Aud Process Dev Delay

Several investigations have revealed a characteristic pattern of behavioral and emotional dysfunction in children that has been referred to as borderline personality disorder or borderline disorder (BD) (Bemporad et al., 1982; Guzder et al., 1996; Kernberg, 1982; Pine, 1986) and more recently characterized as "multiple complex developmental disorder" (MCDD) (Cohen et al., 1987; Towbin et al., 1993; Van der Gaag et al., 1995). Although the labels of BD or MCDD are controversial (Towbin et al., 1993), these children are likely to represent a significant percentage of the childhood psychiatric inpatient population. In an adult outcome study, such individuals continued to manifest significant psychopathology in later life (Lofgren et al., 1991). Cohen et al. (1987) delineated three primary core symptoms found in children with MCDD. These include (1) the impaired regulation of affect states and anxiety, (2) consistent impairments in social behavior, and (3) impaired cognitive processing (thought disorder). BD/MCDD children appear to manifest extreme fluctuations in cognitive, attention, and emotional functioning (Bemporad et al., 1982; Towbin et al., 1993). Comorbidity between BD/MCDD and other disorders of childhood, such as attention-deficit hyperactivity disorder (ADHD), is evident in many cases (Bemporad et al., 1982; Boksenbaum, 1993; Guzder et al., 1996; Towbin et al., 1993). Impairments of attention regulation in children with ADHD are well documented. (Agrawal and Kaushal, 1987; Hamlett et al., 1987; Pearson et al., 1991; Swanson et al., 1991). Attention impairments have also been associated with pathophysiology in individuals with ADHD. Abnormalities of event-related potentials (ERPs) associated with attention, the P300 in particular, have been described in persons with ADHD (Bloom, Lincoln, Courchesne, and Johnson, unpublished; Loiselle et al., 1980; Robaey et al., 1992; Satterfield et al., 1990).