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We retrospectively identified autism spectrum disorder (ASD) incident cases among 31,220 individuals in a population-based birth cohort based on signs and symptoms uniformly abstracted from medical and educational records. Inclusive and narrow research definitions of ASD (ASD-RI and ASD-RN, respectively) were explored, along with clinical diagnoses of ASD (ASD-C) obtained from the records. The incidence of ASD-RI, ASD-RN, and ASD-C increased significantly from 1985 to 1998, then ASD-RI and ASD-RN plateaued while the rate of ASD-C continued to increase during 1998-2004. The rising incidence of research-defined ASD may reflect improved recognition and documentation of ASD signs and symptoms. Although the frequency of threshold ASD symptoms stabilized, the rate of ASD-C continued to increase, narrowing the gap between clinical ascertainment and symptom documentation.

Background: To evaluate associations between attention-deficit/hyperactivity disorder (ADHD) and comorbid psychiatric disorders using research-identified incident cases of ADHD and population-based controls. Methods: Subjects included a birth cohort of all children born 1976-1982 remaining in Rochester, MN after age five (n = 5,718). Among them we identified 379 ADHD incident cases and 758 age-gender matched non-ADHD controls, passively followed to age 19 years. All psychiatric diagnoses were identified and abstracted, but only those confirmed by qualified medical professionals were included in the analysis. For each psychiatric disorder, cumulative incidence rates for subjects with and without ADHD were estimated using the Kaplan-Meier method. Corresponding hazard ratios (HR) were estimated using Cox models adjusted for gender and mother's age and education at the subject's birth. The association between ADHD and the likelihood of having an internalizing or externalizing disorder was summarized by estimating odds ratios (OR). Results: Attention-deficit/hyperactivity disorder was associated with a significantly increased risk of adjustment disorders (HR = 3.88), conduct/oppositional defiant disorder (HR = 9.54), mood disorders (HR = 3.67), anxiety disorders (HR = 2.94), tic disorders (HR = 6.53), eating disorders (HR = 5.68), personality disorders (HR = 5.80), and substance-related disorders (HR = 4.03). When psychiatric comorbidities were classified on the internalization-externalization dimension, ADHD was strongly associated with coexisting internalizing/externalizing (OR = 10.6), or externalizing-only (OR = 10.0) disorders. Conclusion: This population-based study confirms that children with ADHD are at significantly increased risk for a wide range of psychiatric disorders. Besides treating the ADHD, clinicians should identify and provide appropriate treatment for psychiatric comorbidities. (Contains 1 figure and 4 tables.)

Autism prevalence studies have often relied on administrative prevalence or clinical diagnosis as case-identification strategies. We report the "incidence" of "clinical diagnoses" of autism spectrum disorders (ASD), versus "research-identified" autism among residents of Olmsted County, Minnesota, age [less than or equal] 21 years, from 1976-1997. The incidence of "clinically diagnosed" ASD (with 95% CI) was 1.5 per 100,000 (0.0-3.7) in 1980-1983 and 33.1 (22.8-43.3) in 1995-1997, a 22.1-fold increase. In contrast, the incidence of "research-identified" autism increased from 5.5 (1.4-9.5) per 100,000 to 44.9 (32.9-56.9), an 8.2-fold increase. Only 46.8% of research-identified cases received a clinical diagnosis of ASD. These findings demonstrate the potential for misleading interpretation of results from epidemiologic studies that rely on clinical diagnosis of autism to identify cases.

Regression equations are presented for converting the non-K-corrected raw scores on the Minnesota Multiphasic Personality Inventory (MMPI) basic scales to an estimated optimism-pessimism score. This score describes an individual's explanatory style on a continuum from optimistic to pessimistic, These equations will enable clinicians and researchers to estimate an optimism-pessimism score if the MMPI item responses are not accessible or if computer scoring facilities for individual items are unavailable.

