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Inci Izmir SB, Aktan ZD, Ercan ES. The Comparison of Psychological Factors and Executive Functions of Children with Attention Deficit Hyperactivity Disorder and Cognitive Disengagement Syndrome to ADHD and ADHD Comorbid with Oppositional Defiant Disorder. J Atten Disord 2024:10870547241267379. [PMID: 39092505 DOI: 10.1177/10870547241267379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
OBJECTIVE The study aims to examine family functionality, emotion regulation difficulties, preference for loneliness, social exclusion, internalizing and externalizing disorders, and executive functions in children with Attention Deficit Hyperactivity Disorder (ADHD) and Cognitive Disengagement Syndrome (CDS) and compare with ADHD, and ADHD+ Oppositional Defiant Disorder (ODD). METHOD This study included 842 children aged 8-12 years. The subjects were categorized according to DSM-V as ADHD (n = 246), ADHD + ODD (n = 212), ADHD + CDS (n = 176), and Control group (n = 207). The solitude and social exclusion, difficulties in emotion dysregulation and Barkley SCT scales, Child Behavior Checklist, family assessment device, and Central Vital Signs (CNSVS) test were used. RESULTS According to the study, children with ADHD + CDS had higher rates of internalizing disorders. They also preferred being alone and experienced more difficulty communicating with their parents and solving problems within the family. Additionally, these children had difficulty recognizing and understanding the emotional reactions of others. The ADHD + ODD group presented a poorer performance on CNSVS domain tests except for the psychomotor speed test than other groups. Also, ADHD + CDS children had the lowest psychomotor speed scores and lower scores on reaction time and cognitive flexibility than pure ADHD children. CONCLUSION This study will contribute to the etiology, treatment, and clinical discrimination of ADHD + CDS.
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Habibi Asgarabad M, Steinsbekk S, Hartung CM, Wichstrøm L. Reciprocal relations between dimensions of attention-deficit/hyperactivity and anxiety disorders from preschool age to adolescence: sex differences in a birth cohort sample. J Child Psychol Psychiatry 2024. [PMID: 38965813 DOI: 10.1111/jcpp.14038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Symptoms of anxiety and attention-deficit/hyperactivity disorder (ADHD) are prospectively related from childhood to adolescence. However, whether the two dimensions of ADHD-inattention and hyperactivity-impulsivity-are differentially related to anxiety and whether there are developmental and sex/gender differences in these relations are unknown. METHODS Two birth cohorts of Norwegian children were assessed biennially from ages 4 to 16 (N = 1,077; 49% girls) with diagnostic parent interviews used to assess symptoms of anxiety and ADHD. Data were analyzed using a random intercept cross-lagged panel model, adjusting for all unobserved time-invariant confounding effects. RESULTS In girls, increased inattention, but not hyperactivity-impulsivity, predicted increased anxiety 2 years later across all time-points and increased anxiety at ages 12 and 14 predicted increased inattention but not hyperactivity-impulsivity. In boys, increased hyperactivity-impulsivity at ages 6 and 8, but not increased inattention, predicted increased anxiety 2 years later, whereas increased anxiety did not predict increased inattention or hyperactivity-impulsivity. CONCLUSIONS The two ADHD dimensions were differentially related to anxiety, and the relations were sex-specific. In girls, inattention may be involved in the development of anxiety throughout childhood and adolescence and anxiety may contribute to girls developing more inattention beginning in early adolescence. In boys, hyperactivity-impulsivity may be involved in the development of anxiety during the early school years. Effective treatment of inattention symptoms in girls may reduce anxiety risk at all time-points, while addressing anxiety may decrease inattention during adolescence. Similarly, treating hyperactivity-impulsivity may reduce anxiety risk in boys during late childhood (at ages 8-10).
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Affiliation(s)
| | - Silje Steinsbekk
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Lars Wichstrøm
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Child and Adolescent Psychiatry, St Olav's Hospital, Trondheim, Norway
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Hawkey EJ, Williams AI, Chung S, Owens EB, Pfiffner LJ. Emotion Regulation and Organizational Skills in Children With ADHD Symptoms Are Associated With Behavioral Parent Training Adherence. J Atten Disord 2024; 28:1320-1330. [PMID: 38726593 DOI: 10.1177/10870547241251725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVE Behavioral parent training (BPT) is a well-established treatment for ADHD; however, treatment response is variable. Consistency in parent skill use during BPT is known to influence child outcomes post-treatment, while less research has focused on specific child factors that may be impacting parent skill utilization during treatment. The current study examined associations between child organizational skills and emotion dysregulation (ED) with parent treatment adherence during BPT and post-treatment child impairment. METHOD Parents of 72 children (Mage = 8.31) with ADHD symptoms and impairment participated in BPT which was embedded in a 12-week, multicomponent, school-based intervention for children delivered by school mental health clinicians. Outcomes included parent treatment adherence and child improvements in global impairment post-treatment. RESULTS Greater pre-treatment child organizational problems were associated with less parent treatment adherence regardless of ADHD symptom severity. Worse pre-treatment child ED was associated with more impairment post-treatment regardless of ADHD symptom severity whereas the effects of child ED on parent treatment adherence were moderated by child ADHD symptom severity. CONCLUSION The current study suggests that pre-treatment child ED and organizational difficulties impact parent treatment adherence to behavioral interventions targeting ADHD symptoms, potentially in unique ways, and should be considered in future BPT treatment studies.
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Affiliation(s)
| | | | - Sara Chung
- University of California, San Francisco, CA, USA
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Marques S, Correia-de-Sá T, Guardiano M, Sampaio-Maia B, Ferreira-Gomes J. Emotion dysregulation and depressive symptoms mediate the association between inhibitory control difficulties and aggressive behaviour in children with ADHD. Front Psychiatry 2024; 15:1329401. [PMID: 38690203 PMCID: PMC11059059 DOI: 10.3389/fpsyt.2024.1329401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 04/02/2024] [Indexed: 05/02/2024] Open
Abstract
Background/objectives Impulsive aggressive behaviour, although not a core symptom, is often part of the clinical presentation of attention-deficit/hyperactivity disorder (ADHD). Recently, impulsive aggression has been attributed to emotion dysregulation, which is currently conceptualised as a transdiagnostic factor and seems to contribute to the co-occurrence of other problems in ADHD. Thus, this study investigated the presence of impulsive aggressive behaviour and explored whether emotion dysregulation mediates the relationship between inhibitory control difficulties and aggressive behaviour in children with ADHD. Because ADHD may act as a risk factor for the development of other conditions, such as internalising problems, we aimed to understand whether depressive symptoms contribute to this relationship. Methods Seventy-two children were recruited from a hospital and the community, 38 of whom had ADHD and 34 were typically developing (TD). Parents completed the Child Behaviour Checklist, the Behaviour Rating Inventory of Executive Function, and the Emotion Regulation Checklist. Simple mediation and serial mediation models were performed to test our hypotheses. Results Aggressive behaviour was significantly higher in ADHD children compared to TD children. Emotion dysregulation fully mediated the relationship between inhibitory control difficulties and aggressive behaviour in ADHD children. Adding depressive symptoms to the model increased the explained variance in aggressive behaviour. Conclusion The main result of our study supports the role of emotion dysregulation and depressive symptoms in mediating the relationship between inhibitory control difficulties and impulsive aggressive behaviour in children with ADHD. This highlights that aggressive behaviour is, in part, a result of the inability of the child to appropriately regulate their emotions. Future interventions may be tailored to improve emotion regulation skills to address aggressive behaviour.
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Affiliation(s)
- Sofia Marques
- Institute of Psychology and Educational Sciences, Lusíada University, Porto, Portugal
- CIPD—Psychology for Development Research Centre, Lusíada University, Porto, Portugal
| | - Teresa Correia-de-Sá
- Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
- INEB—Institute of Biomedical Engineering, University of Porto, Porto, Portugal
- i3S—Institute for Research & Innovation in Health, University of Porto, Porto, Portugal
| | - Micaela Guardiano
- Department of Paediatrics, Unit of Neurodevelopmental Paediatrics, University Hospital Centre of São João, Porto, Portugal
| | - Benedita Sampaio-Maia
- INEB—Institute of Biomedical Engineering, University of Porto, Porto, Portugal
- i3S—Institute for Research & Innovation in Health, University of Porto, Porto, Portugal
- Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Joana Ferreira-Gomes
- Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
- i3S—Institute for Research & Innovation in Health, University of Porto, Porto, Portugal
- IBMC—Institute for Molecular and Cell Biology, University of Porto, Porto, Portugal
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Harris JL, LeBeau B, Petersen IT. Reactive and control processes in the development of internalizing and externalizing problems across early childhood to adolescence. Dev Psychopathol 2024:1-23. [PMID: 38584292 DOI: 10.1017/s0954579424000713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Reactive and control processes - e.g., negative emotionality and immediacy preference - may predict distinct psychopathology trajectories. However, externalizing and internalizing problems change in behavioral manifestation across development and across contexts, thus necessitating the use of different measures and informants across ages. This is the first study that created developmental scales for both internalizing and externalizing problems by putting scores from different informants and measures onto the same scale to examine temperament facets as risk factors. Multidimensional linking allowed us to examine trajectories of internalizing and externalizing problems from ages 2 to 15 years (N = 1,364) using near-annual ratings by mothers, fathers, teachers, other caregivers, and self report. We examined reactive and control processes in early childhood as predictors of the trajectories and as predictors of general versus specific psychopathology in adolescence. Negative emotionality at age 4 predicted general psychopathology and unique externalizing problems at age 15. Wait times on an immediacy preference task at age 4 were negatively associated with age 15 general psychopathology, and positively associated with unique internalizing problems. Findings demonstrate the value of developmental scaling for examining development of psychopathology across a lengthy developmental span and the importance of considering reactive and control processes in development of psychopathology.
