments for children are almost nonexistent. This project will test the continuing care model of maintenance treatment that assumes that conduct disorder is a chronic condition requiring monitoring and booster treatment at times of incipient relapse during childhood. Participants will be 100 families of children ages 3 to 6 with Oppositional Defiant Disorder referred to one of two clinics for treatment. Families will be randomly assigned to the standard treatment group (parent-child interaction therapy; PCIT) or to the maintenance treatment group (standard treatment followed by a two-year period of monitoring and treatment-as- needed). We predict significant differences at 2-year follow-up favoring the maintenance treatment group in child and parent functioning assessed by multiple method/multiple informant measures across settings. We expect responsiveness to treatment in both groups to be influenced most strongly by parent psychological variables. Predictors of outcome will be examined separately for the African American subgroup to inform the development of a culture specific treatment protocol. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NEIGHBORHOOD, SOCIOECONOMIC STATUS & ADOLESCENT DISTRESS Principal Investigator & Institution: Aneshensel, Carol S.; Professor; Community Health Sciences; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2001; Project Start 01-FEB-2000; Project End 31-JAN-2003 Summary: The objective of this inquiry is to explore the multiple ways in which socioeconomic status (SES) influences the mental health of adolescents. To attain this objective, we will analyzes data from the National Longitudinal Study of Adolescent Health (Add Health), a 2-wave panel survey of a nationally representative sample of approximately 20,000 adolescents and their parents. There are several sources of data: adolescent interviews and self-administered questionnaires; parental interviews; school administrator self-administered questionnaires; and official statistics for Census tracts and blocks, counties, and states. Data pertain to several units of analysis: individual, family, and neighborhood. The project will use state-of-the-art methods of multilevel modeling to accurately describe how SES in two contexts-family and neighborhoodjointly influences adolescent emotional well-being. The primary hypothesis is that symptoms of depression are inversely associated with neighborhood SES over and above the contribution of family SES and that these multi-level effects are synergistic rather than merely additive. Preliminary data analysis supports this hypothesis. The research will also explore mechanisms at both macro (e.g., collective efficacy) and micro (e.g., parenting behaviors) levels to explain how SES influences, emotional distress among adolescents. It also examines the extent to which these processes are universal or are specific to particular ethnic and/or gender subgroups. Finally, the research explores the extent to which models developed behaviors indicative of oppositional defiant disorder and conduct disorder. This extension across a spectrum of disorders) from the etiologic impact of SES for a specific disorder. These scientific results will be translated into policy recommendations aimed at ameliorating the adverse mental health effects of growing up within socioeconomically disadvantaged conditions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NEUROPHYSIOLOGY IN CHILDREN AT HIGH RISK FOR ALCOHOLISM Principal Investigator & Institution: Porjesz, Bernice; Associate Professor; Psychiatry; Suny Downstate Medical Center 450 Clarkson Ave New York, Ny 11203 Timing: Fiscal Year 2001; Project Start 01-JUL-1982; Project End 31-AUG-2006 Summary: (provided by applicant): For the past twenty years it has been repeatedly observed that the P3(00) component of the event-related potential (ERP) is not only significantly lower in alcoholics, but also in young offspring of alcoholics at high risk (HR) for developing alcoholism. These observations suggested that reduced amplitudes of the P3 component in HR individuals might antecede the development of alcohol dependence. There is some evidence that reduced P3 voltage in childhood and adolescence in HR individuals is associated with externalizing disorders (conduct disorder, attention deficit hyperactivity, oppositional defiant disorder and adult antisocial behavior) and increased substance use, and may predict later substance and alcohol abuse. A meta-analysis of all HR studies concluded that the low amplitude P3 in HR individuals provides a reliable phenotypic marker of alcoholism, and it has been postulated to be indicative of increased Central Nervous System (CNS) disinhibition. Thus P3 as a potential vulnerability marker may provide insight into some causative
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pathophysiology process involved in the development of alcohol dependence. Here it is hypothesized that the P3 amplitude may index some CNS vulnerability (e.g. disinhibition) which may result in any one of a number of adverse conditions, such as alcohol dependence, drug abuse, antisocial personality, attention deficit hyperactivity disorder, conduct disorder, oppositional disorder, etc. The research strategy used to date has been based on a familial high-risk model, because it is well known that children of alcoholics are at high risk to develop alcohol dependence. In the present renewal a complementary strategy is proposed based on a "neurophysiological high-risk" model. In this model, individuals are hypothesized to be at high-risk based solely on their extreme scores on neurophysiological features (e.g. visual P3 amplitude), well established to be associated with a number of clinical conditions such as alcohol dependence, substance abuse, etc. Several scientific issues will be examined with the use of this novel approach, using innovative neurophysiological assays and methods. Specifically, electrophysiological measures (P3 and other measures) will be recorded in a large randomly ascertained sample of adolescents (15-17). The P3b amplitude provides a quantitative variable that typically yields a normal distribution in the general population. This distribution will be divided into the lower, upper and middle third. These three groups based on P3b amplitude will provide the basis for subsequent dependent variables, such as other EEG/ERP experiments, the clinical data to be collected (externalizing symptoms, other psychiatric symptoms, alcohol use, drug use, family history of psychiatric disorders, etc.). It is hypothesized that those individuals at the low end of the P3 amplitude distribution will manifest more evidence of electrophysiological disinhibition, externalizing traits, and substance use. Moreover, it is proposed that individuals with low P3b amplitude will manifest significantly greater prevalence of externalizing traits, alcohol and drug abuse compared to subjects with high P3b amplitude when retested four years later (ages 19-21). Retesting will begin in the last year of this application, and will continue in the future. The identification of individuals with neuroelectric deficits will have great utility in prevention initiatives. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TREATING OPPOSITIONAL DEFIANT BEHAVIOR Principal Investigator & Institution: Lavigne, John V.; Children's Memorial Hospital (Chicago) Chicago, Il 606143394 Timing: Fiscal Year 2001; Project Start 01-SEP-1998; Project End 31-DEC-2002 Summary: The proposed study examines the effectiveness of a psychological intervention conducted in primary care pediatric settings for the treatment of oppositional defiant disorder (ODD). This disorder: 1) occurs at a high rate among young children in the primary care setting; 2) has the potential to be identified in the primary care environment; 3) is likely to be more responsive if treated early; 4) has long term consequences for many children if not treated; and 5) may be treatable in the primary care area if identified early, enabling the child to avoid later specialized mental health services if the problem becomes more entrenched or significant comorbidity develops. The proposed study is a randomized controlled trial of the effectiveness of two primary care treatment models for children ages 4-6 years with ODD. The two models include a highly structured parent-training intervention of documented effectiveness, involving a ten sessions, manual-driven treatment with accompanying videotapes. The intervention will be provided either by 1) pediatric office staff nurses, or 2) a mental health professional working in the primary care setting. These two models of intervention will be compared to a usual care control group over the course of one year. To examine changes in behavior problems and diagnoses resulting from treatment,