There do not seem to be any harmful side effects of nicotine patches for teenage smokers. Twenty-two teenage smokers who smoked more than 20 cigarettes per day and were trying to quit smoking wore nicotine patches for 8 weeks. During this time period they also participated in a support group and received individual counseling. The participants reported only minor side effects including skin reactions, vomiting, headaches, and dizziness. Three participants had quit smoking at the end of the 8-week period and one was not smoking 6 months after the study period., ABSTRACT. Objective. To evaluate the safety, tolerance, and efficacy of 24-hour nicotine patch therapy in adolescent smokers who were trying to stop smoking. Design. Nonrandomized, open-label, 6-month clinical trial. Setting. Five public high schools in the Rochester, MN, area. Subjects. Twenty-two adolescent smokers, aged 13 through 17 years, with current smoking rate of 20 or more cigarettes per day (cpd). Intervention. Daily nicotine patch therapy for 8 weeks (22 mg/d for 6 weeks followed by 11 mg/d for 2 weeks). Weekly individual behavioral counseling and group support continued for 8 weeks with follow up visits at 3 and 6 months and a mailed survey at 1 year. Main Outcome Measures. Self-reported smoking abstinence verified by expired air carbon monoxide of 8 ppm or less, nicotine withdrawal symptoms, adverse experiences, and blood cotinine levels. Results. Subjects had a mean [+ or -] SD smoking rate of 23.3 [+ or -] 5.0 (range, 20 to 35) cpd at study entry and 2.6 [+ or -] 1.6 years of smoking the mean age was 15.9 [+ or -] 1.2 (range 13 through 17) years, and 68% were girls. Of the 22 participants, 19 (86%) completed patch therapy, 3 (14%) had biochemically validated smoking cessation at week 8, and 1 continued to be smoke free at 3 and 6 months after patch initiation. There was a significant decrease from baseline in the mean nicotine withdrawal scores for days 4 and 7 of week 1 and the mean for weeks 2 through 8. Skin reactions were the most common adverse event. As the worst skin reactions, 55% had erythema only, 5% had erythema and edema, and 9% had erythema and vesicles, whereas 32% had no skin reactions. Other reported adverse events were headaches (41%), nausea and vomiting (41%), tiredness (41%), dizziness (27%), and arm pain (23%). None of these were considered serious, life threatening, or led to the discontinuation of patch therapy. In adults with comparable smoking rates, we found that the adolescents had lower blood cotinine levels. Those smoking 20 to 25 cpd had cotinine levels of 146 [+ or -] 84 (adolescents) vs 260 [+ or -] 98 (adults) ng/ml, and those smoking 26 to 35 cpd had levels of 169 [+ or -] 73 vs 276 [+ or -] 110 ng/ml, respectively. Conclusion. Nicotine patch therapy seems safe in adolescent smokers. Placebo-controlled trials are needed to establish the efficacy of nicotine patch therapy in adolescents. Pediatrics 1996;98:659-667; nicotine patch therapy, adolescent smokers., Tobacco use is the single most preventable cause of death in the United States.[1] In 1992 tobacco killed more people in the United States than alcohol, cocaine, crack, heroin, homicide, [...]

This article reports adolescent norms for the Optimism-Pessimism (PSM) scale of the Minnesota Multiphasic Personality Inventory (MMPI). The PSM scale measures explanatory style on a continuum from optimistic to pessimistic by using 298 MMPI items. It is based on Seligman's theory of explanatory style and was constructed by applying the Content Analysis of Verbatim Explanations (CAVE) technique to the MMPI item pool. The normative equations are based on a random sample of 624 normal boys and 691 normal girls ages 13 through 17 years. Reliability estimates of .94 demonstrate that the PSM scale can accurately assess explanatory style in adolescents. These norms may identify a personality factor associated with poorer physical and mental health and lower levels of achievement.

The Revised Optimism-Pessimism (PSM-R) scale permits researchers to use MMPI and MMP-2 tests to learn about the relationship between explanatory style and probable treatment results. Such a style is given a score between optimistic and pessimistic by using 263 MMPI items for the optimism-pessmism scale. Reliability estimates show that the PSM-R scale is as reliable as the original PSM scale. Norms are based on a random sample of adults.

The Common Alcoholic Logistic Revised Scale (CAL-R), which is developed to screen patients treated for alcoholism, can be used with both MMPI and MMPI-2. Tests of a criterion group of 1221 alcoholics and a contrast sample of 7621 non-alcoholic patients proved that CAL-R is as effective as CAL.

The MMPI-2 tests and Morey personality Disorder scales are provided separate normative tables that offset the effects of deleting some areas during the formation of MMPI-1 scales by Morey and his colleagues. These normative tables are derived from MMPI responses of a large contemporary normal reference sample of healthy adults. These tables render the MMPI-2 useful in providing a reference point for comparing other measures.

Statistically significant and clinically relevant age-related changes in MMPI response patterns have long been known to clinicians. Graphic representations of mean scores that cover an 85-year age span, separately by sex, for each of the 13 basic MMPI validity and clinical scales support the use of adolescent norms and indicate that clinicians should give greater acknowledgement to age-related MMPI changes in adults and their interpretation, particularly among geriatric patients.

We developed a MMPI alcoholism scale based on adult medical patient samples. Our criterion group consisted of 736 inpatients (525 males; 211 females) diagnosed as having alcoholism according to DSM-III criteria. Three contrast samples that totaled 13,120 individuals were used for control purposes. MMPI items were chosen by means of logistic regression. The 33 items yielded by this procedure formed a provisional scale (CA for common alcoholism logistic) that worked equally well for males and females. With new cross-validation samples, with sensitivity (proportion of alcoholics correctly identified) set at 90%, the specificity (proportion of nonalcoholics correctly identified) ranged from 90% to 96% for selected contrast samples. We conclude that this scale shows promise as a screening device in similar populations.

Current adolescent norms for the MMPI are based on data obtained 25 to 45 years ago, from samples established in 1947 to 1957 and 1964 to 1965 (Marks & Briggs, 1967). Recently, MMPIs from 1,315 normal adolescent females and males, aged 13 through 17 years, were gathered from a three-state midwest area. There were significant differences between contemporary adolescent MMPI response patterns and those obtained from the earlier adolescent samples. This article presents new K-corrected normalized T-score conversion tables to encourage research that compares the relative efficacy of profiles calculated with and without K correction.