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Affiliation(s)
- Jordan L Harris
- Department of Psychological and Brain Sciences, University of Iowa, IA, USA
| | - Brandon LeBeau
- Department of Psychological and Quantitative Foundations, University of Iowa, IA, USA
| | - Isaac T Petersen
- Department of Psychological and Brain Sciences, University of Iowa, IA, USA
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Sells RC, Liversedge SP, Chronaki G. Vocal emotion recognition in attention-deficit hyperactivity disorder: a meta-analysis. Cogn Emot 2024; 38:23-43. [PMID: 37715528 DOI: 10.1080/02699931.2023.2258590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/06/2023] [Accepted: 06/28/2023] [Indexed: 09/17/2023]
Abstract
There is debate within the literature as to whether emotion dysregulation (ED) in Attention-Deficit Hyperactivity Disorder (ADHD) reflects deviant attentional mechanisms or atypical perceptual emotion processing. Previous reviews have reliably examined the nature of facial, but not vocal, emotion recognition accuracy in ADHD. The present meta-analysis quantified vocal emotion recognition (VER) accuracy scores in ADHD and controls using robust variance estimation, gathered from 21 published and unpublished papers. Additional moderator analyses were carried out to determine whether the nature of VER accuracy in ADHD varied depending on emotion type. Findings revealed a medium effect size for the presence of VER deficits in ADHD, and moderator analyses showed VER accuracy in ADHD did not differ due to emotion type. These results support the theories which implicate the role of attentional mechanisms in driving VER deficits in ADHD. However, there is insufficient data within the behavioural VER literature to support the presence of emotion processing atypicalities in ADHD. Future neuro-imaging research could explore the interaction between attention and emotion processing in ADHD, taking into consideration ADHD subtypes and comorbidities.
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Affiliation(s)
- Rohanna C Sells
- School of Psychology and Computer Science, University of Central Lancashire, UK
| | - Simon P Liversedge
- School of Psychology and Computer Science, University of Central Lancashire, UK
| | - Georgia Chronaki
- School of Psychology and Computer Science, University of Central Lancashire, UK
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Akman H, Serdengeçti N, Yavuz M, Kadak MT, Ercan O, Doğangün B. Attachment and comorbid anxiety in ADHD. Clin Child Psychol Psychiatry 2024; 29:368-380. [PMID: 37747351 DOI: 10.1177/13591045231204052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Anxiety comorbidity is quite common in children with attention-deficit hyperactivity disorder (ADHD). What is known about the relationship between anxiety, attachment and emotion regulation in such children is still limited. We aimed to investigate the associations between attachment, emotion regulation and comorbid anxiety in children with ADHD. 100 children with ADHD and 100 children without any diagnosis aged 8-13 years were included. After the participants were clinically evaluated, Turgay ADHD Scale, Emotion Regulation Checklist, Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV) and Kerns' Security Scale were completed. According to the RCADS-CV scores, ADHD/ANX(+), ADHD/ANX(-), and control groups were formed. The emotional lability/negativity levels were higher in the ADHD groups compared to the non-ADHD controls. Paternal and maternal attachment security levels were lower in the ADHD/ANX(+) group compared to the controls. The regression analysis indicated that higher hyperactivity/impulsivity symptom levels and lower maternal attachment quality were associated with higher anxiety in children with ADHD. These results suggest that focusing on attachment quality and emotion regulation problems may be significant in management of core symptoms and comorbid anxiety problems in children with ADHD.
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Affiliation(s)
- Hazal Akman
- Department of Child and Adolescent Psychiatry, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Nihal Serdengeçti
- Department of Child and Adolescent Psychiatry, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Mesut Yavuz
- Department of Child and Adolescent Psychiatry, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Muhammed Tayyib Kadak
- Department of Child and Adolescent Psychiatry, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Oya Ercan
- Department of Pediatrics, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Burak Doğangün
- Department of Child and Adolescent Psychiatry, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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Reinke AL, Stiles K, Lee SS. Childhood ADHD With and Without Co-occurring Internalizing/Externalizing Problems: Prospective Predictions of Change in Adolescent Academic and Social Functioning. J Atten Disord 2023; 27:1520-1531. [PMID: 37496457 PMCID: PMC10552349 DOI: 10.1177/10870547231187146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
OBJECTIVE Internalizing and externalizing problems predict poor academic and social outcomes. However, ADHD co-occurs with internalizing and externalizing problems and is itself a risk factor, thus preventing precise inferences. This study evaluated childhood anxiety, depression, and aggression as predictors of change in adolescent academic and social outcomes, including moderation by childhood ADHD. METHODS 182 ethnically-diverse 5- to 11-year-old youth with (54.7%) and without (45.3%) ADHD completed a separate baseline and 6- to 7-year prospective follow-up assessment, consisting of parallel measures across youth psychopathology, academic functioning (i.e., academic achievement, school competence), and friendship quality domains. RESULTS Whereas childhood ADHD inversely predicted academic competence, depression and aggression uniquely predicted worsening friendship quality. Interestingly, anxiety was unrelated to change in academic and friendship outcomes; similarly, neither ADHD, depression, nor aggression predicted change in objectively-measured academic achievement from a standardized assessment. CONCLUSION Implications for intervention and prevention are considered, including school-based approaches, within a developmental psychopathology framework.
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Murray A, Speyer L, Thye M, Stewart T, Obsuth I, Kane J, Whyte K, Devaney J, Rohde LA, Ushakova A, Rhodes S. Illuminating the daily life experiences of adolescents with and without ADHD: protocol for an ecological momentary assessment study. BMJ Open 2023; 13:e077222. [PMID: 37775284 PMCID: PMC10546102 DOI: 10.1136/bmjopen-2023-077222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/31/2023] [Indexed: 10/01/2023] Open
Abstract
INTRODUCTION Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at elevated risk of a range of difficulties, among which emotion regulation, peer and co-occurring mental health problems are prominent challenges. To better support adolescents with ADHD, ecologically valid interventions that can be embedded in daily life to target the most proximal antecedents of these challenges are needed. Ecological momentary assessment (EMA) designs are ideally suited to meeting this need. METHODS AND ANALYSES In the mental health in the moment ADHD study, we will use an EMA design to capture the daily life experiences of approximately 120 adolescents aged 11-14 years with a clinical diagnosis of ADHD and the same number of age-matched and gender-matched peers without a diagnosis of ADHD. We will combine this with comprehensive information gathered from online surveys. Analysing the data using techniques such as dynamic structural equation modelling, we will examine, among other research questions, the role of emotion regulation and peer problems in mediating the links between characteristics of ADHD and commonly co-occurring outcomes such as anxiety, depression and conduct problems. The results can help inform interventions to support improved peer functioning and emotion regulation for adolescents with ADHD. ETHICS AND DISSEMINATION This study received a favourable ethical opinion through the National Health Service ethical review board and the University of Edinburgh PPLS Research Ethics panel. The results will be disseminated through journal publications, conferences and seminar presentations and to relevant stakeholders, such as those with ADHD, their families and clinicians.
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Affiliation(s)
- Aja Murray
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Lydia Speyer
- Department of Psychology, Lancaster University, Edinburgh, UK
| | - Melissa Thye
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Tracy Stewart
- Moray House of Education and Sport, University of Edinburgh, Edinburgh, UK
| | - Ingrid Obsuth
- Clinical and Health Psychology Department, University of Edinburgh, Edinburgh, UK
| | - Jennifer Kane
- Clinical and Health Psychology Department, University of Edinburgh, Edinburgh, UK
| | - Katie Whyte
- Department of Psychology, St Andrew's University, St Andrews, UK
| | - John Devaney
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Luis Augusto Rohde
- ADHD Outpatient Program and Developmental Psychiatry Program, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry & National Center for Research and Innovation in Mental Health, Sao Paolo, Brazil
- UniEduk, Brazil, Brazil
| | - Anastasia Ushakova
- Centre for Computing, Health Informatics and Statistics, Lancaster University, Lancaster, UK
| | - Sinead Rhodes
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Bierens M, Hartman CA, Klip H, Deckers S, Buitelaar J, Rommelse N. Emotion dysregulation as cross-disorder trait in child psychiatry predicting quality of life and required treatment duration. Front Psychiatry 2023; 14:1101226. [PMID: 37547199 PMCID: PMC10399689 DOI: 10.3389/fpsyt.2023.1101226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 06/28/2023] [Indexed: 08/08/2023] Open
Abstract
Background Emotion dysregulation (ED) is increasingly under investigation as a cross-disorder trait, and is by some considered as the core feature in mental disorders. The aims of this study were to scrutinize the overlapping and distinct characteristics of ED for internalizing, externalizing and neurodevelopmental disorders and to identify the most pertinent ED characteristics to guide clinicians in treatment choice. Methods Information on clinical diagnosis (Attention Deficit/Hyperactivity Disorder ADHD, Autism Spectrum Disorder, Oppositional Defiant Disorder/Conduct Disorder, Anxiety and Mood Disorders), ED (measured by the CBCL-Emotion Dysregulation Index), Quality of Life (Qol, measured by the Kidscreen-27), and treatment duration (measured by Electronic Health Records) was retrieved from two large samples of toddlers (1.5-5 year old; N = 1,544) and school aged children (6-18 year old; N = 7,259). Frequency scores and logistic regression were used to study symptom profiles of ED, as measured with CBCL-EDI, across all disorders. Linear regression was used to determine the predictive value of ED (CBCL-EDI total score) regarding QoL and treatment duration in addition to-and in interaction with-clinical diagnosis. Results Across disorders, equal levels of total ED were found, which predicted lower QoL and a longer treatment duration in addition to clinical diagnosis. The majority of items (11/15 and 16/18) were of equal relevance to the disorders; items that were not, largely reflected disorder specific DSM definitions (i.e., externalizing symptoms in ODD/CD and internalizing symptoms in Anxiety and Mood disorders). Conclusion ED is a clinically useful cross-disorder trait to predict severity of impairment as well as required treatment duration. In addition, ED is largely composed of shared features across disorders, with certain disorder specific colored elements.
