• Home
  • Store
    • Newsletter Subscriptions
    • Multimedia
    • Books
    • eBooks
    • ABPN SA Courses
    • Social Work Courses
  • CME Center
  • Multimedia
    • Podcast
    • Webinars
    • Blog
    • Psychiatry News Videos
    • Medication Guide Videos
  • Newsletters
    • General Psychiatry
    • Child Psychiatry
    • Addiction Treatment
    • Hospital Psychiatry
    • Geriatric Psychiatry
    • Psychotherapy and Social Work
  • FAQs
  • Med Fact Book App
  • Log In
  • Register
  • Welcome
  • Sign Out
  • Subscribe
Home » Are there Really Two Types of Antisocial Behavior in Children?

Are there Really Two Types of Antisocial Behavior in Children?

August 1, 2013
From The Carlat Child Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Sharon M. Kahler, MD

Treatment options for pediatric PTSD and trauma symptoms are limited, and the symptoms are clearly detrimental to youths’ functioning, particularly in the presence of comorbid disorders. As recommended treatments, trauma-focused cognitive behavioral therapy (TF-CBT) and SSRIs rarely leadto a quick remission of symptoms, so child psychiatrists are in need of a larger pharmacologic toolbox.

A recent open-label pilot study was conducted investigating the tolerability and effectiveness of guanfacine XR (GXR) for children and adolescents with trauma symptoms, including re-experiencing, avoidance, and hyperarousal. (This study was sponsored by Shire Pharmaceuticals, the makers of Intuniv, a branded version of guanfacine.)

Seventeen subjects were enrolled, having been recruited through psychiatrists’ offices, advertisements,or word of mouth. Inclusion criteria included being six to 18 years old, having trauma symptoms as measured by standard rating instruments, and being free of other psychotropic medications.

Children were allowed to have comorbid conditions, and many did: 89.5% met criteria for ADHD, 68.4% for PTSD, 47.4% for GAD, 21.1% for depression, 10.6% for separation anxiety disorder, and 5.3% for reactive attachment disorder.

Subjects were started on 1 mg of GXR at bedtime during week one, which was titrated as needed by 1 mg weeklyto maximum dose of 4 mg/day by week five. Thirteen of the original 17 children completed the trial, with an average does of GXR of 1.19 mg/day over the course of the 8 week trial. Four dropped out due to worsening depression, side effects (sedation/fatigue), lack of effectiveness, and transportation issues.

How well did the treatment work? Pretty well. Thirteen children completed the treatment: 70.6% were rated by clinicians as very much improved or much improved on the CGI, and 82.4% showed a greater than 30% reduction on the UCLA-RI, a measure of PTSD. Subjects also reported significant improvements in hyperactivity and inattention aswell as anxiety symptoms. At study conclusion, 12 of the original 17 elected to continue GXR treatment (Connor D et al, J Child Adolesc Psychopharmacology 2013;23:244–251)

CCPR’s Take: Generalizability of these results is limited because this was not a double blind trial and the sample size was small. Nonetheless, given the paucity of treatment options for pediatric PTSD, low dose guanfacine—either as the branded XR or the cheaper immediate release generic—may be worth a try.

Child Psychiatry
KEYWORDS child-psychiatry research_updates
    www.thecarlatreport.com
    Issue Date: August 1, 2013
    SUBSCRIBE NOW
    Table Of Contents
    Neglect Most Common Form of Child Abuse
    Report: 10% of high school seniors "extreme" binge drinkers
    Diagnostic Comorbidity in DSM-5: More of the Same
    PTSD in DSM-5
    The Problem with Child Psychiatry in DSM-5
    Does Guanfacine Work for Pediatric PTSD?
    Are there Really Two Types of Antisocial Behavior in Children?
    DOWNLOAD NOW
    Featured Book
    • PB4e_Cover2.png

      Psychiatry Practice Boosters, Fourth Edition (2023)

      Teaches you the key points of 63 of the most clinically relevant studies in psychiatry.
      READ MORE
    Featured Video
    • KarXT (Cobenfy)_ The Breakthrough Antipsychotic That Could Change Everything.jpg
      General Psychiatry

      KarXT (Cobenfy): The Breakthrough Antipsychotic That Could Change Everything

      Read More
    Featured Podcast
    • shutterstock_2622607431.jpg
      General Psychiatry

      Should You Test MTHFR?

      MTHFR is a...
      Listen now
    Recommended
    • Join Our Writing Team

      July 18, 2024
      WriteForUs.png
    • Insights About a Rare Transmissible Form of Alzheimer's Disease

      February 9, 2024
      shutterstock_2417738561_PeopleImages.com_Yuri A.png
    • How to Fulfill the DEA's One Time, 8-Hour Training Requirement for Registered Practitioners

      May 24, 2024
      DEA_Checkbox.png
    • Join Our Writing Team

      July 18, 2024
      WriteForUs.png
    • Insights About a Rare Transmissible Form of Alzheimer's Disease

      February 9, 2024
      shutterstock_2417738561_PeopleImages.com_Yuri A.png
    • How to Fulfill the DEA's One Time, 8-Hour Training Requirement for Registered Practitioners

      May 24, 2024
      DEA_Checkbox.png
    • Join Our Writing Team

      July 18, 2024
      WriteForUs.png
    • Insights About a Rare Transmissible Form of Alzheimer's Disease

      February 9, 2024
      shutterstock_2417738561_PeopleImages.com_Yuri A.png
    • How to Fulfill the DEA's One Time, 8-Hour Training Requirement for Registered Practitioners

      May 24, 2024
      DEA_Checkbox.png

    About

    • About Us
    • CME Center
    • FAQ
    • Contact Us

    Shop Online

    • Newsletters
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN Self-Assessment Courses

    Newsletters

    • The Carlat Psychiatry Report
    • The Carlat Child Psychiatry Report
    • The Carlat Addiction Treatment Report
    • The Carlat Hospital Psychiatry Report
    • The Carlat Geriatric Psychiatry Report
    • The Carlat Psychotherapy Report

    Contact

    carlat@thecarlatreport.com

    866-348-9279

    PO Box 626, Newburyport MA 01950

    Follow Us

    Please see our Terms and Conditions, Privacy Policy, Subscription Agreement, Use of Cookies, and Hardware/Software Requirements to view our website.

    © 2025 Carlat Publishing, LLC and Affiliates, All Rights Reserved.