Prevalence of antimicrobial drug-resistant Streptococcus pneumoniae in Washington State.

We conducted a survey to assess the prevalence and geographic distribution of antimicrobial drug resistance among invasive isolates of Streptococcus pneumoniae in Washington State. Sequential sterile-site pneumococcal isolates were submitted from 13 hospital laboratories between 1 October 1995 and 30 January 1997. We serotyped 275 isolates from adults and children and determined minimum inhibitory concentrations (MIC) for commonly used antimicrobial drugs.

Negative life events and the adjustment of school-age children: testing protective models.

Investigated the association between negative life events and protective factors in predicting the adaptive, emotional, and behavioral functioning of school-age children. Three possible models of this relation were tested using hierarchical analyses: the compensatory model, the challenge model, and the immunity/vulnerability model. Participants were 140 children between the ages of 8 to 13.

Validity of DSM-IV subtypes of conduct disorder based on age of onset.

Objective: To present data from the DSM-IV field trials that led to the distinction between subtypes of conduct disorder (CD) that emerge in childhood or adolescence. In addition, data from a household sample were used to attempt to cross-validate these findings.

Method: Differences between youths who met criteria for the two subtypes of CD were examined in the field trials sample of 440 youths aged 4 through 17 years and in a household sample of 1,285 youths aged 9 through 17 years.

Validity of the age-of-onset criterion for ADHD: a report from the DSM-IV field trials.

Objective: To examine the validity of the DSM-IV requirement of an age of onset of impairment due to symptoms before 7 years of age for the diagnosis of attention-deficit/hyperactivity disorder (ADHD).

Method: The validity of this criterion was examined in a clinic sample of 380 youths aged 4 through 17 years by comparing youths who met symptom criteria for ADHD and either did or did not display impairment before age 7 years.

Results: Nearly all youths who met symptom criteria for the predominantly hyperactive-impulsive subtype also met the age of onset of impairment criterion, but 18% of youths who met symptom criteria for the combined type, and 43% of youths who met symptom criteria for the predominantly inattentive type, did not manifest impairment before 7 years.

Ineffective parenting and childhood conduct problems: the moderating role of callous-unemotional traits.

A sample of 6- to 13-year-old clinic-referred (n = 136) and volunteer (n = 30) participants was investigated for a potential interaction between the quality of parenting that a child receives and callous-unemotional traits in the child for predicting conduct problems. Ineffective parenting was associated with conduct problems only in children without significant levels of callous (e.g.

Algorithms used in adverse drug event reports: a comparative study.

Objective: To determine if and how the Kramer and Karch algorithms differ in assigning a probability that a published case was actually an adverse drug event (ADE), and to determine if these algorithms could be used to assess published ADEs.

Design: Open, single-rater comparison of Karch and Kramer algorithms in 200 published ADE reports.

Main Results: The algorithms were not significantly different regarding the proportion of cases deemed definite (p = 0.

Psychopathy and conduct problems in children: II. Implications for subtyping children with conduct problems.

Objective: To test whether the presence of callous and unemotional (CU) traits designates a unique subgroup of children with conduct problems that corresponds more closely to adult conceptualizations of psychopathy.

Method: A clinic-referred sample of 120 children between the ages of 6 and 13 years were assessed using parent and teacher ratings of CU traits, as well as parent and teacher report on a structured interview assessing oppositional defiant disorder (ODD) and conduct disorder (CD) symptoms.

Results: A cluster analysis of the ratings of CU traits and ODD/ CD symptoms revealed four clusters of children, two of which had high rates of ODD and CD symptoms.

Reward dominance: associations with anxiety, conduct problems, and psychopathy in children.

The associations between children's behavior and their performance on a task with a steadily increasing ratio of punished to rewarded responses was investigated in a group of clinic-referred (n = 92) and normal control (n = 40) children between the ages of 6 and 13. Clinic-referred children with an anxiety disorder played significantly fewer trials than clinic-referred children without an anxiety disorder but the response style of the anxious children did not differ from that of a normal control group. Children with severe conduct problems who had no anxiety disorder played more trials than (a) children with severe conduct problems and a comorbid anxiety disorder, (b) nonanxious children with attention-deficit hyperactivity disorder, and (c) children in the normal control group.

Developmental change in attention-deficit hyperactivity disorder in boys: a four-year longitudinal study.

One hundred six clinic-referred boys meeting criteria for DSM-III-R attention-deficit hyperactivity disorder (ADHD) (mean age 9.4 years) were assessed annually for 4 years using structured interviews of multiple informants. Hyperactivity-impulsivity symptoms declined with increasing age, but inattention symptoms did not.

Antisocial behavior, somatization, and sensation-seeking behavior in mothers of clinic-referred children.

Objective: The relationship between antisocial behavior and somatization was studied in a sample of mothers of clinic-referred, school-age children. The goal was to overcome some of the methodological limitations of past research in this area and to provide a preliminary test of the theory that these disorders share a common substrate: a tendency toward behavioral disinhibition.

Method: Structured diagnostic interviews and an objective personality measure were used to assess antisocial behavior and somatization in a sample of 90 biological mothers (mean age 34 years) of children referred to an outpatient mental health clinic.