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Affiliation(s)
- Margreet Bierens
- Karakter Child and Adolescent Psychiatry, University Center, Nijmegen, Netherlands
| | | | - Helen Klip
- Karakter Child and Adolescent Psychiatry, University Center, Nijmegen, Netherlands
| | - Stijn Deckers
- Department of Pedagogical Sciences, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Jan Buitelaar
- Karakter Child and Adolescent Psychiatry, University Center, Nijmegen, Netherlands
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, Netherlands
| | - Nanda Rommelse
- Karakter Child and Adolescent Psychiatry, University Center, Nijmegen, Netherlands
- Department of Psychiatry, Radboud UMC, Nijmegen, Netherlands
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Burkhouse KL, Kujawa A. Annual Research Review: Emotion processing in offspring of mothers with depression diagnoses - a systematic review of neural and physiological research. J Child Psychol Psychiatry 2023; 64:583-607. [PMID: 36511171 DOI: 10.1111/jcpp.13734] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Theories of the intergenerational transmission of depression emphasize alterations in emotion processing among offspring of depressed mothers as a key risk mechanism, raising questions about biological processes contributing to these alterations. The objective of this systematic annual research review was to examine and integrate studies of the associations between maternal depression diagnoses and offspring's emotion processing from birth through adolescence across biological measures including autonomic psychophysiology, electroencephalography (EEG), magnetoencephalography (MEG), event-related potentials (ERP), and structural and functional magnetic resonance imaging (MRI). METHODS The review was conducted in accordance with the PRISMA 2020 standards. A systematic search was conducted in PsycInfo and PubMed in 2022 for studies that included, 1) mothers with and without DSM-defined depressive disorders assessed via a clinical or diagnostic interview, and 2) measures of offspring emotion processing assessed at the psychophysiological or neural level between birth and 18 years of age. RESULTS Findings from 64 studies indicated that young offspring of mothers with depression histories exhibit heightened corticolimbic activation to negative emotional stimuli, reduced left frontal brain activation, and reduced ERP and mesocorticolimbic responses to reward cues compared to offspring of never-depressed mothers. Further, activation of resting-state networks involved in affective processing differentiate offspring of depressed relative to nondepressed mothers. Some of these alterations were only apparent among youth of depressed mothers exposed to negative environmental contexts or exhibiting current emotional problems. Further, some of these patterns were observable in infancy, reflecting very early emerging vulnerabilities. CONCLUSIONS This systematic review provides evidence that maternal depression is associated with alterations in emotion processing across several biological units of analysis in offspring. We present a preliminary conceptual model of the role of deficient emotion processing in pathways from maternal depression to offspring psychopathology and discuss future research avenues addressing limitations of the existing research and clinical implications.
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Affiliation(s)
- Katie L Burkhouse
- The Research Institute, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Autumn Kujawa
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
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McKee LG, Yang Y, Highlander A, McCall M, Jones DJ. Conceptualizing the Role of Parent and Child Emotion Regulation in the Treatment of Early-Onset Behavior Disorders: Theory, Research, and Future Directions. Clin Child Fam Psychol Rev 2023; 26:272-301. [PMID: 36385585 DOI: 10.1007/s10567-022-00419-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 11/18/2022]
Abstract
Behavior disorders (BDs) are common and costly, making prevention and early-intervention a clinical and public health imperative. Behavioral Parent Training (BPT) is the standard of care for early-onset (3-8 years old) BDs, yet effect sizes vary and wane with time suggesting the role of underlying factors accounting for variability in outcomes. The literature on emotion regulation (ER), which has been proposed as one such underlying factor, is reviewed here, including a brief overview of ER, theory and research linking ER, externalizing symptoms, and/or BDs, and still largely preliminary work exploring the role of parent and child ER in BPT outcomes. Research to date provides clues regarding the interrelationship of ER, BDs, and BPT; yet, determining whether adaptations to BPT targeting ER are necessary or useful, for whom such adaptations would be most important, and how those adaptations would be implemented requires addressing mixed findings and methodological limitations. To guide such work, we propose a conceptual model elucidating how standard BPT may impact ER and processes linked to ER, which we believe will be useful in organizing and advancing both basic and applied research in future work.
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Affiliation(s)
- Laura G McKee
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Yexinyu Yang
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - April Highlander
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Madison McCall
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Deborah J Jones
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, 27599, USA.
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Allen B. Etiological Perspectives on Problematic Sexual Behavior of Preteen Children: Implications for Treatment. Clin Child Fam Psychol Rev 2023; 26:50-64. [PMID: 36094684 DOI: 10.1007/s10567-022-00412-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2022] [Indexed: 01/31/2023]
Abstract
Problematic sexual behavior (PSB) among preteen children is a poorly understood clinical phenomenon that may leave even the most skilled and knowledgeable of clinicians at a loss when attempting to develop an evidence-based treatment approach. Much of this lack of practical direction can be credited to the relatively scarce clinical trial research examining this outcome. Nonetheless, the etiological research on PSB provides clearer directions and suggests the implementation of already well-established interventions may be effective. This paper reviews the current state of the etiological research pertaining to PSB and places these findings within developmental psychopathology, social learning theory, and post-traumatic stress disorder symptomatology frameworks. Specific treatment directives derived from these three viewpoints are then reviewed, including a review of the current evidence base for the treatment of PSB. Finally, a treatment planning algorithm is specified to help clinicians identify the most beneficial approach to treating PSB in a given case.
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Affiliation(s)
- Brian Allen
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA.
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA, USA.
- Center for the Protection of Children, Penn State Children's Hospital, Hershey, PA, USA.
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Antony EM, Pihlajamäki M, Speyer LG, Murray AL. Does emotion dysregulation mediate the association between ADHD symptoms and internalizing problems? A longitudinal within-person analysis in a large population-representative study. J Child Psychol Psychiatry 2022; 63:1583-1590. [PMID: 35484998 PMCID: PMC9790420 DOI: 10.1111/jcpp.13624] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/25/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Previous research has suggested that children with attention-deficit/hyperactivity disorder (ADHD) symptoms commonly show emotion dysregulation difficulties. These difficulties may partly explain the strong tendency for internalizing problems such as anxiety and depression to co-occur with ADHD symptoms. However, no study has yet provided a longitudinal analysis of the within-person links between ADHD symptoms, emotion dysregulation, and internalizing problems necessary to examine this hypothesis from a developmental perspective. METHODS We used data from the age 3, 5, and 7 waves of the large UK population-representative Millennium Cohort Study (n = 9,619, 4,885 males) and fit gender-stratified autoregressive latent trajectory models with structured residuals (ALT-SR) to disaggregate within- and between-person relations between ADHD symptom, emotion dysregulation, and internalizing problem symptoms. RESULTS We found that emotion dysregulation significantly mediated the longitudinal within-person association between ADHD symptoms and internalizing problems. CONCLUSIONS Results underline the promise of targeting emotion dysregulation as a means of preventing internalizing problems co-occurring with ADHD symptoms.
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Gair SL, Brown HR, Breaux R, Lugo-Candelas CI, McDermott JM, Harvey EA. Neural Activity and Emotion Socialization as Predictors of Later Emotion Regulation Difficulties in Children With and Without Hyperactivity/Impulsivity. J Atten Disord 2022; 26:1668-1681. [PMID: 35510641 DOI: 10.1177/10870547221092171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study examined emotion socialization and neural activity during frustration as predictors of emotion regulation (ER) difficulties, and the interplay of emotion socialization and neural activity, in children with and without hyperactivity/impulsivity (H/I). METHOD At Time 1, neural activity (P1, N2, P3) during a frustration task, H/I symptoms, and emotion socialization were assessed in 68 children (aged 4-7 years old). At Time 2 (1.5-2 years later), child-report, maternal-report, and observation measures of ER difficulties were assessed. RESULTS H/I symptoms moderated the relation between predictors and ER difficulties; there were significant relations for children with high, but not low, levels of H/I. Further, as emotion socialization quality increased, relations between event-related potentials and later ER difficulties became weaker. CONCLUSION The processes underlying ER difficulties differ for children with H/I symptoms. High quality emotion socialization may have a protective effect for children whose neural patterns indicate risk for later ER difficulties.
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Fassot EM, Tuschen-Caffier B, Asbrand J. Association of parental characteristics and emotion regulation in children and adolescents with and without psychopathology: A case-control study. PLoS One 2022; 17:e0271486. [PMID: 35895666 PMCID: PMC9328518 DOI: 10.1371/journal.pone.0271486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 07/04/2022] [Indexed: 11/18/2022] Open
Abstract
This study explores the difference in child emotion regulation (ER) and parenting between a heterogeneous clinical sample (ClinS) and a community sample (ComS). We hypothesized that parents of the ClinS would report more dysfunctional child ER and more dysfunctional parenting regarding the child’s negative emotions than parents of the ComS. Further, we aimed to predict child ER by parenting behavior, parents’ ER, and mental health. Parents of children and adolescents (aged 6–18 years) seeking treatment at an outpatient clinic were compared to a matched sample of parents in a ComS (n = 57 each group). As predicted, the children in the clinical group were reported to use less reappraisal and more suppression than ComS children. No difference was found in dysfunctional emotion parenting between the groups. Reappraisal in parents and supportive reactions to negative emotions predicted reappraisal in children. No predictor was found for child suppression. Child emotion regulation and parents’ psychopathology were not associated. These results could suggest new elements for prevention and intervention programs with parents concerning their own emotion regulation and their reaction to negative emotions in children.