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assessments will be conducted at baseline, posttreatment, and one-year follow-up. There will be 195 children ages 4-6 years enrolled in the study through a consortium of pediatric practices in the Chicago area, including practices serving Chicago's inner city. The participating children will have exceeded the 90th percentile on the externalizing disorders subscale of the Child Behavior Checklist (CBCL), and met criteria for an oppositional defiant disorder. The design of the study will allow us to examine whether: 1) a structured intervention for the treatment of ODD in young children can be effective in the primary care pediatric setting; 2) intervention for ODD by a trained pediatric nurse is as effective as that provided by a mental health professional working in the pediatric setting; 3) there are offset effects and cost savings associated with the provision of these services. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: YOUTH DRUG ABUSE, ADHD, AND RELATED DISRUPTIVE BEHAVIORS Principal Investigator & Institution: Winters, Ken C.; Associate Professor; Psychiatry; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2003; Project Start 15-FEB-2000; Project End 31-JAN-2005 Summary: (Adapted from the Applicant's Abstract): The proposed five-year study will investigate the role of Attention Deficit-Hyperactivity Disorder (ADHD) and other disruptive behaviors, particularly Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD), in the etiology of youth drug involvement, including initiation, maintenance, escalation, and development of psychoactive substance use disorders (PSUD). Drug abuse and ADHD among youth represent vital areas of interest for study because they are highly prevalent in clinic settings, and they are two of the most refractory behavioral disorders of youth. Furthermore, research suggests that rates of drug use and PSUD are significantly greater among ADHD youth compared to nonADHD youth. The study employs a prospective design to continue to follow community-derived samples of ADHD (n=194), a subgroup of which are considered subthreshold cases, and a demographically-matched nondisruptive comparison group (n=124) for whom both child (T1) and early adolescent (T2) evaluations have been completed. The present study proposes to assess the cohort twice gain during late adolescence (T3) and young adulthood (T4). We have followed these cohorts with the goal of identifying various biopsychosocial predictive and mediating influences, and characterizing their individual, collective and interactive effects, on a range of drug involvement variables (i.e., onset, frequency, quantity, and diagnostic symptoms). Nested within the original longitudinai design was a randomized experiment (initiated at T1 ) that tested the effects of a two year, multicomponent competence enhancement intervention that was designed to promote positive change in several of these mediators. Secondary aims of the proposed study are to evaluate whether the intervention displays any "sleeper" effects on outcome, and, relatedly, to characterize relationships between prior exposure to psychostimulant medication and later outcome. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with oppositional defiant disorder, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “oppositional defiant disorder” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for oppositional defiant disorder (hyperlinks lead to article summaries): •
Another look at oppositional defiant disorder. Author(s): Mirabile CS Jr. Source: The American Journal of Psychiatry. 1995 February; 152(2): 302-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7840377&dopt=Abstract
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Attention-deficit-hyperactivity disorder with and without oppositional defiant disorder in 3- to 7-year-old children. Author(s): Kadesjo C, Hagglof B, Kadesjo B, Gillberg C. Source: Developmental Medicine and Child Neurology. 2003 October; 45(10): 693-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14515941&dopt=Abstract
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Children with attention-deficit/hyperactivity disorder and comorbid oppositional defiant disorder: an EEG analysis. Author(s): Clarke AR, Barry RJ, McCarthy R, Selikowitz M. Source: Psychiatry Research. 2002 August 30; 111(2-3): 181-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12374635&dopt=Abstract
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Clinic referral for oppositional defiant disorder: relative significance of attachment and behavioral variables. Author(s): Speltz ML, DeKlyen M, Greenberg MT, Dryden M. Source: Journal of Abnormal Child Psychology. 1995 August; 23(4): 487-507. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7560558&dopt=Abstract
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PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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Criterion validity and the utility of reactive and proactive aggression: comparisons to attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, and other measures of functioning. Author(s): Waschbusch DA, Willoughby MT, Pelham WE Jr. Source: Journal of Clinical Child Psychology. 1998 December; 27(4): 396-405. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9866076&dopt=Abstract
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Diagnostic conundrum of oppositional defiant disorder and conduct disorder. Author(s): Loeber R, Lahey BB, Thomas C. Source: Journal of Abnormal Psychology. 1991 August; 100(3): 379-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1918617&dopt=Abstract
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Diagnostic efficiency of symptoms for oppositional defiant disorder and attentiondeficit hyperactivity disorder. Author(s): Waldman ID, Lilienfeld SO. Source: Journal of Consulting and Clinical Psychology. 1991 October; 59(5): 732-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1955607&dopt=Abstract
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DSM-IV field trials for oppositional defiant disorder and conduct disorder in children and adolescents. Author(s): Lahey BB, Applegate B, Barkley RA, Garfinkel B, McBurnett K, Kerdyk L, Greenhill L, Hynd GW, Frick PJ, Newcorn J, et al. Source: The American Journal of Psychiatry. 1994 August; 151(8): 1163-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8037251&dopt=Abstract
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Effects of dextroamphetamine and contingency management on a preschooler with ADHD and oppositional defiant disorder. Author(s): Speltz ML, Varley CK, Peterson K, Beilke RL. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 1988 March; 27(2): 175-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3360719&dopt=Abstract
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Evidence for developmentally based diagnoses of oppositional defiant disorder and conduct disorder. Author(s): Loeber R, Keenan K, Lahey BB, Green SM, Thomas C. Source: Journal of Abnormal Child Psychology. 1993 August; 21(4): 377-410. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8408986&dopt=Abstract
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Executive functioning, temporal discounting, and sense of time in adolescents with attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). Author(s): Barkley RA, Edwards G, Laneri M, Fletcher K, Metevia L. Source: Journal of Abnormal Child Psychology. 2001 December; 29(6): 541-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11761287&dopt=Abstract
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Familial risk factors to oppositional defiant disorder and conduct disorder: parental psychopathology and maternal parenting. Author(s): Frick PJ, Lahey BB, Loeber R, Stouthamer-Loeber M, Christ MA, Hanson K. Source: Journal of Consulting and Clinical Psychology. 1992 February; 60(1): 49-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1556285&dopt=Abstract
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Increased adrenal androgen functioning in children with oppositional defiant disorder: a comparison with psychiatric and normal controls. Author(s): van Goozen SH, van den Ban E, Matthys W, Cohen-Kettenis PT, Thijssen JH, van Engeland H. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2000 November; 39(11): 1446-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11068901&dopt=Abstract
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Internal validity of attention deficit hyperactivity disorder, oppositional defiant disorder, and overt conduct disorder symptoms in young children: implications from teacher ratings for a dimensional approach to symptom validity. Author(s): Burns GL, Walsh JA, Owen SM, Snell J. Source: Journal of Clinical Child Psychology. 1997 September; 26(3): 266-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9292384&dopt=Abstract
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Is childhood oppositional defiant disorder a precursor to adolescent conduct disorder? Findings from a four-year follow-up study of children with ADHD. Author(s): Biederman J, Faraone SV, Milberger S, Jetton JG, Chen L, Mick E, Greene RW, Russell RL. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 1996 September; 35(9): 1193-204. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8824063&dopt=Abstract
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Mary, a 4-year-old with oppositional defiant disorder. Author(s): Daly CM, Grieger T. Source: Military Medicine. 2002 May; 167(5): 442-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12053858&dopt=Abstract
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Mood disorders in children with oppositional defiant disorder: a pilot study. Author(s): Wenning K, Nathan P, King S. Source: The American Journal of Orthopsychiatry. 1993 April; 63(2): 295-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8484434&dopt=Abstract
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Oppositional defiant disorder and conduct disorder. Author(s): Loeber R. Source: Hosp Community Psychiatry. 1991 November; 42(11): 1099-100, 1102. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1743634&dopt=Abstract