Four-year longitudinal study of conduct disorder in boys: patterns and predictors of persistence.

A prospective study of conduct disorder (CD) was conducted using 4 annual structured diagnostic interviews of 171 clinic-referred boys, their parents, and their teachers. Only about half of the 65 boys who met criteria for CD in Year 1 met criteria again during the next year, but 88% met criteria for CD again at least once during the next 3 years. For most boys with CD, the number of symptoms fluctuated above and below the diagnostic threshold from year to year but remained relatively high.

Psychopathy and conduct problems in children.

Factor analysis of a measure of psychopathy was conducted in a sample of 95 clinic-referred children between the ages of 6 and 13 years. These analyses revealed 2 dimensions of behavior, one associated with impulsivity and conduct problems (I/CP) and one associated with the interpersonal and motivational aspects of psychopathy (callous/unemotional: CU). In a subset of this sample (n = 64), analyses indicated that scores on the I/CP factor were highly associated with traditional measures of conduct problems.

DSM-IV field trials for oppositional defiant disorder and conduct disorder in children and adolescents.

Objective: The purpose of the field trials for oppositional defiant disorder and conduct disorder was to select valid diagnostic thresholds for these disorders and to compare the psychometric properties of DSM-IV criteria for oppositional defiant disorder and conduct disorder with previous DSM diagnostic formulations.

Method: Structured diagnostic interviews, standardized clinician's validation diagnoses, and multiple measures of impairment were obtained for 440 clinic-referred children and adolescents aged 4-17 years.

Results: A diagnostic threshold of four symptoms of oppositional defiant disorder optimized identification of impaired children, improved agreement somewhat with the clinician's validation diagnosis, and had somewhat better test-retest agreement than DSM-III-R.

MMPI-2 profiles of adult children of alcoholics.

This study compared 69 adult children of alcoholics (ACOAs) with 30 control college students on scales from the revised MMPI (MMPI-2). ACOA subjects could be differentiated from control subjects on several MMPI-2 scales and two-scale profiles, many of which differentiate alcoholic from nonalcoholic samples. However, the length of time the child had lived in the home with the alcoholic parent and the degree of impairment associated with alcohol abuse in the parent did not moderate these findings.

DSM-IV field trials for the disruptive behavior disorders: symptom utility estimates.

Objective: We tested the predictive utility of symptoms for proposed DSM-IV definitions of the disruptive behavior disorders using indices corrected for symptom and diagnosis base rates.

Method: The field trials sample consisted of 440 clinic-referred youths who were consecutive referrals to a heterogeneous group of mental health clinics. Multiple informants were interviewed to determine the presence of symptoms and diagnoses.

[Spontaneous remission in chronic lymphatic leukemia].

We describe three patients with chronic lymphocytic leukemia who had a complete spontaneous remission, and review the cases reported in the literature. The mechanism leading to spontaneous remission is unknown, but it is speculated that the loss of a leukemia inducing oncogene or the reappearance of a leukemia suppressor gene could be involved. The interesting observation that, in some reported patients, the remission followed a viral infection, raises the question whether a virus-induced defense mechanism plays a causal role.

Oppositional defiant and conduct disorders: issues to be resolved for DSM-IV.

Oppositional defiant disorder (ODD) and conduct disorder (CD) are reasonably distinct both in terms of statistical covariation among symptoms and ages of onset. The two disorders are related in similar ways to impairment and family history of antisocial behavior, but the association is stronger for CD than ODD. Virtually all clinic-referred youths with prepubertal onset of CD have retained the symptoms of ODD that emerged at earlier ages.

Familial risk factors to oppositional defiant disorder and conduct disorder: parental psychopathology and maternal parenting.

In a sample of 177 clinic-referred children aged 7-13, an association was found between a diagnosis of conduct disorder (CD) and several aspects of family functioning: maternal parenting (supervision and persistence in discipline) and parental adjustment (paternal antisocial personality disorder and paternal substance abuse). Children with oppositional defiant disorder (ODD) were intermediate to families of children with CD and clinic control children on all variables, but differed from control children only in having a higher rate of paternal substance abuse and paternal antisocial personality disorder (APD). When both parental APD and deviant maternal parenting were entered into 2 x 2 logit-model analyses predicting CD, only parental APD was significantly associated with CD, and no interactions between parental adjustment and maternal parenting were found.

Methodological issues and learning disabilities diagnosis in clinical populations.

Previous research suggests that the diagnosis of a comorbid learning disability is dependent on the method used for making the LD diagnosis. This study investigated that proposition by studying the effects of using three approaches to the assessment of learning disabilities in a sample of 177 six- to thirteen-year-old boys referred to outpatient mental health clinics for behavior problems. The use of these three procedures to diagnose comorbid learning problems produced significantly different results.

Academic underachievement and the disruptive behavior disorders.

Academic underachievement (AU) was studied among 177 clinic-referred boys reliably diagnosed as having attention-deficit hyperactivity disorder (ADHD) or conduct disorder (CD). Unlike previous studies, the present study assessed AU using a formula that determined the discrepancy between a child's predicted level of achievement and actual level of achievement while controlling for regression and age effects. AU was associated with both ADHD and CD when the disorders were examined individually.