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Affiliation(s)
- Eva-Maria Fassot
- Department of Clinical Psychology and Psychotherapy, Institute for Psychology, University of Freiburg, Freiburg, Germany
- * E-mail:
| | - Brunna Tuschen-Caffier
- Department of Clinical Psychology and Psychotherapy, Institute for Psychology, University of Freiburg, Freiburg, Germany
| | - Julia Asbrand
- Department of Clinical Psychology and Psychotherapy, Institute for Psychology, University of Freiburg, Freiburg, Germany
- Department of Psychology, Faculty of Life Sciences, Humboldt University of Berlin, Berlin, Germany
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17
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Behrmann JT, Blaabjerg J, Jordansen J, Jensen de López KM. Systematic Review: Investigating the Impact of COVID-19 on Mental Health Outcomes of Individuals With ADHD. J Atten Disord 2022; 26:959-975. [PMID: 34654341 DOI: 10.1177/10870547211050945] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND According to the WHO, the COVID-19 pandemic could have a negative impact on the mental health of individuals, such as an exacerbation of existing difficulties. Individuals with ADHD may be specifically challenged by the pandemic. AIMS To provide a systematic review of evidence regarding the COVID-19's impact on mental health of individuals with ADHD during the COVID-19 lockdown. METHODS This registered review (PROSPERO ID CRD42021238770) adhered to Prisma guidelines. Systematic searches in electronic databases PubMed and PsycINFO were carried out. A total of 12 studies covering 3,028 subjects were included. RESULTS COVID-19 pandemic is associated with increased ADHD symptoms and psychological difficulties. Some studies reported that individuals experienced positive outcomes. The methodological quality of the studies was low to moderate. CONCLUSION COVID-19 can affect the mental health of individuals with ADHD negatively, although methodological limitations should be considered. Further research should generate knowledge about long-term effects impact of the pandemic and about appropriate support.
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Silverman MR, Bennett R, Feuerstahler L, Stadterman J, Dick AS, Graziano P, Roy AK. Measuring Emotion Dysregulation in Children With Attention-Deficit/Hyperactivity Disorder: Revisiting the Factor Structure of the Emotion Regulation Checklist. Behav Ther 2022; 53:196-207. [PMID: 35227398 PMCID: PMC9162246 DOI: 10.1016/j.beth.2021.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/13/2021] [Accepted: 07/23/2021] [Indexed: 11/29/2022]
Abstract
Emotion dysregulation (ED) is prevalent among youth with Attention-Deficit/Hyperactivity Disorder (ADHD) and significantly impacts functioning. Nuanced measurement of ED is central to understanding its role in this disorder and informing treatment approaches. The present study examined the factor structure of the Emotion Regulation Checklist (ERC) among children with ADHD with and without Oppositional Defiant Disorder (ODD). Exploratory factor analysis (EFA) conducted in a sample of 328 youth (mean age = 6.08) with ADHD indicated a four-factor solution, comprised of the following factors: Negative Emotion Lability, Positive Emotion Lability, Socially Appropriate Affect, and Socially Incongruent Affect. The Negative and Positive Emotion Lability subscales assess the reactivity of negatively and positively valenced emotions, respectively. The Socially Appropriate and Socially Incongruent Affect subscales provide an assessment of social-emotional functioning. All subscales discriminated between children with ADHD only and ADHD with co-morbid ODD, such that children with ODD had greater emotional lability and social-emotional difficulties. This revised factor structure of the ERC facilitates a uniquely brief, yet multifaceted and specific, assessment of emotional difficulties in children with ADHD that can inform treatment planning and operationalize emotional reactivity and social-emotional functioning in future research efforts.
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Affiliation(s)
- Melanie R. Silverman
- Department of Psychology, Fordham University, 441 East Fordham Road, Bronx, NY USA
| | - Randi Bennett
- Hassenfeld Children’s Hospital, NYU Langone, 1 Park Avenue, New York, NY USA
| | - Leah Feuerstahler
- Department of Psychology, Fordham University, 441 East Fordham Road, Bronx, NY USA
| | - Jill Stadterman
- Department of Psychology, Fordham University, 441 East Fordham Road, Bronx, NY USA
| | - Anthony Steven Dick
- Department of Psychology, Florida International University, 11200 SW 8 Street, Miami, FL USA
| | - Paulo Graziano
- Department of Psychology, Florida International University, 11200 SW 8 Street, Miami, FL USA
| | - Amy Krain Roy
- Department of Psychology, Fordham University, 441 East Fordham Road, Bronx, NY USA,Hassenfeld Children’s Hospital, NYU Langone, 1 Park Avenue, New York, NY USA
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Hoseini FS, Alimoradi K, Jamshidi F. Help them pass a stormy road: A preliminary study of emotional memory management training on executive functions and difficulties in emotional regulation in adolescents. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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20
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Havewala M, Lorenzo NE, Seddio K, Oddo LE, Novick DR, Fox NA, Chronis-Tuscano A. Understanding Co-Occurring ADHD and Anxiety Symptoms within a Developmental Framework: Risk and Protective Factors of Early Temperament and Peer Relations. Res Child Adolesc Psychopathol 2022; 50:853-866. [DOI: 10.1007/s10802-021-00891-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 10/19/2022]
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21
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Groves NB, Chan ESM, Marsh CL, Gaye F, Jaisle EM, Kofler MJ. Does central executive training and/or inhibitory control training improve emotion regulation for children with attention-deficit/hyperactivity disorder? A randomized controlled trial. Front Psychiatry 2022; 13:1034722. [PMID: 36561637 PMCID: PMC9763728 DOI: 10.3389/fpsyt.2022.1034722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Approximately 48-54% of children with attention-deficit/hyperactivity disorder (ADHD) have impairing difficulties with emotion regulation, and these difficulties are not ameliorated by first-line ADHD treatments. Working memory and inhibitory control represent promising intervention targets given their functional, if not causal, links with ADHD-related emotion dysregulation. METHODS This preregistered randomized controlled trial tested whether two digital therapeutic training protocols that have been previously shown to improve working memory (Central Executive Training [CET]) and inhibitory control (Inhibitory Control Training [ICT]) can improve emotion regulation in a sample of 94 children with ADHD aged 8-13 years (M = 10.22, SD = 1.43; 76% White/non-Hispanic; 29 girls). RESULTS Results of Bayesian mixed model ANOVAs indicated both treatment groups demonstrated significant decreases in emotion dysregulation relative to pre-treatment at immediate post-treatment (parent report; d = 1.25, BF10 = 8.04 × 1013, p < 0.001), at 1-2 months after completing treatment (teacher report; d = 0.99, BF10 = 1.22 × 106, p < 0.001), and at 2-4-months follow-up (parent report; d = 1.22, BF10 = 1.15 × 1014, p < 0.001). Contrary to our hypotheses, the CET and ICT groups demonstrated equivalent reductions in emotion dysregulation and maintenance of effects. Exploratory analyses revealed that results were robust to control for informant expectancies, ADHD medication status/changes, in-person vs. at-home treatment, child age, and time from treatment completion to post-treatment ratings. DISCUSSION To determine whether working memory and inhibitory control are causally linked with ADHD-related emotion dysregulation, future studies should include active control conditions that do not train executive functions prior to making decisions about the clinical utility of CET/ICT for the treatment of emotion dysregulation in ADHD. CLINICAL TRIAL REGISTRATION [https://clinicaltrials.gov/], identifier [NCT03324464].
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Affiliation(s)
- Nicole B Groves
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Elizabeth S M Chan
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Carolyn L Marsh
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Fatou Gaye
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Emma M Jaisle
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Michael J Kofler
- Department of Psychology, Florida State University, Tallahassee, FL, United States
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22
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Executive Functioning and Emotion Regulation in Children with and without ADHD. Res Child Adolesc Psychopathol 2021; 50:721-735. [PMID: 34762251 DOI: 10.1007/s10802-021-00883-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 10/19/2022]
Abstract
Difficulties with emotion regulation affect the majority of youth with attention-deficit/hyperactivity disorder (ADHD) and predict greater functional impairment than ADHD symptoms alone. Deficits in executive functioning are also present for most children with ADHD, and have been linked with emotion regulation difficulties in both clinical and neurotypical populations throughout development. The current study was the first to assess all three core executive functions (working memory, inhibitory control, set shifting) simultaneously in a clinically-diverse sample of children with and without ADHD and common comorbidities and investigate the extent to which they uniquely predict emotion dysregulation. A sample of 151 children ages 8-13 years (M = 10.36, SD = 1.52; 52 girls; 70.2% White/Non-Hispanic) were assessed using a criterion battery of executive functioning tasks, teacher-reported ADHD symptoms, and parent-reported emotion regulation. Results of the bias-corrected, bootstrapped conditional effects path model revealed that better-developed working memory predicted better emotion regulation (β = 0.23) and fewer ADHD symptoms (β = -0.21 to -0.37), that ADHD symptoms (β = -0.18 to -0.20) independently predicted emotion dysregulation, and that working memory exerted indirect effects on emotion regulation through both inattention and hyperactivity/impulsivity (β = 0.04-0.07). Sensitivity analyses indicated that these effects were generally robust to control for age, sex, executive function interrelations, and inclusion/exclusion of children with co-occurring ASD. These findings underscore the importance of working memory (relative to inhibitory control and set shifting) and its relations with ADHD symptoms for understanding children's emotion regulation skills, and may help explain the limited efficacy of first-line ADHD treatments, which do not target working memory, for improving emotion regulation skills.