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Oppositional defiant disorder and conduct disorder: a review of the past 10 years, part II. Author(s): Burke JD, Loeber R, Birmaher B. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2002 November; 41(11): 1275-93. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12410070&dopt=Abstract
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Oppositional defiant disorder symptomatology after traumatic brain injury: a prospective study. Author(s): Max JE, Castillo CS, Bokura H, Robin DA, Lindgren SD, Smith WL Jr, Sato Y, Mattheis PJ. Source: The Journal of Nervous and Mental Disease. 1998 June; 186(6): 325-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9653415&dopt=Abstract
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Oppositional defiant disorder with onset in preschool years: longitudinal stability and pathways to other disorders. Author(s): Lavigne JV, Cicchetti C, Gibbons RD, Binns HJ, Larsen L, DeVito C. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2001 December; 40(12): 1393-400. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11765284&dopt=Abstract
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Oppositional defiant disorder. Author(s): Rey JM. Source: The American Journal of Psychiatry. 1993 December; 150(12): 1769-78. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8238630&dopt=Abstract
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Paired-associate learning in attention-deficit/hyperactivity disorder as a function of hyperactivity-impulsivity and oppositional defiant disorder. Author(s): Chang HT, Klorman R, Shaywitz SE, Fletcher JM, Marchione KE, Holahan JM, Stuebing KK, Brumaghim JT, Shaywitz BA. Source: Journal of Abnormal Child Psychology. 1999 June; 27(3): 237-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10438189&dopt=Abstract
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Persistence and desistance of oppositional defiant disorder in a community sample of children with ADHD. Author(s): August GJ, Realmuto GM, Joyce T, Hektner JM. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 1999 October; 38(10): 1262-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10517059&dopt=Abstract
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Pharmacological treatments of autism, attention deficit hyperactivity disorder, oppositional defiant disorder, and depression in children and youth--commentary. Author(s): Werry JS. Source: Journal of Clinical Child Psychology. 2001 March; 30(1): 110-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11294068&dopt=Abstract
•
Plasma monoamine metabolites and aggression: two studies of normal and oppositional defiant disorder children. Author(s): van Goozen SH, Matthys W, Cohen-Kettenis PT, Westenberg H, van Engeland H. Source: European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology. 1999 January; 9(1-2): 141-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10082240&dopt=Abstract
•
Polygenic inheritance of Tourette syndrome, stuttering, attention deficit hyperactivity, conduct, and oppositional defiant disorder: the additive and subtractive effect of the three dopaminergic genes--DRD2, D beta H, and DAT1. Author(s): Comings DE, Wu S, Chiu C, Ring RH, Gade R, Ahn C, MacMurray JP, Dietz G, Muhleman D. Source: American Journal of Medical Genetics. 1996 May 31; 67(3): 264-88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8725745&dopt=Abstract
•
Preschool boys with oppositional defiant disorder: clinical presentation and diagnostic change. Author(s): Speltz ML, McClellan J, DeKlyen M, Jones K. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 1999 July; 38(7): 838-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10405501&dopt=Abstract
•
Preschoolers at risk for attention-deficit hyperactivity disorder and oppositional defiant disorder: family, parenting, and behavioral correlates. Author(s): Cunningham CE, Boyle MH. Source: Journal of Abnormal Child Psychology. 2002 December; 30(6): 555-69. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12481971&dopt=Abstract
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Oppositional Defiant Disorder
•
Problem of item overlap between the psychopathy screening device and attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder rating scales. Author(s): Burns GL. Source: Psychological Assessment. 2000 December; 12(4): 447-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11147115&dopt=Abstract
•
Psychiatric comorbidity, family dysfunction, and social impairment in referred youth with oppositional defiant disorder. Author(s): Greene RW, Biederman J, Zerwas S, Monuteaux MC, Goring JC, Faraone SV. Source: The American Journal of Psychiatry. 2002 July; 159(7): 1214-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12091202&dopt=Abstract
•
Psychosocial problems in attention-deficit hyperactivity disorder with oppositional defiant disorder. Author(s): Harada Y, Yamazaki T, Saitoh K. Source: Psychiatry and Clinical Neurosciences. 2002 August; 56(4): 365-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12109953&dopt=Abstract
•
Reduced salivary cortisol in children with comorbid Attention deficit hyperactivity disorder and oppositional defiant disorder. Author(s): Kariyawasam SH, Zaw F, Handley SL. Source: Neuroendocrinol Lett. 2002 February; 23(1): 45-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11880861&dopt=Abstract
•
Reduction in children's symptoms of attention deficit hyperactivity disorder and oppositional defiant disorder during individual tutoring as compared with classroom instruction. Author(s): Strayhorn JM Jr, Bickel DD. Source: Psychological Reports. 2002 August; 91(1): 69-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12353805&dopt=Abstract
•
Serotonergic functioning in children with oppositional defiant disorder: a sumatriptan challenge study. Author(s): Snoek H, van Goozen SH, Matthys W, Sigling HO, Koppeschaar HP, Westenberg HG, van Engeland H. Source: Biological Psychiatry. 2002 February 15; 51(4): 319-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11958783&dopt=Abstract
Studies
23
•
Social-cognitive processes in preschool boys with and without oppositional defiant disorder. Author(s): Coy K, Speltz ML, DeKlyen M, Jones K. Source: Journal of Abnormal Child Psychology. 2001 April; 29(2): 107-19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11321626&dopt=Abstract
•
Sources of covariation among attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder: the importance of shared environment. Author(s): Burt SA, Krueger RF, McGue M, Iacono WG. Source: Journal of Abnormal Psychology. 2001 November; 110(4): 516-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11727941&dopt=Abstract
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The influence of ADHD-hyperactivity/impulsivity symptoms on the development of oppositional defiant disorder symptoms in a 2-year longitudinal study. Author(s): Burns GL, Walsh JA. Source: Journal of Abnormal Child Psychology. 2002 June; 30(3): 245-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12041710&dopt=Abstract
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The outcome of parent training using the behavior management flow chart with mothers and their children with oppositional defiant disorder and attention-deficit hyperactivity disorder. Author(s): Danforth JS. Source: Behavior Modification. 1998 October; 22(4): 443-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9755646&dopt=Abstract
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The relationship between DSM-IV oppositional defiant disorder and conduct disorder: findings from the Great Smoky Mountains Study. Author(s): Rowe R, Maughan B, Pickles A, Costello EJ, Angold A. Source: Journal of Child Psychology and Psychiatry, and Allied Disciplines. 2002 March; 43(3): 365-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11944878&dopt=Abstract
•
Toward a transactional conceptualization of oppositional defiant disorder: implications for assessment and treatment. Author(s): Greene RW, Doyle AE. Source: Clinical Child and Family Psychology Review. 1999 September; 2(3): 129-48. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11227071&dopt=Abstract
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Oppositional Defiant Disorder
•
Toward establishing an empirical basis for the diagnosis of oppositional defiant disorder. Author(s): Angold A, Costello EJ. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 1996 September; 35(9): 1205-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8824064&dopt=Abstract
•
Trauma exposure among children with oppositional defiant disorder and attention deficit-hyperactivity disorder. Author(s): Ford JD, Racusin R, Daviss WB, Ellis CG, Thomas J, Rogers K, Reiser J, Schiffman J, Sengupta A. Source: Journal of Consulting and Clinical Psychology. 1999 October; 67(5): 786-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10535245&dopt=Abstract
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CHAPTER 2. DISSERTATIONS ON OPPOSITIONAL DEFIANT DISORDER Overview In this chapter, we will give you a bibliography on recent dissertations relating to oppositional defiant disorder. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “oppositional defiant disorder” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on oppositional defiant disorder, we have not necessarily excluded non-medical dissertations in this bibliography.
