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1.  Perinatal complications in children with attention-deficit hyperactivity disorder and their unaffected siblings  
Objectives
Genetic and nonshared environmental factors (experienced by 1 family member to the exclusion of the others) have been strongly implicated in the causes of attention-deficit hyperactivity disorder (ADHD). Pregnancy, labour/delivery and neonatal complications (PLDNC) have often been associated with ADHD; however, no investigations aimed at delineating the shared or nonshared nature of these factors have been reported. We aimed to identify those elements of the PLDNC that are more likely to be of a nonshared nature.
Methods
We used an intrafamily study design, comparing the history of PLDNC between children diagnosed with ADHD, according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), and their unaffected siblings. Children with ADHD were recruited from the outpatient, day-treatment program of the Child Psychiatry Department, Douglas Hospital, Montréal. The unaffected sibling closest in age to the child with ADHD was used as a control. The history of PLDNC was assessed using the Kinney Medical and Gynecological Questionnaire and the McNeil–Sjöstrom Scale for both children with ADHD and their siblings. Seventy children with ADHD along with 50 of their unaffected siblings agreed to participate in the study. Child Behavior Checklist (CBCL), Continuous Performance Test (CPT) and Restricted Academic Situation Scale (RASS) scores were also used as measures of ADHD symptoms in children with ADHD.
Results
The children with ADHD had significantly higher rates of neonatal complications compared with their unaffected siblings (F4,196 = 3.67, p < 0.006). Furthermore, neonatal complications in the children with ADHD were associated with worse CBCL total and externalizing scores and with poorer performance on the CPT.
Conclusions
These results suggest that neonatal complications are probably a nonshared environmental risk factor that may be pathogenic in children with ADHD.
PMCID: PMC551167  PMID: 15798787
attention deficit disorder with hyperactivity; child; perinatal care; pregnancy complications; siblings
2.  Catechol-O-Methyltransferase (COMT) Val108/158 Met polymorphism does not modulate executive function in children with ADHD 
BMC Medical Genetics  2004;5:30.
Background
An association has been observed between the catechol-O-methyltransferase (COMT) gene, the predominant means of catecholamine catabolism within the prefrontal cortex (PFC), and neuropsychological task performance in healthy and schizophrenic adults. Since several of the cognitive functions typically deficient in children with Attention Deficit Hyperactivity Disorder (ADHD) are mediated by prefrontal dopamine (DA) mechanisms, we investigated the relationship between a functional polymorphism of the COMT gene and neuropsychological task performance in these children.
Methods
The Val108/158 Met polymorphism of the COMT gene was genotyped in 118 children with ADHD (DSM-IV). The Wisconsin Card Sorting Test (WCST), Tower of London (TOL), and Self-Ordered Pointing Task (SOPT) were employed to evaluate executive functions. Neuropsychological task performance was compared across genotype groups using analysis of variance.
Results
ADHD children with the Val/Val, Val/Met and Met/Met genotypes were similar with regard to demographic and clinical characteristics. No genotype effects were observed for WCST standardized perseverative error scores [F2,97 = 0.67; p > 0.05], TOL standardized scores [F2,99 = 0.97; p > 0.05], and SOPT error scores [F2,108 = 0.62; p > 0.05].
Conclusions
Contrary to the observed association between WCST performance and the Val108/158 Met polymorphism of the COMT gene in both healthy and schizophrenic adults, this polymorphism does not appear to modulate executive functions in children with ADHD.
doi:10.1186/1471-2350-5-30
PMCID: PMC544598  PMID: 15613245
3.  Child and Parent Variables Associated with Treatment Response in Narcissistic Youths: The Role of Self-Blame and Shame 
Introduction
this retrospective study aimed at exploring the impact of parental and youth narcissism on service utilization and response to psychotherapy.
Method
thirty-six 9–13 years-old narcissistic youths receiving a combined treatment (psychodynamic psychotherapy + parental counselling) were independently assessed for child pathological narcissism, parental narcissism, child’s treatment attitude and psychiatric/ psychosocial services utilization.
Results
Parent and child narcissistic characteristics were negatively correlated with the use of OPD services. Child self-blame and lack of empathy predicted a lesser OPD utilization. Child pathological narcissism was significantly correlated with the specific treatment response pattern composed of the set of attitudes consistently observed in psychotherapy with narcissistic youths. Sixty percent of the variance in treatment response was accounted for by four narcissistic characteristics of the child: devaluation of others, avoidance of vulnerability, boredom, and self-blame. Post hoc analyses highlighted the role of the child’s self-blame, which mediated the relation between parental narcissism and service use while acting as a moderator in reversing the relation between parent narcissism and treatment response. Relationships between self-blame, shame-proneness and guilt, and limitations of the study are discussed.
Conclusion
Prospective studies with a larger sample are needed to confirm the association between self-blame and response to treatment in narcissistic youths.
PMCID: PMC2538739  PMID: 19030505
narcissism; shame; self-blame; personality disorder; psychotherapy outcome; parent-child relationship; narcissisme; honte; auto-dévaluation; troubles de personnalité; résultats de psychothérapie; relation parent-enfant
4.  Sensitivity of Tests to Assess Improvement In ADHD Symptomatology 
Objective
To assess which measurements best predict improvement on ADHD symptomatology after medication is given.
Methods
147 children aged 6 to 12 years, diagnosed with ADHD, participated in a double-blind placebo controlled twoweek crossover trial of methylphenidate.
Results
There were statistically significant differences on all measures between placebo and medication. Effect size for the overall group was 0.33 (CGI-P), 0.80 (CGI-T), 1.33 (CGI), 0.56 (CPT), 0.82 (RASS).
Conclusions
Acute behavioural response measures, where children are observed by clinicians (RASS and CGI), were overall more reliable than parent reports in detecting improvement on ADHD symptomatology. Teacher reports were also very important, especially in the 9 to 12 year old group.
PMCID: PMC2538631  PMID: 19030484
Attention Deficit Hyperactive Disorder; medication response; methylphenidate; trouble déficitaire de l’attention avec hyperactivité; réponse à la médication; méthylphénidate

Results 1-4 (4)