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23
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Breaux R, Dvorsky MR, Marsh NP, Green CD, Cash AR, Shroff DM, Buchen N, Langberg JM, Becker SP. Prospective impact of COVID-19 on mental health functioning in adolescents with and without ADHD: protective role of emotion regulation abilities. J Child Psychol Psychiatry 2021; 62:1132-1139. [PMID: 33543486 PMCID: PMC8014657 DOI: 10.1111/jcpp.13382] [Citation(s) in RCA: 139] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The impact of chronic stressors like the COVID-19 pandemic is likely to be magnified in adolescents with pre-existing mental health risk, such as attention-deficit/hyperactivity disorder (ADHD). This study examined changes in and predictors of adolescent mental health from before to during the COVID-19 pandemic in the Southeastern and Midwestern United States. METHODS Participants include 238 adolescents (132 males; ages 15-17; 118 with ADHD). Parents and adolescents provided ratings of mental health symptoms shortly before the COVID-19 pandemic and in spring and summer 2020. RESULTS Adolescents on average experienced an increase in depression, anxiety, sluggish cognitive tempo, inattentive, and oppositional/defiant symptoms from pre-COVID-19 to spring 2020; however, with the exception of inattention, these symptoms decreased from spring to summer 2020. Adolescents with ADHD were more likely than adolescents without ADHD to experience an increase in inattentive, hyperactive/impulsive, and oppositional/defiant symptoms. Adolescents with poorer pre-COVID-19 emotion regulation abilities were at-risk for experiencing increases in all mental health symptoms relative to adolescents with better pre-COVID-19 emotion regulation abilities. Interactive risk based on ADHD status and pre-COVID-19 emotion regulation abilities was found for inattention and hyperactivity/impulsivity, such that adolescents with ADHD and poor pre-COVID-19 emotion regulation displayed the highest symptomatology across timepoints. Lower family income related to increases in inattention but higher family income related to increases in oppositional/defiant symptoms. CONCLUSIONS The early observed increases in adolescent mental health symptoms during the COVID-19 pandemic do not on average appear to be sustained following the lift of stay-at-home orders, though studies evaluating mental health across longer periods of time are needed. Emotion dysregulation and ADHD increase risk for sustained negative mental health functioning and highlight the need for interventions for these populations during chronic stressors. Results and clinical implications should be considered within the context of our predominately White, middle class sample.
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Affiliation(s)
- Rosanna Breaux
- Department of PsychologyVirginia Polytechnic Institute and State UniversityBlacksburgVAUSA
| | | | - Nicholas P. Marsh
- Division of Behavioral Medicine and Clinical PsychologyCincinnati Children’s Hospital Medical CenterCincinnatiOHUSA
| | - Cathrin D. Green
- Department of PsychologyVirginia Commonwealth UniversityRichmondVAUSA
| | - Annah R. Cash
- Department of PsychologyVirginia Polytechnic Institute and State UniversityBlacksburgVAUSA
| | - Delshad M. Shroff
- Department of PsychologyVirginia Polytechnic Institute and State UniversityBlacksburgVAUSA
| | - Natalie Buchen
- Department of PsychologyVirginia Commonwealth UniversityRichmondVAUSA
| | | | - Stephen P. Becker
- Division of Behavioral Medicine and Clinical PsychologyCincinnati Children’s Hospital Medical CenterCincinnatiOHUSA,Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiOHUSA
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Abstract
Attention-deficit/hyperactivity disorder (ADHD) is associated with disrupted emotional processes including impaired regulation of approach behavior and positive affect, irritability, and anger. Enhanced reactivity to emotional cues may be an underlying process. Pupil dilation is an indirect index of arousal, modulated by the autonomic nervous system and activity in the locus coeruleus-noradrenergic system. In the current study, pupil dilation was recorded while 8- to 12- year old children (n = 71, 26 with a diagnosis of ADHD and 45 typically developing), viewed images of emotional faces. Parent-rated hyperactive/impulsive symptoms were uniquely linked to higher pupil dilation to happy, but not fearful, angry, or neutral faces. This was not explained by comorbid externalizing symptoms. Together, these results suggest that hyperactive/impulsive symptoms are associated with hyperresponsiveness to approach-related emotional cues across a wide range of symptom severity.
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25
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Darling Rasmussen P, Ribeiro JP, Storebø OJ. Mothers of Children Diagnosed with ADHD: A Descriptive Study of Maternal Experience during the First Three Years of Treatment. Pediatr Rep 2021; 13:450-462. [PMID: 34449712 PMCID: PMC8396042 DOI: 10.3390/pediatric13030052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/02/2021] [Accepted: 07/02/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Attention deficit hyperactivity disorder is the most common childhood psychiatric disorder. Current treatment strategies do not provide a convincing improvement on overall functioning, and further, reciprocity between ADHD and attachment has been suggested. This suggests that we do not fully comprehend the mechanisms of the disorder. This study was part of a larger project investigating factors of potential importance when a child is diagnosed with ADHD. Aim: In this current study we aimed to gain a clearer understanding about whether the mothers experienced the diagnostic process and treatment as helpful. Method: Sixty children newly diagnosed with ADHD and their mothers were included three years prior to this study. Fifty-two (87%) completed a survey about their experience with the diagnostic process and the years after in the psychiatric system and the secondary healthcare sector. Forty-three had also participated in an attachment interview in the original study and answered questions about this. Discussion: The follow-up questionnaire was based on conversations with the mothers was not meant to be used as a quantitative measure. However, one point to take is that the mothers did often not feel the help offered to be sufficient. In our opinion, this underlines that we are still far from understanding what ADHD is and what causes the differences in developmental trajectories as well as how differences in etiological factors may call for more customized approaches in treatment strategies.
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Affiliation(s)
- Pernille Darling Rasmussen
- Center for Evidence-Based Psychiatry, Psychiatric Research Unit, Psychiatry Region Zealand, 4200 Slagelse, Denmark; (J.P.R.); (O.J.S.)
- Private Hospital Hejmdal, 2000 Frederiksberg, Denmark
- Correspondence:
| | - Johanne Pereira Ribeiro
- Center for Evidence-Based Psychiatry, Psychiatric Research Unit, Psychiatry Region Zealand, 4200 Slagelse, Denmark; (J.P.R.); (O.J.S.)
| | - Ole Jakob Storebø
- Center for Evidence-Based Psychiatry, Psychiatric Research Unit, Psychiatry Region Zealand, 4200 Slagelse, Denmark; (J.P.R.); (O.J.S.)
- Department of Psychology, University of Southern Denmark, 5000 Odense, Denmark
- Department of Child and Adolescent Psychiatry, Psychiatry Region Zealand, 4000 Roskilde, Denmark
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Maré L, van Staden W, Hassim J. Primary caregivers' perspectives of the disruptive behaviour of their children attending Weskoppies Psychiatric Hospital, South Africa. J Child Adolesc Ment Health 2021; 33:17-31. [PMID: 35670521 DOI: 10.2989/17280583.2022.2058952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
While practitioners might engage caregivers on their understandings of the disruptive behavioural disorders of their children, their perspectives are yet to be examined in a qualitative study. This study explored perspectives of primary caregivers on the disruptive behaviour of children who attended the child unit of Weskoppies Psychiatric Hospital, in South Africa. Qualitative methods were used in a case study design. Nineteen participants were purposively sampled. The participants were interviewed using individual in-depth, semi-structured interviews. Data were analysed using typological and bracketed grounded theory methods. Both methods revealed these themes: confusion, emotional build-up towards a meltdown; loss of others; spiritual and cultural (dis)connectedness; behaviour of others towards the children; something being wrong medically; behavioural difficulties when "I want my way"; emotional turmoil of caregivers; and corrective responses. Differences yielded by the analytic methods were a yearning for a better future, and the perspective that trauma had impacted the child's behaviour. These findings suggest that practitioners may anticipate and support caregivers in their experiences of emotional turmoil, uncertainty and confusion. Caregivers may be informed regarding emotional dysregulation and that a therapeutic resource may be found in the knowledge that the caregivers have a yearning for a better future for their children.
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Affiliation(s)
- Lanél Maré
- Department of Psychiatry, University of Pretoria, Pretoria, South Africa
| | - Werdie van Staden
- Centre for Ethics and Philosophy of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Junaid Hassim
- Department of Psychiatry, University of Pretoria, Pretoria, South Africa
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Frick MA, Darling Rasmussen P, Brocki KC. Can attachment predict core and comorbid symptoms of attention-deficit/hyperactivity disorder beyond executive functions and emotion regulation? BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 61:93-111. [PMID: 34190353 DOI: 10.1111/bjc.12317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/07/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Previous findings propose an association between attachment and symptoms of attention-deficit/hyperactivity disorder (ADHD). However, the predictive ability of attachment beyond deficits in executive functioning (EF) and emotion regulation is understudied. METHOD Using a dimensional perspective, we examined the longitudinal role of attachment on ADHD and comorbid symptoms, accounting for EF and emotion regulation. The sample consisted of 84 children (aged 8-13 years), oversampled for ADHD symptoms (42% had a diagnosis of ADHD). We assessed attachment with the Child Attachment Interview, EF with laboratory tests, and emotion regulation with parental ratings. Parents and teachers rated symptoms at baseline (T1) and at follow-up 2 years later (T2). RESULTS Attachment insecurity was positively correlated with ADHD symptoms at T2 but with no unique contribution to symptoms beyond EF and emotion regulation. In contrast, poor EF and emotion regulation contributed to more ADHD and ODD/CD symptoms at T2. Poor emotion regulation contributed to more anxiety at T2. CONCLUSIONS The results have important implications for understanding the mechanisms underpinning symptom expression in middle childhood/early adolescence and may guide the search for tailored interventions to reduce and prevent symptoms. PRACTITIONER POINTS Executive functions and emotion regulation should be explored as targets for intervention in personalized treatment. The current results do not support attachment as a target for intervention at a group level, although this does not rule out that individuals/families with attachment difficulties may benefit from training programmes promoting secure attachment bonds.
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Breaux R, Eadeh HM, Swanson CS, McQuade JD. Adolescent Emotionality and Emotion Regulation in the Context of Parent Emotion Socialization Among Adolescents with Neurodevelopmental Disorders: A Call to Action with Pilot Data. Res Child Adolesc Psychopathol 2021; 50:77-88. [PMID: 34195911 DOI: 10.1007/s10802-021-00833-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 02/07/2023]
Abstract
To date, only three studies have examined the role of emotion socialization in the emotional functioning of youth with neurodevelopmental disorders. As such, this review article with pilot data sought to provide a call to action and first step in addressing this limited research body. Pilot data was collected with 18 adolescents (Mage = 13.5, SD = 1.6; 70% male) with a neurodevelopmental disorder and their primary caregiver. All adolescents were diagnosed with attention-deficit/hyperactivity disorder and displayed a range of comorbid disorders: autism spectrum disorder (27.8%), anxiety (66.7%), depression (44.4%), and disruptive behavior disorders (50%). Adolescents and caregivers completed a conflict discussion task while physiological, observational, and self-report measures of emotion socialization and emotional functioning were measured. Observed supportive parent emotion socialization behaviors were significantly associated with more observed adaptive emotion regulation strategies, and decreased observed and adolescent-reported negative affect, whereas non-supportive emotion socialization behaviors were associated with more observed negative affect and less observed adaptive emotion regulation strategies. Our pilot findings support growing research suggesting that adaptive parent emotion socialization practices can help foster less negative emotionality and better emotion regulation in youth with neurodevelopment disorders. We make a call to action for more emotion socialization research focused on youth with neurodevelopmental disorders, and propose four important directions for future research: 1) Research examining emotion socialization behaviors during daily life, 2) Understanding the nuanced role of emotion socialization practices, 3) Considering diversity in emotion socialization practices with clinical populations, and 4) Longitudinal and intervention research studies.