Dissertations on Oppositional Defiant Disorder ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to oppositional defiant disorder. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •
A Comparative Analysis of the WRAML Performance of Adolescents with Conduct Disorder or Oppositional Defiant Disorder and a Non-Clinical Group by Gershon, Maria Bellassai; PhD from City University of New York, 1999, 165 pages http://wwwlib.umi.com/dissertations/fullcit/9946165
•
Enhancing Parent-child Relations in Children with Characteristics of Both Oppositional Defiant Disorder and Attention-Deficit/hyperactivity Disorder by Behnke, Patricia; MA from University of Toronto (Canada), 2002, 48 pages http://wwwlib.umi.com/dissertations/fullcit/MQ73986
•
Executive Functions in Children with Attention-deficit Hyperactivity Disorder, Oppositional Defiant Disorder, and Comorbid Diagnosed Attention-Deficit Hyperactivity Disorder and Oppositional Defiant Disorder by Pedersen, Jason Allen; PhD from The Pennsylvania State University, 2002, 111 pages http://wwwlib.umi.com/dissertations/fullcit/3051723
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Oppositional Defiant Disorder
•
Social Skills in Special Education Adolescent Students with Oppositional Defiant Disorder by Skoulos, Vasilios; PhD from City University of New York, 2001, 110 pages http://wwwlib.umi.com/dissertations/fullcit/9997121
•
The Comorbidity of Attention Deficit Hyperactivity Disorder Subtypes and Oppositional Defiant Disorder on the Severity of Anxiety in 6 to 12-year-old Children by Wayne, Suzanne E.; PsyD from Adler School of Professional Psychology, 2003, 88 pages http://wwwlib.umi.com/dissertations/fullcit/3094919
•
The Impact on the Family of School-Age Children and Adolescents with Attention Deficit/Hyperactivity Disorder And/or Oppositional Defiant Disorder Compared to Those with Normal Adjustment by Hull, Beverly Sharon, PhD from Wayne State University, 1996, 188 pages http://wwwlib.umi.com/dissertations/fullcit/9628903
•
The Relationship between Impaired Executive Functioning and Oppositional Defiant Disorder in Adolescents by Raven, Cynthia Ann; PhD from Marquette University, 2000, 95 pages http://wwwlib.umi.com/dissertations/fullcit/9977740
•
The Relationships of Trauma Symptomatology in Children and Exacerbation of Oppositional Defiant Disorder by Neal, Stephen Clay, Jr.; PhD from Pacific Graduate School of Psychology, 2003, 99 pages http://wwwlib.umi.com/dissertations/fullcit/3077452
Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
27
CHAPTER 3. PATENTS ON OPPOSITIONAL DEFIANT DISORDER Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.4 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “oppositional defiant disorder” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on oppositional defiant disorder, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Oppositional Defiant Disorder By performing a patent search focusing on oppositional defiant disorder, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent 4Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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Oppositional Defiant Disorder
descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on oppositional defiant disorder: •
Use of guanfacine in the treatment of behavioral disorders Inventor(s): Arnsten; Amy F. T. (376 Sperry Rd., Bethany, CT 06524), Goldman-Rakic; Patricia S. (New Haven, CT), Hunt; Robert H. (1701 Cedar La., Nashville, TN 37212) Assignee(s): Arnsten; Amy F. T. (Bethany, CT), Goldman-Rakic; Patricia (New Haven, CT), Hunt; Robert H. (Nashville, TN) Patent Number: 5,854,290 Date filed: September 21, 1995 Abstract: Disclosed is a method of treating disorders which have prominent symptoms of behavioral disinhibition (e.g., Attention-Deficit Hyperactivity Disorder, Conduct Disorder, Oppositional Defiant Disorder, Tourette's Syndrome, Lesch-Nyhan Syndrome, or the disinhibitory symptoms accompanying Post-traumatic Stress Disorder or dementia) in a primate with minimal sedative side effects by administering thereto a therapeutically effective amount of guanfacine. Excerpt(s): Attention-Deficit/Hyperactivity is a major disorder of childhood which often continues into the adult years. Patients with Attention-Deficit/Hyperactivity have difficulty concentrating and organizing their behavior. In addition, they are impulsive and easily distracted. Some display major hyperactivity while others outgrow or never show the motor symptoms. Attention-Deficit/Hyperactivity affects about 3.5 million children and adolescents in the United States, about half of whom retain attentional difficulties into adulthood (Cantwell and Baker, 1988). Attention-Deficit/Hyperactivity can result in low selfe-steem, poor relationships with peers and adults, and inferior performance in school. These difficulties can lead to serious emotional problems, truancy, drug abuse and criminal behavior (Pelham and Murphy, 1986). Moreover, the symptoms of Attention-Deficit/Hyperactivity commonly accompany those of Conduct Disorder (inappropriate aggression) and Tourette's Syndrome (inappropriate movements). Many of these same symptoms of disinhibited, inappropriate behaviors are also observed in elderly, demented individuals (e.g., agitation, wandering, inappropriate aggression). These disinhibited behaviors pose a serious problem to nursing homes and other caregivers. This spectrum of disinhibited behaviors may arise from a dysfunction of the prefrontal cortex (A. F. T. Arnsten, J. C. Steere and R. Hunt, 1995). The prefrontal cortex projects to the brain's motor areas (striatum, motor cortices; Goldman-Rakic, P. S. et al., (1992) The Prefrontal Cortex and Internally Generated Motor Acts, Current Opinion Neurobiol. 2:830-835) and thus functions to guide behavior appropriately. In addition, the prefrontal cortex may perform this function for intellectual and affective behaviors. Degeneration of the prefrontal cortex may produce disinhibited behavior in elderly demented individuals, while altered development of these systems may lead to childhood disorders such as Attention-Deficit/Hyperactivity, Conduct Disorder, and Tourette's Syndrome. Because recent research efforts have focused almost exclusively on developing treatments for the memory problems of dementia, there have been few new treatments for this spectrum of disorders. This focus has resulted in little research directed to the disorders of childhood. AttentionDeficit/Hyperactivity is usually treated with methylphenidate (Ritalin.TM. commercially available from Ciba Pharmaceutical), an amphetamine-like compound
Patents 29
which is helpful for many patients (Hunt et al., 1991). However, methylphenidate has many deleterious side-effects including insomnia, appetite suppression, irritability, attentional "sticking", perseverative thoughts, increased aggression, and stunted growth (Hunt, R. D. (1988) Attention Deficit Disorder: Diagnosis, Assessment and Treatment. In Handbook of Clinical Assessment of Children and Adolescents--A Biopsychosocial Approach. C. Kestenbaum and D. Williams (eds.), pp. 519-561; McBurnett et al., 1991; Tannock and Schachar, 1992). Moreover, methylphenidate is contraindicated in patients with Conduct Disorder or Tourette's Syndrome because it can aggravate aggression and tics. Because many patients cannot tolerate methylphenidate, or find it only partially effective, alternative medications would be beneficial. Web site: http://www.delphion.com/details?pn=US05854290__
Patent Applications on Oppositional Defiant Disorder As of December 2000, U.S. patent applications are open to public viewing.5 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to oppositional defiant disorder: •
Method of profiling genes as risk factors for attention deficit hyperactivity disorder Inventor(s): Comings, David E.; (Duarte, CA) Correspondence: Rothwell, Figg, Ernst & Manbeck, P.C.; 555 13th Street, N.W.; Suite 701, East Tower; Washington; DC; 20004; US Patent Application Number: 20020045171 Date filed: April 5, 2001 Abstract: The present invention relates to methods of profiling candidate genes as risk factors for attention deficit hyperactivity disorder, oppositional defiant disorder and conduct disorder. In one embodiment, the invention relates to a method of determining a genetic predisposition of a subject to ADHD, comprising detecting at least one allele from the group comprising the TPH, PNMT, ADO42A, NOS3, and NAT1 genes. By focusing on the additive effect of multiple genes and on the cumulative effect of functionally related groups of genes, a powerful approach is provided for the dissection of the genetic basis of ADHD, ODD and CD. Excerpt(s): This application is related to provisional application Serial No. 60/195,312, filed Apr. 10 , 2000, which is incorporated herein by reference. Attention deficit hyperactivity disorder is the most common behavioral disorder affecting children. Recent twin studies have indicated that 75 to 90 percent of the variance of ADHD is attributable to additive genetic factors (Stevenson 1992; Stevenson 1993; Sherman et al. 1997a; Sherman et al. 1997b, Gillis et al. 1992; and Hudziak et al. 1997). The publications and other materials used herein to illuminate the background of the invention or provide additional details respecting its practice, are incorporated by reference, and for convenience are respectively grouped in the appended Lists of References. Some of the specific genes involved are just beginning to be identified. They include the dopamine D.sub.2 receptor (DRD2) (Comings et al. 1991; 1996a), dopamine D.sub.4 receptor (DRD4) (Lahoste et al. 1996; Swanson et al. 1998; Rowe et al. 1998; Faraone et al. 1998),
5
This has been a common practice outside the United States prior to December 2000.
