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Fifty children and adolescents with emotional and behavioral disorders (EBD) were assessed for depression and comorbid disorders using a structured interview, the Diagnostic Interview Schedule for Children (DISC), and a self-report measure of depression, the Mood and Feelings Questionnaire (MFQ). The resulting diagnoses and depression ratings were compared to those generated by experienced clinicians, and Kappa coefficients were derived from cross-tabulated frequencies of the DISC and clinician diagnoses. Diagnoses comparisons were made for 26 DSM-III-R categories and nine diagnostic classes. Diagnostic concordance was lowest for affective disorders, whereas higher concordance levels were identified for disruptive behavior and substance abuse disorders. Despite a sample with a high degree of comorbidity, 26% of the participants received no diagnosis on the DISC; however, the DISC generated a higher frequency and greater divergence of diagnoses per participant than did clinicians. The concordance among the three procedures was compared for affective disorders. MFQ total scores failed to discriminate individuals diagnosed with or without affective disorders by clinicians, but higher MFQ scores were obtained by the DISC for patients diagnosed with (versus without) affective disorders. MFQ scores did not discriminate individuals diagnosed with or without disruptive behavior or substance abuse disorders by either method. Overall, a higher level of concordance was observed between MFQ scores and DISC diagnoses than between either MFQ scores and clinician diagnoses or clinician and DISC diagnoses.

We investigated the psychological impact of an organized visit to Polish concentration camps on Jewish-American adolescents. Eighty-seven adolescents who participated in a B'nai B'rith memorial visit to concentration camps in Poland completed measures of general psychological adjustment and posttraumatic stress disorder (PTSD) at four time-points: pretest, posttest, 6-month follow-up and 12-month follow-up. Measures included the SCL-90-R, the Mississippi Scale for PTSD, and the Impact of Events Scale (IES) for PTSD. On the SCL-90-R, changes in somatization, interpersonal sensitivity, obsessive-compulsive tendencies, depression, anxiety, and phobic anxiety were observed over time, with peak symptom scores at posttest and 6-month follow-up. Scores on the Mississippi Scale for PTSD and the IES Intrusion subscale also increased at 6-months. Predictors of PTSD symptoms on the Mississippi Scale included previous psychiatric treatment and SCL-90-R symptoms of paranoia, depression, and psychosis. Elevated psychotic symptoms on the SCL-90-R predicted PTSD symptoms on the IES. Jewish adolescents with preexisting symptoms of generalized distress or psychoticism appeared at increased risk for PTSD symptoms following exposure to Holocaust stimuli. This study contributes a prospective, multi-measure assessment of trauma reactions in adolescents.

One hundred and eighty-five adolescent inpatients with emotional and behavioral disorders completed two self-report measures of depression, the Children's Depression Inventory and the Mood and Feelings Questionnaire, and a structured diagnostic interview of depression, the Diagnostic Interview Schedule for Children (Module C). Measures of depression were entered into a cluster analysis to determine subgroups of depressive symptom patterns. A five-cluster solution was obtained, with clusters characterized as (a) Nondepressed, (b) Endogenous Depression, (c) Depressed Mood with Subclinical Features, (d) Depressed Mood with Clinical Features, and (e) Negative Cognitions. The consistency of these findings with clusters previously obtained in child, adolescent, and adult samples suggested a continuity of depressive presentations in childhood, adolescence, and adulthood. Endogenous depression appears to be a robust subgroup of depression that is evident across the lifespan. A second subgroup of depression, characterized by negative cognitions and suicidal ideation in children and adolescents, may present in adulthood as a personality disorder with depressive features. Finally, two depressive subgroups characterized primarily by dysphoric mood may be distinguished by symptom severity. Depressed mood with subclinical features may occur as an isolated depressive syndrome in adolescents and adults. In contrast, depressed mood with clinical features in adolescence may represent the early stage of a clinical depression emerging in adulthood.

The incorporation of a standardized assessment and monitoring procedure for TD into the treatment plans for all individuals prescribed antipsychotic medications has become the standard of care. There are several well-known and established rating scales designed specifically for this purpose. The AIMS and the DISCUS are two of the most commonly used instruments to detect and monitor abnormal movements associated with TD in individuals with developmental disabilities. The CLAMPS is a newly developed rating scale also designed for use in individuals with developmental disabilities to monitor for and assess abnormal movements, including those associated with TD and other disorders. In this study, we investigated the concurrent validity and interrater reliability of these three scales in a sample of seven adults with mental retardation and TD. The results indicated that, overall, the dyskinesia subscales of the CLAMPS showed the greatest level of agreement with the DISCUS subscales. Lower levels of agreement were observed between the CLAMPS and AIMS dyskinesia subscales. The degree of interrater reliability observed for the AIMS and DISCUS subscale scores was consistent with that found in previous research and, with the exception of three subscales, the CLAMPS demonstrated an interrater reliability of a magnitude comparable to the other two. There are some advantages of the CLAMPS and further research on this rating scale is warranted.

Tardive dyskinesia (TD) is one of the major problems associated with the long-term use of neuroleptic medication in individuals with mental retardation. Although no satisfactory treatment is currently available for TD, there has been a suggestion in the research literature that, in theory, calcium channel blockers and vitamin E may be effective in reducing the symptoms of TD. We assessed the effects of verapamil, a calcium channel blocker, and vitamin E on TD in seven adults with mental retardation in a double-blind, placebo-controlled, cross-over study. Following an open baseline, each subject received placebo, verapamil (80 mg/qid), and vitamin E (400 IU/tid) in random order, with each phase lasting 8 weeks. The subjects were rated on the Abnormal Involuntary Movement Scale (AIMS) and the Dyskinesia Identification System: Condensed User Scale (DISCUS) by trained raters. The maintenance medication for all subjects was kept constant during the course of the study. Results showed that although some subjects had a reduction in their TD ratings neither verapamil nor vitamin E produced clinically or statistically significant changes when compared to placebo and baseline conditions. However, the changes associated with vitamin E were promising enough to warrant further investigation of this agent in the treatment of TD in individuals with mental retardation.