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Affiliation(s)
- Rosanna Breaux
- Department of Psychology, Virginia Polytechnic Institute and State University, PhD, 460 Turner St., Suite 207, Blacksburg, VA, 24060, USA.
| | - Hana-May Eadeh
- Department of Psychological and Brain Sciences, University of Iowa, Iowa, USA
| | - Courtney S Swanson
- Department of Psychology, Virginia Polytechnic Institute and State University, PhD, 460 Turner St., Suite 207, Blacksburg, VA, 24060, USA
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Assessing Irritability in Children with Autism Spectrum Disorder Using the Affective Reactivity Index. J Autism Dev Disord 2021; 51:1496-1507. [PMID: 32734421 PMCID: PMC7855357 DOI: 10.1007/s10803-020-04627-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Irritability is an impairing problem in children with ASD that may be associated with other behavioral and emotional concerns. The Affective Reactivity Index (ARI) is a parent-rated measure of irritability widely used in children with mood disorders, however, its utility in children with ASD remains unclear. In this study, we examined ARI parent ratings in children with ASD and contributions of parent-rated anxiety and noncompliance to irritability measured by the ARI. Participants included 81 children with ASD, aged 8-16 years. Results suggest that both anxiety and noncompliance contribute to irritability, but that anxiety only contributes to irritability in the absence of noncompliance. Further, the ARI is likely to be a useful measure of irritability in children with ASD.
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Schwarzer NH, Nolte T, Fonagy P, Gingelmaier S. Mentalizing and emotion regulation: Evidence from a nonclinical sample. INTERNATIONAL FORUM OF PSYCHOANALYSIS 2021. [DOI: 10.1080/0803706x.2021.1873418] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Weinstein E, Kleiman EM, Franz PJ, Joyce VW, Nash CC, Buonopane RJ, Nock MK. Positive and negative uses of social media among adolescents hospitalized for suicidal behavior. J Adolesc 2021; 87:63-73. [PMID: 33493982 DOI: 10.1016/j.adolescence.2020.12.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 12/07/2020] [Accepted: 12/10/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION There is public concern about potential associations between adolescent social media/smartphone use and risk for suicide. However, no prior studies leverage qualitative methods to explore the experiences of adolescents currently at-risk for suicide. METHODS This study examined social technology use from the perspectives of adolescents (n = 30; Mage = 16.1 years) currently hospitalized for a recent suicide attempt or severe ideation. We conducted in-depth interviews and coded transcripts using thematic analysis. We had three research questions: What (1) negative and (2) positive experiences do suicidal adolescents report related to their use of social media/smartphones? (3) How do adolescents describe their disconnection from these technologies use during inpatient hospitalization and views on a subsequent return to digital connectivity after discharge? RESULTS AND CONCLUSIONS Results reveal both positive and negative social technology uses, with most participants reporting mixed (positive and negative) experiences. Negatives/risks included trouble regulating use, stress related to social media metrics, encounters with "triggering" content, hostility and meanness, self-denigrating comparisons, and burdensome friendship expectations. Positives/benefits included social connection, social support, affect-enhancing content, shared interests, and resources for mental health and coping. Overall, the documented risks and benefits of social technology use correspond with established (offline) risk and protective factors for suicidal thoughts and behaviors. Participants generally valued the break from social technologies during hospitalization, and also viewed them as integral to social re-entry and identified related concerns. Future studies should test well-being focused 'digital hygiene' interventions for maximizing potential benefits and minimizing potential harms of social technologies for at-risk adolescents.
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Affiliation(s)
- Emily Weinstein
- Graduate School of Education, Harvard University, United States.
| | - Evan M Kleiman
- Department of Psychology, Rutgers, The State University of New Jersey, United States; Mental Health Research, Franciscan Children's Hospital, United States
| | - Peter J Franz
- Department of Psychology, Harvard University, United States
| | - Victoria W Joyce
- Mental Health Research, Franciscan Children's Hospital, United States
| | - Carol C Nash
- Mental Health Research, Franciscan Children's Hospital, United States
| | - Ralph J Buonopane
- Mental Health Research, Franciscan Children's Hospital, United States
| | - Matthew K Nock
- Department of Psychology, Harvard University, United States; Mental Health Research, Franciscan Children's Hospital, United States
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Evald TA, Møhl B. Before the damage is done: Early childhood hyperactivity difficulties in adolescents with deliberate self-harm - findings from the DALSC cohort. Scand J Child Adolesc Psychiatr Psychol 2021; 8:176-188. [PMID: 33598440 PMCID: PMC7879016 DOI: 10.21307/sjcapp-2020-018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Deliberate self-harm (DSH) is a growing issue among Danish adolescents, and a dramatic increase in the incidence of DSH has been observed since the turn of the millennium. The importance of early childhood factors on later development has been established, but research on the trajectories of DSH is still scarce, and longitudinal studies are much needed. METHOD Participants were 3,291 children and their mothers from The Danish Longitudinal Survey of Children (DALSC), a Danish population-based birth cohort from 1995. Logistic regression and mediation analyses were used to examine significant early childhood determinants of self-harming behavior in adolescence. RESULTS The study found that 17.9% of the children had a history with DSH at the age of 18 years. A significant relationship was found between the likelihood of DSH at the age of 18 years and hyperactivity difficulties assessed through the Strengths and Difficulties Questionnaire (SDQ) at 3 and 7 years of age. Using a mediation model, it is documented that difficulties in peer relationships at the age of 11 years is a partial mediator explaining 19% of the variation. LIMITATIONS i) a vague definition of self-harm in the questionnaires; ii) lack of sample representation as children of lower socio-economic groups have lower participation rates, and only Danish-ethnicity children have been sampled; iii) possibility of omitted variable bias. CONCLUSION The adolescents engaging in DSH are experiencing a more complex range of psychosocial problems than those who do not have experience with DSH. The main finding of the study is that hyperactivity as a risk factor for the development of DSH in adolescence can be identified as early as 3-7 years of age. This relationship between the very early occurring hyperactivity and later DSH, to the best of our knowledge, has not previously been described.
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Affiliation(s)
- Therese A. Evald
- The Finance Committee, City Council of Copenhagen, Copenhagen, Denmark
| | - Bo Møhl
- Faculty of Humanities, Aalborg University, Aalborg, Denmark
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Johnson D, McLennan JD, Heron J, Colman I. The relationship between profiles and transitions of internalizing and externalizing symptoms in children and suicidal thoughts in early adolescence. Psychol Med 2020; 50:2566-2574. [PMID: 31576782 DOI: 10.1017/s0033291719002733] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Adolescence is a high-risk period for the onset of suicidal thoughts and behaviors. Identification of preceding patterns of internalizing and externalizing symptoms that are associated with subsequent suicidal thoughts may offer a better understanding of how to prevent adolescent suicide. METHODS Data from the National Longitudinal Survey of Children and Youth, a prospective population-based Canadian cohort, contained Child Behavior Checklist items which were used to examine profiles and transitions of internalizing and externalizing symptoms in children, aged 6-11 years (n = 8266). The association between these profiles/transitions and suicidal thoughts in adolescents was examined using multivariate logistic regression modeling. RESULTS Latent profile analyses identified four measurement invariant profiles of internalizing and externalizing symptoms at ages 6/7 and 10/11: (1) low on all symptoms, (2) moderate on all symptoms, (3) high on all symptoms, and (4) high on hyperactivity/inattention and internalizing. Recurrent (homotypic or heterotypic) and increasing symptoms from 6/7 to 10/11 were associated with suicidal thoughts in adolescence, compared to those with stable low symptoms. Those with decreasing symptoms from 6/7 to 10/11 were not at increased risk of suicidal thought in adolescence. CONCLUSIONS While patterns of recurrent symptoms were associated with suicidal thoughts, a similar association was observed between profiles at age 10/11 years and suicidal thoughts. This suggests that the recent assessments of mental health symptoms in children may be as sufficient a predictor of adolescent suicidal thought as transition profiles.
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Affiliation(s)
- Dylan Johnson
- University of Ottawa, School of Epidemiology and Public Health
| | - John D McLennan
- University of Calgary, Department of Pediatrics
- Children's Hospital of Eastern Ontario-Research Institute
| | - Jon Heron
- University of Bristol, Bristol Medical School, Population Health Sciences, Centre for Academic Mental Health
| | - Ian Colman
- University of Ottawa, School of Epidemiology and Public Health
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Serine AD, Rosenfield B, DiTomasso RA, Collins JM, Rostain AL, Ramsay JR. The Relationship Between Cognitive Distortions and Adult Attention-Deficit/Hyperactivity Disorder After Accounting for Comorbidities and Personality Traits. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10115-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Klymkiw DF, Milligan K, Lackner C, Phillips M, Schmidt LA, Segalowitz SJ. Does Anxiety Enhance or Hinder Attentional and Impulse Control in Youth With ADHD? An ERP Analysis. J Atten Disord 2020; 24:1746-1756. [PMID: 28494637 DOI: 10.1177/1087054717707297] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Youth with ADHD and comorbid anxiety (ADHD+ANX) experience increased social and academic impairment compared with youth with ADHD without anxiety (ADHD). Group differences in attentional and impulse control may underlie this increased impairment. Examination of group differences using behavioral measures of attentional and impulse control has yielded inconsistent findings. This study explored group differences using event-related potentials (ERPs), which provide neural information concerning early information processing. Method: ERPs (early frontal positivity [EFP], N2) were collected while youth aged 11 to 17 with ADHD (n = 31) and ADHD+ANX (n = 35) completed a visual and an auditory computer task. Results: Compared with the ADHD group, the ADHD+ANX group exhibited larger N2 amplitudes to no-go stimuli and larger EFP amplitudes to target auditory stimuli, with variable attention allocation to nontarget stimuli. Conclusion: The addition of anxiety to ADHD appears to alter early attentional processing, which may be an important aspect of this comorbidity.