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Oppositional Defiant Disorder
dopamine D.sub.5 receptor (DRD5) (Daly et al. 1999), dopamine transporter (DAT1) (Cook et al. 1995; Comings et al. 1996a; Gill et al. 1997; Waldman et al. 1996; Daly et al. 1999), dopamine.beta.-hydroxylase (Comings et al. 1996a; Daly et al. 1999), adrenergic.alpha.2A (Comings et al. 1999a), adrenergic.alpha.2C (Comings et al. 1999b), and monoamine oxidase A (Comings et al. 1999a). Some studies for these genes have been negative (Lau et al. 1997). Most complex behavioral disorders are inherited as polygenic traits interacting with the environment. A major characteristic of polygenic inheritance is that multiple genes are involved with each gene contributing a small effect. The effects can be additive, heterotic (over-dominant) or epistatic. While numerous examples of epistasis have been reported, the additive effects and heterotic effects are considered to be predominant (Falconer 1981; Loehlin 1992; Lynch 1998). A phenotypic effect is obtained when an individual inherits enough of these genes to exceed a threshold that puts them at increased risk of expressing a given trait (Falconer 1965). The major implications of such a model are that studies that examine one gene at a time provide an incomplete picture, and tend to produce a series of both successful and unsuccessful attempts at replication. The present study is based on the assumption that the most effective way to identify the individual genes and groups of genes for disorders that are due to the additive effect of multiple genes is to study the additive effect of multiple candidate genes. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Use of Molindone to Treat Oppositional Defiant Disorder and Conduct Disorder Inventor(s): Comings, David E.; (Monrovia, CA), Kovacs, Bruce; (Long Beach, CA), Macmurry, Jim; (Claremont, CA) Correspondence: Birch Stewart Kolasch & Birch; PO Box 747; Falls Church; VA; 220400747; US Patent Application Number: 20020156078 Date filed: April 19, 2002 Abstract: A method for treating the psychiatric disorders known as oppositional defiant disorder and conduct disorder is disclosed. The method comprises the administration of molindone or a pharmaceutically acceptable salt of molindone to a patient suffering from oppositional defiant disorder and/or conduct disorder. The molindone may be either a racemic mixture or the levorotatory form. It may be short acting or in a sustained release, long acting form. Excerpt(s): This application claims priority on provisional Application No. 60/285,374 filed on Apr. 20, 2001, the entire contents of which are hereby incorporated by reference. Oppositional defiant disorder (ODD) and Conduct disorder (CD) are two of the most common psychiatric disorders affecting children and adolescents. Rates of ODD range from 2 to 16% depending on the nature of the population sample and methods of ascertainment. Rates of CD are in the same range. This translates into many millions of cases. The Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) characteristics of ODD include short temper, constant arguing with adults, defying rules, deliberately annoying others, blaming others for their own mistakes, being angry and resentful, spiteful and vindictive. In its severe form such children can be highly destructive to family life. Despite these characteristics no pharmaceutical companies market any medications specifically for ODD, and the majority of child psychiatrists feel it is largely a psychological disorder and make no effort to treat it medically. The Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV)
Patents 31
characteristics of CD are a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate norms or rules are violated, as manifested by the presence of three or more of a range of criteria for 12 months. These include aggression to people and animals (bullying, threatening, starting fights, using a weapon to cause harm, being cruel to animal or people, stealing, forcing others into sexual activity), destruction of property, fire setting, deceitfulness or theft (broken into homes or property, stealing things of value), and serious violation of rules (staying out over night when less than 13 years of age, running away from home, truant from school before age 13). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Keeping Current In order to stay informed about patents and patent applications dealing with oppositional defiant disorder, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “oppositional defiant disorder” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on oppositional defiant disorder. You can also use this procedure to view pending patent applications concerning oppositional defiant disorder. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
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CHAPTER 4. DISORDER
BOOKS
ON
OPPOSITIONAL
DEFIANT
Overview This chapter provides bibliographic book references relating to oppositional defiant disorder. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on oppositional defiant disorder include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “oppositional defiant disorder” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “oppositional defiant disorder” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “oppositional defiant disorder” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
Conduct and Oppositional Defiant Disorders: Epidemiology, Risk Factors, and Treatment by Cecilia A. Essau (Editor) (2003); ISBN: 0805840613; http://www.amazon.com/exec/obidos/ASIN/0805840613/icongroupinterna
•
The Defiant Child: A Parent's Guide to Oppositional Defiant Disorder by Douglas A. Riley; ISBN: 0878339639; http://www.amazon.com/exec/obidos/ASIN/0878339639/icongroupinterna
•
Treating Conduct and Oppositional Defiant Disorders in Children (1990); ISBN: 0080364381; http://www.amazon.com/exec/obidos/ASIN/0080364381/icongroupinterna
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•
Treating Conduct and Oppositional Defiant Disorders in Children by Arthur M. Horne; ISBN: 0080364373; http://www.amazon.com/exec/obidos/ASIN/0080364373/icongroupinterna
•
Treating the Disruptive Adolescent: Finding the Real Self Behind Oppositional Defiant Disorders by Eduardo M. Bustamante (2000); ISBN: 0765702355; http://www.amazon.com/exec/obidos/ASIN/0765702355/icongroupinterna
•
What Parents Need to Know About Odd: Up-To-Date Insights and Ideas for Managing Oppositional Defiant Disorder and Other Defiant Behaviors by James D. Sutton (2003); ISBN: 1878878638; http://www.amazon.com/exec/obidos/ASIN/1878878638/icongroupinterna
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APPENDICES
37
APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute6: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
•
National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
•
National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
•
National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
•
National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
•
National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
•
National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
•
National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
6
These publications are typically written by one or more of the various NIH Institutes.
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Oppositional Defiant Disorder
•
National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
•
National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
•
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
•
National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
•
National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
•
Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
•
National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
•
National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
•
Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
•
Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
Physician Resources
39
NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.7 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:8 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
•
HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
•
NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
•
Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
•
Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
•
Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
•
Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
•
Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
•
Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
•
Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
•
MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
7
Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 8 See http://www.nlm.nih.gov/databases/databases.html.