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Karaş H, Çetingök H, İlişer R, Çarpar E, Kaşer M. Childhood and adult attention deficit hyperactivity disorder symptoms in fibromyalgia: associations with depression, anxiety and disease impact. Int J Psychiatry Clin Pract 2020; 24:257-263. [PMID: 32401570 DOI: 10.1080/13651501.2020.1764585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: The first aim of this study was to determine the prevalence of childhood and current attention deficit hyperactivity disorder (ADHD) symptoms in patients with fibromyalgia. The second aim is to assess the role of depression and anxiety on the relationship between childhood and adult ADHD symptoms with disease impact in this population.Methods: Sixty-four patients with fibromyalgia were compared to matched 58 healthy controls. All participants completed the Wender Utah Rating Scale (WURS), Adult ADHD Self-Report Scale (ASRS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Fibromyalgia Impact Questionnaire (FIQ).Results: Patients with fibromyalgia had significantly higher mean scores of depression (BDI), anxiety (BAI), childhood ADHD symptoms (WURS) and adult ADHD symptoms (ASRS total, ASRS hyperactivity/impulsivity subscale and ASRS attention deficit subscale) than the control group. Fibromyalgia impact (FIQ) was significantly correlated with depression (BDI; r = 0.57, p < .001), anxiety (BAI; r = 0.56, p < .001) and childhood ADHD symptoms (WURS; r = 0.41, p < .001) in fibromyalgia group. There was no significant correlation between fibromyalgia impact (FIQ) and adult ADHD symptoms (ASRS total or sub-scale scores). Hierarchical multiple regression indicated that childhood ADHD symptoms (WURS), anxiety (BAI) and depression (BDI) predicted fibromyalgia impact. Both anxiety (BAI) and depression (BDI) mediated the relationship between childhood ADHD symptoms (WURS) and fibromyalgia impact (FIQ).Conclusion: Childhood ADHD symptoms may be a contributory factor to poorer functioning in the patients with fibromyalgia. The relationship was more pronounced in the presence of depression and anxiety symptoms. Evaluation of childhood and adult ADHD symptoms in patients with fibromyalgia is important for recognition and treatment of ADHD comorbidity and also for attenuating the severity of the disease.
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Affiliation(s)
- Hakan Karaş
- Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey
| | - Halil Çetingök
- Department of Algology, Istanbul University Medical Faculty, Istanbul, Turkey
| | - Reşat İlişer
- Fizyorom Physical Therapy and Rehabilitation Center, Diyarbakır, Turkey
| | - Elif Çarpar
- Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey
| | - Muzaffer Kaşer
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.,Department of Psychiatry, Bahçeşehir University, Istanbul, Turkey
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England-Mason G. Emotion Regulation as a Transdiagnostic Feature in Children with Neurodevelopmental Disorders. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2020. [DOI: 10.1007/s40474-020-00200-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Breaux R, Langberg JM. Development and Refinement of the RELAX Intervention, an Intervention Targeting Emotion Dysregulation and Interpersonal Conflict in Adolescents with ADHD: Results from a Pilot Study. ACTA ACUST UNITED AC 2020. [DOI: 10.1080/23794925.2020.1759468] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Rosanna Breaux
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Joshua M. Langberg
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
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Groves NB, Kofler MJ, Wells EL, Day TN, Chan ESM. An Examination of Relations Among Working Memory, ADHD Symptoms, and Emotion Regulation. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:525-537. [PMID: 31900835 PMCID: PMC7318097 DOI: 10.1007/s10802-019-00612-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Emotion regulation difficulties are present in many, if not most, children with attention-deficit/hyperactivity disorder (ADHD) and confer risk for a host of adverse outcomes. Little is known, however, regarding the neurocognitive and behavioral mechanisms that underlie these difficulties. A well-characterized, clinically evaluated sample of 145 children ages 8-13 years (M = 10.33, SD = 1.47; 55 girls; 69% White/non-Hispanic) were administered multiple, counterbalanced working memory tests and assessed for emotion dysregulation and ADHD symptoms via multiple-informant reports. Bias-corrected, bootstrapped conditional effects modeling indicated that underdeveloped working memory exerted significant direct effects on emotion regulation in all tested models as well as indirect effects on emotion regulation via parent-reported hyperactive/impulsive symptoms (95% CIs excluded zero). Interestingly, hyperactive/impulsive symptoms also predicted emotion dysregulation when controlling for the influence of working memory. Inattention failed to predict emotion regulation difficulties in all tested models (all 95% CIs included zero). This pattern of results replicated across parent and teacher models and were robust to control for mono-informant bias, age, and gender. These findings suggest that emotion dysregulation in ADHD reflects, in part, both a direct outcome of underdeveloped working memory and an affective outcome of hyperactive and/or impulsive symptomatology, both attributable to and independent of the role of underlying working memory deficits.
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Affiliation(s)
- Nicole B Groves
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
| | - Michael J Kofler
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA.
| | - Erica L Wells
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
| | - Taylor N Day
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
| | - Elizabeth S M Chan
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
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40
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Wells EL, Groves NB, Day TN, Harmon SL, Soto EF, Miller CE, Kofler MJ. Evidence against emotion inference deficits in children with ADHD. Emotion 2020; 21:665-677. [PMID: 32191096 DOI: 10.1037/emo0000732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Inconsistent evidence suggests that pediatric attention deficit/hyperactivity disorder (ADHD) may be associated with impairments in the ability to use context clues to infer the emotion states of others. However, the evidence base for these impairments is comprised of data from laboratory-based tests of emotion inference that may be confounded by demands on nonaffective cognitive processes that have been linked with ADHD. The current study builds on our previous study of facial affect recognition to address this limitation and investigate a potential mechanism underlying children's ability to infer emotion state from context clues. To do so, we used a fully crossed, counterbalanced experimental design that systematically manipulated emotion inference and working memory demands in 77 carefully phenotyped children ages 8-13 (Mage = 10.46, SD = 1.54; 66% Caucasian/Non-Hispanic; 42% female) with ADHD (n = 42) and without ADHD (n = 35). Results of Bayesian mixed-model ANOVAs indicated that using context clues to infer the emotion state of others competed for neurocognitive resources with the processes involved in rehearsing/maintaining information within working memory (BF₁₀ = 1.57 × 10¹⁹, d = 0.72). Importantly, there was significant evidence against the critical Group × Condition interaction for response times (BF₀₁ = 4.93), and no significant evidence for this interaction for accuracy (BF₀₁ = 2.40). In other words, children with ADHD do not infer emotions more slowly than children without ADHD (d = 0.13), and their small magnitude impairment in accuracy (d = 0.30) was attributable to their generally less accurate performance on choice-response tasks (i.e., across both emotion and control conditions). Taken together, the evidence indicates that emotion inference abilities are likely unimpaired in pediatric ADHD and that working memory is implicated in the ability to infer emotion from context for all children-not just children with ADHD. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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41
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Binder AS, Brown HR, Harvey EA. Executive Function and Trajectories of Emotion Dysregulation in Children with Parent-Reported Behavior Problems. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:481-493. [DOI: 10.1007/s10802-019-00616-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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42
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Christian C, Martel MM, Levinson CA. Emotion regulation difficulties, but not negative urgency, are associated with attention-deficit/hyperactivity disorder and eating disorder symptoms in undergraduate students. Eat Behav 2020; 36:101344. [PMID: 31743854 DOI: 10.1016/j.eatbeh.2019.101344] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 10/27/2019] [Accepted: 11/10/2019] [Indexed: 10/25/2022]
Abstract
Eating disorders and attention deficit/hyperactivity disorder (ADHD) are highly comorbid. The majority of research on this comorbidity has focused on impulsivity, which is a shared vulnerability between ADHD and eating disorders characterized by binge eating. Less is known about which shared factors may contribute to the co-occurrence of other eating disorders (i.e., anorexia nervosa, restricting subtype) and ADHD. Furthermore, little research has focused on other potential overlapping vulnerabilities, though deficits in emotion regulation have been implicated as an additional shared vulnerability. The current study (N = 306 undergraduate students) uses path analysis to examine if emotion regulation difficulties and negative urgency (i.e., impulsivity during negative mood state) are unique or shared vulnerabilities for ADHD symptoms (inattention, hyperactivity-impulsivity) and eating disorder symptoms (bulimic symptoms, drive for thinness). Emotion regulation difficulties were uniquely associated with all dimensions of ADHD and eating disorder symptoms, and negative urgency was uniquely associated with global eating disorder symptoms, bulimic symptoms, and drive for thinness. These results suggest that emotion regulation difficulties are a shared vulnerability factor for the development of diverse presentations of ADHD and eating disorder symptoms, and may be an important prevention target. Additionally, our results support a unique relationship between negative urgency and drive for thinness. Future research should examine these associations prospectively and experimentally to determine directionality and inform preventative interventions for ADHD and eating disorders.