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Oppositional Defiant Disorder
•
Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
•
Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html
The NLM Gateway9 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.10 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “oppositional defiant disorder” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 8118 19 705 1 5 8848
HSTAT11 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.12 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.13 Simply search by “oppositional defiant disorder” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
9
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
10
The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 11 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 12 13
The HSTAT URL is http://hstat.nlm.nih.gov/.
Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.
Physician Resources
41
Coffee Break: Tutorials for Biologists14 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.15 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.16 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
•
Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
14 Adapted 15
from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.
The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 16 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
43
APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on oppositional defiant disorder can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.
Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to oppositional defiant disorder. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to oppositional defiant disorder. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “oppositional defiant disorder”:
44
Oppositional Defiant Disorder
•
Other guides Attention Deficit Disorder with Hyperactivity http://www.nlm.nih.gov/medlineplus/attentiondeficitdisorderwithhyperactivity.t ml Bipolar Disorder http://www.nlm.nih.gov/medlineplus/bipolardisorder.html Child Behavior Disorders http://www.nlm.nih.gov/medlineplus/childbehaviordisorders.html Teen Mental Health http://www.nlm.nih.gov/medlineplus/teenmentalhealth.html
You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to oppositional defiant disorder. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
•
Family Village: http://www.familyvillage.wisc.edu/specific.htm
•
Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
•
Med Help International: http://www.medhelp.org/HealthTopics/A.html
•
Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
•
Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
•
WebMDHealth: http://my.webmd.com/health_topics
Patient Resources
45
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to oppositional defiant disorder. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with oppositional defiant disorder. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about oppositional defiant disorder. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “oppositional defiant disorder” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “oppositional defiant disorder”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “oppositional defiant disorder” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.
46
Oppositional Defiant Disorder
The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “oppositional defiant disorder” (or a synonym) into the search box, and click “Submit Query.”
47
APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.17
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
17
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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Oppositional Defiant Disorder
libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)18: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
•
Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
•
Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
•
California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
•
California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
•
California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
•
California: Gateway Health Library (Sutter Gould Medical Foundation)
•
California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
•
California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
•
California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
•
California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
•
California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
•
California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
•
California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
•
California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
•
Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
•
Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
•
Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
18
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
Finding Medical Libraries
49
•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
•
Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
•
Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
•
Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
•
Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
•
Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
•
Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
•
Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
•
Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
•
Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
•
Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
•
Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
•
Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
•
Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
•
Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
•
Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
•
Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
•
Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
•
Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
•
Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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•
Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
•
Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
•
Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
•
Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
•
Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
•
Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
•
Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
•
Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
•
Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
•
Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
•
Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
•
Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
•
Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
•
Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
•
Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
•
Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
•
National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
•
National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
•
National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
Finding Medical Libraries
51
•
Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
•
New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
•
New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
•
New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
•
New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
•
New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
•
New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
•
New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
•
New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
•
Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
•
Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
•
Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
•
Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
•
Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
•
Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
•
Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
•
Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
•
Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
•
Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
•
Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
52
Oppositional Defiant Disorder
•
South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
•
Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
•
Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
•
Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
53
ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
•
MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
•
Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
•
On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
•
Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
•
Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
•
MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
•
Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
•
Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
55
OPPOSITIONAL DEFIANT DISORDER DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Aberrant: Wandering or deviating from the usual or normal course. [EU] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adolescent Behavior: Any observable response or action of an adolescent. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Ameliorating: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Amniotic Fluid: Amniotic cavity fluid which is produced by the amnion and fetal lungs and kidneys. [NIH] Amphetamine: A powerful central nervous system stimulant and sympathomimetic. Amphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulation of release of monamines, and inhibiting monoamine oxidase. Amphetamine is also a drug of abuse and a psychotomimetic. The l- and the d,l-forms are included here. The l-form has less central nervous system activity but stronger cardiovascular effects. The d-form is dextroamphetamine. [NIH] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anomalies: Birth defects; abnormalities. [NIH] Antecedent: Existing or occurring before in time or order often with consequential effects. [EU]
Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
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Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antihypertensive: An agent that reduces high blood pressure. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiety Disorders: Disorders in which anxiety (persistent feelings of apprehension, tension, or uneasiness) is the predominant disturbance. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Atrial: Pertaining to an atrium. [EU] Auditory: Pertaining to the sense of hearing. [EU] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Biological Markers: Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc. [NIH] Biomarkers: Substances sometimes found in an increased amount in the blood, other body fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH]
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Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. [NIH] Birth Certificates: Official certifications by a physician recording the individual's birth date, place of birth, parentage and other required identifying data which are filed with the local registrar of vital statistics. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Carcinogenic: Producing carcinoma. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Causal: Pertaining to a cause; directed against a cause. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Child Development: The continuous sequential physiological and psychological maturing of the child from birth up to but not including adolescence. It includes healthy responses to situations, but does not include growth in stature or size (= growth). [NIH] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]
Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH]
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Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cortices: The outer layer of an organ; used especially of the cerebrum and cerebellum. [NIH] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cost Savings: Reductions in all or any portion of the costs of providing goods or services. Savings may be incurred by the provider or the consumer. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH]
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Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dextroamphetamine: The d-form of amphetamine. It is a central nervous system stimulant and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diastolic blood pressure: The minimum pressure that remains within the artery when the heart is at rest. [NIH] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Dissection: Cutting up of an organism for study. [NIH] Dominance: In genetics, the full phenotypic expression of a gene in both heterozygotes and homozygotes. [EU] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dose-dependent: Refers to the effects of treatment with a drug. If the effects change when the dose of the drug is changed, the effects are said to be dose dependent. [NIH] Duct: A tube through which body fluids pass. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing
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radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemiologic Studies: Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are case-control studies, cohort studies, and cross-sectional studies. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epistasis: The degree of dominance exerted by one gene on the expression of a non-allelic gene. [NIH] Escalation: Progressive use of more harmful drugs. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Fossa: A cavity, depression, or pit. [NIH] Frontal Lobe: The anterior part of the cerebral hemisphere. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Gestational Age: Age of the conceptus. In humans, this may be assessed by medical history, physical examination, early immunologic pregnancy tests, radiography, ultrasonography, and amniotic fluid analysis. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are
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different for each type of cancer. [NIH] Gravidity: Pregnancy; the condition of being pregnant, without regard to the outcome. [EU] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Guanfacine: A centrally acting antihypertensive agent. The drug lowers both systolic and diastolic blood pressure by activating the central nervous system alpha-2 adrenoreceptors, which results in reduced sympathetic outflow leading to reduced vascular tone. Its adverse reactions include dry mouth, sedation, and constipation. [NIH] Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Intracellular: Inside a cell. [NIH]
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Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Limbic: Pertaining to a limbus, or margin; forming a border around. [EU] Limbic System: A set of forebrain structures common to all mammals that is defined functionally and anatomically. It is implicated in the higher integration of visceral, olfactory, and somatic information as well as homeostatic responses including fundamental survival behaviors (feeding, mating, emotion). For most authors, it includes the amygdala, epithalamus, gyrus cinguli, hippocampal formation (see hippocampus), hypothalamus, parahippocampal gyrus, septal nuclei, anterior nuclear group of thalamus, and portions of the basal ganglia. (Parent, Carpenter's Human Neuroanatomy, 9th ed, p744; NeuroNames, http://rprcsgi.rprc.washington.edu/neuronames/index.html (September 2, 1998)). [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membranes: Thin layers of tissue which cover parts of the body, separate adjacent cavities, or connect adjacent structures. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH]
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Mental Health: The state wherein the person is well adjusted. [NIH] Mental Health Services: Organized services to provide mental health care. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Methylphenidate: A central nervous system stimulant used most commonly in the treatment of attention-deficit disorders in children and for narcolepsy. Its mechanisms appear to be similar to those of dextroamphetamine. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Monoamine Oxidase: An enzyme that catalyzes the oxidative deamination of naturally occurring monoamines. It is a flavin-containing enzyme that is localized in mitochondrial membranes, whether in nerve terminals, the liver, or other organs. Monoamine oxidase is important in regulating the metabolic degradation of catecholamines and serotonin in neural or target tissues. Hepatic monoamine oxidase has a crucial defensive role in inactivating circulating monoamines or those, such as tyramine, that originate in the gut and are absorbed into the portal circulation. (From Goodman and Gilman's, The Pharmacological Basis of Therapeutics, 8th ed, p415) EC 1.4.3.4. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon,
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and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Normal Distribution: Continuous frequency distribution of infinite range. Its properties are as follows: 1) continuous, symmetrical distribution with both tails extending to infinity; 2) arithmetic mean, mode, and median identical; and 3) shape completely determined by the mean and standard deviation. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Parent-Child Relations: The interactions between parent and child. [NIH] Parity: The number of offspring a female has borne. It is contrasted with gravidity, which refers to the number of pregnancies, regardless of outcome. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH]
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Polygenic Inheritance: A phenotypic outcome that is determined by more than one gene, such as a variety of physical characteristics or diseases. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Prefrontal Cortex: The rostral part of the frontal lobe, bounded by the inferior precentral fissure in humans, which receives projection fibers from the mediodorsal nucleus of the thalamus. The prefrontal cortex receives afferent fibers from numerous structures of the diencephalon, mesencephalon, and limbic system as well as cortical afferents of visual, auditory, and somatic origin. [NIH] Pregnancy Tests: Tests to determine whether or not an individual is pregnant. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Prognostic factor: A situation or condition, or a characteristic of a patient, that can be used to estimate the chance of recovery from a disease, or the chance of the disease recurring (coming back). [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Proportional: Being in proportion : corresponding in size, degree, or intensity, having the same or a constant ratio; of, relating to, or used in determining proportions. [EU] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH]
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Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychopathology: The study of significant causes and processes in the development of mental illness. [NIH] Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychotomimetic: Psychosis miming. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiography: Examination of any part of the body for diagnostic purposes by means of roentgen rays, recording the image on a sensitized surface (such as photographic film). [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be
Dictionary 67
cancer in the body. [NIH] Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Single Parent: A natural, adoptive, or substitute parent of a dependent child, who lives with only one parent. The single parent may live with or visit the child. The concept includes the never-married, as well as the divorced and widowed. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by
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Oppositional Defiant Disorder
refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]
Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Striatum: A higher brain's domain thus called because of its stripes. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]
Sumatriptan: A serotonin agonist that acts selectively at 5HT1 receptors. It is used in the treatment of migraines. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Survival Analysis: A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symptomatology: 1. That branch of medicine with treats of symptoms; the systematic discussion of symptoms. 2. The combined symptoms of a disease. [EU] Synchrony: The normal physiologic sequencing of atrial and ventricular activation and contraction. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU]
Dictionary 69
Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Telencephalon: Paired anteriolateral evaginations of the prosencephalon plus the lamina terminalis. The cerebral hemispheres are derived from it. Many authors consider cerebrum a synonymous term to telencephalon, though a minority include diencephalon as part of the cerebrum (Anthoney, 1994). [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Thalamus: Paired bodies containing mostly gray substance and forming part of the lateral wall of the third ventricle of the brain. The thalamus represents the major portion of the diencephalon and is commonly divided into cellular aggregates known as nuclear groups. [NIH]
Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Treatment Failure: A measure of the quality of health care by assessment of unsuccessful results of management and procedures used in combating disease, in individual cases or series. [NIH] Tumor marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body. Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH] Tyramine: An indirect sympathomimetic. Tyramine does not directly activate adrenergic receptors, but it can serve as a substrate for adrenergic uptake systems and monoamine oxidase so it prolongs the actions of adrenergic transmitters. It also provokes transmitter release from adrenergic terminals. Tyramine may be a neurotransmitter in some invertebrate nervous systems. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10
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Oppositional Defiant Disorder
megahertz. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasodilator: An agent that widens blood vessels. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricular: Pertaining to a ventricle. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Vital Statistics: Used for general articles concerning statistics of births, deaths, marriages, etc. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH]
71
INDEX A Aberrant, 6, 55 Adolescence, 4, 5, 7, 13, 14, 16, 55, 57 Adolescent Behavior, 7, 12, 55 Adrenal Cortex, 55, 58 Adrenergic, 30, 55, 59, 60, 68, 69 Adverse Effect, 55, 67 Afferent, 55, 65 Agonist, 55, 59, 68 Alkaloid, 55, 57 Ameliorating, 14, 55 Amniotic Fluid, 55, 60 Amphetamine, 28, 55, 59 Anal, 55, 60, 62 Anatomical, 55, 61 Anomalies, 5, 6, 55 Antecedent, 11, 55 Antibacterial, 55, 68 Antibiotic, 55, 68 Antibody, 56, 61 Antigen, 56, 61 Antihypertensive, 56, 61 Anxiety, 4, 5, 8, 26, 56 Anxiety Disorders, 4, 56 Arterial, 56, 65, 69 Arteries, 56, 58, 63 Astrocytes, 56, 63 Atrial, 56, 68 Auditory, 56, 65 B Bacteria, 55, 56, 68, 70 Basal Ganglia, 11, 56, 62 Base, 56, 62, 69 Biological Markers, 4, 56 Biomarkers, 5, 56 Bipolar Disorder, 5, 44, 57 Birth Certificates, 12, 57 Body Fluids, 56, 57, 59, 69 Brain Stem, 57 Branch, 51, 57, 59, 66, 67, 68 C Carcinogenic, 57, 61, 68 Cardiovascular, 55, 57, 67 Catecholamine, 57, 59 Causal, 5, 13, 57, 60 Cell, 55, 56, 57, 61, 63, 64, 66, 69 Central Nervous System, 6, 14, 55, 57, 59, 60, 61, 63, 67
Cerebellar, 11, 57 Cerebellum, 11, 57, 58 Cerebral, 56, 57, 60, 69 Cerebrum, 57, 58, 69 Child Development, 12, 57 Chromosome, 5, 57 Chronic, 13, 57, 61, 62, 68 Clinical Medicine, 57, 65 Clinical trial, 3, 39, 57, 58, 66 Coca, 57 Cocaine, 7, 57 Cofactor, 58, 65 Comorbidity, 6, 10, 15, 22, 26, 58 Computational Biology, 39, 58 Connective Tissue, 58, 60 Consciousness, 58, 59 Constipation, 58, 61 Contraindications, ii, 58 Control group, 15, 58 Coordination, 57, 58 Coronary, 58, 63 Coronary Thrombosis, 58, 63 Cortex, 28, 58, 60, 65 Cortical, 58, 65 Cortices, 28, 58 Cortisol, 22, 58 Cost Savings, 16, 58 Cranial, 57, 58, 64 D Databases, Bibliographic, 39, 58 Deamination, 58, 63 Delusions, 59, 66 Dementia, 28, 59 Dextroamphetamine, 18, 55, 59, 63 Diagnostic procedure, 27, 59 Diastolic, 59, 61 Diastolic blood pressure, 59, 61 Diencephalon, 59, 65, 69 Direct, iii, 57, 59, 66 Discrimination, 8, 59 Dissection, 29, 59 Dominance, 59, 60 Dopamine, 11, 29, 55, 57, 59, 63 Dose-dependent, 11, 59 Duct, 59, 67 E Efficacy, 7, 14, 59 Electrophysiological, 6, 15, 59
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Empirical, 4, 13, 24, 59 Environmental Exposure, 56, 59 Environmental Health, 38, 40, 60 Enzyme, 56, 60, 63 Epidemiologic Studies, 56, 60 Epidemiological, 9, 60 Epinephrine, 55, 59, 60, 64, 69 Epistasis, 30, 60 Escalation, 16, 60 Excitation, 6, 60 Extrapyramidal, 59, 60 F Family Planning, 39, 60 Fetus, 60, 65 Fissure, 60, 65 Fossa, 57, 60 Frontal Lobe, 60, 65 G Ganglia, 11, 60, 63, 64 Gastrointestinal, 60, 67, 68, 69 Gene, 30, 56, 59, 60, 65 Genetics, 11, 21, 59, 60 Genotype, 60, 64 Gestational, 8, 60 Gestational Age, 8, 60 Governing Board, 60, 65 Grade, 12, 60 Gravidity, 61, 64 Growth, 5, 7, 29, 55, 57, 61, 64 Guanfacine, 28, 61 H Health Promotion, 7, 61 Heredity, 60, 61 Hormone, 56, 58, 60, 61 I Id, 44, 50, 52, 61 Immune response, 56, 61, 68, 70 Immunodeficiency, 9, 61 Immunologic, 60, 61 Impairment, 4, 22, 61, 62, 66 Indicative, 6, 14, 33, 61, 70 Infarction, 58, 61, 63 Infection, 9, 61, 62, 68 Initiation, 7, 11, 13, 16, 61 Inotropic, 59, 61 Insight, 14, 61 Insomnia, 29, 61 Intermittent, 61, 62 Intracellular, 61 K Kb, 38, 62
L Latent, 5, 62, 65 Library Services, 50, 62 Limbic, 62, 65 Limbic System, 62, 65 Liver, 62, 63 Localized, 61, 62, 63, 64 Longitudinal study, 5, 23, 62 Long-Term Care, 5, 62 Lymphatic, 61, 62 M Manic, 57, 62, 66 Manic-depressive psychosis, 62, 66 Manifest, 15, 62 Mediate, 59, 62 MEDLINE, 39, 62 Membranes, 62, 63 Memory, 5, 28, 59, 62 Meninges, 57, 62 Mental Disorders, 4, 6, 8, 30, 62, 66 Mental Health, iv, 3, 7, 14, 15, 38, 40, 44, 63, 66 Mental Health Services, iv, 3, 15, 40, 63 Meta-Analysis, 14, 63 Methylphenidate, 11, 28, 63 MI, 53, 63 Modeling, 5, 7, 8, 14, 63 Molecular, 11, 39, 41, 58, 63 Molecule, 56, 60, 63, 66 Monoamine, 21, 30, 55, 59, 63, 69 Monoamine Oxidase, 30, 55, 59, 63, 69 Morphology, 6, 63 Myocardium, 63 N Narcolepsy, 59, 63 Necrosis, 61, 63 Need, 34, 45, 63 Nerve, 55, 63, 68, 69 Nervous System, 55, 57, 63, 64, 68, 69 Neural, 6, 55, 63 Neurons, 57, 60, 63 Norepinephrine, 55, 59, 64 Normal Distribution, 15, 64 Nuclear, 56, 62, 63, 64, 69 Nucleus, 64, 65 P Pancreas, 56, 64, 69 Parent-Child Relations, 10, 13, 64 Parity, 8, 64 Pathophysiology, 15, 64 Peripheral Nervous System, 64, 68 Pharmacologic, 64, 69
Index 73
Phenotype, 5, 56, 64 Physical Examination, 60, 64 Physiologic, 55, 64, 66, 68 Physiology, 56, 59, 64 Pilot study, 9, 20, 64 Plants, 55, 57, 63, 64, 69 Polygenic Inheritance, 30, 65 Posterior, 55, 57, 64, 65 Practice Guidelines, 40, 65 Precursor, 11, 19, 59, 64, 65, 69 Predisposition, 6, 29, 65 Prefrontal Cortex, 28, 65 Pregnancy Tests, 60, 65 Prenatal, 7, 12, 65 Prevalence, 15, 65 Prognostic factor, 65, 68 Progression, 11, 65 Progressive, 12, 59, 60, 61, 63, 65 Projection, 64, 65 Proportional, 5, 65 Prospective study, 4, 20, 62, 65 Prostate, 56, 65, 69 Protein S, 65 Protocol, 12, 13, 66 Psychiatric, 5, 7, 15, 19, 22, 30, 56, 62, 66 Psychiatry, 4, 5, 6, 10, 11, 14, 16, 17, 18, 19, 20, 21, 22, 23, 24, 66 Psychopathology, 4, 7, 10, 19, 66 Psychosis, 5, 60, 66 Psychotomimetic, 55, 59, 66 Public Health, 6, 9, 40, 66 Public Policy, 39, 66 R Race, 30, 66 Radiography, 60, 66 Randomized, 15, 16, 59, 66 Reality Testing, 66 Receptor, 29, 56, 59, 66, 67 Recurrence, 57, 62, 66 Refer, 1, 66 Refraction, 66, 68 Refractory, 16, 66 Regimen, 59, 66 Relapse, 6, 12, 13, 66 Remission, 57, 62, 66 Research Design, 10, 67 Risk factor, 8, 11, 13, 19, 29, 60, 65, 67 S Saliva, 67 Salivary, 22, 67 Schizophrenia, 5, 67 Screening, 22, 57, 67
Sedative, 28, 67 Sequencing, 67, 68 Serotonin, 63, 67, 68 Sex Characteristics, 55, 67 Sexually Transmitted Diseases, 9, 67 Side effect, 28, 55, 67, 69 Signs and Symptoms, 66, 67 Single Parent, 4, 67 Skull, 67, 69 Smooth muscle, 67, 68 Somatic, 55, 62, 64, 65, 67 Specialist, 45, 67 Species, 60, 66, 67 Spectrum, 14, 28, 67 Sperm, 57, 68 Spinal cord, 56, 57, 62, 63, 64, 68 Steroid, 58, 68 Stimulant, 11, 55, 59, 63, 68 Stimulus, 60, 68, 69 Stress, 4, 28, 57, 58, 65, 68 Striatum, 28, 68 Subacute, 61, 68 Subclinical, 61, 68 Substance P, 7, 68 Sumatriptan, 22, 68 Suppression, 29, 68 Survival Analysis, 7, 68 Sympathomimetic, 55, 59, 60, 64, 68, 69 Symptomatology, 6, 10, 20, 26, 68 Synchrony, 6, 68 Synergistic, 14, 68 Systemic, 60, 61, 69 Systolic, 61, 69 T Telencephalon, 56, 69 Temporal, 6, 19, 69 Thalamus, 59, 62, 65, 69 Threshold, 30, 69 Thrombosis, 65, 69 Tissue, 56, 58, 62, 63, 67, 68, 69 Toxic, iv, 60, 69 Toxicology, 40, 69 Toxins, 56, 61, 69 Transmitter, 56, 59, 64, 69 Treatment Failure, 13, 69 Tumor marker, 56, 69 Tyramine, 63, 69 Tyrosine, 59, 69 U Ultrasonography, 60, 69 Unconscious, 61, 70
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Oppositional Defiant Disorder
V Vaccine, 66, 70 Vascular, 61, 70 Vasodilator, 59, 70 Venous, 65, 70 Ventricular, 68, 70
Veterinary Medicine, 39, 70 Virus, 9, 70 Vital Statistics, 57, 70 Y Yeasts, 64, 70
Index 75
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Oppositional Defiant Disorder