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Affiliation(s)
- Caroline Christian
- University of Louisville, Department of Psychological & Brain Sciences, United States of America.
| | - Michelle M Martel
- University of Kentucky, Department of Psychology, United States of America
| | - Cheri A Levinson
- University of Louisville, Department of Psychological & Brain Sciences, United States of America
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Kampouri M, Margetaki K, Koutra K, Kyriklaki A, Karakosta P, Sarri K, Anousaki D, Chalkiadaki G, Vafeiadi M, Kogevinas M, Chatzi L. Maternal mild thyroid dysfunction and child behavioral and emotional difficulties at 4 and 6 years of age: The Rhea mother-child cohort study, Crete, Greece. Horm Behav 2019; 116:104585. [PMID: 31476313 PMCID: PMC8801161 DOI: 10.1016/j.yhbeh.2019.104585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 08/11/2019] [Accepted: 08/20/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Mariza Kampouri
- Department of Social Medicine, Faculty of Medicine, University of Crete, Greece.
| | - Katerina Margetaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Greece
| | - Katerina Koutra
- Department of Social Medicine, Faculty of Medicine, University of Crete, Greece
| | - Andriani Kyriklaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Greece
| | - Polyxeni Karakosta
- Department of Social Medicine, Faculty of Medicine, University of Crete, Greece
| | - Katerina Sarri
- Department of Social Medicine, Faculty of Medicine, University of Crete, Greece
| | - Despoina Anousaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Greece
| | - Georgia Chalkiadaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Greece
| | - Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Greece
| | - Manolis Kogevinas
- Instituto de Salud Global Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA; Department of Genetics & Cell Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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Rushton S, Giallo R, Efron D. ADHD and emotional engagement with school in the primary years: Investigating the role of student–teacher relationships. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2019; 90 Suppl 1:193-209. [DOI: 10.1111/bjep.12316] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 07/27/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Sophie Rushton
- Murdoch Children's Research Institute Parkville Victoria Australia
- Centre for Community Child Health Royal Children's Hospital Parkville Victoria Australia
| | - Rebecca Giallo
- Murdoch Children's Research Institute Parkville Victoria Australia
- Department of Paediatrics University of Melbourne Parkville Victoria Australia
| | - Daryl Efron
- Murdoch Children's Research Institute Parkville Victoria Australia
- Centre for Community Child Health Royal Children's Hospital Parkville Victoria Australia
- Department of Paediatrics University of Melbourne Parkville Victoria Australia
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Simmons GL, Hilton DC, Jarrett MA, Tomeny TS, White SW. Considering equifinality in treatment planning for social impairment: Divergent paths in neurodevelopmental disorders. Bull Menninger Clin 2019; 83:278-300. [DOI: 10.1521/bumc.2019.83.3.278] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Youth with autism spectrum disorder (ASD) present with deficits in both social cognition and executive functioning (EF), which contribute to social impairment. Autistic youth are also frequently diagnosed with comorbid attention-deficit/hyperactivity disorder (ADHD), a disorder that, like ASD, includes impaired EF and social functioning. The comorbidity of ASD and ADHD may result in compounded social impairment, but prior research has not sufficiently evaluated the extent to which this comorbidity profile responds to evidence-based intervention targeting social deficits. It is conceivable that dually targeting EF and social cognition impairment will be more impactful than direct social skills training alone. The authors present an integrative model for intervention programming that examines pathways to social impairment in order to more effectively improve social skills and thereby impact both proximal (e.g., emotion expression, current peer relationships) and more distal outcomes (e.g., depression, self-esteem) in youth with ASD and other neurodevelopmental disorders.
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Affiliation(s)
- Grace Lee Simmons
- Department of Psychology, University of Alabama, Tuscaloosa, Alabama
| | - Dane C. Hilton
- Department of Psychology, Roanoke College, Salem, Virginia
| | | | | | - Susan W. White
- Department of Psychology, University of Alabama, Tuscaloosa, Alabama
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Revisiting parent-child interactions in early childhood as relevant factor in the development of ADHD. Eur Child Adolesc Psychiatry 2019; 28:1155-1157. [PMID: 31512051 DOI: 10.1007/s00787-019-01403-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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47
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Reilly SE, Downer JT. Roles of Executive Functioning and Language in Developing Low-Income Preschoolers' Behavior and Emotion Regulation. EARLY CHILDHOOD RESEARCH QUARTERLY 2019; 49:229-240. [PMID: 32831469 PMCID: PMC7442263 DOI: 10.1016/j.ecresq.2019.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Young children's regulation of their behaviors and emotions is a foundational skill that undergirds learning, academic achievement, and social competence (Bierman & Erath, 2006; McClelland et al., 2018). Executive functioning (EF) and language are two cognitive skillsets that facilitate behavior and emotion regulation (Blair & Ursache, 2011; Cole, Armstrong, & Pemberton, 2010). What is not yet fully understood is how these two skillsets may work together to promote these regulatory skills. The present study investigated the independent and interactive contributions of EF and language skills at preschool entry to the development of behavior and emotion regulation across the year in a primarily low-income sample. Results indicated that language at preschool entry was associated with children's emotion regulation development during preschool, especially for children who entered preschool with low EF. As such, incorporating language-promoting activities into early childhood interventions designed to facilitate emotion regulation may enhance efficacy, particularly for children at risk for later emotional, academic, and behavioral difficulties due to low emerging EF skills. Unexpectedly, language was not associated with behavior regulation, and EF was not independently linked to behavior or emotion regulation in this sample.
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Affiliation(s)
- Shannon E Reilly
- Center for Advanced Study of Teaching and Learning, University of Virginia, P.O. Box 400267, Charlottesville, VA 22904
| | - Jason T Downer
- Center for Advanced Study of Teaching and Learning, University of Virginia, P.O. Box 800784, Charlottesville, VA 22904
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Vogel AC, Jackson JJ, Barch DM, Tillman R, Luby JL. Excitability and irritability in preschoolers predicts later psychopathology: The importance of positive and negative emotion dysregulation. Dev Psychopathol 2019; 31:1067-1083. [PMID: 31109387 PMCID: PMC7059859 DOI: 10.1017/s0954579419000609] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Emotion dysregulation is a risk factor for the development of a variety of psychopathologic outcomes. In children, irritability, or dysregulated negative affect, has been the primary focus, as it predicts later negative outcomes even in very young children. However, dysregulation of positive emotion is increasingly recognized as a contributor to psychopathology. Here we used an exploratory factor analysis and defined four factors of emotion dysregulation: irritability, excitability, sadness, and anhedonia, in the preschool-age psychiatric assessment collected in a sample of 302 children ages 3-5 years enriched for early onset depression. The irritability and excitability factor scores defined in preschoolers predicted later diagnosis of mood and externalizing disorders when controlling for other factor scores, social adversity, maternal history of mood disorders, and externalizing diagnoses at baseline. The preschool excitability factor score predicted emotion lability in late childhood and early adolescence when controlling for other factor scores, social adversity, and maternal history. Both excitability and irritability factor scores in preschoolers predicted global functioning into the teen years and early adolescence, respectively. These findings underscore the importance of positive, as well as negative, affect dysregulation as early as the preschool years in predicting later psychopathology, which deserves both further study and clinical consideration.
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Affiliation(s)
- Alecia C. Vogel
- Department of Psychiatry, Washington University in St. Louis School of Medicine
| | - Joshua J. Jackson
- Department of Psychological and Brain Sciences, Washington University in St. Louis
| | - Deanna M. Barch
- Department of Psychiatry, Washington University in St. Louis School of Medicine
- Department of Psychological and Brain Sciences, Washington University in St. Louis
| | - Rebecca Tillman
- Department of Psychiatry, Washington University in St. Louis School of Medicine
| | - Joan L. Luby
- Department of Psychiatry, Washington University in St. Louis School of Medicine
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Whitmyre ED, Adams LM, Defayette AB, Williams CA, Esposito-Smythers C. Is the focus of community-based mental health treatment consistent with adolescent psychiatric diagnoses? CHILDREN AND YOUTH SERVICES REVIEW 2019; 103:247-254. [PMID: 31303687 PMCID: PMC6625657 DOI: 10.1016/j.childyouth.2019.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Most adolescents do not receive effective mental health services. This may stem in part from infrequent use of evidence-based and multi-informant diagnostic assessments to guide clinical care. The primary purpose of the present study was to examine whether adolescent mental health diagnoses and suicidality, derived via evidence-based diagnostic interviews and assessments, correspond with reported "reason for treatment" received by adolescents. Secondarily, we examined the potential association between socio-economic status and the match between youth diagnoses and reasons for treatment. The influence of parent-adolescent agreement on diagnoses and reasons for treatment on findings was also explored. Using chi-square analyses, a significant association was found between youth diagnoses of mood disorders, disruptive behavior disorders, and suicidality, respectively, and a focus of treatment on these conditions per combined parent-adolescent report. The same was not true for youth anxiety, attention-deficit hyperactivity, or substance abuse disorders. Results of exploratory analyses suggest that these results are driven by adolescent, but not parent report. With regard to socio-economic status, there was a trend for those with higher incomes to report a treatment focus consistent with youth diagnoses, per combined parent-adolescent report. Results suggest that focus of mental health treatment received by adolescents in standard community-based care may not uniformly address all current disorders. Efforts are needed to disseminate multi-informant evidence-based assessments to enhance the quality and effectiveness of care.
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Affiliation(s)
- Emma D. Whitmyre
- Corresponding author at: Department of Psychology, George Mason University, 4400 University Drive, Fairfax, VA 22030, USA.
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Jiang Y, Lin X, Zhou Q, Hou X, Ding W, Zhou N. Longitudinal dyadic analyses of emotion dysregulation and mother–child relationship quality in Chinese children with teacher‐reported oppositional defiant disorder. SOCIAL DEVELOPMENT 2019. [DOI: 10.1111/sode.12388] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Yongqiang Jiang
- School of Psychology, Institute of Developmental Psychology Beijing Normal University Beijing China
| | - Xiuyun Lin
- School of Psychology, Institute of Developmental Psychology Beijing Normal University Beijing China
| | - Qing Zhou
- Department of Psychology University of California Berkeley California
| | - Xiangning Hou
- School of Psychology, Institute of Developmental Psychology Beijing Normal University Beijing China
| | - Wan Ding
- School of Psychology, Institute of Developmental Psychology Beijing Normal University Beijing China
| | - Nan Zhou
- School of Psychology, Institute of Developmental Psychology Beijing Normal University Beijing China
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